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Baby Medical Q&A, Issue #076 -Obesity Watch
February 01, 2013

Welcome to another edition of Baby Medical Q&A News.

This month's ezine focuses on obesity.

Why? - there is an obesity epidemic. Encouraging healthy eating and regular exercise in your child is what you can do for your child. It's about being conscious of food choices, making healthy choices easy for your child and being aware of risks for obesity.

In this issue we look at a few studies about children's food and risk of obesity. Then I summarise with a few small changes you can make to keep your child a healthy weight.

Reducing Soda Drinks can reduce Obesity

A large Dutch study followed 2 groups of children over an 18 month period. One group had one 8 oz can of soda (containing 10% sugar) to drink daily and the other group had a similar can but the soda had no calories (no sugar as artificial sweeteners were used). Over that time, there was a significant difference in weight increases and in fat deposition in the 2 groups favouring the group who had the no-calorie soda.

Reference: J de Ruyter et al. Effect of sugar-sweetened beverages on body weight in children. Contemporary Clinical Trials, Volume 33, Issue 1, January 2012, Pages 247–257.

Television Viewing time is related to Obesity

It has been long known that increasing television viewing time is associated with increasing risk of obesity in children and as such pediatric guidelines are that television viewing (including the playing of computer games).

The mechanism is thought to be one of or a combination of:
  • lower resting energy expenditure
  • displacement of physical activity
  • food advertising leading to greater energy intake (because of non-nutrient dense foods being advertised)
  • eating while viewing leads to greater calorie intake - studies have shown that children snack more to feel satisfied when watching TV

  • Reference: Amy B. Jordan and Thomas N. Robinson. Children, Television Viewing, and Weight Status: Summary and Recommendations from an Expert Panel Meeting The ANNALS of the American Academy of Political and Social Science 2008 615: 119 DOI: 10.1177/0002716207308681

    Reducing Salt Intake May Reduce Consumption of Sugar-sweetened Drinks

    A recent study published in Pediatrics has shown a relationship between salt intake and the amount of sugar-sweetened drinks children drink. In children who drink sodas, they drink more if they have a higher salt intake in their diet.

    So not only does salt reduction have health benefits in terms of blood pressure, it can also indirectly help weight control by reducing the amount of sugar-sweetened drinks which are a risk for obesity.

    Reference:Grimes et al. Dietart salt intake, sugar-sweetened beverages and obesity risk.

    Proximity to a Large Supermarket and BMI:

    New research has shown that if you are an overweight child and you live within 1 mile of a large supermarket compared to further away, you are more likely to have a greater body mass index (BMI). Interesting study.
    I don't think you need to move if you live close to a big supermarket, but be aware of the association and be conscious of what food your child has access to and is eating. Also take note of how often your child eats and how much is eaten at each sitting. In my experience, there are many overweight children whose parents tell me that they only eat a healthy diet. But when we talk about portions, these are often huge. I have seen a 4 yr old having 'healthy sandwiches' for a snack - he had more sandwiches for that snack than I would have for lunch!!

    To read more about portion sizes and healthy food choices, click here.

    Reference: Fiechtner L, Block J, Duncan DT, Gillman MW, Gortmaker SL, Melly SJ, Rifas-Shiman SL, Taveras EM. Proximity to supermarkets associated with higher body mass index among overweight and obese preschool-age children. Prev Med. 2012 Dec 5. pii: S0091-7435(12)00601-9. doi: 10.1016/j.ypmed.2012.11.023.

    Snack Food - add cheese to vegetables

    Another recent study looked at the calories eaten in snacks by children in 3-5th grade. If cheese was added to a vegetable snack less calories were eaten to satisfy appetite compared to a snack of potato crisps.
    So, consider changing what your child has as a snack and consider a cheese and vegetable snack instead. In the study, children ate 72% fewer calories to provide satiety if eating the cheese and vegetable snack compared to the potato crisp snack.

    Reference: Brian Wansink, Mitsuru Shimizu, Adam Brumberg. Association of Nutrient-Dense Snack Combinations With Calories and Vegetable Intake. Pediatrics. Vol. 131 No. 1 January 1, 2013 pp. 22 -29 (doi: 10.1542/peds.2011-3895)

    5 tips for Keeping your Child's Weight under Control

    • avoid soda. Give your childn water for thirst. Save soda for a special treat
    • watch portion sizes - a portion of protein or carbohydrate is the size of your child's palm. They can have 2 palm sizes of vegetables, so vegetables should cover half the plate
    • try replacing non-nutrient dense snacks (such as potato crisps) with a vegetable snack and add some cheese
    • eat meals at the dinner table and avoid eating or snacking in front of television and limit television viewing and computer game playing to less than 2 hours a day
    • reduce salt intake - my advice is as a general rule not to add salt to food or cooking

    Healthy eating starts today.

    Please feel free to share this ezine with family and friends.

    Till next time,

    Dr Maud

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