Childhood obesity is on the rise - here's how to teach your kids about healthy eating. Photo / Getty Images
It's no wonder that many children – along with their parents – gained weight over the pandemic. Not only was it a profoundly anxious and stressful time for them, says Jane Ogden, professor in health psychology at the University of Surrey, but "being at home, nearer to the biscuit bin and the fridge, they were bound to snack more".
They were also forced to miss out on team sports, and socialising. Despite Joe Wicks' best efforts, a survey in March by charity Youth Sport Trust found 68 per cent of parents believed their children's activity levels had decreased in the last year, while 78 per cent said their children were doing under an hour of activity daily, with 11 per cent admitting their children were doing no physical activity at all.
Another recent study, by Sport England, crystallises these concerns. It found a drop in various activities among school-aged children during the pandemic, as the below graph illustrates.
But while this year was extraordinary, childhood obesity has been rising for over a decade. In 2006-7, 17.5 per cent of 10- to 11-year-olds were obese. By 2019-20, it was 21 per cent, according to the National Child Measurement Programme.
The reasons are clear. A 17-year study of 9,000 children led by Imperial College London (ICL), published this month in medical journal JAMA Pediatrics, found an alarmingly high proportion of English children's diets consist of ultra-processed foods (UPF) and drinks – making up more than 60 per cent of their diet on average.
Indeed, in June the British government announced that, from the end of next year, it was increasing restrictions on junk food advertising on television and online as part of Boris Johnson's efforts to tackle obesity.
But preventing children from becoming unhealthily overweight is not entirely straightforward. What they eat is affected by multiple factors, with genetics also playing their part, yet there is a lot parents can do ...
What are UPFs and why are they so bad for children?
How do we know if we're feeding our child UPFs? "Ultra Processed Foods are industrial products, where cheap ingredients such as sugar, starches, cheap oils and fats are extracted from foods, and recombined into a low-cost product through chemical processes," says Dr Eszter Vamos, senior clinical lecturer in Public Health at ICL. "Because they're not tasty or desirable, many additives are used like artificial flavours, flavour enhancers and so-called cosmetic additives that improve the texture, consistency and colour."
The UPFs children most commonly consume are soft and fruit-based drinks, ready to heat or eat meals and mass-produced breads and cakes. Vamos adds: "These products are high in energy, salt, sugar and saturated fat, so they cater to our basic cravings, and very low in fibre and vitamins." The additives used "are not natural to our body, and we're still learning how they interfere with our biological processes, like hormones that regulate glucose and appetite, and the natural biology of our gut".
Meanwhile, research shows a link between UPF consumption and an unhealthy weight in adults, Type 2 diabetes, cardiovascular disease, cancer and mortality. Vamos says the Imperial led study found "children who have high levels of UPF consumption are more likely, year on year, to have an increased weight gain compared to children who consume low amounts." They're also less likely to eat minimally processed and freshly made foods.
How can we reduce our child's UPF consumption?
Don't feel guilty. UPFs are everywhere, aggressively marketed, and minimising your child's intake is, says doctor and infant nutrition researcher Chris van Tulleken, like "trying to quit cigarettes in the Fifties." He adds, "Even in the most middle class households, half of what kids eat is ultra-processed. Ideally they should have none, but that's not the world we live in, so they should just cut down."
Finding minimally processed alternatives is challenging, says Vamos, but as well as coming in plastic or a jar, a good indicator of a UPF is its long ingredient list. Look out for anything "not used in the kitchen or unrecognisable". For example, high-fructose corn syrup, hydrogenated oils or protein isolates.
Cutting out ultra-processed soft drinks is another important step, says van Tulleken. "The only liquids children should drink are milk and water." And that means eating fruit whole: "Apple juice, orange juice and smoothies – it's all very bad – the sugars in fruit need to be bound up in the cells of the fruit."
Van Tulleken, whose eldest daughter is 4, says banning UPFs from your house only makes them more desirable, and suggests educating your children about how unhealthy they are instead. "You might suggest they read the label, and then you could ask them why they are drinking a drink with phosphoric acid in it? What are these things?"
Focus less on food and keep meals simple
Never make food a battle. Professor Ogden, author of The Good Parenting Food Guide, says our fight against obesity should be covert. "The last thing you want is for food or body image to become an issue, so the more attention you can take away from food, the better.
"Try to pin food to a time and a place, so you have breakfast, lunch and dinner every day, you don't really eat in between, so food doesn't spill out to become part of everything. Eat at a table as much as you can, so it becomes part of a family occasion, and you're chatting but ignoring the food. Then food gets downgraded."
Ogden says we often use food to manage children, to reward them, for example. "If you do your homework you can have a biscuit." Consequently food becomes loaded with meaning, whether it's a treat, or forbidden, or good or bad. This, she says, "builds food up into having a special role in peoples' lives, which is why they then turn to it to manage their emotions."
"If you must enthuse about food, move beyond cake, by praising the crunchiness of carrots for example. It's important, too, that not all food all the time is fantastic or delicious. Sometimes food is just food. And it's just eaten around the chat."
Van Tulleken agrees: "Meals can be simple. Chicken thighs roasted in the oven with a bit of salt. I still make my daughter pesto pasta from a jar, and we probably have fish fingers once a week."
Ogden's staples also included fish fingers, plus jacket potato, beans and cheese and spaghetti Bolognese she cooks in less than 30 minutes. "And that's good enough." Try too hard, she says, and you're more likely to give up and resort to takeaways and ready meals.
How to tackle teenagers who eat junk food outside the home
It's easy to buy fewer UPFs when our children are small. But what about when they're teenagers? Our role as they reach adolescence, says Ogden, "is to make sure they maintain a good relationship with food, because that's the time it can go wrong in terms of developing eating disorder.".
This is the time, says Ogden, to make sure the home meals are healthy and that they're active. But don't fuss about what they're eating outside of the home or you risk exacerbating any issues. Roll your eyes if they've had chips again, but that's it. "And then compensate by making sure they have more vegetables at dinner."
And speak positively about your body, too. "If children are brought up by parents talking about not liking the way they look, body criticism is normalised and they learn that it is a perfectly acceptable way to think about yourself," says Ogden. "If they hear parents criticising them – 'ooh, you've put on a bit of weight' – again, body size becomes the focus."
Chubbiness is often a phase anyway, so play the long game, says Ogden, who didn't let her own children have full length mirrors in their bedrooms when they were teenagers and didn't have scales in the house. "I'd never put a child on a diet and I'd never weigh a child. You can see by looking at them what size they are. If you want to get your child to eat less, do it by covert means."
What if they say "I'm fat" and you secretly agree? You reply: "You're growing at the moment and I think you're fabulous." Never make a child feel self-conscious or ashamed. You might concede that, like most people, they've been less active. "But don't focus on food or weight."
Instead, says Ogden: "Stop the sweets and chocolate by not bringing them into the house, and increase the fruit and vegetables by buying them and cooking them. Help them eat well without them knowing it, and be more active yourself and as a family.
But parents' focus should be on changing family habits, not the child. "What's going to have to change is you, not them."