1:4 children in the UK is obese when they start school

Figures quoted in the news yesterday concerning the rise in childhood obesity make grim reading for the future health and well being of these children. There are many contributory factors – some obvious – others more insidious.

Weight gain occurs as a direct result of a balance between energy input, in terms of food ingested, and energy ouput. The amount of food required to maintain a healthy weight varies according to individual rate of metabolism and many factors can influence metabolic rate. Obvious factors include, amount and types of food eaten against amount of exercise taken. Less obvious factors are use of the contraceptive pill, early feeding patterns and social factors which over the last 40 years have altered the eating and exercise habits of the nation.

Children’s eating habits begin before birth with the diet of the mother. In the later stages of pregnancy the amniotic fluid surrounding the foetus contains flavours from the mother’s diet and the developing baby can develop a “taste” for certain flavours such as sweet and salt. After birth, nature has designed the perfect food for babies in the form of human breast milk, which contains exactly the correct ratio of essential fatty acids needed for brain development, bacteria and flora to prime the infant gut for digestion and which adapts its content from hour to hour to the needs of the maternal-infant environment.

“A study carried out by scientists at the
University of
Bristol [i] as part of the Avon Longitudinal Study of Parents and Children examined the feeding habits of 881 babies at four months of age and compared it to their weight gain in childhood. They found that babies who were fed on formula milk and were weaned onto solid food too early were heavier than expected by 5 years of age, placing them at greater risk of developing obesity.

The differences between breast and bottle fed babies only became apparent after weaning. Infants given formula milk were less likely to eat vegetables and fruit, and more likely to consume commercial infant drinks, compared with infants who were breastfed. In breastfed babies, milk intake was lower when solid foods were introduced, a natural adjustment for the calorific intake provided by an additional food source. In formula fed babies, milk intake remained the same once solids were introduced. The study suggests two possible trends: Firstly, children’s taste preferences may be affected by being fed on formula instead of breast milk and that early taste experience sets up a desire for higher calorie foods in later life. Secondly, that breast fed babies self-regulate their milk intake once solid foods have been introduced whereas formula fed babies continue to be given, and in most cases take, the same amount.”

Added to this are changes in modern living: Centrally heated buildings, which means less energy from carbohydrate and fat sources is needed to keep warm during the winter months; children taking less exercise in terms of walking from place to place; television and computer games, which increase time spent in sedentary as opposed to physically active pursuits; loss of daily physical education as part of the school curriculum; fewer number of families who sit down to a home cooked meal every day; loss of domestic science as part of the regular curriculum and children no longer weighed and measured as part of the school health check on all children.

Sitting down to formal meals is important because mealtimes tend to take longer when they are social occasions. It takes up to 20 minutes for a part of the brain involved in satiety to register when a person is “full”. When food is gobbled, the satiety centre does not have time to register before more has been eaten; home cooked meals tend to have a better nutritional content and contain less hidden fats, salts and sugar (also a fat) than ready-made or processed meals. The availability of fast foods with high carbohydrate and fat content temporarily fool the brain into feeling satisfied but are followed by a blood sugar “low” with craving for more of the same. Packing of food means that the buyer is encouraged to buy more than is actually required. If we are to prevent an obesity epidemic in our young, changes need to be made at all levels of education – pre-conceptual awareness, maternal feeding choices, education of schoolchildren in the science of nutrition, the arts of cooking and the importance of daily exercise.

[i] Noble S, Emmett P, 2006. Differences in weaning practice, food and nutrient intake between breast and formula fed 4 month old infants in England. Journal of Human Nutrition and Dietetics.Vol.19/4:303.

[ii] Owen GC, Martin RM, Whincup PH, Davey Smith G, Cook DG, 2005, Effect of infant feeding on the risk of obesity across the life course: A quantitative review of published evidence. Pediatrics. 115/5:1367-1377.

[iii] Heinig MJ, Nommsen LA, Peerson JM, Lonnderdal B, Dewey KG, 1993. Energy and protein intakes of breast-fed and formula-fed infants during the first year of life and their association with growth velocity. The DARLING Study. American Journal of Clinical Nutrition. 58. 152-161.

[iv] Lucas A, Sarson DL, Blackburn AA, Adrian TE, Aynsley-Green A, Bloom SR, 1980. Breast vs bottle: endocrine responses are different with formula feeding. Lancet. 1:1267-1269.

[v] Von Kries R, Kolezko B, Sauerwald T, et al., 1999. Breast feeding and obesity: cross sectional study. British Medical Journal. 319:147-150.

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