Childhood Obesity and Type 2 diabetes

Within my role as a General Practitioner and Clinical Lead for Diabetes, I can see far more clearly the monumental impact diet and lifestyle choices have on our overall health and well-being into adulthood. It is without a shadow of a doubt, that we need to make the stamp early for good health and longevity later.

In London and the South East, we are near the very top (compared to the rest of the UK) for rates of preventable conditions such as type 2 diabetes (not to be confused with type 1, which is genetic and sadly not preventable).

10% of the NHS budget is currently spent managing diabetes and its vast array of complications. We may think of type 2 diabetes as an ‘adult’ condition; however, from recent data and statistics, alongside my experience, there is an increasing number of children being diagnosed with this condition. One of the primary reasons is obesity.

In 2017, around 9% of the UK’s 4-5 years olds were classified as obese. By Year 6 (age 10-11 years), this figure had risen to 20%. I have been drawn more and more to try to understand how and why this is happening, and what we can do to stop it.

Food Choices 

We all have associations to pleasure and disgust with certain food groups. Foods can also be attached to happy and sad memories. Evidence suggests that the first 1000 days of life are crucial to long term habit-forming.

However, don’t fret, because young children can still be moulded to change their pattern of behaviour around food. 

There is a network of connections that influence food choices these are:

  1. Agents (child’s behaviour/character/parental influence)

  2. Food choices (food choice, consumption, experiences, repeated exposure)

  3. Marketing and external persuasion.

We can’t change any of these facets, but we can, as parents, influence the choices in foods we make for ourselves and our kids, and the way we frame them to our children.

For example, the idea of a ‘treat cupboard’ or rewards for good behaviour with unhealthy food choices can be questionable – are we really offering them a treat? Have we thought about swapping these sweet treats with more practical items like stationery or perhaps a favourite comic or a trip to the park or kick-a-about or a day out to a historical site?

How can we as parents/carers/grandparents make a change?

• Aim for around 50% of the plate to be made of vegetables. Aim for lots of colours, and steamed rather than boiled or fried to retain nutrient content.
• Vegetables can be added to meals, salads, and pasta dishes - including bell peppers, carrots, and sweetcorn.  
• Increasing fibre, in the form of dark green and root vegetables, wholegrain bread, and pulses, beans lentils chickpeas, fills up their stomachs for longer. Replace white bread sandwiches with wholemeal bread.
• Make fruit kebabs. This can be good for them to try a variety of fresh fruits and fun to make too! Fruit can be a great pack lunch snack or after school snack.
• Limiting refined/processed sugars and fat intake. If you do offer processed things, check sugar and salt content, switch the afterschool high-fat snacks to fruits or vegetable snacks.
• Low-fat foods (e.g. yoghurts) are often replaced with sugar, so beware. Try natural yoghurts with fresh fruits including mangoes, strawberries, and berries
• Look at the sugar content of your child’s cereal. Switch to the lower percentage ones or porridge oats with berries.
• If you do offer your child snacks, keep them to items that total less than 100 kCal. No more than two snacks per day are the current recommendations. My advice is if you can’t stick to this, don’t offer any snacks at all.
• Consume less sugar. Too much sugar and foods containing sugar can cause blood glucose levels to rise. It is best to replace these with lower sugar and sugar-free foods instead. Excess sugar is stored as fat.
• Stick to good fats e.g. Oily fish like salmon and tuna, avocado and nuts like almonds and cashews. These can easily be added to wraps, sandwiches, salads and pasta dishes.
• Stick to lean unprocessed meats. e.g. chicken, turkey.
• Try to eat with your children or at least let them see you eating the same as them. Children are mirrors. If they see you eating badly, why would they do it differently?
• Strip the cupboards of bad food choices, and if you have a ‘treat’ keep it as a treat rather than a daily event.
• Food labelling: start teaching children about traffic lights or food label checks - download simple apps where you can scan the bar codes and look up the fat, salt and sugar content.

Eat better

Exercise/Movement

Exercise from a young age helps set our little ones up for a lifetime of keeping active.

Football, swimming, cricket, cycling or just walking, it all helps. Exercise has equal importance in the management of obesity and weight.

Recommended guidance is that children should be doing at least 60 minutes of moderate to vigorous activity per day.

Staying active is free. We just need to move. Walking, running, or getting the kids to help at home with housework all mean their little bodies are moving, and their heart is pumping.

The more active they are, the stronger their muscles and skeleton become.

Look for activities at local leisure centres, after school clubs and school holidays camps where activities are offered.

Move more

With small baby steps towards positive change, this can work in the longer term. Give it a go and see!

I've listed some really useful resources below. These are worth a visit to learn more on this continued journey.

Good reads:

www.diabetes.org.uk/preventing-type-2-diabetes/can-diabetes-be-prevented

www.nhs.uk/Livewell/fitness/Pages/physical-activity-guidelines-for-young-people

https://www.nhs.uk/change4life/recipes