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Question
Posted by: Linda | 2017/11/24

overweight child

I have an 8 yrs old child , she is overweight , I just want to find out if I can supplement one meal with shake especially at night. She eats a lot even if I try to reduce her food intake she will cry for food, I just need something that will supress her appetite without harming her body. I am worried about her health as she grow she might be worse.

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Our expert says:
Expert ImageThe Dietitians
- 2017/12/01

Hi there Linda, 

 

Thank you for writing to us.

 

Let’s start off by first commending you on your courage to get help for your daughter.  A mother’s love for her children is immense and I am sure that you want to do all that you can to protect her. The great news is that with just a few tweaks and changes to the way she is eating you will see results. As a really great ‘side effect’ you’ll probably  also see that your daughter will start having more energy, not get ill as often, feel more confident and happy. From losing weight she will also definitely start to breathe easier at night as there is less pressure on her chest.


I would however not advise you replace food with a shake as this will actually make her hunger worse. This is because  there is no feeling of fullness that comes with a shake as it is just liquid, and she will end up hungrier than ever.


Rather, try some of these tips below and overall help her change her way of eating, rather than starting her on shakes.

 

Remove diet from the dictionary.

·         My first advice would be for you to remove the word ‘diet’ forever. At the age of 8 years it is important for your daughter to not become too aware of being overweight as far as possible.

·         Should you make some changes to her diet get the whole family involved so she doesn’t feel isolated or like she is being singled out. Rather, approach the whole family and say how everyone should be healthy as it gives you loads of energy and you feel so much better.

 

Speak her language

·         Kids don’t understand weight or weight loss. And the truth is they shouldn’t. They should never be aware of a diet and only about being healthy.

·         Equate healthy eating to something she understands. For your daughter, you could stress the importance of healthy eating in feeling more energetic. If she is academically orientated you could say how healthy eating helps her concentrate better at school, study better and then do well in tests and exams.

·         So in summary, rather than stress weight loss stress gaining health. The best way to gain health is to find an approach to eating that makes sense, that doesn’t cut out food groups and has your daughter eating regularly through the day.  The aim is to never have her feeling hungry or deprived from treats as it is when you are hungry that you crave. Rather allow her to eat more of healthy foods like fruits, vegetables, low fat dairy and lean meat. This way she is likely to not crave other foods as much as she won’t be hungry for them.

 

Involve her in preparing foods.

·         Remember that fussy eating may not just be about food, but also about the strive for independence, forming part of a child’s normal social and physical development.

·         Let her help in preparing salads, mixing in a bowl, even setting the table. I know this may sound scary at first, but not only will you both enjoy the bonding time, but it also provides your daughter with a sense of pride and accomplishment.

·         A great way to involve her is to arrange for her to attend a fun kid’s cooking class. There are some great ones out there and this will help her get familiar with food and expose her to the idea of trying new things. You can then encourage her to try the dishes she learns at home for the family on a weekend.

 

Trying new foods.

·         Research shows that it takes up to 15 exposures to a new food before a child accepts it.

·         Another good idea is to let your daughter choose her own new fruit and vegetable to try. Take her grocery shopping with you to the fruit and vegetable section at your grocery store and encourage her to choose any fruit or vegetable they find interesting. Having her choose it will mean she takes  more responsibility to eating it too. You can do this every few weeks and encourage your child to pick a different coloured fruit or vegetable each time.

·         Be patient, and do not give up.

 

Make time for meals and establish a routine.

·         Children thrive on consistent schedule. Set a regular time of the day for each meal.

·         It may also be a good idea to establish a routine before meal time, like it schedules the end of homework, a warm bath, or hand washing.

 

Monkey see, monkey do.

·         Children imitate and copy the habits and attitudes of their parents.

·         Set an example by allowing your child to see you trying new and interesting foods.

 

Do not bribe or barter.

·         “I’ll give you a chocolate if you finish your food” This statement is probably the easiest way to manipulate your child to eat. However, such statements undermine the food that the child is currently eating (which is often healthy, nutritious foods), and very early on creates the impression that sweet treats should be valued over healthier foods.

·         Try refrain from bribing and bartering. Rather reward using play time, her favourite cartoon show, or gold stars on a chart.

 

Offer small snacks between meals.

·         If your child is a fussy eater, it is a good idea to leave healthy snacks in easy-to-reach places. Leave healthy snacks such as sliced apple wedges, carrot sticks, circular cucumbers, peanut butter on wholegrain (cut into fingers) around the house. Have food available on the kitchen table, aside your child when playing with toys, or in the passage way.

·         It is important to offer small snacks and not entire meals. Otherwise, your child will certainly not be hungry at the next meal time, and the cycle of fussiness will continue.

 

Praise.

·         Praise, praise, praise! Acknowledge when she finishes off a plate of healthy food (and focus less on the mess of the kitchen if she’s prepared it herself ?)

 

Create a healthy environment

·         Keep the fridge and pantry well-stocked with healthy foods like fresh fruits and vegetables, whole-grains, lean protein, dried or tinned beans, peas and lentils, fruit juice, milk, among others.

·         Always send a healthy lunch box with her to school. Get her a fun, colourful lunch box (Woolworths has some great ones!) to make it even more enticing.

 

 

Here are some more general ideas around managing weight.

 

1.    Eat more regularly.

·         Eat small, frequent meals spread throughout the day instead of fewer larger meals. Children have smaller tummies yet are bursting with energy and can get excessively hungry and binge eat. Also, frequent snacks stabilize blood sugar levels to help prevent cravings.

·         Erratic eating leads to poorer food choices so try to not skip meals. Try keep weekends consistent, too.

·         Include mid-morning and afternoon snacks to prevent your daughter from getting hungry at school or if at home playing:

o   1 portion of fresh fruit with a small handful of nuts

o   2 cups popcorn (air-popped)

o   1 small tub fat free yoghurt

o   3 provitas or crackers with fat free cottage cheese or 1T peanut butter

o   1-2 rice cakes with Bovril, marmite, or fish paste

o   Lean biltong

o   Vegetable crudités e.g. carrots, baby corn, celery, cucumber, baby tomatoes, etc with hummus

 

2.    Plan her plate.

 

Often we leave out one of the food groups in favour of more of another food group.

 

Step 1:  Bulk up the plate with vegetables and/or salad.

Step 2:  Add low GI / high fibre carbohydrate (see below for more info on carbohydrates).

Step 3: Add lean protein (e.g. fish, chicken breast, lean meat) or fat free dairy.

Step 4: Use 1 portion of fat in either the preparation of the meal or drizzled over salads/vegetables afterwards (see further on for more info on fat).

 

3.    Up the water intake.

·         Ensure that your daughter is well-hydrated at all times

·         Purchase a few bottles of still water, and leave in spots that your daughter visits often, such as your car, her afternoon play area, school bag, etc.

·         Rooibos tea (without milk) and hot water with lemon juice/slices or mint can be counted as water intake. Turn these into homemade herbal iced teas and send to school or offer with dinner instead of sugary drinks.

 

4.    Pack your daughter a lunch box.

·         A packed lunch is a great way to ensure a healthy lunch meal at school.

·         Pack her lunch the night before so in the morning it’s quick for either of you to grab the lunchbox on the way out.

·         As mentioned above get her a fun lunch box. Woolworths has a range of fun, brightly coloured cooler bags which are perfect for packed lunches.

·         Purchase a set of various sized containers, such as Glad containers and Tupperware, as well as various sized sandwich bags, tin foil and cling wrap. These can be used each day to neatly pack lunch.

·         Try limit eating out or buying from the tuck shop as much as possible. Encourage your daughter to rather save up her tuck money for a bigger treat like a video game or pair of shoes.

 

A good and healthy lunch is essential to ensure your child’s energy and concentration levels are kept in check throughout the long school day, and possibly even for after school. The basic healthy lunchbox should look like this:

 

Sandwich with a healthy filling

Choose whole-grain, low GI breads and provide a fun yet healthy filling. Use wraps or pitas to be different.

ü  Peanut butter and sliced banana

ü  Grated carrots and/ or pineapple mixed with cottage cheese

ü  Tuna mayo with crunchy onion

ü  Avo and cooked chicken (from the previous night’s dinner)

ü  Low fat cream cheese and strawberries

 

§  Cut bread into four smaller triangles or squares.

§  Go easy on sandwich fillings that will make bread soggy and thus less likely to be eaten. Layer lettuce between the sandwich filling and bread slice to prevent sogginess.

 

Fruit

§  Peeled and pre-cut fruits make for easy and fuss-free eating. Offer an easy-to-peel whole fruit like apple, banana, and naartjies.

§  Dice larger fruits like oranges into wedges. Sprinkle with cinnamon for a fun alternative to plain oranges.

§  Cut apples and pears into cubes or wedges and drizzle with lemon juice to prevent browning.

§  Make colourful mini fruit kebabs or fruit salad.

§  Small fruits like raspberries, strawberries and grapes are great to nibble on.

 

Water

Provide a sturdy bottle with fresh water. Freeze overnight in the hot summer months, and encourage your child to fill up their water bottle during the day if he gets thirsty.

 

Snacks

§  Dried fruit

§  Nuts and raisins mix (unsalted)

§  Lean biltong

§  Vegetable crudités with a hummus or yoghurt dip

§  Small tub of yoghurt

§  Drinking yoghurt

§  Pieces of cheese

 

Other tips

§  Stock up the cupboards with containers of different sizes.

§  With a packed lunch, your child has no choice but to eat what is offered. Buy a colourful and exciting lunch box. The Woolworths lunch boxes for lunch-on-the-go are colourful and fun for kids.

§  Limit sweet treats like chocolates, sweets and muffins to once weekly, for example, on a Friday or the day of a test. Try placing a marshmallow at each end of the fruit skewer to ensure fruits are eaten with the treat.

§  Don’t forget to pack utensils if needed. Keep a few plastic spoons and forks handy.

§  Keep servings small. Lunch time at schools is often no more than 30 minutes, and teachers won’t appreciate your child eating during class.

§  On days where your child has extra after school activities, be sure to pack extra foods.

 

5.    Choose the right carbohydrates.

·         Starches and carbohydrates are not the enemy. There is no need to cut them out (or in fact any group of foods). Rather, choose the right types of carbohydrates that are low GI.

·         The glycaemic index (GI) is a measure of the ability of a food to raise blood glucose levels.

o   A high GI food (e.g. white grains, chocolates, sweets, cakes, biscuits, etc) will raise blood glucose sharply and quickly.

o   A low GI food (whole-wheat and whole-grain products, fruits, and vegetables) will increase blood glucose much slower and over a longer period of time, preventing excess hunger and cravings. Whole-grain options of bread, rice and pasta are preferred for their low GI nature. Also, low GI foods are generally higher in fibre which helps keep you fuller for longer.

o   See the attached information sheet on carbohydrates and the GI.

·         In summary, choose carbohydrates that are slowly released into the blood stream (e.g. seed loaf bread, Provitas, all bran flakes, oat bran, sweet potato, brown rice, legumes, chickpeas, fruits and vegetables, etc). Choose starchy vegetables e.g. pumpkin or butternut to help fill her up and keep satisfied

 

6.    Keep the diet low in fat.

·         Use low fat (2%) or skim (fat free) options of dairy and dairy products e.g. milk, cheese, yoghurt.

·         Remove all visible skin and fat from meat and chicken before cooking.

·         Choose lean cuts of meat, chicken and fish which is much lower in fat

·         Avoid frying and deep-frying food. Experiment with other cooking methods such as steaming, baking, grilling and roasting.

·         Be wary of high calorie oils, butter, margarine, marinades, cook-in sauces, tomato sauce, BBQ sauce, and other sauces added to meals.

·         Be creative and experiment with a variety of flavours with spices, fresh and dried herbs, lemon juice, vinegar and glazes, fish sauce, soya sauce (low sodium), various healthier oils (avocado, olive, sesame, peanut), ginger and garlic to make the most of your meals.

·         Read labels and aim for products with less than 10g of fat per 100g of product.

·         Watch for fats in treats like chocolates, sweets, chips (e.g. Niknaks, Simba, etc), pastries, cakes, muffins, cupcakes, and the like.


Include small portions of the fats that are good for you. One portion of healthy fat is the same as:

o   1t olive, canola, peanut, avocado, and sesame oil*

o   1t sunflower oil

o   1t olive oil/ canola oil margarine*

o   1t regular margarine (soft tub varieties only)

o   ¼ avocado

o   5 olives *

o   2T low fat/ lite salad dressing or mayonnaise

o   2T seeds or unsalted nuts

o   1T peanut butter * (e.g. Black Cat yellow lid- sugar and salt free)

o   1T humus 

*Monounsaturated fats- opt for these healthier fats over other fats

 

7.    Watch your intake of hidden sugars.

·         Cut down on her sugar.

·         Limit high sugar foods such as fruit juice, cold drinks (e.g. Oros), soft drinks, chocolates, sweets, biscuits, cakes, Powerade and Energade.

·         Treats such as chocolates, chips, sweets, cakes, cookies, muffins, biscuits and so forth, should be limited. Enjoy a guilt-free treat once or twice a week.

 

8.    Save on the drinks.

·         Avoid fruit juice, energy drinks (e.g. Red Bull, Play), sports drinks (e.g. Energade, Powerade) and also flavoured waters.  They all contain lots of sugar and have unnecessary kilojoules.

·         Rather opt for more water (as above). Drink low kilojoule cordials such as lecol, herbal teas and plenty of water.

·         If you want a bit of a fizz to your drink, try sparkling water. Add a bit of lecol or fruit juice for your own home-made fizzy drink (but much healthier!).

·         Again, read the food labels to compare the nutritional content of the product. You’ll be surprised at how much sugar and calories are in these drinks. 1t of sugar is 5g, so if a drink says it has 30g of carbohydrates/sugar it’s the same as 6t of sugar!

 

I hope this information offers you good guidance and answers your question. Best wishes to you both 

The information provided does not constitute a diagnosis of your condition. You should consult a medical practitioner or other appropriate health care professional for a physical exmanication, diagnosis and formal advice. Health24 and the expert accept no responsibility or liability for any damage or personal harm you may suffer resulting from making use of this content.

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