An F for BMI

Switching the radio on in the car, I heard of plans to include body mass index (BMI) measurements on school reports. Later, when I looked around on the internet a little, it transpires that an expert has suggested this particular strategy as one tool in the battle against childhood obesity. The radio story made it sound like a done deal. Should BMI assessment be part of the school feedback system? Please take a moment to vote on the sidebar poll.

Of course, childhood obesity is a concern but strategies like this really concern me. I was horrified recently when all the children in my daughter's class were weighed in front of each other. Comments were made by some children to those who were heavier. Is this helpful? I think not and I really worry about the negative impact this could have longer term.

Apparently the report card thing is already done is some U.S. states and in Singapore. Does this happen in your particular part of the world? Would love to hear some feedback about your experiences.

Update: Poll results. Is including the BMI on a report card a good idea? 18% (2 votes) thought so, 18% (2 votes) highlighted some concerns, 64% thought it was a bad idea.

Chewing the fat over anti-obesity programs

Back on the subject of childhood obesity again.

I previously expressed concern that, while accepting that childhood obesity was a problem that needed to be addressed, I wasn't sure that some of the approaches suggested weren't likely to cause more problems than they actually intended to resolve.

The latest news from Singapore seems to confirm that the proof of the pudding is indeed in the eating (poor pun intended)...

For the past 15 years, Singapore has run an anti-obesity program in its schools. The "Trim and Fit" program required children deemed overweight or obese to do vigorous exercise during breaks and after school until they reached a desired weight.

While the program achieved a measure of success in that it reduced the number of overweight children from 14 percent in 1992 to 9.5 percent last year, it also had a negative impact. The program was seen to stigmatise overweight children and led to problems with teasing and bullying of children in the program by their non-affected peers.

Complaints from families have now seen a revision to the program. Singapore has decided to replace the scheme with a more holistic approach, required to be undertaken by all children, irrespective of weight. The aim is to raise fitness levels but to also address mental and social health by promoting a healthy lifestyle overall.

Food for thought for all those currently involved in developing such programs.

And you did realise it's International Bad Pun Day, didn't you?

*wink*

Resources
Singapore ending anti-obesity program after teasing

The fattening of a generation

Photograph from the ABC

A confronting question from Sydney University's Dr Michael Booth, the state's top expert on childhood obesity, asks whether the greatest child abuse of our time will be the fattening of a generation?

Unless you've been under a rock, you can't help but be aware of the increasing rates of obesity in children and the potential costs in terms of increased rates of type-2 diabetes, hypertension, cardiovascular disease, cancer and osteo-arthritis. With 25% of Australian school-age children overweight or obese, the implications are enormous.

Dr. Booth says although there other issues to be taken into consideration, a diet of junk food could easily be considered a form of abuse.

"It is actually doing their life's chances very great harm. Failing to provide adequate nourishment to your children is a form of abuse, like failing to provide adequate shelter or education or sleep or safety."

Dr. Booth attributes this to parents being in denial about the effects of junk food, to laziness, to time-poor parenting, where it's often about getting food on a plate quickly rather than nutritional content.

The results of a new study by Dr. Booth are frightening, showing obesity begins to cause disease when Australians are still in their teens. Blood samples were taken from 500 Sydney year 10 students to assess risk of diabetes and cardiovascular disease and whether fatty liver disease was present.

15% had elevated insulin levels, a precursor to Type 2 diabetes.
10% of boys and 5% of girls had liver damage.
20% of boys had high blood pressure.

Importantly, the study showed that while children were actually increasing their amount of physical exercise, they were eating more junk food.

Earlier this year, the 10th International Congress on Obesity was held in Sydney. Dr William H. Dietz, director of the Division of Nutrition and Physical Activity at the United States-based Centers for Disease Control and Prevention, spoke about the worldwide problem of childhood obesity.

"Childhood obesity now constitutes a major threat to the health and welfare of populations worldwide. Sixty per cent of overweight five- to 10-year-old children have at least one additional risk factor for cardiovascular disease, and 25 per cent have two or more. Recent data suggest that 15 per cent of adolescents who develop Type 2 diabetes will have end-stage renal disease in 15 years."

Dietz outlined strategies the CDC have found to be useful including physical activity, reduced television viewing, breastfeeding, increased fruit and vegetable consumption, reduced sugar-sweetened beverage consumption, and reduced portion size.

Two approaches, largely based on common-sense practices, that address some of these strategies were also highlighted:

Weightwatchers' Healthy Parent Healthy Child

Weightwatchers is one of the best known weight-loss services but it's not as simple as rolling out the program to children. Research conducted in Sweden concluded that the adult-based program was not suitable. Therefore, Weightwatchers joined forces with pediatricians in the US to put together this pilot program, which puts the Weightwatchers program into a family setting. The basis of the program is setting up a healthy-weight home, a home where everyone who lives there has a lifestyle that encourages them to be at a weight that is right and healthy for them.

The program is based on five simple rules:

1) A focus on wholesome, nutritious foods.

2) Inclusion of treats.

3) A limit on non-homework screen time to two hours (or less) per day.
4) Increased activity - an hour or more per day.

5) The rules apply to everyone in the home.

While the program is not presently available in Australia, Weightwatchers hopes to roll it out within the next year. However, the book of the program is available.

The Mend Program

A healthy Mind, sufficient Exercise, good Nutrition and a balanced Diet. Developed by Dr Paul Chadwick and pediatric nutrition consultant Paul Sacher, the community-run program has had great success in Britain where it is running at 24 sites around the country. Sacher is also the author of From Kid to Superkid, a book which outlines the principles behind the MEND program.

"The key to MEND's success is its integrated approach, combining all the elements the medical community knows to be vital in preventing and treating obesity: family involvement, increasing physical activity and reducing inactivity, dietary education and behavioural modification. The challenge for us is how quickly we can bring MEND to Australia."

Paul Sacher

Resources
Child obesity frightening
Obese kids are headed for heart attacks

Great Expectations

The controversy around Steve Irwin continues.

Firstly, there were the less than kind (and unsolicited) comments from the person I shall forever think of as 'Germaine Sodding Greer' (apologies but blame Bridget Jones).

Then there were the mutterings regarding Terri Irwin's decision to talk to a woman's magazine.

Now talkback radio is awash with discussion about the authenticity of the eulogy delivered by Bindi Irwin at Steve Irwin's memorial service and the pressure being placed on this child to carry on the work of her father.

Alison Garton, a professor of psychology at Western Australia's Edith Cowan University, has come forward to express concern following Bindi's appearance at the memorial.

"She's obviously a very poised and mature eight-year-old, but I think some of these public statements are probably a bit extreme in this point in time."

Newspaper reports focused on Bindi with headlines such as 'The Future of the Dream' and 'The Little Wildlife Warrior'. Even John Stainton, Steve Irwin's manager, predicted Bindi's fame could exceed that of Steve's in five years.

It does sound a little overwhelming. The danger of setting up such high expectations is that failure to meet them can have a devastating impact on the child.

Of course, these are extraordinary circumstances. Bindi hasn't led the life of your typical 8 year old. She's been around her father's work all her life and was already filming her own television series.

But still, too much?

Easy to point the finger when this situation can just as easily be mirrored in our own lives. We all have hopes and expectations for our children. It's natural. It's where we cross the line between encouragement to gross intervention that it becomes problematic.

An article in the Sydney Morning Herald this week covered the issue of parents doing homework on behalf of their children. Such behaviour illustrates the practice of what has become termed the "parachute" parent, who rescues their child from difficulties.

"The message parents send when they do the work for their kids is, 'You can't do it well enough, I'll do it for you'. It's producing some very anxious children."
Elbie Van Coller, school counsellor.

Then there's the infamous sports parent. We've all heard stories like this.

This past Friday, I attended my daughter's first sports day.

She's only small. I'm not in the least athletic, apart from unravelling a chocolate bar (I hold the world speed record). I had no major expectations and said all the right things about 'having fun' and 'just giving it your best shot.'

Then, suddenly, she was coming first and someone was yelling rather loudly. I was shocked to find it was reserved British me, up on the chair, screaming at the top of my lungs.

I surprised myself and not in a good way. I was, of course, otherwise well-behaved (as in I didn't trip up her nearest rival) but I could suddenly see how easy it could be to morph into a pushy parent.

Professor Garton makes a very valid point if it's generalised beyond the Irwin family. We all need to manage our expectations of our children. Me included!

Postscript: My colleague, Alison Tuck, a child psychologist, also posted on this subject here.

References

Cartoon from Sydney Morning Herald
Psychologist voices Bindi Irwin concerns
Stop doing the homework, overzealous parents warned