To be pretty upset that ds1 has been assessed as overweight and not to find any of the 'Top Tips' relevant to us?

[lecce]

Ds1 (4.10) was weighed and measured at school and we received a letter today telling us he is on the 91st BMI centile and therefore is just into the overweight category.

Of course I am upset. I had no idea there was a problem. I suppose he does look a little more 'solid' than some children, indeed some children I see do look particularly tiny. Ds has no rolls of fat, no double chin and his tummy still sticks out a bit (only noticeable when naked) and you can see and feel his ribs.

The last time he was weighed and measured (about 2 years ago) he was on the 75th centile for height and the 50+ for weight - so longer than wide. However, now these seem to have swapped over and he isn't so tall but appears to be chunkier.

I have always considered his diet to be good. The booklet the NHS have sent is full of tips about cutting down on biscuits, crisps etc but we very rarely have these. We don't keep biscuits in the house, or crisps. He loves all fruit and mostly snacks on that or oat cakes but he doesn't snack a huge amount at all. We may put peanut butter on the oatcake, but spread it thinly. Puddings are fruit, alone or with Greek yoghurt. About once every six weeks or so we bake flapjacks or fruit muffins. We visit MacD's once every six weeks or so. Dh cooks all our meals from scratch - pasta sauces etc. I noticed today he'd put a little butter on the potatoes and carrots - should we not be doing that at all?

Among my friends, I am considered on the strict side regarding food but, in fact, nothing is off limits but it is limited, iyswim. His diet has a few 'naughty' things in it but is basically pretty good and very low on processed food. He only drinks water with the occassional glass of milk or carton drink when we are out - a couple of times a month.

He walks to school, goes to the playground for 30-40mins every day, has swimming lessons once a week, dance lesson once a week and uses his scooter, balance bike or legs both days of the weekend pretty much without fail. He is not a total whirlwind, like some boys his age, but that is just his nature and he's certainly no couch potato either.

I just feel so down about this - like we have let him down. The letter is saying about how he is likely to suffer from health problems and be overweight as an adult and I could just cry. Yet looking through the tips, we already do pretty much everything they suggest. I really didn't think young children were supposed to follow a 'low-fat' diet, I though it was about balance but we've obviously got it wrong .

Would love some suggestions from anyone about what we could do about this.

Btw, I am not overweight (slightly under) and dh is a little but he is ridiculously tall so hides it well! We all eat the same food, pretty much, though not the same portion sizes, obviously.

"Id say look at your child and trust your instincts."

Unfortunately though, there's a body of research which is suggesting that there are many parents doing this, and getting it wrong!

This is a very interesting thread. I am currently having a sort of low-level argument with the school nursing team from the opposite perspective - I got a handwritten letter home because my five year old child is about 9th centile for height but less than 0.4th centile for weight.

The thing is, I don't think any of these letters and recommendations take into account a child's family background particularly sensibly because the monitoring process doesn't ask - I realise that it would make it all pretty complex but without this info the data makes little sense in isolation. The OP says that her husband is ridiculously tall. Amongst my siblings (three just above average height children and one very very tall child) the child who grew up to be very tall (6'3") was consistently a lot heavier than the others from birth - I don't think this is unusual from personal experience. All of us are much thinner and lighter than average for our heights but none have ever been on a diet. So my child has on her mother's side a strong family history of healthy people who are skinnier than average. Her dad weighs 9 stone at just under average height but is v fit, active and muscular. It would make sense for my daughter that she would be on a lower centile than average (and someone has to be at the bottom of the charts) - if a child with two healthy skinny parents who eat plenty isn't down there then I would wonder why not, personally.

Also, there is a perception among the health professionals that I've encountered that a child's weight and height should always be on the same centile. Even without getting into the seriously underweight or overweight areas, this seems to me completely nuts. People are not all the same shape. Some are rounder or more muscular or skinnier or have smaller or larger bones.

I see the problem with parents estimating their child's weight profile inaccurately - many people I know do seem to think their children are normal when they look fat to me. And I completely see why they have to check these things and that the data can be used to plan for the future so I really don't have a problem with the measuring per se. But it seems to me that people don't apply enough common sense to the results. And for me, the children who are underweight in those drawings look normal to me, because that is what is normal for my family, who all eat completely normally and many more calories per day than the vast majority of the population and would no more think of dieting than taking a weekend break on the moon.

Anyway, I've consented to further monitoring of my daughter's weight. But I can't see the point, really - she eats a sensible age-appropriate amount of home-cooked food and is full of energy and bursting with health. She gets pudding after her dinner every night - something calorific like a steamed fruit pudding or baked custard and fresh fruit, maybe with custard or cream or ice cream. She eats lots of fruit and veg and she eats a great variety of different kinds of food. I put butter on her vegetables, btw. I think the extra calories won't do her a scrap of harm. And I add cream and cheese and nuts to anything that will take it. I do actually want her to develop a taste for butter and full fat milk and cheese as they are what stand between me and losing weight, which I don't want to do! So far, DD weighs a kilo or so more than me at any given age which seems to me ideal. I weigh much less than 8 stone and have longed to be a tiny bit heavier all my adult life. If I was 18, I'd be on the 4th centile (but I am 43 and assume that most 43 year olds are considerably heavier than most 18 year olds). When I was actually 18, I suspect I was down there below the 0.4th centile with DD.

I don't know what the answer is, apart from maybe a better understanding of what centiles are and how genetics can work among the healthcare fraternity!

i agree the centiles can be V misleading...however oatcakes [as original post] can actually have fair amount of fat and sugar in...also greek yogurt ...depending on brand and type[eg some VV creamy] dont assume their always a virtiuous option ; poss stop eating before full......that comes later with digestion

That is very interesting, haberdashery, and makes a lot of sense. Dd is indeed rather shockingly tall for her age (taller than all of her year and most in the year above). Such is my anxiety on this issue since receiving The Letter that I've started wondering whether her height is also the result of overfeeding. That isn't possible, right?

Fat doesn't make you fat... excess carbs make you fat.
I thought most people had clocked onto this by now. Not heard of the book, 'Eat Fat Get Thin' and the like?

So all this 'my kid is in the 99.9th percentile but all I feed him is oatcakes and pasta', well IMO you've just answered your own question. Feed a few less oatcakes and a few more portions of fat and protein and he'll be alright.

FWIW, I would never worry and never have worried about feeding my daughter fat, and TBH the more saturated it is the better (its the polyunsaturated you need to worry about). My DD is as thin as a rake though but thats more to do with activity levels and ethnicity.

excess calories make you fat, you can over-eat on a low carb diet

excess saturated fats is a contributory factor to heart disease and you should absolutely worry about fats if they are trans fats.

just because something is in a book doesn't mean it's right, there were endless books about low fat diets in the 90s.

Skew, if your child is tall, then she's tall. I imagine somewhere in her family history there will be tall people. I really don't think you can make a short kid tall by feeding her too much. And being tall is not a bad thing, per se. It's just one of those things that people are, like being brown-skinned or blonde or green-eyed. You can't stop someone having blue eyes and nor can you stop them being tall or short. You can mitigate the effects of a propensity to fatness to some extent, but even that doesn't always work. My aunt, who has three fat children (all adults now), fed them an extremely healthy diet throughout their childhoods. They are all now at around 30ish actually genuinely fat and one is obese. They eat fairly well and healthily but they're all fat. They're fat because their dad is enormously fat and has clearly passed those genes on, IMO. If their mum hadn't tried to train them to eat healthily, they would all probably be fatter so this is why it's good to have an awareness of how this works early on. But their genes mean that they will always be fatter than average even if on quite stringent weight loss regimes. Me and my siblings will always be thin, even though I am eating nearly 3000 calories a day and I suspect the others do the same. I probably eat more than twice as much in calorie terms as my very fat cousin.

Interestingly, with my tall sibling, he wasn't always tall. In fact, as a child he was shorter than average. He was always heavier than the rest of us at similar ages, though. Suddenly, when he was about 16, he just shot up. He never looked fat, even when shorter than average. In fact, looking at photos, I have no idea where that extra weight was hiding. He had those skinny boy legs where the knees are twice the size of the rest of him. No idea where I'm going with this! But I do think the whole thing is a v blunt instrument and not as helpful as it could be. I wonder if it would actually be more helpful to look at parents' weights (in conjunction with child weights) and target families where everyone seems to be fatter than average. Or would it be better to zero in on families where the child is fatter than the parents?

I think that the BMI is a tool, nothing more, nothing less. It gives a head up to parents that their child may or may not be overweight. What we choose to do with that information is the key.

I look at my athlete son and know that his weight:height ratio has not taken into account his build and his level of activity, nor has it taken account of the fact that at 12, he is about to hit puberty.

I look at his body, and see he has very little fat. I also look at him over the Christmas period, where he has done very little exercise due to training downtime and illness, and I could see he was turning to fat. He had a nice covering of podge. But I knew that once he started training again, his weight would fall off again.

The BMI does offer a wake up call to parents who might be in denial, and for that reason alone, should continue to be used. But with a little common sense applied. For a child to be 1lb over the expected weight for height is not really significant. If a child is 5-10lbs or more over the expected weight, then parents need to take a hard look at their child and their eating habits.

Ruddy hell - where did I say "all I feed him is pasta and oatcakes" .

He has pasta-based meals 2/3 nights a week (the sauce will contain a protein item) and doesn't snack mych but when he does, it may mweel be an oatcake.

8demi* So now oatcakes can be added to the long list of things I thought were reasonably ok for an occassional snack but are, in fact full of fat/sugar/salt/all three! Wtf can dc snack on?

Agree OP. What I've learned from this thread is that all children's ribs should be showing and if they are not that children are positively overweight, oatcakes are not a generally suitable snack, butter on veg is like heroin and that we are totally lost with regard to food and children. Do we give ourselves and other people this much grief if their children are at a slightly different point on the reading spectrum? Or socially?

This thread to me illustrates how emotive food is and even people who claim to be clear-eyed with regard to food and obesity end up suggesting that the problem is oatcakes.

"Do we give ourselves and other people this much grief if their children are at a slightly different point on the reading spectrum? Or socially?" Blimey, margo, you've clearly never been to the Primary Education section

Agree though

boobiebrain carbs do not make you fat. Fats do not make you fat. Polyunsaturated fats are OK and excess saturated fats are a contributory factor for developing atherosclerosis. Transfats are best avoided completely.

People with insulin resistance (who tend to be already overweight) need to reduce their carb intake but for the majority of adults and nearly all children carbs are not the enemy.

Oh ffs. OPs son is just in the overweight category not obese. He is 4!!4year olds need all food.group a low.carb diet is completely inappropriate as is a very low fat one. He needs energy to run around,stay warm atm and learn.

Op please don't rescrict the range of food you give him. I work on an all things in moderation principle. With a MINOR adjustment if necessary (which from one weight is not remotely apparent).
Yes I am a hcp and have worked with both v. under and overweight children.

"butter on veg is like heroin"! I think thats a tad exaggerated!

What I said was that vegetables were fine as they were and shouldn't need fat added to make them a "yummy treat" or at least not a treat in addition to any other treat that day. And I'm not sure its a particularly good message to send a child that vegetable needs to taste of butter. I even excluded situations where a child needed to put on weight.

Margo - much of what you said I agree with for example I don't believe that every child whose ribs you can't see is overweight. However I do believe that the majority of slim children have visible ribs (from observation of DS and his friends).

However i think there has been every bit as much of an over-reaction to some of the things I (and others with a similar message) have said the other way - have been called a kill-joy for suggesting that butter on vegetables should not be a healthy standard food option! And I'm hardly the food police - we had cupcakes for breakfast this morning I am just totally bemused by how many people who haven;t seen OP's DS and now nothing about him who are so ready to categorically state that he doesn't have a problem and that OP should do nothing about it.

FWIW I think OP's approach is perfectly sensible as she is reviewing his diet and will keep an eye on his weight.

Naughtymum - obese children start as overweight, they don't parachute straight into morbidly obese. I wish someone had taken my weight problem seriously (not obsessively just seriously) when I was just "overweight" maybe then I wouldn't have become morbidly obese.

By the way I was a chubby child/ teenager and managed, despite my obvious disadvantage, to attend an RG university , hold down a professional job, find a man prepared to marry a chubster, have three children, run 4 miles twice a week, run a 10k in 51 minutes, do a second degree etc etc

All that,and chubby too! So ladies all is not lost! If your child is chubby you might find they have a fabulous loving life full of opportunity ( and they might slim down later like I did)

hi again....OATCAKES are great and prob better than biscuits..... but dont assume too much....... brands vary

"and they might slim down later like I did" or they might not like I didn't. And will put themselves at much higher risk of diabetes, sleep apnoea, heart disease and many cancers. Of course we all hope our children will be happy and successful and have a fabulous fulfilling life whatever their shape, size or looks. But it would be nicer if they could do it without dragging around an extra person like I did for most of my life.

"butter on veg is like heroin"! I think thats a tad exaggerated!

Ok- I feel I need to explain this as otherwise I will go down in MN history as some diet freak loon who really thinks that buttered carrots and mainlining heroin are on a par.

It was actually a response to a poster who said that "buttered carrots are better than a plate of chips" .Well, yes, I agree, but buttered carrots are better than a lot of things (my example of heroin was a bit extreme I admit- perhaps pop tart would have been better) but the point I was trying to make (badly, clearly) was that whilst of course it's all comparative , but why compare with the worst rather than think how you can make simple improvements that stack up and your child will barely notice eg non-buttered carrots.

I was that poster.

I don't even think chips are that bad actually. As long as they are made with fresh potato and clean oil.

But i have never been overweight so I subsequently have never dieted, so I guess I look at food differently.

To me food is not just fuel, it is something to be enjoyed. So I buter my veg ( Talking about half a teaspoon here, you do not need much) and like to eat home made chips, home made pizza, pan fried fish ( in butter) , Olive oildin my salad etc.

My ds is 8 and weighs the same as your ds. He is also average height for his age. He has a heathy diet but does 12 hours of formal exercise each week of gymnastics and dance.

Perhaps you could increase his exercise to a more structured sport that will concentrate on fat burning

I also enjoy my food Chandon but half a teaspoon of butter everyday and a coating of oil on salad is enough to push a person who is on the heavy side into being overweight. If you have no problem with your weight and aren't inclined to put on weight then add fat to whatever you like, it really doesn't make any odds if you are healthy and within normal BMI.

I can't add unnecessary oil to food without putting on weight because I like to have a latte and a biscuit or a piece of cake regularly and I can't do both without putting on weight.

We are talking about children who are not within the normal BMI range and may (may) be heading for a weight problem.

In any event I don't particularly like veg with butter on because it tastes like butter not veg luckily