Childhood Obesity: Webchat with Professor Paul Gately, Friday 6 July, 12-1pm

[RachelMumsnet]

Today one in three children are overweight or obese and research suggests that, if untreated, 85% of these children will become obese adults. To coincide with National Childhood Obesity Week Professor Paul Gately is joining us on Friday at 12 midday for a webchat about childhood obesity.

Professor Gately has over 20 years research experience in the field of childhood obesity and the study of weight loss programmes throughout the world. He formed the MoreLife programme which works across the country in partnership with the NHS to deliver specialist weight management services.

Paul has presented a number of television programmes on the subject of childhood obesity and is a spokesperson for Change4Life. He is also consultant to many government agencies, health organisations and corporations throughout the UK and internationally.

If you're worried your child is obese, or you have concerns about their diet or want advice on how to help them lose weight, join the webchat on Friday at midday or post a question in advance to Professor Gately.

[StillSquiffy]

No, he has one desert a day. If he has desert at school he will tell me and not have desert in the evening.

And yes, we have thought about making him not have deserts at all. But we'd then have to ask him to self-moderate and avoid all deserts at lunchtime, which TBH we think is a big ask of an 8yo, especially when all his friends are around him. We think it could end up with food issues for him (which are creeping in anyway, because he is so upset at being teased). At least this way he has a think, works out if he really wants gypsy tart or a fab lolly, and he usually chooses the lolly which TBH we think is OK. If it were just a question of deserts we would have got the whole problem licked (so to speak).

The bigger issue is when he eats one chicken breast, get half of another one for seconds and still wants more. And more.

[tripletipple]

swanthing you say you found my comment about snacking "really odd". France was the first country in the EU to report a levelling out of childhood obesity after the government introduced regulations to tackle the problem some of which were targeted at stopping snacking such as, I believe, cutting out snack in nursery and removing vending machines from schools.
As another person who grew up in the 60s/70s and never snacked, I don't recall feeling hungry between meals. Your comments show that snacking has become so normalised in this country that some people believe it to be necessary.
I am interested to know PG's views on this.

[SpringGoddess]

tripletipple I agree with you on snacking - we are constantly feeding our kids - its like we fear them being hungry even for a second, there is nothing wrong with a child feeling hungry and looking forward to dinner. Constant snacking is bad for dental health too, it introduces a constant eating habit, I just don't see how it is necessary for most people.

stillsquiffy I feel for you and your ds that sounds awful. Like his appetite hormones are not working the way they should do. You say our ds would eat a second chicken breast - he'd be better to eat lots of chicken and some veg till he was full - lots of people who struggle to control their eating, do so naturally when they drop starch and sugar.

[nicolamary]

SpringGoddess I watched the diet doctor video and had a look at the site last night, so interesting and the theory seemed sound. However, my question is this, do children need some carbs to maintain healthy development? Today I have sent my daughter to school with cooked chicken, ham and cheese in her lunchbox and no carbs. She had porridge for breakfast.

[SpringGoddess]

I can't answer that question nicola but my gut feel is that we are feeding our dcs too many carbs, you could try halving the portion of carbs and directly swapping it for more protein - especially wheat carbs. Dr briffa on the web chat the other day suggested a small portion of potato but that was not for an over weight child. I believe you need a small amount of glucose for the brain but the body can produce this from fats and proteins. Brain development requires essential fatty acids and on low carb you should get those in buckets!

By the same token don't over do the protein though, I'm not sure how much protein is too much for your dc....but excessive protein isn't good either for the kidneys. It would probably be best if you could find a sympathetic doctor or dietician to work out a lower carb diet for a child.

Lower carbing is a way of eating that is very sustainable - you don't feel hungry like on low calorie diets but I don't know how much research has been down into applying the theory to children's diets, it's still such a controversial area - even for diabetics where you'd think it would be readily accepted by doctors, my dad who is type 11 is still being told by dieticians to load up on carbs and then take drugs to control the damaging effect the carbs they have recommended cause - it makes me so angry!

[Indith]

I'm interested in this lowcarb talk, we eat a Lot of pasta! Thankfully I think as a rule we have a pretty healthy diet and none of us has any weight issues. Could one of the low carb enthusiasts post a fairly normal family meal plan for a couple of days so we can see the sort of things you would eat to compare to our own diets?

[PostBellumBugsy]

My questions for Professor Gately.

1. What profit did your company MoreLife make in the last financial year?
   

1. Looking at the MoreLife website the thrust of the advice seems to be eat less, exercise more. This is the advice that the NHS has been giving for the last 30 years & given the population is getting fatter & fatter, do you feel that this is good advice to give?
   

1. What are your views on the increasing evidence that suggests as populations start eating vast quantities of carbohydrate they get fatter, regardless of the exercise they do?
   

1. Historically, the traditional way to build an appetite, was to exercise - surely as you expend more energy, your body wants to replace it and therefore you get hungry after exercise? Equally, as you consume less calories, the metabolism slows down to conserve energy. Would it not be better to look at the change in food intake in the last couple of hundred years, and particularly in the last 40 years and address that?
   

1. Given that as a population, we have more access to recreational facilities and have more leisure time than ever before - why are we still getting fatter?
   

1. What are your views on the sponsorship by companies like Coca-Cola of sporting events, the British Dental Association and other nutrional organisations?
   

1. What are your views on the very successful lobbying campaign conducted by food manufacturers & in particular cereal manufacturers (such as Kellogs) to prevent Ofcom banning the advertising of junk foods to children?

[vezzie]

Springgoddess - I agree about the snacking. I hate it when we are out with friends in the afternoon and someone produces "healthy" cereal bars. My 3yo dd has a very finite appetite and I know after she eats that she won't eat as much of the salmon and broccoli (say) I am going to put on the table in an hour's time. I actually believe that if people didn't go on about food so much - the constant babble of "health"-talk (half of which is wrongheaded) trying to compete with the constant babble of advertising from the people pushing this stuff - it wouldn't have occurred to my friends to pack a snack for a 90 minute play in the park. And I think we are expanding our children's appetites (in some cases - some people are more prone to feeling hungry than others, but those who are lucky enough to be without that impulse aren't without it for long in this culture, and I am afraid it will change my dd's appetite)
Don't get me wrong, if dd says she is hungry I will give her something. But she usually doesn't and there is no need to raise the issue. I feel it is constantly being raised for her, around her, and it is not in our or our children's interests.

So I suppose this is my cheeky second question (closely related to the first) - don't you think that all this talking about healthy eating adds to the problem? Even if the advice was good, the message is still: consume, consume, consume

[berthabean]

My Question: Do you have advice for a parent of a 6 year old disabled child/wheelchair user rapidly gaining weight even though she doesn't graze or snack badly and I home cook all our meals and don't eat sugary cereals or have sugary drinks. I've changed from full fat milk to semi-skimmed but really need any other ideas and advice. Thankyou

[SpringGoddess]

I agree vessei I can't quite believe the amount of junk that gets handed over to dcs in the playground on meeting their mums or dads - they don't even seem able to wait till they get home. I overheard one mum practically force a cake on her chunky kid - the previous week she had been moaning to me about his endless appetite - what's going on there?

My dcs notice all the cake eating and complain that I don't bring along a bag of cakes everyday - but there is no way I am starting that, no way.

[SpringGoddess]

Thank you Postbellambugsy for asking the questions I should have asked rather than getting all ranty

Rather nervously I'm posting our weekly menu


It's meant to be simple, dh is cooking due to me being ill!

Steak with chilli & garlic cauliflower and buttered courgettes - dcs had roast chicken with peas and salad pots - I wanted chicken leftovers for curry the next day and dcs struggle with steak.

Chicken korma served with green beans - dcs will have brown rice

Warm cauliflower, bacon, egg & spinach salad with steamed fish - dcs will either have salad potatoes or homemade wholemeal rolls ( made once a week and frozen)

Roasted pepper & preserved lemon salad with roast chicken - dcs will have some roast potatoes - always with skins on! Maybe something green in butter.

Steamed fish with fresh tomato & caper sauce with broc - potatoes for dcs

Shoulder of lamb with veg mash and green beans - dcs will have crushed potatoes and mint sauce.

Lamb curry using leftovers with cauliflower rice for adults and brown rice for dcs - although dcs like the cauliflower rice.

No processed cereals for breakfast.

[lovelydogs]

Sorry, running out of the door..just wanted to say thanks to the people who replied to me yesterday and spring I will hunt that book down! This morning I recieved my Low GI Vegetarian cookbook (Dr Jennie Brand-Miller) which I assume is the same thing as low carb?

The other sunday I did a roast with all the trimmings (don't have it every sunday) my DD had a battered Quorn chicken fillet, she ate it and said it was a nice dinner but she could have eaten TWO fillets!

[JaxTellerIsMyFriend]

Will be interested in reading what is said regarding girls/puberty/overweight.

My DD (just 9) is above average height and above average weight for her age - according to paediatrician - not fat, but she is bigger than other girls her age, in height and 'size'. It bothers her hugely and it upsets me to see her upset. We have also just been told that she is on the cusp of puberty and to expect periods in the next year. She is 'budding' amongst other things. Her little body is changing shape and I want her to feel comfortable in her own skin.

We have written a food diary and it is perfectly healthy, lots of veggies, fish, fruit, salad, some sweets, some ice cream. Portion size seems to be fine too.

Total loss what to do to help my DD. She swims, trampolines (in garden) and we walk to school often.

Not sure what my question is, but hope you can help.

[Indith]

Thanks SpringGoddess :)

I think looking at yout menu the first thing that springs to mind is cost. A heck of a lot of people cannot afford to feed their family in that way, the relatively large amounts of nice meat are out of the question. We do ok, we are not rich but we are not quite scrabbling down the back of the sofa for pennies and we eat stews, things with mince, bacon scraps. We do pad them out with a lot of lentils and beans. However I do think I need to be better at menu planning, making nice salads to go with the spag bol so we eat a bit less pasta and so on.

[SpringGoddess]

indith I completely agree with your comments about my weekly menu. It is not a normal week in this house, I am unwell so I planned a week of easy quick food which for dh evolves very few ingredients cooked with little prep.

I agree that menu planning makes things easier - I am relatively inexperienced when it comes to meat cooking, I want to learn how to cook the cheap cuts slowly to get the best flavour from them, I'll get there soon.

The roast chicken - I get 2 meals and the dcs lunch from and I make stock with the bones - nothing goes to waste.


Whatever we have the leftovers are eaten the next day and we make a basic creamy soup with the leftover veg we have. So while the ingredients for low carbing will always be more expensive you can work it so that very little is wasted.

Worth noting the relative cheapness of carbs has probably contributed to the obesity epidemic - see High Fructose Glucose Syrup and the subsidies it gets from the US Gov which make it cheap, cheap, cheap!

The week I had planned before i got ill looks slightly cheaper - I hope!

Low carb Mackeral fish cakes with green salad - pots for dcs
Low carb Moussaka with salad & green veg
Beef korma with cauliflower rice or brown rice
Savoury cheesecake with salad
Pumpkin curry with cauliflower rice or brown rice
Red pepper & goats cheese timbales with avocado & lemon salad
Day seven is always pot luck - using up stuff from the fridge

[Indith]

I need to get the dcs into curries, they are great but one of the only things they are suspicious of! Last night we had a lovely bean stew with a couple of tins of beans, atin of tomatoes and a bit of chorizo. Yummy. I did give it to the dcs with a bit of pasta though. Sadly ds1 hates potato, always has. I love fish cakes, might make some for tonight actually, fish cakes green beans and rice :)

[SpringGoddess]

Alec Baldwin interviews Dr Robert Ludstig paediatric endocrinologist on the effects of insulin and sugar on obesity in children.

www.wnyc.org/shows/heresthething/2012/jul/02/

[RachelMumsnet]

Paul Gately is about to join us and attempt to get through as many questions as poss over the next hour.

Just a quick note that MoreLife have FREE, week-long summer clubs running this school holiday; to see if they are available in your area, see j.mp/M8FBQ4

They also have FREE places available on their famous residential summer camp (in Yorkshire) for young people from Camden, Doncaster and North Yorkshire. To find out more about the camp see j.mp/KQGrQG (Conditions apply)

Over to you Prof Gately...

[PaulGately]

@berthabean

My Question: Do you have advice for a parent of a 6 year old disabled child/wheelchair user rapidly gaining weight even though she doesn't graze or snack badly and I home cook all our meals and don't eat sugary cereals or have sugary drinks. I've changed from full fat milk to semi-skimmed but really need any other ideas and advice. Thankyou

Really difficult question, we have some expertise in working with disabled children but, there are few services or research in place. My advice would be to see food and activity as just parts of normal daily lifestyle. Keep positive on these behaviours and as you have already outlined you are doing many of the right things. Keep monitoring your child's behaviours just like you monitor their school work thier health and their overall well being. where you see the need for action read, gather information or ask for advice. good luck

[PaulGately]

Hi everyone, I'm looking forward to answering your questions. Lots in already i better get going!!

[yolo]

Hey how can I hear this??? PLEASE HELP!!!

[PaulGately]

@SpringGoddess

Alec Baldwin interviews Dr Robert Ludstig paediatric endocrinologist on the effects of insulin and sugar on obesity in children.

www.wnyc.org/shows/heresthething/2012/jul/02/

Yes sugar is very important issue. we are learning more and more about its impact on the body. It will always be part of our diet but it should be used sparingly in the diet as the eat well plate suggests.

[PaulGately]

@Hervana

What are your thoughts on BMI index particularly in relation to children?

DS was born on 90th centile in red book and stayed there until he was two. Health visitors loved him being so 'big' lots of healthy weight comments, he never really dropped weight even as a newborn (he was exclusively breastfeed til 6 months then baby led weaned btw)

So imagine my shock when we recently recieved the healthy start letter from school at the start of the year (DS now just turned 5) stating that DS was very overweight and 98 on the bmi index. I don't get it? These messages seem very mixed to me

DS father is very well built and always will be perhaps my DS is too? He certainly doesn't seem overweight I can see his ribs when he is undressed!

Is using BMI a good way to ascertain overweight children? How does using the BMI index correlate to the weight gains etc used in the red book?

BMI is a valuable tool, it really does help us address the issue of weight, by understanding where children are at in their development. Despite it's critics it has a range of benefits. We did a study recently that showed it is more likely to underestimate levels of weight rather than overestimate it, so its actually a conservative tool and unlikely to wrongly classify someone as overweight or obese when they are in the normal weight range

If you do get a letter or informed by a health professional, dont see it as a criticism its a piece of information that you can act upon. Just like their maths scores or SATs etc. Just like their maths scores beign able to improve through some lessons, so weight can change through a change in behaviours. Its an indicator and i would suggest assesment over time. MoreLife run a range of free services across the UK that helps parents deal with the weight issues of their chidlren. I would say look at our website if you are concerned.

[PaulGately]

@MyAmygdalaDidIt

Are interventions for childhood obesity effective or should we be more focused on prevention as a society?

Great question, if fact the evidence base shows that interventions for childhood obesity working with overweight and obese children are effective. This is in contrast to prevention programmes that often don?t show effective outcomes. But I think the prevention / treatment debate is slightly confused. What is the objective is the most important question, are we trying to prevention weight gain (primary prevention), or are we trying to prevent ill health (secondary prevention). Whilst they are linked, they are not the same thing. Obese children are at much greater risk of ill health so to prevent these consequences we must treat obesity in these children. Whilst you might be surprised to hear this, the action around obesity treatment is minimal. We have done an analysis of the investment made by government between 2005 and 2010. It shows that over that period of time government spent £5bn on primary prevention compared to £30m on treatment of childhood obesity (or secondary prevention).

It is widely accepted that about 33% of our children are overweight or obese, so it does seem strange that we spend 0.6% of the budget on 33% of children that are more likely to have health consequences of obesity. I strongly believe that both primary and secondary prevention are important, but I also think we need a better balance to help those children that really are in need. As an organisation that provides free weight management services to children and families across the UK, MoreLife are surprised by the lack of support despite the large need and demand for high quality services.

[PaulGately]

@StealthPolarBear

And if we d focus in prevention, what's the best way to do it?

We basically need a plan, I think most of the plans that are put forward by government, (this one and the last) are wish lists rather than a clear plan. There is no one person (i.e. a minister) or organisation that is responsible for the issue, so it should not be a surprise that we are not doing a good job at tackling obesity. In addition to the lack of leadership, the resources that are made available are small. Obesity costs our society nearly as much as the interest payments on the national deficit (£35bn vs £43bn per year) but the government action is comparable. In most local government plans obesity is identified as a top 3 priority, however, there are often no funds to support services. I think it?s critical to get the systems right and not just blow hot air about the issue but take real action.

I would also say that we need to reframe how we view overweight and obese children and people. There is so much negativity about the issue that most obese people are demonised and stigmatised. These attitudes are both unfair and unhelpful. So I think the most important change we need is in attitudes towards the obese.