Fats and sugars: Should children diet?

The number of overweight children is soaring, mainly due to lack of exercise. But doesn't food play a part too? Mary Whiting explains how to avoid excess calories

It's simple,' someone once told me. 'Fat children should diet!' Actually, it's not that simple. Quite apart from the risk of stigmatising individual children, 'dieting' is not the answer unless it is a medical necessity.

Essentially, a slimming diet is a semi-starvation diet - if you stayed on it long enough you would waste away. It is not at all the health-building diet needed by growing children. On the contrary, children need to eat well in order to get the nutrients they need and to give them enough energy to enjoy playing and running about. It's a circle: children need plenty of exercise to strengthen developing bones and muscles, to burn off excess calories, and to work up a good appetite for the next meal. Sedentary children may not be eating enough to supply all their nutritional needs.

Children's meals should be based on lots of fruits, vegetables and carbohydrates, dairy foods, fish and lean meat, and very little sugar. Snacks (if any) should be minimal - a little milk, fingers of bread and cheese, slices of kiwi, orange or apple, vegetable sticks, mashed ripe banana on a piece of bread. Sometimes children say they are hungry when they are actually just thirsty, so always offer water.

Types of fat

Of course, some foods are 'fattening' or 'calorie-dense'. Fats and oils contain the most calories. We should all get no more than 35 per cent of our calories from fat. At present we get 40 per cent, creating a variety of health problems besides obesity. Some recent research even suggests that eating a lot of saturated fat impairs brain function. However, if children are given too little fat (as would happen if they were fed an adult 'slimming' diet) they would probably not be getting enough energy.

Some types of fat are positively beneficial. These include the fat in 'oily' fish such as sardines, mackerel, pilchards, trout, salmon and herring, which is unsaturated fat, and contains essential fatty acids (EFAs), crucial for good health.

Nuts and seeds also contain EFAs. They should be served finely ground or as nut butter for under-fives, and only if there are no allergic children in the group.

Nutrient-dense fatty foods include milk, cheese, full-fat yoghurt, eggs, liver, kidney, avocados. Although these contain saturated or mono-saturated fats that are less desirable, you should nevertheless serve these types of food regularly because of their huge array of health-building nutrients that children need. The idea is to be able to justify any fatty food you serve.

As for which kind of milk to give, official advice is that children under two years should have full-fat milk, and for two- to five-year-olds, full-fat should gradually give way to semi-skimmed. Skimmed milk is not recommended for children. All cheese is good, especially hard cheeses like cheddar, parmesan and gruyere, as they have the most calcium.

I don't think it matters much whether you serve butter or margarine as long as you don't serve too much. Sometimes the taste of butter is useful; for example, if a big knob of it on the vegetables gets them eaten, then it's worth it.

Fats to avoid

Hydrogenated fat made by treating food with hydrogen is a highly saturated, 'rigid' fat. Watch out for it on labels of many prepared foods and then choose something else. For example, you should buy natural, unhydrogenated peanut butter (usually from health food shops), not the hydrogenated kind.

Fried food soaks up a lot of fat, adding huge numbers of extra calories but no extra nutrients. Deep fried foods such as chips, crisps and similar bag-snacks, and foods coated in batter or crumbs, are especially fatty. Commercially, many of these types of foods are targeted directly at children.

Fatty meat should have all the visible fat cut off before cooking. Gravy should also be skimmed. Avoid cheap mince, burgers and sausages, as these are usually the fattiest. Cheap burgers can be over 40 per cent fat with nearly half of that saturated fat (see issue 50, The Food Magazine, 'Burger Bites').

As for olive oil, use it sparingly, like other oils. It seems the chief benefit of the traditional 'Mediterranean diet' lay in the plentiful exercise that people there took, not in the type of oil they used (Journal of the American College of Cardiology, 36, pp1455-1460).

All about sugar

The sugar that is in fruit and milk ('intrinsic' sugar) is dilute and harmless, but added sugar ('extrinsic' sugar), whether added at home or put into a food or drink by the manufacturer, is another matter. Extrinsic sugars tend to be very concentrated and calorie-dense, but provide few or no nutrients - whatever the type of sugar and whatever the manufacturers' claims.

Look at food labels for added sugars such as glucose, dextrose, fructose, maltose, concentrated fruit juice, honey, and so on. As sugar is not filling it is easy to over-consume.

The market for sweetened soft drinks is booming, and they are now replacing water, milk and real fruit juice as a drink for children. This is a seriously regrettable development for children's teeth, their general health, and their behaviour - sugar can give children a 'high'. Even 'children's' packets of fruit juice drink can be stuffed with sugar, so always check the label. New research shows that children who drink an average of 265ml or more of soft drinks daily consume 835kj more total energy than those who have no soft drinks (The Lancet, 17 February 2001). The study concluded that the odds of becoming obese increased significantly for each additional daily serving of a sugar-sweetened drink.

Artificially sweetened drinks are not, however, the solution. Sweeteners are thought by some to be too much of an unknown quantity for children, and the drinks usually contain acids that erode tooth enamel. In any case, they are no substitute for milk, plain water or, at mealtimes, diluted fresh fruit juice.

Of course, sugar also presents a risk to teeth, so there are two good reasons for limiting it. As many sugary foods also contain fat, cakes, puddings, chocolate and biscuits should be kept for special occasions. One mother I know limits her four-year-old son to two sweets every Sunday after lunch. He regards this as a treat - and has perfect teeth.

Avoid sugary breakfast cereals, 'fruit' yoghurt and fromage frais. Instead, you can buy the plain version, add your own fruit and sweeten with orange juice. You should completely ignore the appalling but growing array of 'children's' novelty foods which are usually very sugary, fatty or both.

Refined carbohydrates

White bread and rice are calorie-dense, and as they are easy to chew they are not very filling, so it's easy to eat large quantities. Wholemeal bread and brown rice are more nutritious than white. Bear in mind, however, that too much high-fibre food is unsuitable for children, as it is bulky and filling and can leave children short of calories. For this reason, cereals that contain added bran are not recommended.

The best solution is simply to make good food delicious, serve it attractively and eat it sitting with the children at enjoyable, relaxed mealtimes, with no mention of 'slimming' or of food being 'fattening'.

Packaged foods

A large part of today's diet problems is that shops are filled with attractively packaged, ready-made foods and drinks that can be very high in added fat and sugar and therefore very high in calories.

Many of these are created for and marketed directly at children. We should be careful about blaming children who pester us for such foods, or blaming ourselves for giving in, because that is precisely what the manufacturers planned to happen. Nevertheless, we are professional-minded adults who are supposed to know what suitable food comprises. We are letting children down if we don't use our skills and our wits to bypass clever advertising and packaging, and give children the type of food they need.