By Rebecca Pilkington, Outreach Officer

Last week I attended the EDUcatering Forum 2015 representing ANH-Intl on their childhood obesity panel debate, chaired by Jane Renton.

It was gratifying to be able to present ANH’s Food4Kids guidelines to such a relevant and interested audience that understand that if we don’t change the way children are being fed, obesity rates are only going to spiral further out of control. The latest UK public health statistics for 2013/14, show 19.1% of children were obese and a further 14.4% overweight, in year 6 (aged 10-11).

That is a staggering 33.5% — a third of the UK school population. Between 1993 and 2013 obesity numbers in adults rose from 14.9% to 24.9% in England, almost a quarter of the population. Demonstrating that rather than reversing the childhood obesity trend, it actually gets worse into adulthood.

Alongside myself, the other members of the childhood obesity panel were Myles Bremner from the School Food Plan and Robin Ireland from Health Equalities Group. The audience consisted of local authorities, school caterers and chefs keen to provide the best food to children in the UK.

On 28th October we published an article entitled Instilling Healthy Food Habits in an effort to break the cycle of ‘deadly diets’ being perpetrated on children. Conditioned habit patterns are cemented in children by the time they are 5, whether they be good or bad habits. Childhood is a fertile time to instill healthy eating habits that take in food frequency (no snacking), eating whole, unprocessed, phytonutrient dense foods and nurturing a love of flavour to extend and mature the palate. School meal providers have a vital role to play in the food education of children given the extent to which children are exposed to school meals throughout their education.

10 key contributors of childhood obesity

  1. HOLLOW CALORIES. It’s not just too many calories in and not enough out, it’s the quality of those calories. For example the effect of 100 kcal of white bread is entirely different to that of 100 kcal of broccoli or oily fish. Plant-based diets are extremely rich in a whole range of micronutrients that support metabolic processes and act as anti-inflammatory agents and antioxidants

  2. INSUFFICIENT PHYSICAL ACTIVITY. Sedentary lifestyles are an issue linked closely to excess consumption of simple carbs. Less focus on team sports at schools, sale of school playgrounds, rise in TV watching and screen time among kids, fear of allowing kids to play outdoors unsupervised (post-Jamie Bulger), dissociation from nature through increased devotion/reliance on technology, all play their part.

  3. MANY KIDS ARE OVER-DEPENDENT ON CARBS (ESPECIALLY SIMPLE CARBS) AS THEIR ENERGY SOURCE. Whilst the body prefers fats (9kcal/g) for fuel, it can derive its energy from carbs (4kcal/g) and protein (4kcal/g). Children’s diets these days are over-reliant on starchy carbs (e.g. from white bread and pasta), sugars (especially sugary drinks and fructose in concentrated fruit juices) and refined carbs (e.g. highly processed cereals like many types of breakfast cereals). The UK’s Food Standards Agency (FSA) says 50% of energy should be derived from carbs, we say it should be around 35% with healthy fats being the most important source of energy. It’s worth remembering that fruit and vegetables are good source of complex carbohydrates.

  4. ADDICTION. Many kids effectively have become addicted to junk foods. This addiction being both physiological (i.e. in order to avoid hypoglycaemia when facing a sugar crash as they are often not beta-oxidising fats sufficiently or consume too few healthy fats in their diets) as well as and psychologically (via reward/hedonic circuitry within the brain, central and enteric-nervous sytems).

  5. SUGAR SUBSTITUTES. In recognising that most kids are over-consuming sugar and fructose, many soft drinks (fizzy drinks, squashes and cordials) have moved to using non-nutritive intense sweeteners. These are usually synthetic (e.g. aspartame, saccharin, sucralose, acesulfame potassium) while others are natural (e.g. steviol glycosides). They still trip the reward circuitry in the brain and still trick the brain into thinking it has received sugar. This is in turn causes an insulin spike so will feed into addiction and insulin resistance (the precursor to type 2 diabetes) for many. Some parents think that by giving their children products sweetened with fructose (e.g. purified form, or from sources such as agave nectar) they are helping their kids to lose weight. But while the glycaemic load of fructose is lower, it places the liver under stress and the sheer amount that kids consume can overwhelm their capacity, hence the issue with high fructose corn syrup (HFCS) and fatty liver disease.

  6. GOVERNMENT ADVICE. Dept of Health advice via Eatwell plate is part of the problem, not part of the solution. See ANH’s 4 plate shoot-out for a deeper understanding of why our guidelines are so different from government advice.

  7. GENETICS & EPIGENETICS. Every individual has a different way of metabolising energy and processing food. There are different requirements between males and females, so blanket recommendations tend to fail. Health is ultimately the expression of a very complex set of interactions between our genes and our environment, and we now know some of these differences may even be inherited. The rapidly emerging scientific discipline of epigenetics is now providing us with more and more useful information to help us individualise approaches to overcome obesity and other metabolic disorders.

  8. MISPROGRAMMING OF CHILDREN. Most of our dietary and lifestyle behaviours are programmed by the age of 5. Low levels of outdoor activity, team sports, excessive screen time, limited diary exposure, junk food, etc is causing children to adopt diets and lifestyles that will express with an even higher rates of health dysfunction than those we see in adult populations today.

  9. PSYCHOLOGICAL FACTORS. Excessive levels of stress drive people to seek sugary foods as ‘comfort foods’ because they satisfy the reward system in our enteric-nervous system.

  10. PROCESSED FOODS/INAPPROPRIATE COOKING & FOOD PREP/TV DINNERS. Many kids are forgetting how to use cutlery and are more used to nibbling finger foods in front of the TV then they are sitting at a dining room table with cutlery. The UK has one of the highest rates of out-of-home eating in Europe and the highest obesity rate. Highly processed carbs are broken down to glucose very quickly. Processed foods are often rich in the wrong (omega 6) fats, skewing our omega 3 to omega 6 ratios even further in the wrong direction (should be around 1:2, but often 1:16-20). High temperature cooking denatures delicate proteins, damages heat-sensitive fats (e.g. olive oil), cross-linked sugars (glycosylation), creates carcinogenic compounds (e.g. heterocyclic amines and polyaromatic hydrocarbons) on browned/blackened meats, and yields acrylamide (on baked cereals, roasted coffee, fries, chips/savoury snacks, toast, etc), which is classified as a probable carcinogen by the IARC/WHO.

Top tips for school meal providers:

  1. Increase in healthy dietary fats, especially omega 3 fats from oily fish, flaxseeds and walnuts. They are essential for growth, brain health and motor development. We have also evolved as human beings to survive by burning fat for energy rather than carbohydrates. Burning fat (beta-oxidation) is a more efficient, ‘clean’ fuel that promotes metabolic and immune health and reduces the risk of chronic disease. Constant consumption of starchy and refined carbs switches off our inherent metabolic protective pathways.

  2. Reduction in refined carbohydrates and a move away from grains. Complex carbohydrates can be consumed through vegetables that provide an abundance of vitamins and minerals, plus fibre. We don’t need empty calories for energy production.

  3. Removal of soft drinks, including fruit juices, as unnecessary sources of sugar that put kids on the roller coaster of blood sugar imbalance. Such blood sugar imbalances are linked to excess aggression, poor concentration and anxiety. The addictiveness of sugar lays down the neural pathways that lead to comfort eating. Water should be the drink of both choice and availability.

  4. Prepare and eat wholefoods (follow Food4Kids guidelines) and promote eating at tables. Cut out junk food from the menu and institute healthy cooking/eating concepts for children e.g. mindful eating, engaging with food.

  5. Kids should not consume more than 10% of their total energy from ‘free sugars’ daily. That is consistent with the Scientific Advisory Committee on Nutrition’s guidance from July 2015. Therefore for a 2000 kcal diet, that would mean a limit of 25 g free sugars per day. Free sugars include all added sugars, excepting those naturally contained within real, whole fruit or in dairy.

  6. Be active every day. You cannot separate diet from activity. They work together synergistically, so school lunches should be organised as much as possible, around activity. In general kids should be active for at least 1 to 2 hours every day, preferably more, with at least 30 minutes of this activity being high intensity (causing sweating). Kids also benefit from engaging in team sports to that they also learn teamsmanship, sharing, coordination and skills. This also motivates them to stay active. Active children are less prone later in life to chronic diseases associated with ageing.

Consensus

Our thanks go to Jane Renton of EDUcatering Magazine for both the day’s forum and the foresight to include this important debate. The panel member’s agreed that whilst no one wants a ‘nanny state’, the right guidelines need to be provided to both school meal providers and parents if our children are to be protected from the fate of obesity currently facing too many of them.