South Africa is climbing the list of the most obese nations in the world. According to the International Obesity Taskforce, 26 percent of children and adults in South Africa are obese.

“An overweight child is more likely to become an overweight adult and is at higher risk of heart disease, diabetes, orthopaedic problems, sleeping problems and depression,” says Gauteng paediatric dietician Deborah Jacobson. To avoid obesity, it’s vital that good eating habits are taught from a young age and children are encouraged to be active.

Size does matter

It starts with knowing how much to feed, and what portion sizes to give. “The food pyramid has been the food guide we all adhered to. However, now there is a move towards the ‘food plate’ as the new nutritional guide,” says Jacobson. “The concept of the ‘food plate’ is to teach us practically, and visually, how to divide and choose foods from the different food groups on our plate for meals.

“Although there are five food groups – dairy, meat (protein), vegetables and fruit, starch and fat – we like to simplify things when it comes to children. Starch and fats are considered ‘energy foods’ or ‘go foods’ while protein and dairy are grouped as ‘protein’ or ‘grow foods’. The food plate is for meal times only. Generally, dairy products are taken as snacks, or with cereal, so these are not included on the plate. The plate is divided into three sections: half is assigned for vegetables (cooked or raw) and fruits. The remaining two-quarters are for proteins and starches (preferably wholegrain varieties).”

No need to eat up

While it’s important that parents encourage their children to eat a balanced diet and exercise regularly, one should never “pressurise” a child to the point where they develop a power struggle over food.  To avoid obesity, parents should set realistic nutritional goals for  their children.

“One of the most common mistakes parents make is forcing their children to ‘clean their plates’,” says Paula Lawson. Lawson is a Durban dietician who specialises in the dietary requirements of children from the age of six. “If your child won’t eat their vegetables, for example, and so can’t complete their balanced meal, that’s fine, but then don’t offer them anything else to eat as a substitute. Should they ask for something else, tell them ‘if your tummy is full for healthy foods, that is fine, but then your tummy is full for all food. There is no more to eat’.”

Moms often feel guilty that their child is not eating all their food, so they offer a myriad of unhealthy alternatives after the meal. But, when it comes to food, there should never be emotions attached. Don’t use food as a reward and don’t use it to comfort your child.”

“Just by changing a few things in your child’s diet, you can make a big difference. Give your child water to drink instead of juice, don’t stock the fridge and pantry with junk food and ensure that veggies and fruits are available at all times. Most importantly, lead by example – follow a healthy lifestyle yourself,” says Lawson.

Menu guidelines to help avoid obesity

Because children have different needs based on their activity level, age and sex, it’s difficult to generalise how many servings of each food group are recommended for the various age groups. However, there are basic guidelines for children between the ages of two and 13. The Nutrition Information Centre at Stellenbosch University says a portion of meat, grains, fruit or veg is equivalent to one tablespoon for each year until the age of 12. So a six-year-old would have six tablespoons of meat. As a rule of thumb, children should eat:

Milk or dairy products

Two to three servings a day. One portion is 250ml of milk, 175ml yoghurt or one matchbox-size piece of yellow cheese.

Protein foods

Two servings a day. One portion of meat or chicken is the size of a child’s palm or a hand-size of fish, or one egg.

Starch

Six to ten servings a day. One portion is one slice of bread, three crackers, a fist of pasta, potato, corn, mash or rice.

Vegetables and fruits

Five servings a day. Half a cup cooked or one cup of raw veggies and one fist-sized fruit or half a cup of fruit salad. A fist-sized fruit is one apple, peach, orange, etc,

Unsaturated fats

Not more than three servings a day, or 30 percent of their daily calorie intake. A portion is one teaspoon of canola or olive oil, two tablespoons of avocado or a handful of nuts – only for children older than three. Two portions of fish a week, of which one can be a child’s palm size of fatty fish such as tuna or salmon.

Other tips from the dieticians to help avoid obesity

• If you suspect your child is overweight, take them for a professional assessment by a doctor or dietician.
• Incorporate exercise and physical activity into your child’s daily routine.
• Enrol your children in extramural sports at school.
• Cook nutritious home-made meals and steer clear of takeaways.

for babies aged one to two

• Breast-feed your baby as long as possible.
• Opt for home-made puréed food over commercially sold baby food as a healthier option and don’t add salt, sugar and processed fats.
• For babies under the age of two, full-cream milk is recommended.

for children aged two to six

• Use your child’s palm and fist size as a guide to portion sizes.
• Choose a diet that provides enough calcium (dairy) and iron (protein) to meet your growing child’s needs.
• Do not force your child to clean his plate.
• Do not “reward” your child with food.

for children aged six to 13

• Your child should be eating three meals and two nutritious snacks a day.
• Limit your child’s screentime and encourage them to participate in other fun activities.
• Ensure your child eats a healthy breakfast every day.

Vanessa Papas

Learn more about children’s common eating disorders and how to recognise them.