What should we prioritise: childhood obesity or health?

Top View of Sneakers on the grass with the text: Obesity

Last week, at the same time as presenting a webinar in connectedpe.com on “Upgrading PE to further improve the health and wellbeing of your students”, The Childhood Obesity Summit UK was being held in London. I was keen to read updates about the Summit, and participate in an online discussion as to how we can resolve the obesity crisis we are seeing in our children today. I’m passionate about improving health education for children (hopefully you’ve noticed?!), but what I found, shocked me:

“#childhoodobesity @juliettekellow @cosummitUK asks how we get #obesity recognised? If you see a childs ribs that’s a good sign: use this?” (Source: Twitter @cosummituk)

And after further investigation, I realised that the source of this discussion around ‘seeing a child’s ribs’ may have come from Professor Dame Sally Davies, England’s Chief Medical Officer:

“Too often, parents were blind to the fact their children were unhealthily overweight, and thought visible ribs were something to worry about. I remember in the clinic, parents thinking (it) was unhealthy if their children’s ribs showed. For my generation, that was normal – how have we lost this national knowledge and understanding of what is healthy?” (Source: The Telegraph)

These comments come at a time when we know children as young as eight are unhappy with their bodies, and are therefore at a higher risk of developing eating disorders, and 55% of boys aged 8-14 would change their diet to look better.

So, what a delight…we have a nutrition consultant and dietician, plus the Chief Medical Officer herself suggesting ‘seeing children’s ribs’ is not only a sensible method for recognising a healthy weight, but also that it is ‘normal’ and forms basic knowledge and understanding of what is healthy. Coupled with this, we have concerns for children with body image issues, because our society is so focused on how a person looks rather than their actual health. I suspect this may be a recipe for disaster.

I guarantee I can find you at least 50 people in my gym, golf club and community of PE teachers whose ribs you cannot see, who have a healthy weight, and are some of the fittest, nourished and most vibrant people you could meet. They have a love of movement, the motivation and passion to learn about their bodies, and the ability to coach others to feel great about themselves. I have taught children who take part in every sports club going, compete at weekends in competitions, smile all day, and heartily eat anything that’s put in front of them, whose ribs I doubt you can see.

However, I have also met children and adults, whose ribs you can see, who I would struggle to describe as healthy. Who tell me (at 7 years old) that health is “looking good in a bikini”. Too many adults in gyms are underweight, desperate to lose more weight, and concerned that lifting weights will cause them to ‘bulk up’, and most frightening of all: refusing to look in a mirror (ever). What will this look like in twenty years if we inspect their rib cages at an early age to check their ‘health’?!

So this begs the question: what should we prioritise – childhood obesity, or childhood health?

In response to some of the tweets that day, I posted:

“The answer is BETTER HEALTH EDUCATION – not diets, not ‘seeing their ribs’. We need to educate, not disorientate!”

Consultant Nutritionist Charlotte Stirling-Reed (@SR_Nutrition), a specialist in child nutrition and weight loss replied:

“…but education alone doesn’t work. We know this from NDNS, 5 a day etc etc…”

I agree, to a certain extent. Telling children to eat 5 fruits and vegetables a day hasn’t worked:

“Eight per cent of children aged 11 to 18 years met the 5-A-Day recommendation for fruit and vegetable consumption.” (NDNS, National Diet and Nutrition Survey, Sept. 2016)

When I ask children why they should eat 5 fruits and vegetables per day, usually they answer “Because it’s good for you.” I’d question whether we’ve educated these children, or instructed these children?

And so, we go back to the same problem – education in its knowledge based, didactic form, will rarely have a deep-enough impact. True education comes from children investigating foods, researching the role of vitamins and minerals, and asking questions about things called ‘anti-oxidants’ and ‘polyphenols’, for example.

If children have the opportunity, support and motivation to test and recognise the impact foods have on their body systems, we’ll start to make our way towards a healthier community of people. Our children could be educated by their own bodies: through listening and respecting their body’s reactions. To me, this would lead to better choices in food, activity, lifestyles and fundamentally a decent understanding of basic health and wellbeing.

This is true health education. This is, alongside other health interventions, what will make the difference.

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