‘Incorrect and damaging’: Babies as young as six months put on diets

A fixation with an “ideal” weight range is driving poor advice, including that young children be put on diets.

Obesity expert Dr Nick Fuller says he’s seen parents with children as young as six months old being told to restrict their baby’s food intake because they are too high on weight-for-age charts.

Fruit is not the problem. Instead, issues lie in restriction, diets and a focus on weight, says Dr Nick Fuller.Credit: Getty Images

“Unfortunately, healthcare professionals are often getting it wrong when it comes to our childrens’ weight,” says Fuller, of the University of Sydney’s Charles Perkins Centre.

“They rely too heavily on weight-for-age charts. And when a child is not falling within the ideal weight-for-age range, they’re prescribing diets and advising food restriction. This is incorrect and damaging advice.”

In fact, Fuller says, such advice may be contributing to the increasing number of children he sees in clinic with obesity, as well as type 2 diabetes and other metabolic disorders.

Though obesity, nutrition and weight management are complex sciences, few healthcare professionals have adequate training in these areas.

“It’s a very small part of their tertiary education, but it’s such an important part of shaping a child’s trajectory when it comes to health and weight,” says the father of two.

“For decades now we’ve been brainwashed to think that if we’re not in a healthy weight range, the way to react to that is to restrict and diet. It’s doing nothing more than contributing to the problem it proclaims to solve.”

Weight will come down when energy intake is restricted, but as the body’s systems slow to try to conserve energy, there is “a cascade of physiological responses” and the body rebounds to its former size.

Restriction and diets also mess around with children’s innate ability to regulate their appetite, Fuller says.

Dr Terri-Lynne South, chair of obesity management for the Royal Australian College of General Practitioners, agrees.

“I think we are far too focused on healthy weight range,” South says, adding that “additional dangers” of a restrictive dieting mentality include a lifetime of poor body image and eating behaviours.

Children grow and develop at different rates. Some children may carry extra fat before a growth spurt and children can be petite or bigger and still healthy, despite sitting at opposite ends of the graph, explains South. She gives this analogy: humans are different shapes and sizes just like different dog breeds.

“So you’ve got your little chihuahuas, you’ve got your bull mastiffs; you’ve got your Great Danes, you’ve got whippets,” she says. “You can’t help your genetics. It’s really about being the healthiest Great Dane or the healthiest chihuahua or the healthiest whippet you can be.”

Some babies as young as six months are being put on diets, says an expert.

Professor Louise Baur, a paediatrician and child obesity expert, adds that monitoring a child’s weight can detect failure to thrive and is an indicator of health, but interpretation is important.

“It’s not the actual value that’s important, it’s the trajectory over time,” she says. “You want to see kids following percentile lines.”

Baur says that if restriction only refers to kids’ intake of ultra-processed foods, soft drinks and screen time, “then I’d say hallelujah”.

Otherwise, even among a subgroup of children with significant weight, metabolic or sleep apnoea issues, who ought to see a specialist, she is “very hesitant” to talk about restriction. “I’d be talking about providing healthy food environments, healthy activity and so-on.”

Children are good at regulating their appetites.Credit: Getty Images

Some principles of good health, such as encouraging children to eat more vegetables, move more and get good sleep are obvious, if challenging in an environment where children are exposed to unhealthy food marketing and ultra-processed foods are affordable, accessible and addictive.

Other principles are less clear.

Despite grand health claims, new research shows that commercially produced infant and toddler food products currently available in Australian supermarkets fail to meet World Health Organisation recommendations.

Doron Lavan, a Melbourne-based father of three says the existence of conflicting claims causes parents anxiety and guilt.

“A lot of the advice is all or nothing and ‘if you do this or don’t do that’ they will be damaged for life,” says the 35-year-old. “You start stressing and that creates a bad environment around food.”

When a nurse told him not to give his children pouches that contained 100 per cent fruit because they were too high in sugar, he contacted Dr Nick Fuller via a Facebook group, asking for advice.

Parents are often told to restrict fruit, as well as dairy and carbohydrates because they’ve been told they are fattening, says Fuller, whose new book, Healthy Parents, Healthy Kids, debunks nutrition myths and provides six foundations for raising healthy children.

“It’s madness,” he says. “If they want to eat six mandarins, that’s perfectly fine. They have naturally occurring sugars and fruit is full of fibre and nutrients that fill them up.”

‘We should never be focusing on a child’s weight. That should never be the goal.’

Obesity expert Dr Nick Fuller

And, provided parents offer mostly whole foods, including fruit, dairy and carbohydrates, children are extremely good at regulating their appetite, he says.

“Some days they’re going to have huge amounts of food and the next day they’ll eat a small amount to compensate,” he explains, stressing that there is no need to restrict their food intake, though not eating for an hour or two before a main meal is a good rule of thumb.

If, however, parents provide mostly ultra-processed foods which are hyper-palatable but have very little fibre and nutritional value, then the child’s hedonic pathway overrides their brain’s ability to regulate appetite.

This matters when the neuronal connections that influence our life-long food and activity behaviours are being established in the first five years of life.

A quarter of Australian children are overweight and almost one in eight are obese. Most children who are overweight or obese will continue to be so in adulthood.

If a child continually tracks in the overweight or obesity range, then the habits in the home need to re-evaluated.

“But we should never be focusing on a child’s weight,” Fuller says. “That should never be the goal.”

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