Country – France
Prevention of obesity and overweight among children in France
Obesity and overweight affect respectively 3.5% and 14.5% of children in France. These figures doubled in the last ten years. In order to prevent what has become a real public health problem, the French Association of Nutritionist Dietitians (AFDN) strives to raise awareness amongst public and professionals on the recommendations from the French National Authority for Health (HAS).
Dietitian’s mission: preventing overweight in children.
According to AFDN, the dietitian involved in a multidisciplinary team (GP and/or pediatrician, psychologist, social worker), has two substantial concerns: helping to get on a healthy diet after an overweight diagnosis and fighting inactivity.
To prevent overweight, the dietitian relies on monitoring of Body Mass Index (BMI) percentile obtained by measuring the size and weight several times a year. If weight is stable without associated pathology, only weight gain is monitored. Otherwise, the goal is to reduce weight in a reasonable and progressive way (as the child grows the weight stabilization in the year helps to decrease the BMI).
To prevent inactivity, the dietitian assesses daily activities and physical abilities. The goal is very simple: to encourage the child to move without compelling him, and without weight loss targets.
To understand and anticipate risk situations through dialogue and listening.
When confronted with overweight and obese young patients, the dietitian and her team try to build a relationship of trust with the patient and his family in order to identify all the factors that contributed to weight gain: family medical history, socio-cultural factors (sleep rhythm, screen time) and eating habits (meal structure, time and duration of meals). The effectiveness of nutritional, medical, psychological or even social support relies on the quality of this relationship. Families proceed to an early nutritional assessment for their child because habits are easier to modify before the age of 10. Consultation time also constitutes a good opportunity for the dietitian to evaluate the level of families’ involvement.
The AFDN dietitian identifies situations like the following:
The dietitian includes common sense solutions
A child who eats fast often eats larger quantities, and he should be encouraged to take longer time eating the meal.
A 4 year child who is fed the same amount as a 10 year old should be taught to adjust quantities according to age.
A home alone child after school should have access to appropriate snacks to prevent nibbling on cakes and sweets.
Children need to learn to eat a little bit of everything in reasonable quantities. It is more about providing a daily balanced diet that contains all the indispensable nutrients. Pleasurable foods like a small cake or a piece of chocolate from time to time will not damage their health.
The messages on the dangers of sweetened drinks are becoming better understood. But, they should not be replaced by fruit juices that are just as sweet. To hydrate nothing better than water. And finally, meals can be an opportunity to exchange and to share within the family, not only while eating but also during their preparation.
ASSOCIATION FRANÇAISE DES DIÉTÉTICIENS NUTRITIONNISTES
French Association of Nutritionist Dietitians