Advice to Promote a Healthy BMI

Childhood is an important time in the development of lifestyle patterns related to food and physical activity that can continue for many years. It is important that families establish good habits that promote a healthy lifestyle for their children. The identification of a child's BMI and weight status is an important step, but is worthless if it is not acted upon.

Understanding Growth

Parents often like to see growth charts, but may need help interpreting them. Parents may be familiar with height and weight charts, but the BMI (or weight-for-height) charts are likely to be new to them and therefore will need explanation. When discussing a child’s BMI chart with parents it is important to tell them that:

  • Growth patterns are individual
  • Growth patterns over time are more important than a single measurement. Repeated measurements every six months is ideal
  • Growth is one sign of general health
  • A child’s growth often reflects family growth patterns – for example a child with two short parents is also likely to be small. However, if both parents are overweight this does not make it OK for the child to be overweight too!

A selection of phrases that could be used to help explain BMI charts to parents are shown below. Some of the sentences impart the same message, but are phrased in different ways.

  • BMI is a figure which represents a relationship between height and weight.
  • The height and weight measurements are combined to give a figure which lets us know if s/he is the right weight for their height and age.
  • For the best health, children need to be within a certain weight range for their height, age and gender, BMI tells us whether they are within this range.
  • We would not recommend that children should lose weight if they are a bit overweight, but rather slow their weight gain compared to height growth.
  • Children should not lose weight, but rather grow into their weight gradually.

Become familiar with some explanations of the BMI chart so that you are able to easily discuss it when it arises in conversation with parents.

Healthy Eating Principles

Australian Guide to Health Eating

The Australian Guide to Healthy Eating (AGTHE) is produced by the Australian Government and is one of the best ways to show healthy eating guidelines. The AGTHE shows the different food groups and indicates how much food from each food group should be eaten.

Breads, cereals, rice, pasta and noodles occupy the largest portion of the plate. These foods help fill us up and are nutritious as they contain some vitamins and minerals, complex carbohydrates and fibre. A variety of these foods should be eaten several times a day and should form the basis of healthy meals and a healthy diet.

Vegetables and legumes occupy the second largest portion of the plate. It is recommended that 5 servings of vegetables and legumes are eaten every day. Vegetables and legumes provide vital vitamins and minerals necessary for good health, growth and development. They also provide lots of soluble fibre, which is excellent for optimal bowel health. Vegetables and legumes are often vibrant in colour, making meals appealing to the eyes and are low in energy so are useful for weight control. A wide variety of these foods will allow people to benefit from all the goodness they provide.

The next portion of the plate is made up of fruit. It is recommended that 2 servings of fruit be eaten each day. Fruit has many of the same health benefits as vegetables, including lots of vitamins, minerals and fibre. Fruit makes the ideal snack food or can be incorporated into breakfasts or desserts.

Parent information sheets:

The last quarter of the plate is made up of protein rich foods. Protein is essential for tissue growth and repair, particularly important for children.

  • The first protein group contains dairy products, such as milk, yoghurt and cheese. Dairy products provide one of the best sources of calcium, which is crucial for bone health. In most children over the age of 2, low fat dairy varieties should be chosen where possible.
  • The second protein group includes animal products such as meat, fish, poultry and eggs, and substitutes such as nuts and legumes. These foods provide essential nutrients that are vital for good health; one to two portions should be eaten every day. Nuts are a choking hazard, therefore great care should be taken if they are given to young children.

It is recommended that people of all ages drink plenty of water. Water does not directly fit on to the plate, but has a vital role on the AGTHE. Water is superior to all other drinks to quench thirst and should be the first choice for children and adults alike.

Parent information sheet:

The last section on the AGTHE shows "sometimes foods" or foods that should only be eaten in small amounts. Foods that are high in sugar and/or fat are included in this section.

Sugary foods include sweets, lollies, chocolate, fruit juices and fizzy drinks. These foods contain very few vitamins and minerals, lots of calories (energy) and are bad for our teeth.

Fatty foods include butter, margarine, oil, pastries, biscuits, chips and take away foods. Some fats are healthier than others. Healthy fats should be eaten once or twice a day, these include oily fish and plant based oils such as olive oil or vegetable oil. Animal fats are not so good for health and can increase blood cholesterol levels, which can contribute to heart disease. Foods in the sometimes section should be used sparingly and kept for special occasions.

It is important that children have as varied a diet as possible. Each food group provides a mixture of vitamins and minerals that are important for health, growth and development. As well as eating the correct sorts of foods it is also important to eat the correct amount of food, therefore we also need to consider portion sizes.

Parent information sheets:

Portion Sizes

The Australian Guide to Healthy Eating indicates the proportion of foods in each food group that people should eat every day.

In recent years, portion sizes have drifted upwards which has contributed to the increasing prevalence of overweight and obesity. Children are much smaller than adults, so their portion sizes should also be smaller.

As a general guide, a portion is considered to be the amount of food that fits into the palm of that child's hand.

However, a child's appetite may vary considerably from one day to the next due to differences in activity or growth spurts. Therefore, for a child to have a healthy diet in the right quantities a general guide is that:

  • Parents are responsible for what foods (and portion sizes) they provide to their child.
  • Children are responsible for what they choose to eat from what is provided.
  • Parents provide, children decide.

Meal Patterns for Young Children

Regular meals and snacks are important for children.

  • Children should have 3 main meals and 2- 3 snacks every day.
  • At least 112- 2 hours should separate each meal or snack.
  • All meals and snacks should be based upon healthy choices, with high fat and sugary foods and drinks being kept for special occasions.
  • Make sure children are seated and supervised, especially when eating foods such as raw vegetables and nuts.

For examples of healthy meals and snacks for children between 2 and 6 years, read the information below.

Breakfast Examples

  • Bowl of non-sweetened cereal (approx 12 cup) with reduced fat milk.
  • 1 – 2 slices of toast with vegemite or peanut butter cut into quarter pieces.
  • Small bowl (approx 12cup) of low fat yoghurt, fruit and oat mix.

Lunch Examples

  • Boiled egg with wholegrain toast soldiers and sliced tomato.
  • Dips such as salsa or humus with pitta bread or crackers and vegetable sticks.
  • Wholegrain bread sandwich with a cheese and grated carrot.
  • Piece of fruit or small fruit salad with yoghurt.

Main meal Examples

  • Pasta with bolognaise made with lean minced beef, carrots, onion, capsicum and a tomato sauce, served with penne pasta.
  • New potatoes, 1 – 2 slices of roast meat, corn and mashed pumpkin and green beans.
  • Chicken stir fry with capsicum, zucchini and bean sprouts served on rice or noodles.

Snacks Examples

  • Fresh or tinned fruit. (Dried fruits are sticky and high in sugar, so only offer these occasionally).
  • Cheese slices, sticks, triangles.
  • Fruit or plain low-fat yoghurt (can be frozen).
  • Raisin bread, fruit loaf or toasted English muffins.
  • Fruit or vegetable muffins, such as sultana, carrot, banana, zucchini or pumpkin.
  • Glass of milk / fruit smoothie.

Drinks

The best drink for children is water (especially if fluoridated).

Fruit juices add to caloric intake and also threaten children’s dental health (not only because they contain sugar and are acidic, but also because they reduce the intake of fluoridated water). Fruit juice should be limited and, when used, diluted at least by half with water. Children should not drink any more than one small glass (125ml / half cup) of juice each day. Cordials, fizzy drinks and soft drinks should also be limited. Children can often fill up on juice and then not feel hungry for nutritious foods at meal times.

It is a common misconception that children between the ages of 2 – 6 years need to drink a lot of milk. Whilst milk is a good nutritious drink, if the child is eating a well balanced diet, they do not need more than 500 – 600mls a day (less if other dairy products such as yoghurt and cheese are eaten). If a child drinks too much milk, their appetite for other foods may also be diminished. From the age of 2 years, reduced fat milk is most suitable.

Parent information sheets:

Activity Guidelines for Children

Young children need at least two hours of physical activity every day. The two hours of activity can be broken up into smaller blocks of time, say 5 – 15 minutes. Activity should be moderate to vigorous intensity.

  • Moderate activity involves getting slightly out of breath, but still being able to talk.
  • Vigorous activity will get the child huffing and puffing.

Research shows that it is much easier for children to achieve moderate and vigorous levels of activity when they are outside rather than indoors.

It is important to remind parents that physical activity does not have to be structured (such as swimming lessons) but includes simple activities such as playing at the playground, going for a walk or simply playing with a friend outdoors.

Limit Screen Time

  • There are very strong links between the amount of time a child watches TV or plays on the computer and long-term obesity and health risks.
  • Screen time should never exceed 2 hours a day for all children and ideally should be less than 30 minutes a day.
  • Children should be encouraged to play outside or indoor activities that develop their skills and imagination.

Parent information sheets: