It is vital for parents to understand lifestyle factors that determine the healthy growth of their children.
ARE parents aware of what their children are consuming, how they eat and in what environment they are eating in? In our cover story on “Ensuring children chomp on healthy treats” last month, we focused on the enforcement of the Healthy School Canteen Management Guide to limit the access and availability of unhealthy food and drinks to school children.
In this issue, we feature experts who give their take on the role parents play in ensuring their children’s diet contain a healthy amount of nutrients and the different benefits of consuming wholesome food.
We often hear from our neighbours or relatives how they get caught up with work commitments, subsequently handing down their parental duties to caretakers or the child’s grandparents.
When this happens, more often than not, parents are left unaware of their child’s eating habits.
Many rely on food provided by the child’s school canteen, despite knowing the various unhealthy treats that are served on the premises.
The Education and Health Ministries have taken considerable measures to ensure healthier options are served in schools.
Health Ministry director-general Datuk Dr Noor Hisham Abdullah told StarEducate recently that efforts to “healthify” school canteens began in 2016, in collaboration with the Education Ministry under the purview of the National Plan of Action for Nutrition of Malaysia 2016-2025.
The new guide, known as the revised “Healthy School Canteen Management Guide”, will be enforced this year to limit the accessibility and availability of unhealthy food and drinks to school children.
Meanwhile, school canteen operators are given a strict list of banned food that cannot be sold in government school canteens. While schools play a significant role in ensuring healthier options are dished out to students, parents play a role no less important.
Experts weigh in
It is vital for parents to understand other lifestyle factors that determine the healthy growth of their children, says Assoc Prof Dr Hazreen Abdul Majid. A child is too young to understand how to choose a healthy selection of food by themselves and parents always know best.
“It important to educate them at an early age on nutritious food. When they start young, it is easier for them to adapt to the environment and adopt a healthy lifestyle as they progress in life.
“The more you expose them to healthy options, the more it becomes a habit,” adds the Universiti Malaya Faculty of Medicine, Centre for Population Health and Department of Social and Preventive Medicine associate professor of Nutrition and Dietetics.
Echoing Dr Hazreen, Assoc Prof Dr Muhammad Yazid Jalaludin says the responsibility to ensure a child’s diet contains good nutrition is not in the hands of healthcare professionals alone.
“I have come across parents who heavily involve their children in sports, training for five to six hours a day. Due to such hectic training schedules, many of them lack time to eat.
“Hence, their calorie intake is disproportionate to their loss of energy, causing them stunted growth and a lack of focus during their lessons,” adds the Universiti Malaya Medical Centre Department of Paediatrics head and Consultant Paediatrician, Consultant Paediatric Endocrinologist.
Food that are high in glycemic index such as cereals and white bread digest faster, causing one to feel hungry more quickly. When this happens, Dr Hazreen says, a child will not have sustainable blood sugar in their system and thus, end up lacking attention during their lessons, disrupting their concentration and studies. “Therefore, the type of food and carbs they take play an important role,” he adds.
Dr Hazreen encourages the consumption of food high in fibre such as wholemeal and whole grain bread.
It delays gastric emptying, is wholesome, provides energy and is low in glycemic index. It also leads to a healthy bowel, a common problem among young children, he says.
“The vitamin and oil content in wholemeal and whole grain bread is higher compared to white bread. In addition to this, to add colour and creativity to their food, some parents even add fruits to make it interesting for their children. The role of food today has expanded more holistically,” he adds.
Dr Hazreen shares that eating meat on a daily basis is not advised. Instead, he encourages parents to alternate meat with fish sources such as tuna, sardines or deep-sea fish as it contains essential oil such as docosahexaenoic acid (DHA).
“Don’t skip meals! Data gathered from various studies show that a number of children do not have their breakfast. When a child does not have fuel in their system, how will they be able to survive their day, especially when they have physical education in school? This will of course affect their studies. Parents play a crucial role here; they must be alert and monitor their children’s eating timings,” he adds.
Sharing similar sentiments as Dr Hazreen, Dr Muhammad Yazid says it is vital for children to never skip their meals, especially breakfast. It sends your body into a state of “yo-yo” as sugar levels fluctuate, he stresses. Having timely meals allow children to grow well, subsequently helping them to better understand and absorb lessons taught in school, he adds.
“When we eat, we provide energy to our brain in the form of glucose; the main fuel for our body. A child sleeps for some eight hours, on average. This means, they have been fasting and their stomach is empty for that duration of time.
“When they don’t have breakfast, they end up breaking their sugar resources from other parts of their body and this is not good, compared to simply having a meal. Therefore, a good amount of calorie intake is necessary as it provides energy; nutrition plays a significant role in the development of a child,” he says.
The Nutrition Society of Malaysia (NSM) conducted a survey in 2014 on 8,705 school children across the country to study their breakfast habits. See Table 1 for key findings from the study.
In a World Health Organisation report published last year, it stated that 41 million children under the age of five were overweight or obese in 2016.
For Dr Hazreen, this figure comes as no surprise as energy is not just derived from the food we devour, but from the type of beverages we consume. Instead of making fruit juices, for example, he suggests that parents feed the fruit to their children. One regular sized mug contains at least six teaspoon of sugar, he stresses.
“Unknowingly, parents feed their children excessive amounts of sugar, and this is just fruit juice. Can you imagine if their children consume carbonated beverages coupled with fast food?”
In our previous report, Dr Noor Hisham says food and beverages that are not allowed to be sold in school canteens are food and drinks that are high in sugar, fat and salt (sodium).
Carbonated drinks, sweets and chocolate, ice confections and ice cream and processed food such as burgers, nuggets, sausages, are examples of foods that are listed under this category, he explains.
In 2016, Dr Hazreen conducted a study on adolescent children and found that many teenagers consume too much sugar in their drinks and lack calcium and fibre in their diet.
“The reason behind this is multifactorial. There are cases where when a child is young and refuses to eat vegetables, parents give up reintroducing these foods to their children. Research suggests that when a type of food is reintroduced at least 15 times, the chances of the child consuming it is greater. Veggies are good not just to keep one’s cognitive functions sharp, but it is also beneficial for the bowel,” he adds.
Antioxidants in vegetables and fruits are also vital to ensure the smooth flow of blood to brain. Brighter fruits are better for one’s health as it contains more vitamins, he explains.
In an era where the fear of missing out on latest trends is astonishing and the inclination to believe messages forwarded over instant messaging apps are high, Dr Hazreen warns parents to do their research before succumbing to any sort of food craze.
“People enjoy following trends without understanding the rationale behind it. Be careful of what you are adopting, know if your child has any underlying diseases and always go back to basics such as looking into your child’s diet,” he adds.
Adequate sleep and meal prep
Dr Muhammad Yazid advocates the consumption of supper in small portions before a child goes to bed.
These include a glass of milk and one exchange of carbohydrate. It can be three pieces of biscuits or a slice of bread, provided they have a good dinner, he adds.
While a healthy diet for growing children is vital, he emphasises that sleep is of equal importance.
“Parents need to understand that a child requires a good amount of sleep per day, and they must sleep within a certain time to ensure their optimal growth. A child grows mainly during their sleep due to the hormones that are secreted during those hours.” He opposes the idea of children sleeping past midnight.
“Even if they get eight hours of sleep, it does not mean they will get the optimal hours as required, in comparison to a child who sleeps by 9pm.” Likewise, Dr Hazreen says inadequate rest coupled with unhealthy eating habits could cause a domino effect on a child and their academic performance.
He believes having a balanced meal is important, suggesting that parents follow the Health Ministry’s Nutrition Division Malaysian Healthy Plate recommendation of filling our plates in fractions or as they say, “Suku-Suku-Separuh”; a quarter is carbohydrates, another quarter protein (fish, poultry, meat and legumes) and the remaining half is vegetables and fruits.
Thanks to video-sharing websites such as YouTube and food networks such as Buzzfeed’s Tasty, busy parents are a click away from preparing simple meals for their children on days they find themselves racing against time.
“Parents can prepare something as simple as sandwiches, fruits and low-sugar cereals for breakfast.
“Breakfast doesn’t necessarily need to be heavy, some parents even prepare oats with raisins for their children. For lunch, the children can have something light such as mee soup rather than nasi lemak as the latter has high contents of fat. Our stomach requires time to digest food with high fat content and when this happens, we often tend to feel sleepy,” Dr Hazreen says.
While there is no harm in consuming rice for lunch, he says one should consume it in moderation.
Lunches such as laksa or ‘mee soup’ are good alternative meals for children as food such as ‘mee curry’ and ‘chicken chop’ contain too much grease, he adds.
“For dinner, parents can spruce things up by making pita sandwiches or chapati, as it’s easier for the child to digest,” he shares.
In an effort to inculcate healthy eating among primary school children across the country, NSM collaborated with Nestle Malaysia to launch an educational programme in 2010.
Known as the Healthy Kids Programme in Malaysia, NSM president Dr Tee E Siong says the underlying objective behind the programme is to improve nutrition knowledge and promote a healthy lifestyle among school children.
“It is timely in view of the significant prevalence of nutrition-related problems, such as nutrient deficiencies and obesity, among Malaysian students. Some of the key findings we obtained by the end of the second phase in 2016 include; the prevalence of overweight students dropped from 5.9% at pre-intervention to 4.6% post-intervention. Nutrition knowledge, attitude and practice scores also improved following the module implementation by teachers,” Dr Tee says, adding that continuous efforts to implement a systematic nutrition education programme in primary schools must be undertaken to address the increasing prevalence of children being overweight and obese.
This will help pave the way to a healthier nation, he adds.