A weighty issue for parents and children to tackle

Whether or not you agree with how Michelle Obama recently used her daughters to publicise an anti-obesity campaign, what she did for eating habits was laudable.

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Speaking in Virginia last week as part of the US government's anti-obesity campaign, the first lady, Michelle Obama, explained how her concerns over her daughters' weight led her to change their eating habits. This has sparked controversy, not about her suggested changes, which were wholly sensible, but over the fact that she used her daughters' weight "issues" as an example in front of the nation.

Ironically, given that her speech was televised and reported in the press, Obama explained that she "didn't make a big deal out of it", but made minor changes to their eating that, she suggested, were so simple that everyone could have a go. Sharing with the world that Malia's and Sasha's body mass indices (BMI) worried her was perhaps not the most sensitive approach Obama could have taken. She could just as easily have engaged with her audience by talking about the whole family's approach to healthy eating.

And it is not the first time the Obamas have spoken openly about concerns over their daughters' weight. In an interview with a parenting magazine in November, President Obama referred to Malia as having been a "bit chubby". These girls live their lives in a fish bowl, with heavy media scrutiny of their every move and appearance. Girls of Malia's and Sasha's age are just becoming aware of their bodies and how they may look different from their friends. At this age, their self-esteem is fragile. Questions such as "Mummy, am I fat?" need to be handled with care.

Children's correct BMI cannot be assessed by a standard BMI calculator. Children's growth hormones are released at different times, their growth spurts can be erratic, and their body fat and BMI will change as they grow. The last thing any parent would want to do is saddle their child with an unhealthy relationship with food and put them on the road to a potentially life-threatening condition such as anorexia nervosa or bulimia. But obesity is life-threatening as well. The first lady is spearheading the campaign to reduce obesity, which is defined as a BMI of 30 or more, in the US. According to the Centers for Disease Control and Prevention, more than 30 per cent of adults in America are obese. These people are more likely to develop medical conditions including heart disease, diabetes and some cancers. Research has shown that more children are overweight and suffering from type-2 diabetes, previously thought of as an adult's disease.

Obama was trying to reach out to mothers across the United States and show that she is also concerned about her children's health. She was speaking from experience to illustrate that even small changes to a child's diet can reap huge rewards. Whether or not you agree with Obama using her daughters to publicise the campaign, what she did in relation to their eating habits was laudable. Obama explained that her children's paediatrician was concerned "that something was getting off balance" in respect to the girls' BMIs. At the time, she was working as well as supporting her husband's campaign, and, she explained, it was often easier at the end of a hard day to swing by the drive-through rather than cook a nutritious meal at home.

After the paediatrician's warning, Obama cut down the girls' midweek television time, encouraged Sasha and Malia to be more active, paid attention to portion sizes, replaced fizzy drinks with water in lunch boxes and introduced more fruit and vegetables at meal times. The improvements in their BMIs were "significant", she claimed. In the UAE, too, we face an obesity epidemic. Eating habits laid down with primary school-age children can shape their future lifestyles. Although we cannot always control what our children put into their mouths, we can educate them about healthy foods, pack them a nutritious lunch and ensure that they take regular exercise.

But perhaps the most important thing is to lead by example. If we encourage healthy eating and regular exercise across the family, we can show children that this is a sustainable way of life. Plan that family trip cycling along the Corniche or go to the park; walk when the weather permits or take up a sport with your child. Seeing that it is normal for families to eat healthily and be active is the best lesson they can learn.

For more information on healthy eating and ideas for nutritious lunch boxes, visit www.nutrition.org.uk, www.bbc.co.uk/food or www.eatwell.gov.uk. For a children's BMI calculator visit www.betterhealth.vic.gov.au.