Pregnant women deficient in vitamin D may give birth to obese children, a new study has shown. Paediatric nutritionist Edwina Revel shares her tips for preventing childhood obesity
Obesity amongst children is on the rise, according to the NHS, with over one in three children measured as obese or overweight by year six (age 10-11), and one in five children in reception (age 4-5). But new research suggests the problem could be starting from the mother’s pregnancy.
The study, published in Paediatric Obesity, found that women who are deficient in vitamin D in their pregnancy are more likely to have obese children. Researchers found that 6-year-olds born to mothers with very low vitamin D levels during their first trimester had two per cent more body fat and bigger waists – about half an inch plumper on average – than peers whose mothers had enough vitamin D in early pregnancy.
Vitamin D is commonly known as the sunshine vitamin, because the sun’s rays on our skin is our main way of producing vitamin D. From March to September, the sun promotes vitamin D synthesis from cholesterol in the skin, so no sunshine equals no vitamin D production.
But even in Greece, where the research was undertaken on over 500 mother-child pairs, about 66 percent of the pregnant women in the study had insufficient vitamin D in the first trimester.
‘It’s possible that children of mothers with low vitamin D have higher body mass index (BMI) and body fat because vitamin D appears to disrupt the formation of fat cells,’ said Vaia Lida Chatzi, senior author of the study and an associate professor of preventive medicine at the Keck School of Medicine. ‘Optimal vitamin D levels in pregnancy could protect against childhood obesity, but more research is needed to confirm our findings.’
‘The multiplicity of causes of obesity has led to lots of research into the issue’, says paediatric nutritionist Edwina Revel, programme director at Early Start Group. ‘There are so many risks associated and there isn’t just one thing. I haven’t seen a lot of other studies showing the link between vitamin D and obesity and it’s very early days.
‘However a positive message we can take from it is the importance of vitamin D’, says Edwina. ‘It is required for good bone health as it helps to regulate the absorption of calcium and phosphorus from the diet. Vitamin D is required also for healthy muscles.’ It’s for this reason that Public Health England recommends that everyone in the UK should take a vitamin D supplement during Autumn and Winter months to counteract not only the lack of sunshine but also our increasingly indoor lifestyles and processed diets (read more about recommendations below).
Here, Edwina Revel provides her key tips for preventing childhood obesity.
Breastfeeding is the best form of nutrition for infants. The Department of Health recommends exclusive breastfeeding [no other liquids or solids] for the first six months of life as it provides all the nutrients a baby needs. It reduces their risk of obesity in later childhood, with every month of breastfeeding associated with a four per cent decrease in risk.
2. Provide a varied diet
We should all aim to eat a healthy, varied diet based on the principles of the Eatwell guide, to meet our energy requirements. It is important to get the balance right. Children need regular meals and healthy snacks to get all the energy they need as part of an active lifestyle.
3. Help them be active
Children in the UK now are less physically fit than past generations which has implications for their future health. Current studies show that only nine per cent of boys and ten per cent of girls aged two to four years of age are meeting their activity recommendations. Children under five years should be active for at least three hours spread across the day.
Young people are spending more time playing and socialising online than watching television programmes. Statistics show that children aged seven to 16 spend an average of three hours a day online, and that watching TV for more than eight hours a week may be a risk for obesity. It is important for children to think about increasing the types of activities that suit their lifestyle and can be easily included in the day. Ask children what activities they enjoy. Encourage them to follow their interests and make activity fun.
4. Teach children mindful eating
The appetites of children will vary and it is important that children are allowed to eat to appetite at mealtime. From birth infants are able to regulate their own appetite and energy intake. They will eat the right amount of food to meet their body’s energy needs. Encourage children to recognise the signs of hunger and the signs of fullness. It is important not to teach children to over-ride their sense of fullness.
Offer smaller portions at first. It is OK to give second helpings if the child has eaten everything and is asking for more. Remember that second helpings should still be nutritionally balanced. Offer second helpings of the vegetables, salad or fruit. Encourage children to eat slowly, chew their food well and pause between mouthfuls. Perhaps try putting the knife and fork down between each mouthful.
5. Look at your own weight, too
One of the causes of obesity is family weight history. The risk increases when both parents are obese by 19.8 per cent, and 8.4 per cent if one parent is obese. It’s important for the parent to take the initiative and think about family meal times. That might be doing some cooking activities as a family or changing some simple traditions. Instead of ordering a pizza, get some pitta bread, add tomato puree and some pizza toppings. It’s about installing a love around food as a family event, not just focusing on the child whilst the parent eats crisps in the corner!
6. Make sleep a priority
Another risk factor for obesity is sleeping fewer than ten hours each night. For children aged between one and three, 11-12 hours a night is recommended. If a child isn’t getting enough sleep they’re likely to be more lethargic in the day which can impact on their activity and they will be more likely to snack on high energy foods when not necessarily hungry. To help them sleep better and wake up feeling more energised, try to turn the TV off earlier in the day and look at bedtime routines such as reading a book or playing a game as family.
7. Make small changes
Grill, boil or bake foods without adding fat, rather than frying. Don’t forget the drinks – go for low-calorie drinks such as semi skimmed milk and of course water. Make sure you avoid giving them sugary drinks such as juice drinks and squashes.
Vitamin D: recommendations for children, adults and pregnancy
‘It is important to recognise that at certain times of the year in the UK, we may not obtain an adequate amount of vitamin D from sunlight and diet alone in order to prevent deficiency’, says Edwina.
- All pregnant and breastfeeding women should take a daily supplement containing 10µg
of vitamin D, to ensure the mother’s requirements for vitamin D are met and to build
adequate fetal stores for early infancy.
- All infants and young children aged 6 months to 5 years should take a daily supplement containing vitamin D in the form of vitamin drops, to help them meet the requirement set for this age group of 7-8.5 micrograms of vitamin D per day.
- However, those infants who are fed infant formula will not need vitamin drops until they are receiving less than 500ml of infant formula a day, as these products are fortified with vitamin D.
- Breastfed infants may need to receive drops containing vitamin D from one month of age if their mother has not taken vitamin D supplements throughout pregnancy.
- People aged 65 years and over and people who are not exposed to much sun should
also take a daily supplement containing 10 micrograms of vitamin D
- Everyone over the age of five will need to rely on dietary sources of vitamin D. Since vitamin D is found only in a small number of foods, it can be difficult to get enough from foods alone. Therefore, everyone should consider taking a daily supplement containing 10 micrograms of vitamin D particularly between September and March.
Edwina Revel is a Registered Nutritionist with 14 years of experience working in nutrition with the food industry, NHS and local government bodies. She is Programme Director for the Wellbeing and Nutrition service who are leaders in developing and delivering training for a range of practitioners including early years providers and health care professionals such as health visitors and GPs. As part of the UK All Parliamentary Group on a Fit and Healthy Childhood, Edwina regularly contributes to group reports which seek to influence the views of parliament and the performance of government to improve health and wellbeing outcomes for families. She has many years’ experience working with parents and babies from infants to school aged children.
Follow Edwina and her team on Twitter @earlystartnutr and on Instagram @earlystartnutrition.