Seriously overweight children between three and eight years old benefit from the treatment programme Aan Tafel! This is the conclusion Esther van Hoek defended at her PhD ceremony on Friday 18 September.
Photo: Luke Saagi
The aim of the programme is to tackle child obesity early and prevent people from going on struggling with overweight and the accompanying health problems all their lives. The programme includes guidance for parents, physiotherapy and nutritional advice. It was developed together with Arieke Janse, paediatrician at the Gelderse Vallei hospital in Ede.
Among seven-year-olds today, 14 percent of boys and 19 percent of girls are overweight. Two to three percent of them suffer from obesity. In adult life they have raised risks of diabetes and cardiovascular diseases. Moreover, children get teased about their weight and it hampers their mobility. ‘You sometimes see children of four or five having difficulty getting up the stairs,’ says Van Hoek.
The aim of the programme was not to get children to lose weight, says Van Hoek. At such a young age, losing weight can actually be bad for their development. The aim was for participants’ weight to remain stable while they grew in height. And that worked quite well. After a year the children’s BMI, the ratio of height to weight, was closer to the Dutch average. Participants also proved to be eating less and to have healthier blood test results. They did not, however, get any more exercise than before the programme.
Van Hoek got 32 seriously overweight children to participate in Aan Tafel! together with their parents. The parents shared experiences relating to child-rearing and food in group therapy sessions. The children got to take part in supervised exercise and had taste lessons in which they were introduced to healthy food. The parents could read up on this information online at home, and record their experiences. The entire programme was supervised by experts including psychologists, dieticians and physiotherapists.
The researchers ran up against all sorts of obstacles when setting up Aan Tafel! ‘We know that child obesity is pretty common,’ says paediatrician Arieke Janse, ‘but it still proved difficult to really reach people.’ The approach needs parents who are open to it and motivated to change their lifestyle. Many of the children also came from lower socio-economic classes: a vulnerable group which often has other problems as well. ‘Some people are going through debt rescheduling, for instance,’ says Janse, ‘and in that case overweight is not in the top ten of their problems.’
Janse hopes to bring Aan Tafel! closer to the target group in the coming years. By offering the programme in the neighbourhood instead of at the hospital. An experiment is already under way in Veenendaal. The paediatrician is also working on a ‘maintenance programme’ to help children and parents maintain their new lifestyle. ‘A change like this is a slow process.’