Children had to be taught the importance of healthy food choices and nutrition from an early age if Malta was going to successfully tackle the problem of obesity, according to clinical psychologist Dorothy Scicluna.
"A lot of the overweight and obese children I see have no clue how the body works, so it comes as quite a shock when they realise that the burgers they are guzzling down is turned into fat," she said in an interview.
Ms Scicluna believes children should be empowered to make healthy choices now and forever in order to avoid growing up into overweight or obese adults.
The rates of obesity among schoolchildren in Malta has reached mammoth proportions and according to the World Health Organisation's health behaviour survey, carried out in 2002, Maltese 13-year-old boys and girls topped the obesity list, surpassing the US.
In fact, 13.5 per cent of the boys and 17 per cent of the girls were obese. Among the 15-year-olds, 12 per cent of Maltese boys and girls were obese - just below the US average.
Ms Scicluna pointed out that studies clearly indicate that overweight and obese adolescents have up to an 80 per cent chance of becoming overweight and obese adults, especially if one or both parents have the same condition.
She is also worried to see the emergence of binge-eating disorders among children, which are being referred to her by endocrinologists.
"I have come across 10- or 12-year-olds with a weight of 97 kilogrammes - these children will already have high cholesterol levels and are at risk of diabetes," she said.
Overweight or obese children were also prone to low self-esteem that stemmed from being teased, bullied or rejected by their peers. These children were often the last to be chosen as playmates, even as early as pre-school, she said.
Together with Saint James Hospital, Ms Scicluna is working to devise a holistic family programme, which will offer the services of a multi-disciplinary team, to tackle obesity.
The programme, which should be launched next month, will offer the entire family the chance to change their eating habits together and introduce more exercise in their daily schedule.
"Sometime we get parents approaching us with their child's overweight problem and they fail to realise they too are overweight," she said.
She pointed out that Maltese families were becoming busier and they had less time to prepare wholesome meals while parents tended to unknowingly overfeed their children.
Unfortunately, school tuck shops did not offer healthy choices and fat-laden fast food and soft drinks were readily available.
Ms Scicluna said it was important for parents to lead by example by making eating and exercise a family affair. "Most of all, let your children know you love them, no matter what their weight is. If you, as a parent, eat well and exercise often, while incorporating healthy habits into your family's daily life, you are modelling a healthy lifestyle for your children that could last into adulthood."
Tips for parents to avoid falling into common food and eating behaviour traps
¤ Don't reward children for good behaviour or try to stop bad behaviour with sweets or treats. Come up with other solutions to modify their conduct.
¤ Don't maintain a clean-plate policy. Be aware of your child's hunger cues. Even babies who turn away from the bottle or breast signal they are full. If children are satisfied, do not force them to continue eating. Reinforce the idea that they should only eat when they are hungry.
¤ Don't talk about "bad foods" or completely eliminate all sweets and favourite snacks from the diet of overweight children. Children may rebel and overeat these forbidden foods outside the home or sneak them in on their own.
Recommendations for children of all ages:
¤ Birth to age 1: Some doctors feel that breastfeeding, as opposed to using formula may help prevent excessive weight gain. Breastfed children are more able to control their own intake and follow their own internal hunger cues. Also, limit the amount of extra sugar infants get, particularly in what they drink. Instead of juice, offer water when they are thirsty.
¤ Ages 2 to 6: Start good habits early. Limit their time in front of the television - better yet, leave it off - and increase their physical activity. Encourage children to eat healthy foods and to only eat when hungry. Make good foods fun and try to eat meals together as often as possible.
¤ Ages 7 to 12: Encourage children to be physically active every day, whether it's a game of football or playing in a community sports league. Keep your child active at home, too, through everyday activities such walking or playing in the yard. Even basic household chores like vacuuming, dusting and washing the car burns calories.
¤ Ages 13 to 17: At this age children like fast-food joints, but try to steer them towards healthier choices like grilled chicken sandwiches, salads and smaller sizes. Encourage them to join a sports team. If they do not feel very athletic, suggest a less competitive programme or sport like skateboarding, inline skating or mountain biking. Do not force any one sport or activity; help your children find what they enjoy and then support them in their efforts.
¤ All ages: Cut down on the time they spend in front of the television, computer, or playing video games and discourage eating in front of the television. Try to include five servings of fruits and vegetables a day in their diet, plan healthy snacks and encourage children to eat a nutritionally balanced breakfast every day.