Half-term holiday has seen my clinics even more than usually full of children who came to see me about everything from coughs and colds to constipation. One notable consultation was a small boy presenting with dysuria; having excluded a UTI I was shocked to discover that all he ever drinks is Coca Cola!
Childhood obesity has been much in the news recently, but even before the recent publicity I have frequently been taking the opportunity to weigh children who I happen to notice seem rather on the heavy side. I have regularly found eight-year-olds weighing more than I do (and believe me, I am no size zero)! When tactfully attempting to discuss the weight issue with parents I have found that many really do not know how to feed their families a healthy diet.
I work in a very deprived part of South London and see poverty on a daily basis. For families on a limited budget it may be a struggle to provide healthy meals, but appropriate community resources are often lacking - our local mini-supermarket doesn't seem to do fruit and veg!
There are clearly already some major initiatives under way – improvements in school meals and new sports activity schemes are planned. I welcome the recent news that school nurses will be required to weigh and measure children regularly. But the thing that I feel would make a real difference, at least in areas like mine, is education. We need much more emphasis on helping parents and children understand what healthy nutrition is, and how this is possible even on a limited budget. There is a strong link between poverty, obesity and education, and we need a total community approach to tackle the problem.
I am amazed at how much money is spent on antiobesity drugs for adults. It would be so much better if more resources were directed at preventing the adverse effects of poor nutrition early on, as it is much more difficult to change later in life.
I recently visited a large new primary care centre in the Midlands that brought together GP practices, community nurses and a whole raft of diagnostic and therapy services in an impressive modern building. Absolutely superb facilities, and the thing that struck me most was the "coffee point" on the ground floor. The area was glass-fronted looking onto the street, so clearly visible to passers-by. A range of delicious "healthy" snacks and light meals were available, all at very reasonable prices. Chips, fizzy drinks and sugary snack bars were nowhere to be seen. Of great interest to me were the attractive free recipe leaflets for all the meals being served. Walls were decorated with schoolchildren's paintings displaying healthy eating messages. Clearly a huge success, the place was packed and seemed to be quite a focal point in the village with families, groups of mums and children and older people all tucking in.
What an excellent idea! We need more community-focused programmes like this, providing an innovative and enjoyable approach to nutrition education.
Your comments: (Terms and conditions apply)
"I think the Radio 4 Farming & Food Awards show the way, showcasing a school that invites children into the kitchen. They help with cooking for the breakfast club, lunches, and can cook food to take home if they wish. Not only do children need to learn how to cook, they also need to develop a relationship with food and how it is produced in order to bring about change" - Name and address supplied
"Great to hear about the multidisciplinary work at the new PHC centre with its focus on healthy eating. Also good to hear about weighing children opportunistically at the GP practice. This gives a good starting point for education about preventing obesity, and is advised in DH Guidelines. But, I disagree with the government directive for school nurses to do mass measurements of 11 year-olds in schools. This is a wasteful and ineffective intervention. It is not child-centred as there is no time to follow up overweight children to give the support they need, it's inaccurate due to heavier children opting out and is time-consuming for school nurses who are already thin on the ground. Their time could be better spent having regular, reliable drop ins in schools so that pupils who want health advice can get it. Cath Gleeson, Practice Nurse, previously SN for nine years, West Yorks
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