Nutrition, health and SEN: a guide for families

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Healthy eating should start in the cradle

In the UK it is estimated that a quarter of eleven to fifteen year olds are overweight or obese. Overweight children tend to grow up into overweight adults. They then have a higher risk of developing serious health problems such as heart attack, stroke, high blood pressure and bowel cancer, as well as diabetes which, if undetected, can lead to kidney failure or blindness.

Excessive weight may be particularly difficult to identify in some SEN children, for example those who have Down’s syndrome or are confined to a wheel-chair, for whom being overweight tends to be seen as “normal”. However, the health risks it poses are no different, and in later life excessive weight can also pose a serious problem for carers.

The temptation to buy unhealthy snacks can present a special problem for older children and young people with learning difficulties who find it difficult to understand the importance of a good diet, or even what it means to be on a diet.

Because most of our eating and drinking habits are developed as children, parents and carers have an enormous responsibility to build good habits from the very first year. The most effective way to arm children against the “Bad Teeth Fairy” and the “Fat Food Giant” is to train them from an early age, by word, practice and example, to eat in moderation and avoid unhealthy food and drink.

Babies who can take food by mouth should be introduced gradually to a full healthy diet of natural food. If time allows, it is best to prepare baby-food at home from fresh natural ingredients using a food blender. If food is used to comfort or reward children they are more likely to become overweight later in life through “comfort eating”; it may be appropriate to advise parents to comfort their children instead by giving cuddles, listening to them, or singing or praying with them. Similarly, a good school report, for example, might be celebrated with a special outing, but not with a box of chocolates or a visit to a fast-food restaurant.

One way to help avoid childhood obesity is to involve children in the preparation of food. This makes them more aware of what they are eating, and it can also build self-confidence and provide a sense of achievement. Kneading dough or licking out a spoon is simple fun for children of limited ability, whereas following precise instructions on weights and cooking times may appeal to some autistic children. Cookery can also offer scope for the imagination and creativity of exceptionally gifted and talented children.

So what is a healthy diet? Most experts agree that:

•    Foods high in sugar or saturated fat should be eaten sparingly.
•    Some food containing protein or starch should be eaten daily.
•    Five portions of fruit and vegetables should be eaten daily.
•    Children of school age should drink a litre of water daily.
•    Everyone who can should have at least 30 minutes of moderate physical exercise each day, preferably an hour.

Sugar damages young teeth. The skeleton of a Tudor man excavated in London in 1992 was found to have perfect teeth, almost certainly because his diet would have contained no added sugar. Many artificial colourings and preservatives found in soft drinks and food can exacerbate attention deficit hyperactivity disorder, which eight to ten per cent of school-age children, particularly boys, suffer from (as do their parents and teachers!). Sodium benzoate, the preservative found in several popular fizzy drinks, has been found to cause other health problems in some children too, so it seems best for all children to avoid these substances so far as possible.

Anyone responsible for the health of older children will consider carefully whether the use of alcohol should be encouraged. Its prolonged consumption significantly increases one’s chances of contracting many serious physical diseases and mental problems, and in one way or another alcohol is estimated to cause 33,000 deaths a year in the UK.

Thyroid disorder, usually hypothyroidism (an underactive thyroid gland), occurs more frequently in people with Down’s syndrome. Between fifteen and twenty per cent of adolescents with Down’s syndrome are believed to have thyroid trouble. An underactive thyroid slows the metabolic rate, leading to weight gain, tiredness, depression, puffiness of the face, a hoarse voice and other symptoms. These effects can be cured by a combination of medical treatment and diet. Fat, sugar and salt intake should be kept very low, and foods with a high iodine content should be avoided altogether. Energy is best provided by slow release carbohydrate foods such as oats, granary bread and basmati rice; five daily portions of fruit or vegetables and two servings of protein in lean meat, fish, poultry, pulses or tofu are important too. Dietary advice for sufferers from hyperthyroidism (an over-active thyroid) is similar, except that shrimps, crabs, soya products, preservatives and food high in carbohydrates and starch, such as white bread, should be avoided.

In all cases of thyroid disorder moderate exercise is helpful, and a litre of fresh water (two litres for adults), preferably at room temperature or above, should be drunk each day.

The Qualifications and Curriculum Authority (QCA) has published guidance for teachers on personal, social and health education (PSHE) and citizenship for pupils with learning difficulties. Amazingly, there is nothing in this 10,000 word document about diet or healthy eating until Key Stage 3, and then only three lines. Let’s not forget the subject of healthy eating in our own dealings with parents and their children!

Further information

Arnold V Page is a director of Anastasis Ltd, creators of Captain Cook’s Tuck Box. The Tuck Box is a BECTA-approved cookery/food technology pack of software and teaching aids for Key Stage 1-3, which can be purchased from the website www.anastasis.co.uk. Information sheets including the Traffic Light Diet and Captain Cook’s Five a Day can be downloaded from the Help for Teachers pages on the same site.

Article first published in SEN Magazine issue 41: July/August 2009

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