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    • Are you worried about your child's size? Here's why it may not be an issue

    Size doesn't tell the whole story of a child's health, said Jill Castle, a pediatric dietitian in Massachusetts. (wera Rodsawang/Moment RF/Getty Images/FILE via CNN Newsource) Size doesn't tell the whole story of a child's health, said Jill Castle, a pediatric dietitian in Massachusetts. (wera Rodsawang/Moment RF/Getty Images/FILE via CNN Newsource)
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    Do you ever find yourself comparing the size of your child with those of their classmates and worrying about their health?

    Just as you shouldn鈥檛 judge a book by its cover, you can鈥檛 judge a person鈥檚 health solely by the way their body looks, said Jill Castle, a pediatric dietitian in Massachusetts. In her new book, 鈥,鈥 Castle aims to offer a new model for assessing and addressing kids鈥 health.

    Kids with bodies either larger or smaller than average are at higher risk for related to their size than their average-size counterparts, Castle said. And some of the tactics that adults use to influence their child鈥檚 size can have consequences on their health and relationship with food for the rest of their lives, said Jennifer Rollin, founder of The Eating Disorder Centre in Rockville, Md.

    With a new school year ahead, kids with larger or smaller bodies face the potential for difficulties at school, but the adults who care for them have an opportunity to reset the family鈥檚 approach to health and size, Castle said.

    If you want to reset your child鈥檚 healthy habits as you kick off the academic year, here鈥檚 what Castle wants you to know 鈥 and what you may need to rethink.

    Weight-focused versus whole child health

    The way children鈥檚 health has been assessed has often centred greatly on their size and shape, Castle said.

    鈥淲e鈥檝e been operating under the fixed weight model or the fixed size model, which is a model that looks at a child that鈥檚 too small and says, 鈥楬ey, we need to fix that child鈥檚 body size and make it larger,鈥欌 she said. 鈥淥r we look at a child with a larger body and say, 鈥楬ey, that doesn鈥檛 fit our norm.鈥欌

    There are a few problems with this approach. One is that weight and size rarely tell the full story, said pediatrician Dr. Nimali Fernando, founder of the , a Virginia-based nonprofit helping communities overcome obstacles to eating well.

    鈥淭here are a lot of social determinants of health that we need to consider when we鈥檙e looking at a child鈥檚 overall health, and it鈥檚 very easy to get laser focused into the things that we can measure, instead of really taking time to understand what鈥檚 going on in a child鈥檚 life,鈥 she said.

    Another issue is that the ways to address size directly often aren鈥檛 helpful.

    鈥淧ressuring children to eat more or to eat less, restricting children from having seconds 鈥 we know those feeding practices don鈥檛 work very well in the long run, and can disturb that developing relationship with food,鈥 Castle said.

    Instead, Castle developed a model called 鈥渨hole child healthy,鈥 which emphasizes a balance of physical health and emotional well-being.

    鈥(The factors) include things like sleep and movement and screen time and food, but it also includes family culture and self-love as a pillar,鈥 she added.

    Habits for a healthy child

    Strict health rules aren鈥檛 the way to have a hale and hearty child 鈥 instead, Castle said, 鈥渆very child needs good, healthy lifestyle habits to grow up healthy and happy.鈥

    Family culture: The first pillar of health Castle emphasizes isn鈥檛 about a child鈥檚 diet or exercise. It鈥檚 about the family culture surrounding them.

    鈥淎 family culture is who your family is,鈥 she said. 鈥淎s a family, it鈥檚 what you believe in, your core values, your attitudes, what you spend your time doing. And for children who may grow up with a larger body or a smaller body, they need families with a strong, positive family culture.鈥

    She recommends really investigating the way in which your family talks about food, your own bodies, other people鈥檚 bodies and the other things that are important to you. Having family meetings, family mantras and activities that support those values can help reinforce the environment you want to create for your children, she said.

    Food: 鈥淭he goal of the food pillar is really to embrace flexibility with food and to emphasize foods that are highly nutritious and 鈥 to allow foods also that might be minimally nutritious within the diet in ways that can be fully enjoyed and flexible,鈥 Castle said.

    That flexibility doesn鈥檛 mean there are no boundaries and structure, however.

    Mounting evidence has pointed to the first 1,000 days of life -- from conception to two years old -- as a critical period for preventing childhood obesity. (AFP)

    Instead, Castle recommended focusing on things such as having mealtimes at around the same time every day, having predictable snacks, eating with mindfulness and sitting to share a meal as a family as often as possible during the week.

    鈥淎nd really doing the job of parenting, which is buying the food, preparing the meals, getting it on the table, and then releasing yourself as a parent from any further job of trying to get your child to eat,鈥 Castle said.

    Lastly, try to move toward understanding food as more or less nutritious and away from branding food 鈥済ood鈥 or 鈥渂ad,鈥 Castle said.

    鈥淭he clean club or rewarding with sweets 鈥 they might work in the moment, but they don鈥檛 do a good job of establishing the self-trust and an intuitive, good relationship with food as kids grow up,鈥 Castle said.

    Sleep: Getting quality sleep is crucial for both your kid鈥檚 physical and emotional well-being, so practicing good should be on your list of priorities, Castle said.

    That means building habits such as not having screens in the room, minimizing sound around the bedroom, making it dark and making sure your child has a relaxing routine around bed, Castle said.

    A sleep routine should include establishing a regular bedtime and a regular wake-up time in the morning, she added.

    What to do about the school year

    Without the anchor of school and extracurriculars over the summer, some key health routines might have fallen to the wayside. Fortunately, your family can treat the new academic year as a fresh start.

    鈥淭his is a great time to get back on the habit wheel and jump-start or refresh or renovate any habits that perhaps over the summer got a little wonky and off-kilter,鈥 Castle said.

    Sending your child back to school doesn鈥檛 have to mean relinquishing any boundaries around what they eat, Castle said.

    Your family can think ahead by reviewing the school cafeteria menu or establishing plans to pack lunch and make choices together 鈥 as well as talk about your expectations around food, she said.

    鈥淧arents should feel empowered to be able to say to their children 鈥業 expect you to have a serving of fruit on your tray at school lunch every day this week. 鈥 You choose what you want, but fruit is really important to your overall eating pattern, and it鈥檚 important for you to get some at school,鈥欌 Castle added.

    Families may also feel anxiety about the new school year and any bullying that may happen to their children with larger or smaller bodies.

    First, it鈥檚 vital that you know you can advocate for your child, whether it鈥檚 by pulling the pediatrician aside to discuss how they talk about weight in appointments with your child or by speaking against school curriculum or policies that are stigmatizing, Rollin said.

    Then it鈥檚 essential to look at the environment you create at home, Castle said. Have you communicated with your child that everyone is accepted at home? Do you treat your kids differently based on their size? Or do you emphasize the value your child has that isn鈥檛 related to their appearance?

    And one of the biggest influences you have on your child is the behavior you model to them. It may be important to look at the way you talk about your own body and your relationship with food, Rollin said.

    Working with a weight-neutral dietitian or talking with a therapist may help you heal your own ideas around body image so you can release your anxiety and create the best environment for your child, she said.

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