Health: Making changes to our diets is really bearing fruit . . and veg

JOSH Fisher points to his tummy, rubs it hard and laughs as he recalls how, not too long ago, it was just a little bit bigger.

"I had these jeans that were a bit too tight for me," he explains with a cheery smile. "When I wore them on holiday last week and they were too big, I didn't have a belt with me and they kept falling down."

The nine-year-old bursts into more giggles and his mum, Christine, nods approval. Not too long ago she was struggling to fit Josh into clothes that were intended for boys a year older.

Now, because of a radical new NHS Lothian "fit family" programme, she's delighted to be digging out old outfits from the back of the wardrobe which were once too tight.

"It's made a big difference to both our lives," says Christine, while Josh crunches a cube of cucumber and nods in agreement. "Not just in terms of losing some weight and exercising more. It's encouraged us both to do things together that we hadn't thought of ever doing. It's definitely opened my eyes to what we were eating."

They are taking part in Get Going, aimed at families struggling to deal with weight gain or simply, like them, hoping to stop the scales tipping too far in the wrong direction.

It uses "personal trainers" with expertise in diet and fitness, and since its Edinburgh launch last year it has successfully helped at least 50 children with varying degrees of weight problems towards new, healthier lifestyles.

Now the free, eight-week project, drawn up in a bid to help halt rising levels of childhood obesity, has expanded to cover East, West and Midlothian.

Josh was one of the first East Lothian youngsters to take part in the course earlier this year and the results, smiles Christine, have helped both of them emerge slimmer and healthier.

"It's not until someone points out what you are doing and what you have to change that you realise where you were going wrong," she adds. "For example, I found out that part of the problem was portion sizes, I was just giving Josh too much to eat."

Mum and son, who live at Elphinstone Walk, Tranent, signed up for the programme in January after medics monitoring his long-standing intolerance to lactose noticed his weight had a tendency to spike and then stabilise.

"His weight just wasn't on a steady keel, it would go up and then down a bit and then up," explains Christine, 40, a part-time barmaid. "It wasn't clear if it was related to exercise - if at certain times he'd lose weight or put it on because he was more or less active, maybe - or if was it his food.

"He wasn't obese or even very overweight, but I was having to buy clothes that were a stage further up.He's nine but he was in trousers made for a ten to 11-year-old."

The programme provides families with one-to-one and group advice sessions, exercise tips and nutritional guidance. Since completing it, Josh's Body Mass Index - which indicates the proportion of fat on the body - has improved and he has shed around half a stone in weight.

"Now he's back in trousers for nine-year-olds, which is exactly right for his age," smiles the single mum. Josh leaps up and charges through to the kitchen to grab a bite of lunch. While other nine-year-olds might crave a burger or pizza, he's happily chewing on salad vegetables and chatting about his plans to whip up a healthy chicken wrap.

"I love salad," he says, eating his cucumber. "I still like things like deep-fried pizza, but I know it's not good for you. This is much better for me."

Christine adds: "It's not that everything we did was wrong, but I now realise that on the days I was working, I'd grab something like a takeaway. Now I've learned to be more organised and that you can cook something from scratch in just the same time."

The Get Going programme was drawn up in response to shocking statistics that show one in five Scottish children is overweight, putting them at risk of diabetes, heart disease and cancer. It was developed from an initial pilot scheme created by academics at Edinburgh, Glasgow and Stirling universities which had achieved remarkable successes among families taking part.

Christine and Josh signed up in January, starting with a one-to-one consultation with a specially-trained healthy lifestyle coach. Over the following weeks they attended group sessions at Prestonpans Community Centre with other local families. While the children enjoyed lively exercise and sport sessions, parents received key advice on diet, activity, portion sizes and tactics to help control treats.

Programme co-ordinators also offered key tips on how to make the whole family more active and suggestions for limiting time spent watching television or playing with computers and games consoles. In addition, families received a card to access Edinburgh Leisure facilities for a discounted rate, encouraging them to kick-start a fitness regime.

The impact, says Christine, quickly turned around both her and Josh's diet and sparked a new interest in activity.

She says: "I remember my parents would tell me when I was young to eat up my food and that's what I'd tell Josh. But when I was young, you were out all the time running about and playing. We were never inside, there wasn't anything on television to watch and there were no computers or Nintendo DS games.So I don't think Josh was getting the chance to burn off what he was eating."

Christine learned how simple changes, like swapping jars of pasta sauce rich in fat and salt with homemade tomato sauce, cutting visits to fast-food restaurants to once a month and limiting sweets to a post-school Friday treat, could help them both shed weight.

And subtle swaps, such as switching full-fat cheese to low fat, cutting back on potatoes in favour of piling on other vegetables and opting for WeightWatchers bread could have a dramatic impact.

The plan has also brought mum and son even closer, adds Christine. "I started to give Josh more chores to do around the house, little things to get him up and moving. So now he does the dishes and after tea we go out for a walk together.

"He also gets involved with preparing what we eat, he cuts the vegetables or makes up the salad. At the shops he's the one who goes and gets the vegetables we need.

"The programme just made us both think more about what we do."

Graham Mackenzie, consultant in public health at NHS Lothian says Get Going is a unique chance for families to tackle the weighty issues such as diet and exercise in a fun environment. "We wanted a programme that we could deliver with groups of families together, so they can learn from each and bounce ideas around while the kids can take part in exercise," he says.

"Some of the families who have already taken part have gone on to make major changes in their behaviour and have had huge health benefits, too.

"They have found that small changes in lifestyle, eating better and taking more exercise have long-term health benefits."

For details of NHS Lothian's Get Going programme, go to www.nhs lothian.scot.nhs.uk/getgoing