Part 2 - looking at the nutrition/healthy eating aspect of managing childhood obesity and how to talk to your PCP
How
do I help my child eat healthier/reduce the calorie imbalance?
Help Kids
Develop Healthy Eating Habits12
Encourage
healthy eating habits. Small changes can lead to a recipe for success!
·
Provide
plenty of vegetables, fruits and whole-grain products.
·
Include
low-fat or non-fat milk or dairy products.
·
Choose
lean meats, poultry, fish, lentils and beans for protein.
·
Encourage
your family to drink lots of water.
·
Limit
sugar-sweetened beverages, sugar, sodium and saturated fat.
Making
healthier food and lifestyle choices
One of the first steps to helping your child overcome
obesity is to help him or her develop a healthy relationship with food. This may mean making some lifestyle changes.
The following are options for beginning your lifestyle changes.
Eat
the rainbow. Serve and
encourage consumption of a wide variety of fruits and vegetables. This should include
red (beets, tomatoes), orange (carrots, squash), yellow (potatoes, bananas),
green (lettuce, broccoli) and so on—just like eating a rainbow.
Make
breakfast a priority. Children
who eat breakfast are less likely to be overweight or obese than those who skip
the first meal of the day. Focus on healthy choices like oatmeal, fresh fruit,
whole grain cereal, and low-fat milk instead of sugary cereals or toaster
pastries – go for more protein-based foods than carbohydrate based.
Cut
back on fat. Some fat is
needed to maintain good health, but these fats should come from sources of polyunsaturated and monounsaturated fatty acids, such as fish, nuts and vegetable oils.
Cut way back on fast food, junk food, and sweets.
Schedule
regular meal times. Children
like and often need routine. If your kids know they will only get food at
certain times, they will be more likely to eat what they get when they get it.
Limit
dining out. If you must
eat out, avoid fast food and make the healthy choices
you are trying to make at home. Many fast food chains are now offering
“healthier” options. Have a Happy Meal
with apple slices instead of fries.
Remove
calorie-rich temptations.
Treats are OK in moderation,
but limiting high-fat and high-sugar or salty snacks can also help your
children develop healthy eating habits.
Examples
of easy-to-prepare, low-fat and low-sugar treats that are 100 calories or less:
·
A
medium-size apple
·
A
medium-size banana
·
1
cup blueberries
·
1
cup grapes
·
1
cup carrots, broccoli, or bell peppers with 2 tbsp. hummus
Don’t ban sweets entirely. Completely banning sweets will only incite cravings. Try to
limit the amount of cookies, candies, and baked goods your child eats and
introduce fruit-based snacks and desserts instead.
Limit juice and soda. Soft drinks are loaded with sugar (“empty” calories) that
don’t do anything healthy for your child’s growing body. Many juices aren’t any
better nutritionally. Instead of soda, offer your child sparkling water with a
twist of lime or a splash of fruit juice.
Keep snacks small.
Don’t turn snacks into a meal. Limit them to 100 to 150 calories.
Focus on fruit.
Keep a bowl of fruit out for your children to snack on. Offer fruit as a sweet
treat. Kid-friendly favorites include frozen juice bars, fruit smoothies, frozen
bananas dipped in chocolate and nuts, strawberries and a dollop of whipped
cream, fresh fruit added to plain yogurt, and sliced apples and peanut butter.
Help your kids understand the benefits of being physically
active. Teach them
that physical activity has great health benefits like:
· Strengthening bone
· Decreasing blood pressure
· Reducing stress and anxiety
· Increasing self-esteem
· Helping with weight management
Help kids stay active.
According to the American Heart
Association, children and
teens should participate in at least 60 minutes of moderate-intensity physical
activity most days of the week. You can
set a great example!
Reduce sedentary time. Although quiet time for reading and homework is fine,
limit “screen time” (TV, video games, Internet) to no more than two hours a
day. The American Academy of Pediatrics doesn’t recommend TV for kids age 2 or
younger.
Limit daily screen
time. Studies show a
link between screen time and obesity, so set limits on your child’s
TV-watching, gaming, and web surfing. Experts recommend no more than two hours
per day.
*these are suggestions from the American Academy of Pediatrics
**more to come on this topic in later posts
Stop eating in front of the TV. This is a bad
habit many of us fall into! Tell
your child that, starting now, your family does all their eating at the table.
This helps form good habits and limits the number of calories you and your
child are likely to eat.
Pick a different reward or punishment. Instead of rewarding your child with more
time in front of the television or computer, promise something different, such
as an outing or an activity of their choice.
We all want our efforts to be fruitful. So here are some factors that
have been shown to predict success:
• Including parents in the dietary
treatment program – this is a team effort!
• Strong social support of dietary
intervention from others involved in preparing food
• Regular physical activity prescription
including social support – supporting your children and being a role model are
sure-fire ways to help you child beat or prevent obesity!
If you are
interested in looking at these ideas by age, here are some additional
recommendations for kids of all ages.
Much of this is repeated from above, but is a slightly different
perspective:
Recommendations
by Age13
• Birth to age 1: In addition to its many health benefits,
breastfeeding may help prevent excessive weight gain. Though the exact
mechanism is not known, breastfed babies may be more able to control their own
intake and follow their own internal hunger cues.
• Ages 1 to 5: Start good habits early. Help shape food
preferences by offering a variety of healthy foods. Encourage kids' natural
tendency to be active and help them build on developing skills.
• Ages 6 to 12: Encourage kids to be physically active
every day, whether through an organized sports team or a pick-up game of soccer
during recess. Keep your kids active at home, too, through everyday activities
like walking and playing in the yard. Let them be more involved in making good
food choices, such as packing lunch.
• Ages 13 to 18: Teens like fast food, but try to steer
them toward healthier choices like grilled chicken sandwiches, salads, and
smaller sizes. Teach them how to prepare healthy meals and snacks at home.
Encourage teens to be active every day.
• All ages: Cut down on TV, computer, and video game
time and discourage eating while watching the tube. Serve a variety of healthy
foods and eat meals together as often as possible. Encourage kids to have at
least five servings of fruits and vegetables a day, limit sugar-sweetened
beverages, and eat breakfast every day.
Addressing your Child’s Weight at the
Doctor
The discussion
of weight is never comfortable, especially when it pertains to your child. Talking
with your primary care physician about any concerns you might have can begin
the process of helping your child and can ultimately put you at ease.
Here are some
tips on how to make talking with your doctor about weight and childhood obesity
less daunting:
•
Come
prepared with your concerns.
Write down all your questions and concerns about your child’s weight before you
visit the doctor. Write down if your child is experiencing any symptoms or
behaviors you are concerned about. Be sure to ask for clarification if there is
anything you don’t understand – DO NOT BE AFRAID TO ASK QUESTIONS.
•
Be aware of any pre-appointment restrictions. If your doctor is going to
test your child's blood sugar or cholesterol, your child may need to fast for
eight to 12 hours. When you're making an appointment, ask if any type of
fasting is necessary.
•
Bring a notebook and a pen or pencil to write down important
information. There can be a lot of
information to retain. Writing down the
information and resources your physician gives you will help you remember and
be on the ball.
• If you are uncomfortable discussing the
topic of weight in front of your child,
ask the doctor for a time when you can ask your questions over the phone or
over email or even step briefly into another room to discuss your concerns.
• If you are having the discussion in front
of your child, begin to
discuss aspects of healthy living before the visit so he/she doesn’t feel
attacked. Have conversations about what your child thinks it means to be
physically active or to eat healthy. By making the overall topic familiar with
your child, they will be less likely to feel overwhelmed when you address it
again at the doctor.
• If you have a concern, be sure to voice
it. Just because your
doctor does not bring up the topic of your child’s weight, doesn’t mean there
isn’t an issue. Even your doctor may feel uncomfortable approaching the topic,
so make certain you address any worries you have before you leave.
• Ask the doctor for recommendations and
resources. If there is
an issue with your child’s weight, ask what the next steps should be. There are
many resources on our website as well, but your physician will be able to give
you the best starting point for your child.
• Make it a family issue. Talking about the health and habits of
the entire family will keep individual children from feeling targeted and the
motivation of making changes together as a team will help everyone achieve
their health goals.
Some basic questions to ask
your doctor include:
•
What other health problems might my child have?
•
What are the treatment options for my child?
•
Are there medications that might help manage my child's weight
and other health conditions?
•
How long will treatment take?
•
What can I do to help my child lose weight?
•
Are there any brochures or other printed material that I can
take home with me?
•
What websites do you recommend visiting?
Some
questions you may be asked regarding your child:
•
What does your child eat in a typical day?
•
How much activity does your child get in a typical day?
•
What are the factors that you believe affect your child's
weight?
•
What diets or treatments, if any, have you tried to help your
child lose weight?
•
Do you have any family members with weight problems?
•
Are you ready to make changes in your family's lifestyle to help
your child lose weight?
•
What do you think might prevent your child from losing weight?
•
How often does the family have meals together? Does the child
help prepare the food?
Does
the child, or family, eat while watching TV or using a computer?
In
Summary: Strategies for Real Life
•
Recognize that you have more control than you might think. You can turn off the
TV and the video game. You can choose to get off the bus one stop
earlier than usual and walk the rest of the way, especially when you are with
your kids. You can give your family more vegetables for dinner.
•
Think about the immediate benefits. If reducing the risk of
future heart disease seems abstract, focus on the good things that can happen
right now. You won’t feel so full if you have a smaller portion or skip
dessert. Going hiking with your teenager might lead to a wonderful talk that
neither of you anticipated. A fruit salad tastes great and looks beautiful.
Dancing or playing with your kids is lots of fun and can give you a great
workout.
•
Make small, easy changes over time. Suggesting that family
members take a run together every day will probably get you lots of eye-rolling
and “no-thank-you’s.” It’s easier and more appealing to start out with some new
approaches to nutrition and physical activity that the whole family is really
willing to try. For example, take a walk after dinner a couple of nights a week
instead of turning on the TV. And, instead of chocolate cake with frosting,
enjoy sliced strawberries over angel food cake.
Source:
We Can! Families Finding the Balance, U.S. Dept. of Health & Human
Services
Resources:
Other resources:
Choose My Plate - the government initiative for healthier eating; a good resource for meal planning, tips for lifestyle changes, and more resources for weight management
NEXT: Activities to do with your kids! How to keep them moving! And for PTs - what is our role, how can we help.
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