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Posts Tagged ‘Childhood Obesity’


Children mimic your behaviors!

Contrary to popular belief, children hear what you say and see what you do.  Your behaviors and comments can leave a lasting impression.  Even your body image or weight concerns can be passed on to your kids.  Evidence shows that stressing thinness and weight control promotes eating disorders, low self-esteem, decreased body image, and weight bias in children.  Furthermore, eating behaviors linked to a higher risk for obesity are known to develop very early in life.  A 2001 study showed family food environments and attitudes around food and eating affect even preschool-aged kids’ eating behaviors.  You may think youngsters don’t pick up on your drastic dieting or negative comments you make about your body like older children, but they do!

Several studies show that restrictive feeding can impair a child’s ability to regulate their intake, resulting in overeating and weight gain.  Worrying about your own weight can influence your feeding style.  For example, forbidding high calorie foods or sweets in your home can result in your child sneaking food or feeling deprived and overeating when given the opportunity.  Overly controlling or eliminating fun foods simply doesn’t work with kids – balance is key.

Have you ever found yourself saying out loud:

“I have got to lose weight, I am getting so fat”

“I am going to be good and skip lunch today”

“No more desserts for me, I don’t deserve it”

If so, you may want to censor your comments and think before you speak.   Remember, your words could promote your child’s weight gain!

As a parent, you can model  “good for you” behaviors without fixating on weight.  There’s nothing wrong with guiding your child towards adopting healthy habits that will benefit him or her – that’s part of your role!

Fortunately, there are several steps you can take to promote a healthy weight for yourself while empowering your child.

DO:

  • Be physically active and limit your own sedentary activities
  • Aim to eat when feeling physically hungry
  • Have a neutral view about all foods
  • Stock a range of nutritious foods in your home and choose these options more often
  • Offer balanced family meals as much as you can
  • Choose to talk about yourself and others with respect and appreciation

DON’T:

  • Get caught up in the latest fad diet or encourage your child to diet
  • Skip meals
  • Eliminate all sweets or high calorie foods from your home
  • Use food for rewards or punishments for yourself or for others
  • Eat while standing up or distracted (may lead to eating mindlessly)
  • Emphasize effects of unhealthy eating
  • Focus on anyone’s weight, especially yours or your child’s

Bottom line:  You are your child’s biggest role model – do you want your child viewing and treating their body the way you do?

Contributing Author:  Katherine Fowler, MS, RD, LDN

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I am not  a fan of diets.  They don’t work.  Especially with kids.

Many adults argue that a calorie-restricted diet is just the nudge they need to launch their new eating habits and the resulting weight loss they desire. But for kids, restrictive approaches to weight management just don’t seem to work well. Maybe it’s the aspect of hunger, or the emotional responses that erupt, the growth influence, or just human nature that complicates weight loss for kids.  I suspect many adults would agree that some of these obstacles exist for them when using restriction as a diet attitude.  Maybe that’s why ‘diets’ aren’t working in a lasting way for adults.

We know that there are significant risks associated with dieting in teens, such as increased eating disorders and disordered eating, continued weight gain despite efforts at weight loss, and lowered self-esteem.  Diets dish up a mind-set of  “I can’t have this…”.  Human nature shows us that when we cannot have something we want, we want it even more…in the case of dieting and children, you can see where this path leads to: overeating. Having worked with many children and teens who need and begin the path to a healthier weight, I know first-hand how difficult and frustrating the process can be. And how much time it can take.

But I am here to tell you, be patient, healthy weight loss takes time. Especially for kids.

As we all get ready to begin the year 2011, I have compiled an analogy to describe the process and patience required for you and your child as you better your eating habits and your lifestyle.  It’s the Garden-Planting Analogy. I won’t get into the details of foods, portions, exercise, TV/screen time here, because you can find that in my Why Weight? blog series from last year, and the Family Pocket Guide that resulted from the blog.

Real change takes time. Whether it’s starting a new exercise routine, trying to be a better mom or dad, or getting to church regularly, making real change in your life requires a commitment to practice new behaviors every day. This is true for new health behaviors as well.  So how is planting a garden similar to waiting for weight loss? Let’s take a look, step by step:

The Garden-Planting Analogy

STEP 1: Prepare the soil Just like you prepare the ground to plant your crops, your child’s body must prepare for weight loss. This means getting rid of excess nutrients (like calories, sugar, and fat) and including nutrients that are missing from their diet.  Start a movement program that your child (and family) can stick with.

STEP 2: Plant the seeds Seeds are the nuggets of information from which change can root and thrive. Educate your child with credible nutrition advice that includes what to eat, hunger management, and fun, healthy activity. Educate yourself with how to feed your child, using positive attitudes and actions that include role modeling, daily movement, and meal routines that support healthy eating.

STEP 3: Water regularly Crops die without regular water and nutrients.  So will your efforts at weight loss if you don’t pay attention to your healthy behaviors every day. Practice good nutrition, adequate sleep and physical activity daily.

STEP 4: Wait for the roots to take hold Herein lies the frustration.  We want to plant the seeds and see an immediate garden.  But you and I know, an abundant garden requires daily care.  This same nurturing and care-taking is needed for child weight loss too.  It takes time for nutrition education and daily health practices to synchronize and internalize. Practice your health management techniques everyday, and wait.

STEP 5: Watch the plants bloom and grow Before you know it, a plant sprouts and takes hold.  The same will happen with your family efforts for better health. Soon, kids will be sleeping better, be more active, and eat healthier. And the scale will begin to move (or stay the same, depending on the weight goals for your child).  But even better than that, your family will have practiced and adopted skills and health behaviors that can last a lifetime!

A cup of  “Good things come to those who wait” blended with a pound of  “Practice makes perfect” and you’ll have a recipe with the right attitude, level of commitment, and patience to see your child (and your whole family) succeed with weight loss.

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“Don’t worry, he’ll grow out of it.”

How many times have parents heard this classic line?  Friends, grandparents, teachers, and pediatricians use this solution for parents who are concerned with a multitude of childhood behaviors. 

  • My child is wetting the bed!  Oh, she’ll grow out of it. 
  • My child won’t eat vegetables.  Don’t worry, my child did the same…and he grew out of it!

When it comes to infant obesity, this advice may not be an effective or helpful response.  A recent study in The Journal of Pediatrics looked at a sample of infants, aged 6 months, and identified a 16% rate of obesity among them.   Babies who were obese at 6 months, were still likely to be obese at 24 months.  And so our national childhood obestity problem begins.

What causes obesity in infancy?  Although it is complicated and not fully understood, the following are potential parenting behaviors that may encourage the path toward infant obesity:

Inappropriate feeding practices:  The methods and practices in which we feed babies may contribute to obesity, such as:  adding cereal to the baby bottle to encourage a baby to sleep through the night; improper mixing of formula which may result in a concentrated calorie source; forcing an infant to “finish the bottle”; and feeding a baby “all day long” are just some of the red flags that a baby may be fed inappropriately.

Missing infant cues:  Babies let their parents know when they are full–they turn their heads away, fall asleep, or pull off the breast or bottle.  Likewise, they let their hunger be heard…by crying!  Confusing these signals or worse, ignoring them, can result in overfeeding.  Paying attention and accurately reading infant cues will help parents feed their baby enough, but not too much.

Confusing infant cues:  A crying baby doesn’t always mean a hungry baby.  Parents may be confused by their baby’s signals, misreading boredom, a wet diaper, or tiredness, for hunger.  Interpreting crying and/or discomfort as a sign of hunger can lead to overfeeding a baby.

Starting solids too early:  Many new parents feel the pressure from outside influences to introduce solids early.  Or perhaps they are under-informed about how and when to begin solid food.  The timing for solid food introduction to infants is generally between 4 and 6 months.  Following a guideline for starting solids can help parents stay on track with their baby’s nutritional needs and developmental progression.  Starting too early can pose the risk of overfeeding, and overfeeding can lead to obesity.

Lack of nutrition knowledge:  Many parents lack the information and confidence to feed their baby, and may not have the resources to seek out this information.  This lack of knowledge may lead to the presentation of unhealthy foods, an inadequate balance of the important food groups in the diet, and feeding practices that encourage excess weight gain. 

Feeding your baby, and doing it well, sets the foundation for the overall health of your baby.   In order to have a positive impact on childhood obesity, parents need to pay attention to food selection, timing, and the attitudes and actions they use in the high chair.

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Why Weight?

If you have read this 12 part series, you are well aware that there are many things to think about in regards to children and their weight.  Activity level, food selection, hunger response and management, and feeding techniques are just some of the many considerations.   Childhood obesity isn’t simple–it is a layered, multi-faceted condition that involves what you eat, how you eat/feed it, how you feel about your body and self, whether you exercise, and a multitude of environmental influences including school, community, and economic status.  Wouldn’t it be easy to point the finger at one contributor?  Rarely in counseling  am I able to name one single issue as the culprit–there is usually a multitude.  Pinpointing the critical contributors can build awareness, and change.  Childhood obesity is a complex issue– treating it is far more difficult than preventing it.  Yet prevention hinges on knowledge and commitment, so building awareness, especially among parents, is critical.

Why Weight?

Excess weight gain in childhood is no party.  The psychosocial impact begins at a young age and may last a lifetime.  The physical impact may perpetuate the problem, challenging children in their efforts to be active.  The medical toll is well known, from the affiliated conditions of heart disease to diabetes, as well as the exhorbitant cost to our nation.  One thing we know for sure, we cannot wait to address this weight problem in children.

Treatment of childhood obesity is challenging.  It generally requires a lifestyle change that involves the entire family.  Success is dependent on motivation and commitment, and that is a large and variable factor among families.  Children hold little power and generally assume a “follower” position, relying on parents to lead the effort.  Parents make the food shopping decisions, the dining out rules,  and the TV allowances–children’s weight status is a by-product of many of these decisions.  As children grow older, they tend to mimic their family habits, adopting behaviors that may or may not support their health.   A positive parent leader is a key component to a child’s weight management treatment. 

Prevention is the key and it begins in the highchair.  Yes, the early decisions count.  Allowing little Sally a Dum-Dum sucker at the bank drive-through, or Baby Sam a soda in his bottle are the decisions that set the foundation for future tastebuds.  Research shows that feeding habits in the first 2 years of life set the precedence for future eating habits.  In other words, if you want your child to eat healthy and be at a healthy weight, you’ve got to pay attention early on.  Further, recent research suggests that infants as young as 6 months of age are showing signs of obesity.  As the age of 4-6 months is the time to transition to “real food”, this research is compelling and urges parents to pay more attention to what and how they feed their infants in the highchair.

We owe it to our own and our nation’ children to become educated about food and nutrition, be involved in teaching and modeling a healthy lifestyle, be more thoughtful about feeding and role-modeling, be committed to activity, and be committed to prevention, rather than await treatment.  As the parent, the gatekeeper, and the leader–it’s up to YOU.

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They say bad habits start young…

We have discussed many of the practices and behaviors that can contribute to childhood obesity already, from too much soda consumption and not enough fruits and veggies to portion distortion and excess screen time.  There are other practices, independent of actual food selections and portion sizes, that can evolve into habitual behaviors.  These behaviors may take on a life of their own and when they do, can be a contributor to childhood obesity.

The Sneaker. “My mom yells at me if I snack in between meals.  But I am so hungry at night…when my parents go to bed, I go to the pantry and get the box of cereal.”

The Hoarder. “I hate being hungry, but mostly I feel hungry, especially at lunch.  I carry extra granola bars and crackers in my backpack at school and store them in my locker.  Oh, and I have some candy hidden in my closet, too…. just in case I get hungry.”

The Hider. “My parents are really focused on eating healthy and exercising—they never eat anything bad for them.  When I want bad foods, I definitely make sure they don’t see me eat them, because I would get in trouble or they would dissapprove.  It stinks to eat alone, but that’s the only way I can eat the foods that I like.”

The Offsite Overeater“We never have anything good to eat in my house, but when I go to Johnny’s house, his mom has everything!  I just can’t help myself…”

As adults, many of you can probably identify with some of these feelings and behaviors…maybe these remind you of your own childhood struggles.  The seeds for the above behaviors are planted at a young age.  Parents have the difficult job of balancing healthy eating and food with food security.  How can you assure your child is secure about food, is getting enough to be satisfied, and is avoiding the bad habits that can sabotage healthy eating and weight?

Be a great provider:  Stock your kitchen with a balanced variety of foods.  Avoid the extremes in food—all healthy or all “junk food”.   Prepare enough food at mealtimes to satisfy your family’s appetite, and keep a schedule for meals and snacks—this helps avoid excess hunger.

Avoid “good” and “bad” food labels:  Positive and negative food labels can confuse children and set up conflict in their minds—how can my teacher eat “bad” food?  How can this food be “bad” when it tastes so good?  It’s best to keep a neutral attitude about all foods.

Tune into hungerHunger varies with children and children want to eat when they are hungry.  Putting off hunger can lead to overeating—either in an obvious way or in a secretive way.

Family-style meals:  Do you want your child to eat what they need and leave the table satisfied?  Offer a variety of food groups in serving platters and bowls, and allow your child to determine if and how much food they will consume.  You get to determine the health and quality of the foods you serve.

Encourage eating in the open:  Don’t shame your child if they want to eat.  Help them find a satisfying snack, and if able, sit with them while they eat it.  Children should not have to hide when they want to eat in order to avoid a parent’s disapproval.  There is no shame in eating; we all have to eat to live.

Address bad habits openly:  Don’t be afraid to speak to your child lovingly about bad habits.  You might learn that your child is not eating enough or properly…which is something you can work with your child to solve.  Alternatively, your child ends up navigating the situation on his own, and perhaps in an unhealthy and unsuccessful manner.

Why Weight? to help your child prevent the damage that can spring from bad habits?  It’s up to YOU.

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Children love to move.  And need to move.  And let’s face it, kids need lots of physical activity to maintain good health and a body weight that is right for them, along with plenty of healthy food options.  Lack of daily physical activity is a strong contributor to childhood obesity.  These perspectives and guidelines may help your child become more active:

The Physical Prescription:  Duration, intensity, and type of activity do matter.  While any movement is better than none, experts recommend at least 1 hour of physical activity per day, both planned activity and free play.  No longer is walking the dog adequate, experts want to see children sweaty, red-faced, and breathless every day.  If you are relying on school efforts, be aware that daily recess and physical education varies from school to school and may not be a significant contributor to your child’s daily activity level.

Nurture with nature:  The number one predictor of physical activity in children is time spent outdoors.  Get outside as a family and encourage your child to play outside as often as possible.  

Get in gear:  Let your child pick out their own active wear, shoes and sports aids.  Whether an independent exerciser or part of an athletic team, children enjoy having gear that supports their activities.  Who doesn’t love running to music?  Or shooting baskets in the driveway?  Having the right gear can rally excitement around being active and can promote movement.  For the teen, gym memberships, pedometers, and exercise groups/classes can be a positive motivator, as well.

Walk your talk:  More than 40% of a child’s health is determined by behavior.  That’s more than genetics, healthcare, or social influences.  You are your child’s behavior barometer—your child will do what you do.  So get moving on getting moving!

Breaking down barriers:  Identify any road blocks that may get in the way of your family’s activity level, such as busy work schedules.  Find solutions, not excuses, for how to deal with these road blocks that will fit your unique family circumstances.

Be Tech Savvy:  If your child is having a difficult time giving up video games, try compromising with ones that are more active and interactive.  Hands-on video games, TV exercise programs, and interactive websites can be the beginning of increased activity for your child.

Physical activity is a necessary part of being healthy and having a healthy future.  And often, one avenue of activity is not the magic pill—it is a conglomeration of several efforts, each and every day.  Why Weight?

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No doubt most parents have savvy school-aged children who are able to navigate the web, program their iPhone, and operate the family plasma TV.  It is certainly true that we live in a technological world, and this is obvious in our children.  With the advent of advergames (advertisements on video and computer games) and advercation (advertisements on educational websites and games), children are lured to return to the “screen” to continue “playing”—but they aren’t playing like they used to!   Literally, children are letting their fingers do the walking.

What is “screen time”?   “Screen time” is a term to describe the variety of technological devices to which children are exposed for general entertainment.  “Screen time” encompasses anything with a screen–the TV, the Nintendo DS, the computer, the phone, the iTouch, the iPod, and the like. 

How does “screen time”  influence childhood obesity?  Researchers show a strong correlation with the number of hours spent watching TV to an increased prevalence of obesity in children.  If your child spends more than 2 hours in front of the TV per day, he/she is at greater risk for being overweight.   The effects of TV viewing and “screen time” results in overeating and lowered energy expenditure (calorie burning).   Have you ever watched a movie with a bowl of popcorn and consumed the entire bowl?  The TV is a powerful distraction when it comes to eating sensible amounts.  Additionally, sedentary behavior, or sit-down time, promotes a lower calorie burn  than moving (activity).   It’s simple:  TV and screens promote more sit-down time which results in less activity and overeating, leading to a higher potential for weight gain. 

Simple steps to curb your child’s TV/”screen time” appetite:

Remove the TV and other screens from the bedroom:  Children with TV’s in their bedroom watch a lot of TV!  The presence of a TV in a child’s bedroom is one of the leading indicators of excess “screen time”.  Removing the TV and other lurking “screens” will curtail the number of hours your child is inactive…watching TV, playing video games, and laying on the bed listening to the iPod.  

Limit all “screen time”:  The recommendation for reasonable “screen time” is 2 hours per day maximum; homework-oriented, computer time does not fall within these limitations.  Each family has unique dynamics and demands on their time—consider parameters around “screen time” limits that will be advantageous to your child, ie., the school week is focused on school work, projects, and educational endeavors.

Start early:  Limits on “screen time” should begin as early as 5 years of age.  This makes sense–toddlers and pre-schoolers are moving creatures–when we use the TV or “screens” to entertain them, we are training them to be sedentary!

Emphasize hands-on, active endeavors:  Cultivate an attitude of “let’s do” rather than “let’s see”.  Be an active parent–your children will mimic your active and your sedentary behaviors.

A little bit goes a long way:  Any modification and limit you can make around TV and “screen time” will be an improvement!  Be realistic with what you can tackle, without too much rebellion from your child.  Get “buy in” from your child–if children have other, fun things to do in lieu of “screen time”, they will be more accepting of the new “screen time” limits.

A reduction in “screen time” and TV viewing helps every member of the family and it provides an opportunity to get moving.  Help your child let their feet do the walking, not their fingers.  Help them have greater opportunities for movement and activity, rather than ample sit-down time.  Why Weight?

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