Weight is Weighing on My Mind

Reports of increasing obesity levels have been circulating for years on the news. I see kids in my office regularly who are in the overweight or obese category and we all struggle how to treat this growing problem. Excess weight in childhood is linked to many health issues such as high cholesterol, diabetes, metabolic syndrome, and it can trigger earlier puberty – leading to overall shorter adult height. Not to mention the psychological and social implications of bullying, depression, eating disorders, and more.

Why is weight so much more of a problem now than it was years ago?
unhealthy foods
Childhood obesity is a growing problem. Kids need to eat healthy and move daily.

I think it’s a combination of what they’re eating and what they’re doing. Today’s kids are shut up in the house after school watching one of many tv channels or playing video games. Even those who are shuttled to activities get overall less exercise because it is structured differently than free play. They ride in the car to practice or class, then sit and wait for things to start. They might sit or stand while others are getting instruction.

Simply put: They eat a lot of processed and junk food and they don’t get to do active things at their own pace with their own creativity for as long as they want.

What to do???

On one hand kids need to learn to make healthy choices to maintain a healthy body weight for height, but on the other hand you don’t want to focus so much on weight that they develop eating disorders. I think this is possible if we focus on the word “healthy” – not “weight”.

Starting at school age I ask kids at well visits if they think they are too heavy, too skinny, too short, or too tall. If they have a concern, I follow up with something along the line of, “How would you change that?” I’m often surprised by the answers, but I can use this very important information to guide how I approach their weight, height, and BMI. We talk about where they are on the graph, and healthy ways to either stay in a good place or how to get to a better BMI. I focus on 3 things we all need to be healthy (not healthy weight, but healthy):

  1. Healthy eating (eat a plant and protein each meal and snack)
  2. Exercise (with proper safety equipment but that’s another topic!)
  3. Sleep (again, another topic entirely!)
Food is a part of our daily needs, but much more than that.

It’s a huge part of our lifestyle. We have special meals for celebrations but on a day to day basis it tends to be more repetitive. We all get into ruts of what our kids will eat, so that is what we prepare. The typical kid likes pizza, nuggets, fries, PB&J, burgers, mac and cheese, and a few other select meals. If we’re lucky our kids like one or two vegetables and some fruits. We might even be able to sneak a whole grain bread in the mix. If our family is busy we eat on the run– often prepared foods that are low in nutrition, high in fat and added sugars, and things our kids think taste good (ie things we won’t hear whining about). We want our kids to be happy and we don’t want to hear they are hungry 30 minutes after the meal is over because they didn’t like what was served and chose not to eat, so we tend to cave in and give them what they want.

We as parents need to learn to stop trying to make our kids happy for the moment, but healthy for a lifetime.

There’s often a discrepancy between the child’s BMI (body mass index) and the parent’s perception of healthy. The perception of calorie needs and actual calorie needs can be very mismatched. I have seen a number of parents who worry that their toddler or child won’t eat, so they encourage unhealthy eating unintentionally in a variety of ways:

  • turn on the tv and feed the child while the child is distracted
  • reward eating with dessert
  • refuse to let the child leave the table until the plate is empty
  • allow excessive milk “since at least it’s healthy”
  • allow snacking throughout the day
  • legitimize that a “healthy” snack of goldfish is better than cookies
Any of these are problematic on several levels.  Kids don’t learn to respond to their own hunger cues if they are forced to eat.  
If offered a choice between a favorite low-nutrition/high fat food and a healthy meal that includes a vegetable, lean protein, whole grain, and low fat milk, which do you think any self-respecting kid would choose?
If they’re only offered the healthy meal or no food at all, most kids will eventually eat because they’re hungry.
No kid will starve to death after 1-2 days of not eating.  
They can, however, over time slowly kill themselves with unhealthy habits.  

So what does your child need to eat?

Think of the calories used in your child’s life and how many they really need.  Calorie needs are based on age, weight, activity level, growing patterns, and more.
It’s too hard to count calories for most of us though.
If kids fill up on healthy options, they won’t be hungry for the junk.
Offer a plant and a protein for each meal and snack. Plants are fruits and vegetables. Proteins are in meats, nuts, eggs and dairy.
Don’t think that your child needs to eat outside of regular meal and snack times.
One of my personal pet peeves is the practice of giving treats during and after athletic games. It’s not uncommon for kids to get a treat at half time and after every game. Most teams have a schedule of which parent will bring treats for after the game.
Do parents realize how damaging this can be?  
  • A 50 pound child playing 15 minutes of basketball burns 39 calories.  Think about how many minutes your child actually plays in a game. Most do not play a full hour, which would burn 158 calories in that 50 pound child.
  • A 50 pound child burns 23 calories playing 15 minutes of t-ball, softball, or baseball.  They burn 90 calories in an hour.
  • A non-competitive 50 pound soccer player burns 34 calories in 15 min/135 per hour. A competitive player burns 51 calories in 15 min/ 203 in an hour.
  • Find your own child’s calories burned (must be at least 50 pounds) at CalorieLab.
Now consider those famous treats at games.  Many teams have a half time snack AND an after game treat.  Calories found on brand company websites or NutritionData:
  • Typical flavored drinks or juice range 50-90 calories per 6 ounce serving.
  • Potato chips (1 ounce) 158 calories (A common bag size is 2 oz… which is 316 calories and has 1/3 of the child’s DAILY recommended fat intake!)
  • Fruit roll up (28g) 104 calories
  • 1 medium chocolate chip cookie: 48 calories
  • Orange slices (1 cup): 85 calories
  • Grapes (1 cup): 62 calories
  • Apple slices (1 cup): 65 calories

So…Let’s say the kids get orange slices (a lot of calories but also good vitamin C, low in fat, and high in fiber) at half time, then a fruit drink and cookie after the game. That totals about 200 calories. The typical 50 pound soccer player burned 135 calories in a one hour game. They took in more calories than they used. They did get some nutrition out of the orange, but they also ate the cookie and fruit drink. The cookie has fewer calories than other options but no nutritional value and a lot of added sugars. The kids end up taking in many more calories than they consumed during play.

 

What’s wrong with WATER? That’s what we should give kids to drink at games.

They should eat real food after the game if only they’re hungry.  Snacks are likely to decrease appetite for the next meal, so if they’re hungry give a mini-meal, not a sugar-filled, empty calorie treat every game.

There are many resources on the web to learn about healthy foods for both kids and parents. Rethink the way you look at how your family eats.

Simple suggestions:

 

      • Offer a fruit and vegetable with a protein at every meal and snack. Fill the plate with various colors! (As I tell the kids: eat a plant and a protein every time you eat ~ meals and snacks!)
      • Picky kids? Hide the vegetable in sauces, offer dips of yogurt or cheese, let kids eat in fun new ways – like with a toothpick. Don’t forget to lead by example and eat your veggies!
junk food
Smiling boy eyeing a burger and candy
  • Buy whole grains.
  • Choose lean proteins.
  • Don’t skip meals.
  • Make time for sleep.
  • Get at least 60 minutes of exercise a day!
  • Eat together as a family as often as possible.
  • Turn off the tv during meals. Don’t use distracted eating!
  • Encourage the “taste a bite without a fight” rule for kids over 3 years. But don’t force more than one bite.
  • Don’t buy foods and drinks with a lot of empty calories. Save them for special treats. If they aren’t in the home, they can’t be eaten!
  • Drink water instead of juice, flavored drinks, or sodas.
  • Limit portions on the plate to fist sized. Keep the serving platters off the table.
  • Eat small healthy snacks between meals. Think of fruit, vegetable slices, cheese, and nuts for snacks.