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Docs to Use BMI in Child Obesity Fight

New Policy Puts Pediatricians on Front Lines in Preventing Obesity

Stopping Obesity Before it Starts

The guidelines, which appear in the August issue of Pediatrics, emphasize recognizing and addressing the issue of a child's weight before it gets out of control.

Key recommendations include:

  • Identify and track children at risk for becoming overweight due to a family history of obesity, birth weight, socioeconomic status, ethnicity, and other cultural and environmental factors.
  • Calculate and plot BMI once a year in all children and adolescents according to CDC growth charts for age and sex.
  • Use changes in BMI to identify excessive weight gain relative to growth.
  • Encourage breast feeding. Studies have linked breast feeding to a decrease in obesity later in life.
  • Encourage parents and caregivers to promote healthy eating patterns.
  • Routinely promote physical activity, including unstructured play.
  • Limit television and video time to a maximum of two hours per day.

Once at-risk children are identified, researchers say pediatricians should talk to parents about strategies to prevent childhood obesity.

"The good news is that for families who see a problem and are willing to get involved, family-based behavioral interventions can be effective for many overweight children," says Faith. "Many small changes have to be implemented, any one strategy by itself probably won't be as effective as multiple strategies."

Those strategies might include training parents about setting an example with healthy food choices, decreasing sedentary activities, and rewarding healthy food choices.

Creating a Healthy Home

Melinda Sothern, PhD, co-author of the book Trim Kids and director of the childhood obesity prevention laboratory at Louisiana State University, says parents can do little things to create a healthy environment and encourage physical activity at home. For example:

  • Turn on the stereo instead of the TV when you get home.
  • While watching TV, have children "do the commercial boogie" and get active during commercial breaks.
  • Enact a 30-minute rule. Take a five-minute break after 30 minutes of sedentary activities like homework or sitting at the computer.
  • Set up an imagination station in the living room or den filled inexpensive games that require movement, such as a Hula-Hoop, balloons, basketball-type hoop games, Twister, jump rope, small hand weights, and stretch bands.

"Anything is better than vegging out in front of the TV," says Sothern. "It doesn't have to be vigorous. If they are up on their feet, it's three times more calories being burned than when they're sitting in front of the TV."

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