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    Town Hall With First Lady Michelle Obama

    [opening remarks]

    Elizabeth Ward, MS, RD: Hi, everyone. Hey. Welcome to the WebMD town event to celebrate the second anniversary of Let's Move! I'm a registered dietitian and nutrition expert Elizabeth Ward, and I am thrilled to be joining first lady Michelle Obama and our panel of experts at this exciting event. Woo. Yeah.

    Now, I want to introduce our panel. First up we have pediatrician and mom, Dr. Hansa Bhargava, who oversees WebMD's Fit initiatives, which are devoted to raising healthy children.

    Next, we have Kathleen Zelman, WebMD's director of nutrition and a registered dietitian. Kathleen is also on the board of directors of the American ‑‑ of, excuse me, of the Academy of Nutrition and Dietetics.

    Jim Kauffman is the national director for health and well-being for the YMCA. Jim also supervises all YMCA of the USA programming of aquatics in sports. Yeah.

    And now for the woman you've all been waiting for. Woo. She's our mom in chief and a passionate advocate for raising healthy children. Ladies and gentlemen, please give a warm welcome to the first lady, Michelle Obama.

    Very good. Very good. This is great. Well, Mrs. Obama, we'd like to start by acknowledging your amazing displays of strength and agility recently, uh‑huh, when you competed against Jimmy Fallon and Ellen DeGeneres.

    I hope you all saw that. This is a push‑up queen here.

    But also, I know a lot of the kids are very curious about your appearance on the iCarly television show and they would like to know how that was.

    First lady Michelle Obama: How many people here saw iCarly?

    Oh, yeah. Well, see, my girls love iCarly, but I didn't know how many kids across this country love iCarly. So the reason why we worked with iCarly is that, and I didn't realize this, because I watch the show with the girls every now and then, but she's a military kid, as you guys know, and one of the things that I worked a lot on is making sure that the country supports our military families and iCarly ‑‑ exactly. Absolutely.

    So we are looking at all kinds of creative ways to get the message out, and one important element is making sure that other kids around the country realize the sacrifices that military kids make, because I don't think most people understand that military kids oftentimes are moving from school to school to school. Every few years, they have to get readjusted, keep their grades up, oftentimes dealing with a loved one deployed, a mom or a dad, and that's tough, but they manage to keep it together, and that time on iCarly was a lot of fun. There are two members of the cast that are military kids, so it was really great. They're all down‑to‑earth kids. They're nice. They're kind. They're polite, so keep that in mind. In real life, they're good people. So it was a lot of fun and I'm glad you all watched.

    Ward: Great. Great.

    We have so much to get to. We've got some great questions from our viewers and also from the audience, and the first one is for you.

    When you and your family are on the road, what are your favorite go to healthy meals?

    Obama: Oh, favorite go‑to, now, that's the tough thing, is really staying on track when you're not at home, and a lot of times we travel, whether it's campaigning or doing things like this, but what I remind my kids is that a lot of foods that are out there are healthy. I mean, you know, a hamburger is not unhealthy, right, if it's on a whole wheat bun, if the fries are baked, if it's not fried, if it's grilled. Sandwiches are good, you know, turkey sandwiches and ‑‑ on whole wheat. If you put lettuce and tomato, you've got a good mix.

    What I usually encourage my kids to do is to, you know ‑‑ I tell them, you know, that they have alternating opportunities to pick a fun lunch and a healthy lunch, and the fun lunch means they can eat whatever they want. A healthy lunch means it's got to be something that has a vegetable, you know, but it can be something like pasta, and oftentimes we use whole wheat pasta. So a lot of times it's the way it's prepared and it's not necessarily, you know, the actual thing. So, you know, chicken nuggets are good. Oftentimes we look at them when they're baked and not fried. That's a good meal.

    So, you know, when we're on the go, you have to make do with what's out there and just, you know, tweak it the best you can to make it something that's not just completely over the top, and what I tell my kids, whether we're on the road or not, is that dessert is that sometimes treat, so we don't have desserts every day of the week. Desserts are reserved for the weekends, and that's true even if we're traveling, you know. We just try to keep it to a minimum, and then we make sure that we have snacks that are healthy, so they're not just cookies and chips, but we've got lots of fruit around, nuts, you know, trail mix, things like that, and, you know, popcorn, air‑popped popcorn is good. So those are the kinds of things that you don't have to be, you know, a culinary genius to make the simple things easy, so we just try to keep it simple.

    Ward: So true.

    Obama: OK.

    Ward: Thank you. Dr. Hansa, this is for you.

    Susan on WebMD asks, "My 12 year old, 5 foot 7 inch son, Nick, is always hungry. He eats well at mealtime, but an hour later, he's asking for a snack. Can you suggest some quick, easy, and healthy snacks?"

    Hansa Bhargava, MD: Absolutely. Well, I think a lot of people with teenagers and kids who are tall feel that way. I'm sure many families in this audience, it's really important for kids to eat healthy like Mrs. Obama was talking about. Often what you can do is combine a fruit or a vegetable with a protein and that actually gives them the nutrients they need and gives them the energy they need to go forward.

    Also, it's important to make sure that they're getting a variety of fruits and vegetables as well.

    Did you have anything to add to that?

    Kathleen Zelman, MPH, RD, LD: I think I would add that the winning combination is protein and fiber, so you get fiber from fruits and vegetables and whole grains, and protein sources are dairy and beans and nuts and eggs, and if you have that winning combination, it fills you up and so you'll ‑‑ the 12‑year‑old will go a little longer, but also it kind of crowds out the foods that are maybe less healthy. So it's important to always think of that winning combination at snack and at meals.

    Ward: Kathleen, we have an audience question for you from 9‑year‑old Brianna.

    What type of foods should I eat every day to be a healthy person?

    Zelman: Oh, I love that question, Brianna. That feeds right into MyPlate, which Mrs. Obama is very familiar with and Elizabeth wrote a book about it.

    If you look at the plate, it's divided into four quarters and each ‑‑ half of the plate is fruits and vegetables, one quarter is protein, and one quarter is a grain. So if you use that and you pair it with some dairy, that always gives you an idea of what your plate should look like, what breakfast, lunch, and dinner, so you can always try to make sure that you have lots of fruits and vegetables.

    Bhargava: And if I may just add to that, it's not only what kinds of foods you eat, but also when you eat them and how you eat them. So it's important to sit down and eat them, not in front of a television, so that you know what you're eating and enjoy your food and remember always to have as many family meals as possible, because that will make you healthy and happy.

    Ward: Now, Jim, speaking of food, I have a question for you.

    Are there any foods you should avoid before you exercise, and how about after?

    Jim Kauffman: That's a really good question. It's ‑‑ a lot of it is personal preference and what you're most comfortable with and what your body can tolerate before you're going to go out and do some kind of physical activity. So a lot of people they don't do dairy, they don't do well with that. Recommended is probably something that you're comfortable with, a protein about an hour before you go. One thing to actually include is water, and water regularly and often if you're thirsty. Other things to avoid would be anything really heavy that's going to sit in your stomach, some pastas, some of the more unhealthy breads and cereals, and then afterwards, after a good strenuous workout, a good thing to do is to include some kind of protein to help replenish the muscle breakdown that you've had during the exercise. So some time about 30 minutes to an hour afterwards would be a good thing.

    Zelman: And I would add that chocolate milk, here's your opportunity to drink chocolate milk, because it's been proven, there are studies that say it's one of the best beverages that hydrates and provides those nutrients from the muscles that have been exercised.

    Ward: Can you think of any other snacks, maybe protein ‑‑

    Zelman: Yogurt, you know ‑‑

    Kauffman: Peanut butter, tuna salad.

    Obama: I often do peanut butter and apples, a good dip, or honey. I do that before my workout.

    Ward: So, Mrs. Obama, this one is for you.

    Do parents have the right to recommend to their kids' schools what kind of food the kid should eat?

    Obama: You know, I think parent involvement in schools at all levels is really critical, and I don't think that there's any parent here who should feel that they don't have the right to ask those kind of questions. I mean, we're fortunate, because we just got some wonderful new legislation passed that's going to improve school meals. Thirty-two million kids will be getting better meals at lunch and at breakfast. As a result, more proteins, more low fat, more fruits and vegetables. It's going to be a good thing for our schools. But how things are implemented on the ground in your school is really up to the parents and the students and the teachers. So it's really important for you to keep an eye on what's happening in your kids' lunchrooms. And you definitely should ask questions and sit down and talk to the principal and get other parents involved to make sure that you're satisfied with the choices that are being made for your kids. I mean, when you think about school lunches, and for many kids who are coming from families that are struggling, these school meals may be the main source of nutrition that they get. And if your kid is getting breakfast and lunch, that is more than half of their calorie intake coming from those school meals. So I think it's ‑‑ that makes it really important for parents to be involved and to take an active role, and don't let anyone intimidate you. I mean, you should be in the position to be able to ask those kind of questions. So I've been to many schools where the parents have taken an initiative.

    They've started that school garden that's used to feed the kids at lunch. Many parents use their own resources and expertise to add value to what's going on. So if you have something to add, do not hesitate to do it. Our kids need parents who are watching and concerned; school meals are critical to their overall development, and if there are any teachers out here, you know that if a child doesn't come to school ready to learn with a good set of nutrients in their system, they have a tough time focusing, and this ‑‑ their meals, their nutrition directly effects their success, not just in school, but in life. So we have to get them off to a good start.

    So this is a fight worth fighting for parents, and I would urge you all not to shy away from it.

    Ward: So don't feel intimidated, make your wishes known.

    Obama: Absolutely.

    Ward: I know a lot of parents who do feel like they shouldn't say anything.

    Obama: Right. Right.

    Ward You know.

    Obama: Right. Well, people should know in, you know ‑‑ when the parents are involved, that affects everything at the school level. So don't ever be intimidated.

    Kauffman: And if I could add a piece in that also, the Partnership for a Healthier America recently set some standards for, not just for what goes on in a school area, but also the after‑school time, and Mrs. Obama is the Honorary Chair of the Partnership for a Healthier America, and these standards are that when your child is involved in an after‑school activity, that water is the primary drink of choice, and that that's going to be available, and that any kind of snack is going to be some kind of fruit and vegetable or a healthy grain, and that there's going to be adequate physical activity that goes with that. So if you combine a great healthy lunch with school along with some good standards in the after‑school time, you're really starting to have an opportunity to make some significance inroads, too. So it's just a healthier atmosphere for kids.

    Ward: Good. That's great.

    So, Kathleen, an overwhelming amount of people asked us for some advice on fitting healthy foods into a grocery budget which may be tight. So what are your thoughts?

    Zelman: Well, if you're looking to stretch your food dollar, it's good news, because you can do it without skimping on good taste or good nutrition.

    If you keep that plate in mind, one of the most expensive parts of the plate is the protein source, but it doesn't have to be fish or chicken or meat. It can be beans. Beans are so nutritious. They're inexpensive. You can keep them in the pantry. You can take your family meals, your family favorite recipes, and stretch them with things like beans or eggs, make dinners out of eggs, have vegetarian dinners where you just eat all vegetables, plus whole grains and beans. So you really can do it without compromising the health of your family. And when you think about the amount of protein you need, it's really small. So you can make that 1 pound of ground beef stretch and feed the whole family.

    Bhargava: And I would add two other things to that. One‑third of our families right now are shop ‑‑ are going outside to eat. That's how many meals we're eating outside the home. If you stay at home and you cook, you're going to save a lot of money. Put that money into a jar and use it for fun activities like going skating with your kids if you live up in the North, or maybe roller skating in the South, you know. You can actually save that money and save the gas money that you're going out ‑‑ when you go outside and eat as well, and you're teaching your kids good habits, because you need to model that behavior. Cooking at home is something they will learn and then they can pass that on to their families.

    Obama: That's one of the main things we did in our household before we lived in the White House when I was still cooking, is we eliminated the number of times we went out, and that made a huge difference.

    Now, that meant that I had to be way more organized about cooking, but, you know, I would cook a big meal on Sunday, so we'd have Sunday. That would last until Monday. I'd get a break on Tuesday, you know. We come around on Thursday, get another meal, so, you know, eliminating those opportunities to eat out made a huge difference, and it also, you know ‑‑ my kids liked it. They liked being at home. They liked sitting around the table. I mean, that became and still is. For us at the White House, no matter what is going on at 6:30, we stop everything. We have dinner together.

    When the president travels, his goal is to get home in time for dinner, and that's really the time that we get to connect with our girls. I mean, we're running to and fro and dropping people off and kids in the back seat, and the only time you really get to find out those little hidden treasures of information that slip out, you know, a good teaching moment, you know, what would normally be a lecture is a nice conversation around the dinner table, you know, so ‑‑ and I find that my girls aren't as focused on gobbling their food down if they're engaged in the conversation, you know. They're really focused on tasting their food and taking their time and cutting their food, and then we use that time to talk about manners, how to hold a fork, and sitting up, and take your elbows off the table, little things like that, that, you know, nowadays kids, you know, they don't know these basic things, because we don't have time to sit down with them.

    So the family meal is much more critical than we ever imagined and we experience that every day at our home.

    Bhargava: And just as a pediatrician, there's been plenty of research to show that not only do you get the benefits that Mrs. Obama is talking about, but guess what? Your kids are more grounded. They're less depressed, less likely to be overweight. There's just so many benefits that you get in addition to having those wonderful conversations with your children.

    Ward: And time spent together is the most important, and I think, Jim, you would agree, just even a walk with your child, a 30‑minute walk. would be a great thing for you, too.

    Kauffman: Absolutely. Any time that a parent can spend time with their kids, and by the way, the research does show that kids do want to spend time with their parents. So despite what they might say, it's just the opposite, and when you do spend time with your parents and you do some kind of physical activity, you're getting a double whammy. You're getting all the benefits that were discussed here along with some additional physical activity.

    Ward: Well, we're going to go to Olivia in the audience. She has a question for Mrs. Obama. And Olivia, where are you? OK.

    Tell us about the vegetables you grow in the White House garden, please.

    Obama: I would be happy to. Well, as you all know, one of the first things I did as first lady was to plant a White House kitchen garden, and it has been one of the best and most fulfilling things that I've done as first lady. It's about 1,100 square feet. It may be a little bit larger, because I think we expanded it here or there, a few new beds, and we grow a little bit of everything. Lots of herbs, lots of different lettuces. Sweet potatoes are a big favorite because you never know what they look like until you pull them up from the ground and they're these huge, monstrous potatoes. So the kids that help us harvest get a big kick out of that. We've tried to plant watermelon, not having done so well on watermelons. We got some little pumpkins. We worked on some berries, but we can't keep the birds away from the berries. Lots of snap peas, broccoli. So we plant what we enjoy. And the White House kitchen garden just doesn't feed our family, but we use it at important state dinners and lunches, and the leftovers we donate to a soup kitchen that focuses on healthy eating, making sure that their customer base is eating well, too. And we also have a beehive that has really helped with pollination and it's helped our garden grow in many ways, and we get many pounds of honey every year, and we use those as gifts. I've given them to almost every first lady of every country that has come to visit or I visited, so it's a wonderful gift. So it's been a real fun experience, and we work with kids in the community. They help us do everything from planting, sowing, harvesting, and eating. We actually do a little eating, too. So it's a lot of fun. So you have to come and visit my garden, right? All right.

    Vicky on WebMD says, "My 7 year old son does not like to eat veggies."

    Ward: Kathleen, please help.

    Zelman: Well, if you want to win the battle of the broccoli, you have to be creative. One of the best ways is when kids grow vegetables, they know that it's going to taste better. They're going to at least be more inclined to do it, but you can't always have a garden. You have to be creative. You can't open up a can of peas and put them in the microwave and expect them to be delicious. I got my kids to love vegetables because I would grill them, roast them in a high temperature with a little olive oil. It makes them sweet. It makes vegetables take on a whole different life when you try to use some fresh herbs, use different seasonings. You've got to take a little time to be creative to help kids love vegetables. Their taste buds are very acute and vegetables are strong, so when they're in a mixed dish, like a soup, a soup that has lots of vegetables is a lot easier to eat those carrots in the soup than maybe just grab a carrot. Or shred up some carrots and add them with some raisins, and all of a sudden that salad makes it a little easier. Sometimes a dip. My favorite is hummus. It's made from chickpeas, which is another bean high in protein, very satisfying, and you can dip, oh, baby carrots and jicama is a favorite when kids get a chance to taste it. So parents, you have to expose them, continue to expose them, be a role model, incorporate them into dishes as much as you can, and keep trying.

    Bhargava: If I could just add to take your kids grocery shopping. I have two 6-year old twins and they love going grocery shopping with me because they get to pick some vegetables. They help me cook them, so they get excited about it, and when they come to the table, they actually want to try it. And don't give up if they say no a few times. Most studies have shown that it takes sometimes eight or nine times for a child to actually start liking something, so keep on trying.

    Obama: And then there's the flip side, right? You've got to eat your vegetables, period, you know? You want dessert, you've got to eat your vegetables. Our motto is: If you're full, then finish your vegetables and you can be done, but you can't ask for anything else. And if you're walking away, you definitely can't come back later and ask for cookies or chips or whatever. If you're full, you're full. I don't want to see you in the kitchen after that. And pretty soon, they're going to be hungry. So there's that. You know, you've just got to do it sometimes.

    Ward: I think the audience liked that. If you're full, you're full, right? That's great. OK. This next question is for you.

    A WebMD user asks, "I have watched the first lady exercise, and I'm always watching her husband working under pressure. Their bodies have maintained their weight and are healthy. My question is, how are they balancing time, diet, exercise, and stress, and sleep, and everything else that goes along with the healthy lifestyle?"

    Obama: Well, it's just prioritizing what's important, and there are some sacrifices. Sometimes sleep gets sacrificed, getting up early to get your workout in. But, you know, what I tell my girlfriends who are, you know, struggling, we're all the same age and everybody's wondering how to keep my weight down, the secret is good diet and exercise. Sorry. It just, it is. I know, everybody's looking for the magic pill, but it is. But the thing is, and I tell a lot of my friends this, you have to give it some time. It's just like kids with vegetables. If you go into the gym and walk on the treadmill and it hurts, you can't give up because it will feel better. It will gradually, just like kids with vegetables, you will build up your endurance, and if you give yourself some time, six weeks, eight weeks, you're going to feel better doing the workout, and then you're going to start seeing results, and then your ego's going to come in. You got that dress size going down, and then it makes it a little ‑‑ you get a little more incentive to get back on the treadmill. But it takes some time to build up endurance, especially if you're going from doing nothing to doing something. And it can be walking. It can be walking fast. It can be walking on a little bit of an incline. It can be jumping rope. It can be dancing with your kids. I mean, it doesn't have to be complicated; it just has to be something that you enjoy and know that you can't give up on it, and you're just thinking every day, if I just do a little bit, the next day, if I can just do it, the next week, if I can do a little more. You know, don't feel like you've got to take these huge chunks, you know, you have to go from zero to doing 25 pushups on Ellen. You don't have to be there to get ‑‑ to get the kind of benefit that you need. And eventually, your body will ask for it. So what happens with the president and I is that exercise is a de-stressor. It is the thing that just keeps you calm. So now you need it, right. So the president works out because he needs to work out. He's got to blow off that steam. He's got to sweat a little bit. He's got to use that so that he can, you know, sleep at night. It becomes a necessary tool just for getting through. And we're encouraging our girls to start early with exercise. You know, just making sure that they've got some routine, some sport that they do, because what I don't want is my girls to grow up like many girls grow up, thinking that sweating isn't cute. You know, that girls shouldn't be on teams and learn how to fall and to compete. You know, sometimes we do that to our young girls, particularly. So I think we, as women in particular, have to be that role model for our girls especially. So when I get on the treadmill and my girls see me, I make sure they know mommy is tired. Mommy doesn't want to work out. I would rather go back to bed, but after you go to school, I'm going up to the gym because it's good for me and I'll feel better once I'm done. So if you just get over that hump, just do it, and eventually just know it's going to feel better. I promise you, so ‑‑

    Ward: Sometimes just putting your exercise clothes on, it gets you motivated.

    Obama: That's another thing I do in the evening. I told friends to do this: When you come home from work, put on your workout clothes. Put your gym shoes on. Do not put on your pajamas. Do not pass go. You know, because if you have the clothes on already, you're more likely ‑‑ it's just the notion of taking your clothes off and putting something else back on, right? Nobody wants to do that. But if you start out, and my trainer always tells me that working out early is the best thing, but not everybody can do that. If you get it out of the way then nothing gets in the way of your day, it doesn't interfere with anything. You get up, you do it first thing. That's why I work out in the morning, because I never know what my day is going to look like.

    Zelman: And I would add that you don't have to do it all at once. I mean, if you're really busy and your schedule doesn't allow for it, increments, 10 minutes here, 10 minutes there, strap on a pedometer. Fit it into your day is another way to be active and move.

    Now, Jim, Ann on WebMD asks, "My child is on the clumsy side and organized sports are not for her. So even if I take her to the playground, she falls a lot and she gets upset. What can I do to encourage her to exercise?"

    Ward: Since we're on the topic.

    Kauffman: Well, that's a really good question. And No. 1, know that clumsy is a stage and that you will eventually get out of that. But in the meantime, we do want kids to grow and thrive in whatever they're doing. So a couple of things that come to mind with that kind of a question is No. 1, don't think about exercising as sports, but think about play and physical activity. What is it that we can do that's maybe not quite so tough for a clumsy person, and let's see if we can go engage in that, because there's got to be something. Somebody's not clumsy in everything. So let's go find out what it is. And I've got to tell you, the minimum is walking. And because kids do want to be with their parents, I would say to the parent, don't just take your child to the playground and say go play. Let's go play together. Let's do this together. So that's one thing is, know that there's a variety of things that you should be looking at in physical activity. And the other one is you should be doing it with them, because the role model is a very, very important piece to having kids grow up just as Mrs. Obama said right now.

    So speaking of exercise, Dr. Hansa, how much exercise do kids need every day?

    Bhargava: Well, the recommendations are 60 minutes a day, but it doesn't have to be all at once. It can be in 15-minute spurts, or it can be incorporated, like Jim was saying, into your daily lifestyle. Park far away from the grocery store entrance or from the mall, or you know, take a walk instead of taking the school bus. I know communities who are doing walking school buses or walking carpools. What a great idea. You get to be with your kids, you get to walk, you get the exercise in, and you do it together as a family. So you can incorporate it in. And as Mrs. Obama was saying, take small steps. Don't think you have to get that 60 minutes in tomorrow. Just do 15 minutes three times a week to start with, and the next week just edge up that amount, and you will find it much easier than you think. And lastly, I just have to say this. I was reading a statistic the other day. Our kids are spending 7.5 hours a day on media. I don't even understand where they're getting that time. I mean, eight hours of school and seven‑and‑a‑half hours of media? So just ask yourself and your family how many hours a day am I spending on TV, Internet, texting, all of those things, and maybe we can cut away some of that time. Because we're all busy, I know it, I'm a working mom, too. I know there's a ton of working parents out there, and working grandmas, and military families who are single-parent families for, you know, temporarily. We need to find out where we can carve that time out and make it a priority, as Mrs. Obama said.

    Well, Vicky on WebMD would like to know, Mrs. Obama, "How often do you work out and what is your favorite type of workout?"

    Obama: Well, I work out every day. If I'm traveling, I couldn't work out this morning, but you know, that's why I work out whenever I can all the time because I never know when that, I'm going to wake up, go to bed late, and I'm just tired and I need the rest. So I also have to listen to my body if I'm not feeling well. But the president and I work out every single day, and you know, what do I like to do? OK. Well, hula hoop, yeah, hula hooping is fun, but you know, we mix it up. I mean everything from cardio to a little kickboxing, which lets out a little steam, some Pilates every now and then, stretching. That's one thing, now that I'm 48 years old, it's to prevent injuries, it's really important for us to stay limber. So you know, we try to do a little bit of everything. The president plays basketball. I like to play tennis. Sasha plays basketball. Malia plays tennis. So we each have something we can do with the girls. Riding bikes when we can, when we can sneak off and nobody can see us, we'll get on our bikes and we'll go. Sometimes it works. Sometimes it works. So we just try to mix it up. I did a Zumba class over vacation that was a ton of fun. Lots of aerobics and good dancing, good music, you know. So the important thing is for people to find the thing that they love, especially when you're starting out. What's the thing that you think you can do? If you like music, then go with the dancing. Step class is good music, you know, good beat that gets you going and keeps you going. So it doesn't have to be, you know, something specific. It should be what you enjoy to start out with, and you know, then it grows from there.

    Ward: I like the idea of mixing it up, and you also talked about having fun when you're moving, too. So, Jim, I just wanted you to address that. What do you think about mixing up different types of activities?

    Kauffman: Well, physiologically, it is the best thing to do is to mix things up. Your body will adapt to whatever you're doing, so you do want to mix up what you're doing so that your body is always guessing what's next, and as a result, it will start to rebuild itself in places, so that's good. And what we also know is that variety is a big key. There's some rare people that will want to go to the same exercise class or the ‑‑ do the same workout time and time and time again. I couldn't do that, myself. I would get bored after a while, and boredom is what we don't want to have. So the variety is very, very key to have a whole slew of different things that you can do. You know, and that's why, if you look at a YMCA, for example, you can come into a Y and you can see every different kind of exercise class that you can ever imagine, along with all kinds of equipment, and that's really fun. And to be able to go from one piece to the next and try something else. And what I would also say is don't hesitate. If somebody gives you an invitation to try something new, regardless of what age you are, say yes. Try something different in the way of activity. And again, realize you don't have to go in and do an hour of it. Even if you go in and do five minutes of it, you tried it. You'll start to see "I do like this" or "I don't like this," and you just keep looking for the variety.

    Ward: What are some easy ways to get the exercise I need? And we've talked about it several times already, break it up into chunks during the day, but can you give us some specifics? What exactly?

    Kauffman: Well, my recommendation would be not to look at just exercise, but look at physical activity. Look at the little things that you might be able to incorporate into your every day. If you work in an office building that has an elevator, how about if you get off the elevator two floors before yours and walk up the stairs for the last two floors. And maybe walk down those. Rely less on the electronics, more on your own power. I would also say that to look at the rituals that you have in your life, that if you're in front of the sink washing dishes, there isn't anything that says you can't do one or two or three or five little bit of knee bends. That's a time it just gets you moving, gets you a little bit more active. One other thing that I know has worked for some people. They were just starting out in physical activity and I said, "Tonight, and every other night, pick two commercials while you're watching television and get up and move for just 30 seconds." And their response was, "Just 30 seconds?" I said, "Yeah, that's all I want you to do, just 30 seconds." And they came back and they said, "Well, I did those, but I wanted to do more." All right. You see what the secret is there. It's incorporating those little things, and all of a sudden you can add up to that 60 minutes that you're looking for.

    Ward: OK. Mrs. Obama, this is for you:

    As a parent, how do I compete with an Xbox?

    Obama: The Xbox. Tough. Just say no. Turn it off. Turn it off. Say no. But the other thing, you know, we're ‑‑ they have these games, all these computer games, now they're getting a bit more savvy and they're things that require kids to move. So what is it, the dance one, well, there's the dance one where I don't even know where, it takes a picture of your body and then all you have to do is dance in front of it. You guys have that one? That's a good one. I mean, that's a good party goer and you'll work up a sweat and you'll learn some good moves. So some of these Xboxes, you know, I don't want to pick out a brand, but some of these computer games are getting pretty savvy. If you got, if there is time in front of it, I would just urge the kids to focus on the thing that's going to get them up. Move away from the things that are just thumb oriented, where they're sitting, because now there are more games that require kids to be up. But you know, when in doubt, sometimes the answer is just no. You know, I know in our house we have pretty strict rules about TV time, computer time, nothing during the week. They can earn an hour if they finish everything they have to do for that week, and they have to earn it. So they can work towards an hour during the week. They have two hours on Friday, three hours on Saturday, two hours on Friday. Period. And what happens is that they're bored, so then they wind up doing stuff like playing with their dog and then they're running around, throwing, you know, because kids can't sit still. So they're not going to just sit there and stare, they might do a little more reading, but eventually, they're going to figure out, just like we did when we were growing up, when we were bored, you just picked something up and you started moving, right? So it's important for us as parents to set those limits, and it's tough, because I know there are just times you need them in front of that box so that you can get a little peace of mind. But I think, you know, it's our job to kind of just cut them off because this stuff is so enticing and it's a lot of fun for them, and it's just pulling them in. And if they're sitting ‑‑ if kids are sitting for hours on end, it's just never good for them. It's just ‑‑ it's just not going to work. Just like us. You know, whenever a kid is sitting, the question is, how can we get them moving? How can we take every opportunity where they're sitting and turn it into a game where they're up? Doing the same things. You know, making them go get the laundry. Seeing how many, you know, make it a competition, see how many sit-ups they can do over the course of a commercial, you know. Set up award systems. Kids are good at competing for things. So if we help them make it fun, that Xbox, that computer game is going to be a little less interesting to them because, as was said before, kids ultimately want our time more than anything else, but it is a challenge. It's a challenge.

    Ward It is a challenge for sure.

    Dr. Hansa, this is for you:

    Preparing for tests really stresses out my child. How can I help him relax?

    Bhargava: Well, I think a lot of parents feel that way, and I certainly see a lot of parents in my practice coming in asking those questions as well. It's really important to pay attention to your children's moods and stress levels. And to prepare for a test specifically, it's a good idea to sit down with them, talk to them about what's stressing them out, no matter what it is, and have an organized way of handling it. The most important thing you can do for your child is really to talk to them. If you can carve out time to talk to them, whether it's a family meal or a family breakfast or, you know, wherever you can find the time, on the car ride home. Sometimes I pick up my kids from school and I ask them how their day was. And it's wonderful. It's a 30‑minute ride, and I can actually talk to them and find out what's going on in their minds. So if you can talk to them, you'll actually find out what's stressing them out and you can help them. And again, going back to what Mrs. Obama was saying, if you cut out some of that media time, some of that, you know, Xbox or video time or TV time, you'll actually find the time not only to move, but to connect as a family. And the more you connect as a family, the less likely they're going to be depressed, less likely they're going to go and do drugs, less likely they're going to smoke, I mean, there's been plenty of research to show this. So as a mom, I know that it's hard with everything that you have on your plate, but we have to prioritize and just talk to our children.

    What can we do to encourage getting enough sleep?

    Ward: It doesn't matter what age the child is, this always seems to come up as an issue.

    Bhargava: I know I said this before, but unplug. You know, 50% of our kids have TVs in their bedrooms. Forty percent are 4‑year olds. I mean, that means that they're watching TV more than they should. They're watching what they may not be wanting to watch, you may not want them to watch, they're being exposed to commercials, and they're certainly not moving those little bodies. So you know, it's very important to make sure that your kids are unplugged, especially before sleeping, an hour before, and let me just say that sleep, interrupted sleep or lack of sleep in children, has been shown to have serious health effects as well, depression, inattention. They don't have the energy, bad school grades, and of course, being overweight. So there are just so many benefits for your child to go to sleep on time and to get enough sleep, that it really has to be a priority for us.

    Ward: Mrs. Obama, do you have rules about what goes on at bedtime, certain bedtimes?

    Obama: Yeah, we still set bedtime. The older they get, the more homework that comes into play. You know, that winds up taking up the time, so it's hard to tell a kid who hasn't finished their homework to go to bed, but you know, there is a bedtime expectation, and there's a goal to work towards that. And we don't have TVs in the bedrooms, you know, or any other kind of distraction like that, so ‑‑ and, again, if they're active and, you know, this is also where schools come in, why we're focusing on physical activity, because many schools have eliminated that. When money is tight, sometimes the first thing to go is recess, PE, those. So if they're not getting an opportunity during the school day to burn off that energy, you know, they have to have a place to make it happen. But we do need to focus back on our schools, to try to get recess back into play, to try and get PE, so that kids are having an opportunity to burn off that extra energy, so that by the time they come home, they are tired. But if we've got our kids in sports and other extracurricular activities, the truth is, there are times when Sasha puts herself to bed, she's so tired. So, you know, if they're really staying engaged, and again, sitting in front of the TV means they're not burning off energy, so they may not be tired enough. That means they need to walk around the block, you know. You know, just walk them.

    Ward: Jim, I know you have something to say about research.

    Kauffman: Well, there is significant research that shows that when someone, a child, does engage in physical activity, that extra blood flow to the brain and to the rest of their system actually does increase their ability to retain what they're learning, what they're studying. So I would recommend that you don't say you can't go out and play until you get your homework done. Maybe look at that and say, "I'm going to let you go out and play for 15 minutes, and then come back in and we'll break up the homework that way." Because the research does show, the increased blood flow from exercise does make a difference in your retention of what you're studying.

    Bhargava: And just to that fact, there are some school programs that are using that research, you know, and inserting 10 minutes of physical activity into classrooms because of that research; it makes you feel good. In fact, if you've ever tried, if you're feeling down or tired around 3 o'clock in the afternoon, which does happen to me, actually going for a vigorous walk can wake you up just like a cup of caffeine can. So I mean, there's definitely, you know, a practical application of that.

    Ward: There is. And I think, you know, we should be advocates as parents, right, about physical activity that our kids are getting in school, just like you were talking about when it comes to food as well.

    Obama: Absolutely. We've got to really put the focus back on the schools in terms of what we expect is, you know, constitutes a full educational experience. And you know, we can focus on test scores, we can focus on grades, but the truth is that our kids have to be well‑rounded. I mean, when they go to college, that's going to be the expectation these days. It's not just the A student with the great scores, they want to know did you play a sport, did you take a leadership role, did you do community service, and that's how they start winnowing down. So we have to make sure that our kids, all of our kids, have that kind of opportunity in their elementary schools and their high schools so that they're competitive in life, they're competitive in college, and they have all those experiences to draw upon when they start figuring out who they want to be in the world.

    Ward: Great. Well, unfortunately, we've come to the end of our time together, and I want to thank you all for coming. I want to thank Mrs. Obama and the panel for making this a national priority, and get out there and Let's Move!

    WebMD Ask the Specialist Transcript

    Reviewed by Hansa D. Bhargava, MD on February 10, 2012

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