Food, food, food. The ads, the signs, the daily stories about an epidemic of childhood obesity. Often overweight adults have (pardon the expression) pounds of baggage about teasing, discrimination, and "dieting."
So what is a parent to do if one or more kids seem to be putting on a few more pounds than they seem to need?
Bottom line: All children -- not just overweight ones -- would benefit from eating good quality, healthy, fresh food to use for fuel so they can be active and perform well in daily life.
"Usually, I see several in a family who are above ideal weight," Kattia Corrales-Yauckoes, RD, a nutrition and diabetes educator at the Harvard-affiliated Joslin Diabetes Center, tells WebMD. "But I don't prescribe diets."
Hunger Plays a Key Role
Jean Antonello, RN, author of Naturally Thin Kids: How to Protect Your Kids from Obesity and Eating Disorders for Life, tells WebMD that most kids today are predisposed to gain weight. "Their bodies have a higher famine sensitivity," she says. This means their bodies are more likely to store unburned "fuel" as fat.
"Fat is a survival tool," she says. "Some stressor makes a kid accumulate extra weight. After years of studying this, I have decided that this stressor is hunger. When a kid goes hungry ['No eating between meals!'], he or she tends to overeat, crave sweets and fatty foods, and engage in what we call makeup eating. Going hungry slows metabolism and increases appetite."
Antonello's answer is to offer children high-quality food. This starts with newborns, who are now fed "on demand," where they used to be kept on a four-hour schedule. (Evidence that breastfeeding can prevent obesity in adulthood is not compelling, Corrales-Yauckoes notes.)
Being fed on demand is normal for babies, Antonello contends. And also for 8-year-olds, 14-year-olds, 22-year-olds -- and everyone.
Some toddlers don't even like to eat much -- they pick or scrunch up their faces at everything for a day or two. "This may lead parents to offer sweet or fatty stuff," she says. "Don't. A toddler can get along on a little for a while. Just offer small amounts -- a tablespoon per year of age is plenty of an item for a small child."
The key is to nosh on decent-quality foods, which Antonello defines as salads, veggies, fruits, nuts, lean meats, and grains. "French fries are borderline, because of how they are prepared," she says. "Once in a while borderline foods are OK. Then there are the pleasure foods, which are cakes, cookies, ice cream, and high-fat, high-sugar items." These should be a treat, not a normal snack.
"Kids eat crap!" Pat Lyons, RN, MA, who is on the steering committee of the Center for Weight and Health Training at the University of California Berkeley, exclaims to WebMD. "The old 'eat less, exercise more' thing doesn't work for adults. Why should it work for kids?"
Children, Lyons says, should be offered a wide variety of foods and this applies to all the kids. "I have heard kids say, "Why do I have to eat broccoli, I am not fat,' she says.
All About the Timing
Corrales-Yauckoes, along with Antonello, approves of intermittent snacks. These are especially important for children who are insulin-dependent, she adds, and for kids undergoing a growth spurt. Kids are growing and are supposed to be putting on some weight, she reminds us.
Good-quality snacks include:
- Small bowl of cereal with a handful of frozen blueberries and skim milk.
- Whole-wheat toast with peanut butter.
- Whole-wheat English muffin with melted mozzarella.
- Ants on a log -- stick of celery with peanut butter and raisins.
- Low-fat yogurt with fruit or veggies to dip.
- Banana covered with peanut butter, rolled in nuts, and wrapped with waxed paper and frozen.
Antonello recommends kids eat on somewhat of a schedule. "Very few people have a loose schedule," she says. "You are in school or on someone else's meal program." Her rule of thumb is for kids to eat a high-quality snack between each meal and if the kid is active in sports, after dinner, as well.
Corrales-Yauckoes says most of her clients cite time as an obstacle. Teens eat more healthfully at home, but many families don't have time for an organized dinner. "This is a huge obstacle," she says.
But even when they are not home, parents have control over what food is in the house, she points out. "Often parents will say they get food the kids like, kid-friendly food," she adds. "I am not a fan of kid-friendly food. Look at kids' menus in restaurants -- it's all fatty, like macaroni and cheese, hot dogs, or chicken nuggets.
"Sure toddlers like juice, but that doesn't have to be all they are offered." (And, incidentally, scientists have established that no one needs soda to live.)
Kids' bodies are built to move -- and kids need to wiggle and play! Ever notice how a toddler will whirl in circles if no other activity is presented? So often, Corrales-Yauckoes says, parents she sees will say the kids can't go outside because it's not safe or no one is there to supervise them. Usually there is some way around that, such as an after-school program.
She recommends, in fact, that kids go outside right after school. "Go out the minute they get home. Otherwise, they will sit in front of the TV, play video games, or do homework, then dinner, then no one is going out (unless it's for organized sports)."
Just 20 minutes to half an hour under the portable basketball hoop can be great exercise. "Their brains are fried after school," she says. "That's when they need to play!" Corrales-Yauckoes is also in favor of Dance Dance Revolution and other video games that require the kid to gyrate around and shake out the sillies.
Taking a Stand
"We don't call it exercise," she says. "We call it moving."
"Well-fed kids," Antonello adds, "are more likely to be active and want to play or exercise. The human body is designed with movement in mind!"
Parents, she says, should take a stand, and by that she means physically stand in front of the TV or between the kid and the computer. Go out, go in the basement, do something! "They will find something to do," she says.
And parents? Take better advantage of the weekend to move with kids. Corrales-Yauckoes says she is amazed at how many parents do not do active things with kids on weekends.
"The culture has changed so dramatically," Lyons sighs. "The state of Alabama is putting kids' body mass index number on their report cards. This hurts. I was the third fattest kid in school; I can tell you it ruined my life to be thought of that way."
The surgeon general has called obesity "the terror within." How would a kid feel about that?
The Learning Channel has a TV show called Honey, We're Killing the Kids, in which children's pictures are computer-enhanced to show them 30 years in the future as bald, jowly, and unshaven and supposedly trudging toward that early grave they dug with their fork. The implication is only the cringing parents can prevent this.
Lyons recommends that doctors and parents focus on what the family is doing right -- camping, hiking, shagging balls, going to the driving range, swimming, skiing -- rather than what the kids are eating.
"We rode bikes. We walked to school. I was still the third fattest kid," she says. "These are the most hated kids in school. Studies show that even 3-year-olds treat overweight kids differently."
Pediatricians, she thinks, should be allies of the children and not let parents shame the kids. "No shame, no blame. Build on the positive," Lyons says. "Talk to the child about what various nutrients add to the body, what tastes good, and what provides the most energy to feel good and do things."
"Dieting causes obesity," Antonello maintains.
Could be -- if the kids are not getting too hungry and desperate, are eating appropriate amounts of high-quality food at appropriate intervals, and are playing more -- the next growth spurt will streamline their torsos as they get taller.
Best of all -- they will have healthy eating habits to pass on to their kids.