By Denise Mann
Reviewed By Brunilda
on Tuesday, August 05, 2003
Newspaper articles and television reports constantly remind us that a growing number of children in the U.S. are overweight or obese. And many parents are being told to put their kids on a diet or risk that they will develop serious health problems. But what is the best way to get a child to lose weight and keep it off?
To get to the bottom of it, WebMD asked experts to cull a sure-fire list of diet dos and don'ts to help families triumph over obesity . And it's about time.
The latest statistics show that as many as 30% of children aged 6-19 in the U.S. are overweight or obese, which puts them at increased risk for chronic diseases such as heart disease, high blood pressure, and diabetes and emotional problems in adolescence and adulthood.
In children, body fatness changes over time as children grow, and boys and girls differ in the amount of fatness considered to be normal. Overweight is defined as having a weight that is greater than 95% of children of the same age and sex.
Obese kids who remain heavy through adolescence tend to stay that way in adulthood. The resulting illnesses associated with obesity in adulthood -- diabetes, heart disease, high blood pressure, and several cancers -- now claim an estimated half-million lives per year, costing $100 billion in medical expenses and lost productivity.
Here's what the experts have to say about how to reverse these alarming trends:
Do be a good role model. "The No. 1 thing that parents can do is to be a good role model for their children," says Rallie McAllister, MD, MPH, a family physician in Kingsport, Tenn., and author of The Healthy Lunchbox: The Working Mom's Guide to Keeping You and Your Kids Trim. "Parents so often unwittingly set their kids up for failure," she says. "If there are only chips, Ho-Hos, and Twinkies and no fruit or vegetables when your kids look for snacks, how can they succeed?" Instead, she suggests, line your refrigerator and cabinets with fresh fruits, nuts, low-fat cheese, and things for kids to snack on besides chips, dip, or low-fiber, high fat, high-calorie type of snacks.
In a 2000 survey conducted by the CDC, close to 80% of adults reported eating fewer than the recommended five or more servings of fruit and vegetables daily -- not good role-model behavior.
Do be positive. "Instead of saying, 'Lose weight', say, 'Let's be healthy and start taking care of our bodies,' McCallister says. "Be positive and focus on the foods you can eat, not the ones that you cannot. Say, 'Let's go pick out fruits and make a fruit salad,' not 'Don't eat this or that.' Instead of saying, 'We have to exercise,' say, 'Lets go to the park.'" She stresses that "we can't approach this from a cosmetic standpoint and we can't even imply that this is about self-worth. Say, 'You want to be healthy and we want to keep you around for a long time.'"
Do make healthy eating a family affair. "Make whatever plans or food preparation appropriate for the whole family so you don't single out the overweight child as having a special meal, which is like saying, 'You are fat, so you can't have this serving of mashed potatoes,'" says Arlington, Va.-based obesity expert Denise Bruner, chairman of the board of the American Society of Bariatric Physicians. And let your kids help you prepare the meal. "Whether male or female, your child may have to live on his/her own one day and should know how to cook because relying on fast foods has certainly contributed to the obesity epidemic," Bruner says. "Make cooking fun and interesting." And when you are finished, eat together. A family that eats together, eats better, according to a recent study in the journal Archives of Family Medicine. Children who report frequent family dinners have healthier diets than their peers who don't, the study showed.
Do avoid portion distortion. "When serving the food, institute portion control, as in 'this is what you are allocated,' not a buffet-type or family-style situations," says Bruner. Potentially making this endeavor easier is the fact that Kraft Foods has announced plans to change serving sizes on its food labels. Many obesity experts suggest the supersizing of portions at fast-food restaurants plays a role in the obesity crisis in America.
Do start the day off right with a good breakfast such as "a bowl of low-sugar cereal with low-fat milk, low-fat yogurt with a granola or breakfast bar, or an English muffin with peanut butter, rather than a doughnut or muffin," says Dana Greene, MS, a Boston-based community nutritionist whose work with overweight children puts her on the frontline of the obesity crisis.
Do pack a nutritious lunch for schoolchildren. A study by University of Minnesota researchers showed schoolchildren who have access to high-fat, low-nutrition foods at school will consume more unhealthy meals overall than children who have access to healthier options. And a national poll commissioned by Harvard University showed that more than eight in 10 Americans support providing healthier school lunches. "One of the major sources of fat and sugar in a child's diet becomes school lunches," McCallister says. So try and "make packed lunches fun and give a bottle of water, not soda or sugar-flavored juice, and a piece of fresh fruit as opposed to a fruit roll-up, which is loaded with sugar," she suggests. "Encourage the child to have whole-grain breads to eliminate a white-flour and white-sugar rut."
Do rise to the challenge. "We all know that diets don't work, they are short-term solutions to what will be a lifelong challenge," she says, referring to the challenge of eating properly. "The goal is to learn to eat today the way you have to eat for the rest of your life," she explains. "Can you eat steak and eggs and butter for the rest of your life? No. Take a few weeks and learn what a healthy diet is ... and then you don't have to diet."
Do make time for physical activity. "Make physical activity a family activity," Kava says. "Every night after dinner in the summer, go for a half-hour walk and make it an activity that kids look forward to. If you can afford it, enroll your kids in dancing or a sporting activity that they enjoy because they need to enjoy it to keep doing it." Or just turn on some dance music and have a dance party around the house.
Do try again. "Some parents say, 'My kids just don't like broccoli or cauliflower or string beans,' but sometimes it takes more than one introduction to a food. And remember, she says, "a child is not going to sit at the dinner table and eat broccoli if everyone else is eating ice cream," Kava says.
Do think outside the box. Consider weight-loss camps, such as the New Image Weight Loss Camps, which are based in Stroudsburg, Penn., Lake Wales, Fla., and Ojai, Calif. "It's a very typical summer camp experience [replete with] lakes, swimming pools, tennis courts, and all mainstream camp activities along with nutrition classes, cooking classes, aerobics, weight training, and calisthenics," says Tony Sparber, owner of the camps. "The average weight loss is three to four pounds per week. Kids who need to lose 70 to 100 pounds may lose five to six pound per week." The more weight a child has to lose, the larger the weight loss is going to be, but the amount of weight is not as important as changing lifestyle, he says. "The failure of most programs is that there is too much temptation, such as having to deal with other kids eating french fries. At a [weight-loss] camp, everybody is on pretty much the same program and all the food is normal food -- pizza, BBQ, hamburgers and hot dogs, and things that kids enjoy. The difference is that it is prepared healthfully." They serve low-fat frozen yogurt instead of ice cream and Baked Lays instead of fried chips. The cost is about $7,000 for eight weeks, but children can go for shorter sessions. "We give them a program that they can continue at home," Sparber says. "A lot of programs look to take off as much weight as possible in the shortest period of time. We are into trying to create a healthy lifestyle for these children." (For more information, contact New Image Weight Loss Camps at www.newimagecamp.com.)
Don't count calories. "I am opposed to putting kids on caloric restrictions," McCallister says. "It's damaging emotionally because they feel deprived, and it's damaging physiologically because they can't get the nutrients that they need." Instead, she suggests, shoot for cutting out 100 to 200 calories a day. "That is one soft drink, and it will result in weight loss."
Ruth Kava, PhD, RD, director of nutrition at the American Council on Science and Health, has this to say: "The bottom line is not to restrict them, but to help them grow into their weight because children need extra calories to grow. Don't put kids on a strict diet because they are probably going to resent it."
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Don't say diet. "Put your child on any diet and you are setting them up for an eating disorder -- whether binge eating or closet eating or another type of disorder," McCallister says.
Don't take supplements. These days, so-called dietary or herbal supplements that promote weight loss are hawked to everyone -- including children. But whatever you do, say no to weight-loss supplements for kids, Kava says. "You don't really know what's in them, and most have not been tested in kids to determine their safety or effectiveness."
Published Aug. 4, 2003.
SOURCES: Denise Bruner, chairman of the board, American Society of Bariatric Physicians. Ruth Kava, PhD, RD, director of nutrition, American Council on Science and Health, New York. Rallie McAllister, MD, MPH, author, The Healthy Lunchbox: The Working Mom's Guide to Keeping You and Your Kids Trim. Tony Sparber, owner, New Image Weight Loss Camps. National Center for Chronic Disease Prevention and Health Promotion web site.
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