Kids Are What They Eat

How to Help Your Child Develop
Healthy Eating Habits and Avoid Obesity

From http://msnbc.com/news/TODAY_front.asp
Dr. Keith Ayoob, spokesperson for the American Dietetic Association, talks to “Today” host Katie Couric about the importance of nutrition when dealing with kids and obesity.

January 28, 2003 —  Are your kids healthy eaters or do you find they’re eating a little too much and not keeping nearly active enough? Well, whatever the case, teaching good habits can’t start early enough. On NBC’s “Today” show, Dr. Keith Ayoob, an associate professor of pediatrics at Albert Einstein College of Health and the spokesperson for the American Dietetic Association, offers some advice for helping kids develop healthy eating habits. Read his tips below.

The Facts:
The figures are staggering. According to the Centers for Disease Control (CDC) and the National Center for Health Statistics, in 1999 over nine million or 15 percent of American children and adolescents between the ages of six and 18 were overweight, or triple what the percentage was in 1990. That number is growing rapidly and experts say that figure is now at least 25 percent. Over 10 percent of preschoolers between the ages of two and five are overweight, up from seven percent in 1994.
 
The Consequences:
 * High blood pressure and cardiovascular disease
 * Type 2 Diabetes, which used to only be diagnosed in adults
 * Liver disease
 * Breathing disorders
 * Back pains
 * Elevated cholesterol
 * Hip and knee strain
 * Chronic health problems that shouldn’t happen for decades
 * 70 percent chance of becoming overweight adults. This increases to 80 percent if both parent are overweight.
 * Depression, low self-esteem, lack of self-confidence

Why Are So Many Kids So Overweight?
Dr. Atkins says it’s carbohydrates, Suzanne Sommers says it’s sugar. Everyone has their own theory about why children and adults gain weight, but the reality is, the reason kids (and adults), gain weight, is excess.
 You can blame it on everything and anything, but it’s really a disease of excess. Excess calories. They can come from a number of places. So the cure is balance.

How Do You Know if Your Child is Seriously Overweight, ir if it’s Just "Baby Fat"?
With adults, you can measure the Body Mass Index (BMI), but with kids it’s more complicated because they go through growth spurts. You can look at the sliding scales that measure height to weight and see where they fit with kids of the same age.
But there are red flags — obsession with food: thinking of food all the time as an activity as opposed to a necessity. If all they want to do is eat and go back to the kitchen again and again. Hoarding or hiding food: You find food in their room, they are embarrassed to let you know they are eating.

Important Reasons for Changing Eating Habits:
This is a health issue and not about cosmetics. Children are facing chronic health problems that shouldn’t occur for years or decades. (See “consequences” above.) Another matter is that even though children are overweight, and their calorie intake is excessive, they aren’t necessarily well-nourished. They’re often not getting enough calcium, vitamins and fiber because many of them don’t eat enough fruits and vegetables.

Eating at Home
Parents: Look at your own eating habits. You can’t expect your children to learn good eating habits if you don’t have them yourself. Eating habits are learned. Now your children need to relearn good ones. This may not make parents popular, but it’s about health. Keep in mind, one out of every four children is overweight. This is an opportunity to make changes.
 
Make Changes Slowly:
Pick one habit you want to change every month, but take your time. Kids take a long time to make changes. Think about what you’re going to change next month. For example:
 * One night a week, don’t have dessert, have fruit.
 * Get kids involved. You win on several fronts here. It’s a time for parents and kids to catch up, gives the parent help after a busy day, and very important: Kids will eat more of what they prepare.

Family Meals:
Sadly, fewer and fewer families eat meals together. But kids love to eat with their parents, and parents should make time to eat with their children so they can work on eating habits together. It’s also a time for families to be together without distraction. This means no television during a family meals.

Keep Healthy Food on Hand:
Stock the house with good things to eat. If you know your child likes tomatoes or oranges, make sure you have them around.

Limit High Calorie Food:
If they aren’t in the house, kids are more likely to turn to healthier snacks. You don’t want a kitchen with chips, cookies, candy and one rotten banana.

Breakfast:
Amazingly, 40 percent of children don’t eat breakfast regularly. There are all the obvious reasons kids should eat breakfast: It gets their metabolism going, and they aren’t starving and overeating later. But also important: Breakfast is a really good opportunity for kids to get the foods they need: fruit, grains, protein.
There really is no excuse for children not eating breakfast. Parents have to make time and make sure their kids do so.
Parents can make it very easy for kids to take care of their own breakfast if they really can’t make time.
 * Eggs: Keep a bowl of hardboiled eggs on hand.
 * Cereal: whole grain, Cheerios, Raisin Bran, Oatmeal. Even fairly young kids can prepare their own bowl of cereal.
 * Fruit: Kids can grab it as is, as they go out the door if needed.
 * Milk: Lowfat chocolate milk is OK if you can’t get them to drink the regular stuff.

Portion Size:
Take a look at the food pyramid. Kids are getting far too many calories from the top sections of the pyramid. Kids need to limit what they’re eating from the top sections. Portion size has also gotten way out of control. Portions need to be served appropriately.

Soda:
Soda is a huge problem because it’s just empty calories. Soda is at the very top of the food pyramid. When soft drinks first came out, they were in 6oz. bottles. Now you see kids with liter bottles of soda, or 33oz. The bottles in many vending machines are 20oz. No five-year-old needs 20oz. of high fructose corn syrup. If your child absolutely has to drink soda, stay away from the large bottles and offer cans.

Juice:
Juice is also a big problem, but not as big as soda. It’s important to get 100 percent juice, otherwise it’s nothing more than sugar water and flavoring.

Measuring Portions:
Foods like pasta get a lot of play, but portion sizes have become much too big. Children shouldn’t have more than a cup to a cup and a half of pasta. The problem when you load up on pasta is that other good foods get squeezed out. There’s not room for broccoli, green beans and other vegetables if the plate is filled with pasta.
Pasta and rice shouldn’t be eliminated, but portions should be cut back so they are more of a side portion, not the main ingredient. This way you have room for other things. Add vegetables, a salad. Don’t make the plate look empty, but substitute some of the foods kids need. The same thing happens if you have a huge slab of meat and buttery mash potatoes. You end up with room for maybe three string beans and a carrot.

Fast Food:
The reality is, kids are going to eat fast food. It’s not a matter of good or bad, it’s a matter of how much and how often. Parents need to monitor this better. Kids need to eat a little less and a little less often.
Supersizing: Try not to think supersize even if it’s a great money deal. Think small. If you supersize a meal, it’s about 1,800 calories. Kids need between 1,600 and 2,000 calories a day, so 1,800 from a supersized meal is too much, and in many cases, this is a snack, something they pick up after school. So, think small. Order a small hamburger and small fries. Order the lowfat milk instead of the soda or shake. If you downsize, you’re looking at about 650 calories instead of the 1,800.

School Meals:
There are 21 meals a week. Kids eat five of those at school. So while schools are guilty of offering some very unhealthy foods, kids are gaining most of their weight elsewhere.

Dr. Keith Ayoob, is associate professor of pediatrics at Albert Einstein College of Health. He is also a spokesperson for the American Dietetic Association.