Fall 2002 Volume Six Number One

• The New Epidemic: The Fattening of America
—You are what you eat.

The rate of obesity in adults and kids has skyrocketed in this country during the past ten years. Current estimates from the National Center for Health Statistics show that at least one in five American children is overweight, and nearly 15 percent are obese.

What’s worse, children who are overweight today are 20 to 30 percent heavier than they were ten years ago. Overweight children are more than twice as likely to have high blood pressure or heart disease as children of normal weight.

Type 2 diabetes, which is reaching epidemic rates in the U.S. for adults, may start at an earlier age for heavy children. Finally, the day to day emotional burden for overweight children is difficult. Overweight children are teased by their peers and often have poor self-esteem.

What can parents do about protecting your child from too much weight?
Take a look at your own family history and your current environmental factors, such as physical activity and diet at home. Factors you can’t change include gender and family history, including race and ethnicity. According to the National Longitudinal Survey of Youth, by 1998 nearly 22 percent of black and Hispanic children ages 4 to 12 were overweight. The influence of genetics in obesity is powerful. (The inheritability of obesity is more of a factor in children than in adults.)

Things that a family can change are eating habits and activity. Listed below are some easy steps that the entire family can do:

• Be supportive. Reassure your child that no matter what weight, he or she is a wonderful, worthwhile person. Don’t single out your child as the one with the weight problem; rather work as a family to assure support and live toward a healthy lifestyle.

• Be an everyday model for healthy self-acceptance. If kids hear you talking about what’s wrong with your body, they will focus on their own flaws. If you love and take good care of your body, that’s what they will see. Show them and teach them how to find clothes that look good and feel comfortable on their body type.

• Look at the family’s eating habits. Take a look at your cupboards and mealtimes. Keep your kitchen well-stocked with a variety of healthful foods, such as:

-Fresh fruit or easy to serve, such as water packed, convenient indi- vidual fruit bowls or canned fruit.

-Low fat snacks—popcorn, pretzels, graham crackers or Nilla wafer crackers.
-Convenient vegetables and low fat salad dressings and dips, such as ready-to-serve lettuce packages or carrot/celery sticks.

-Limit the number of high fat or high sugar foods available to your family, such as potato chips, pop, high fat luncheon meats such as salami or bologna, cereals and candy.

•Stick with regular meal and snack times. The chance of overeating goes down when kids know when to expect the next snack or meal.

• Limit chances for emotional over eating. Using food to comfort, reward or discipline kids sets up a lifetime habit of emotion-driven eating.

• Don’t have a portion distortion. Practice normal portion sizes at home and at restaurants. Use a child’s palm as a meat portion size or for older children and teens a piece of meat no bigger or thicker than a deck of cards. Keep pasta, noodles and rice to no more than one-half cup to one cup, or the size of a child’s fist.

• Practice the plate rule when you eat. Your plate should be divided as one-third or less animal protein and two-thirds vegetables, fruits, whole grains and beans.

• Don’t “supersize” or “extra value” your meals. Have a single hamburger or cheese- burger; four chicken nuggets instead of an eight piece meal. Try splitting a small order of french fries. These measures will help significantly to bring down the fat and calorie counts.

• Be an active restaurant eater rather than a passive eater. Ask for lower fat substitutes and order salad dressings “on the side” or exchange the french fries for fresh fruit. Take at least one-half of your meal home, as most restaurant portions are two to three times the normal portion sizes. Take your time eating. It takes 20 minutes for your brain to signal your stomach with a feeling of fullness.

• Turn off the TV and set limits on the computer. Try to make daily exercise a family activity, such as a walk after school or dinner or riding bikes in your community. If the weather is cold, try the popular mall-walking programs or an indoor swim at a community center. Try to do a continuous activity with your child for 20 to 30 minutes three to four times each week.

• Embrace enjoyable activity as a family value. Forget regimented exercise—which few adults, and even fewer children, enjoy. Choose activities where the whole family can have fun together—hiking, biking or even kite flying. Or look for activities that match a child’s natural skills such as karate, canoeing or gardening, even if no one else does it.

• Sing their praises. Praise youngsters for being active, progressing in learning a sport and improving performance

• Stop the pop and drink the water. Did you know that a can of pop is equivalent to drinking ten to twelve cubes of sugar? In fast food restaurants, the average size of a serving of soda is 24 to 32 ounces in an extra-value meal, and is 300 to 400 calories.

Soft drinks are replacing milk as the beverage of choice in America. Bone health is altered by this reduced calcium intake throughout life. Juice is another calorie-laden drink that can significantly raise the number of calories in a child’s diet.

A recommendation from the American Academy of Pediatrics is to keep juice to no more than 6 to 8 ounces (3/4 cup to 1 cup) per day. Choose 100 percent fruit juice with vitamin C added to it.

Otherwise water, especially tap water (city water also contains fluoride) is the best hydrating fluid for you and your child.

• Plan ahead for snack attacks. But remember that a snack is not a meal. Snacks should be only 100 to 200 calories. A snack after school is okay, but avoid night-time snacking. You don’t have to eliminate snacks; just try healthy ones instead of high calorie cookies, candies or chips. Suggestions include:

-A handful of pretzels or air-popped popcorn or microwave low-fat popcorn.

-Low-fat cookies such as graham crackers, fruit newtons, gingersnaps or animal crackers.

-Skim milk, string cheese or low fat, calcium added American cheese slices and whole grain crackers.

-Raw vegetables served with a low fat dip.

-Fruits. Fresh or dried or canned in water.

• Build a pyramid. Choose foods from the five major food groups every day.

What counts as one food guide pyramid serving?

Each of the portions listed in the five major food groups count as one Food Guide Pyramid serving for anyone over four years of age.

When counting servings, smaller portions count as part of a serving and larger portions count as more than one serving. Most 2- to 3-year-old children need the variety and the same numbers of servings as older children, but may need fewer calories.

To get variety but fewer calories, offer two- to three-year-olds a smaller portion but count it as one serving. Offer about 2/3 of the portion you would give a four- to six-year-old, except for milk. Children two to six years-old need a total of two servings from the milk group each day.

As with all epidemics it takes a good game plan and a strong will to stop a disease’s spread. These have been just a few suggestions to start. For further questions, give me a call at the Maple Grove office or call your provider.

—Jackie Uglow, RD