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Obesity Trends In Children – Who Is To Blame?

admin — Thu, 03 Sep 2009 14:23:50 +0000

By Christine Wood, M.D.

www.kidseatgreat.com

The public health alarm has sounded and most people are well aware of the increase in overweight children in the U.S. The questions we are grappling with – why is this trend occurring and what does it mean for the future of our children?

Answering the first part of this question could be stated very simply – too many calories and too little activity, but in reality it is more complex.

The media marketing food and sedentary activities to our children, cheap processed food choices, the ease of fast food for stressed out parents, schools offering sodas and candies, communities that make driving necessary and walking almost impossible, and the list could go on and on.

But who is ultimately responsible for the problem?

In many cases, we need to take a good look at the family. It is not the overweight 6-year-old who is doing the grocery shopping or running to the local drive-thru to pick up dinner. Parents need to take the ultimate responsibility and this can be taken in many ways despite the challenges. Parents are still in control and they can set limits.

For example, examine what foods are brought into the house (do the parents understand how to read a nutrition label?), set limits on media (does a child need a TV in their own bedroom?), decide what types of restaurants are frequented (there are better choices out there), and get involved with the schools (school boards need to hear from parents voicing concerns about food choices in the schools).

The problems for the future of our children is not about the cosmetics of looking skinny, but more about the health impact and risks for diseases such as heart disease and diabetes. The concern with diabetes is that overweight children are being struck with a disease that was considered to be a grown-up disease for old people.

As waistlines of our children continue to expand, their lifespan will be shortened and dollars spent on healthcare in treating their diseases will skyrocket. Is this the future we wish for our children?

We as parents can not only take responsibility for what occurs in our homes, but should be out there advocating with the schools, restaurants, food industry, businesses and our government to ask them to support us to keep our kids healthy. No one wants to be blamed for the childhood obesity epidemic, but if everyone claims they are not to blame and chooses to do nothing, well-needed changes will not happen.

Smart Food Shopping Tips For Healthier Kids

admin — Mon, 17 Aug 2009 16:23:46 +0000

By Christine Wood, MD

When we walk into the grocery store and see all the choices available, it can be an overwhelming experience. With over 12,000 new processed food choices introduced each year into the United States, no wonder we are overwhelmed! When I walk by that fruit roll-up section, I realize how food choices have expanded and how many choices are marketed to children. Here I present a few principles of how to shop smart for the family.

Focus on lots of fresh vegetables and fruits. Look for new fruits and vegetables to try, even things that you as a parent may not enjoy that much. Artichokes, edamame (soy beans that are cooked) are a couple of vegetables that you would not necessarily consider “kids foods,” but many children like them.

Buy organic when possible. Because of concerns with environmental exposures that children receive through their lifetime, organic choices may be something you will want to consider when buying for your children. To learn the problems with pesticides in our foods, see the Pesticide section. If your child is eating primarily grapes for their fruit, consider buying organic grapes. Also, check out the list of foods you will want to buy organic from the Environmental Working Group.

Avoid processed foods with “partially hydrogenated oils.” These are also known as “trans fats” and are the unhealthiest fats. In clinical studies, trans fatty acids or hydrogenated fats tend to raise total blood cholesterol levels, but less than more saturated fatty acids. Trans fatty acids tend to raise LDL (“bad”) cholesterol and lower HDL (“good”) cholesterol. Trans Fats are now listed on the Nutrition Facts Label, making it easier to identify. However, if a food has < 0.5 grams of trans fats per serving, they can still be listed as having Zero trans fats on the label. You would need to read the ingredient list to discover this and look for the words: “partially hydrogenated…” type of oil (like soybean or vegetable oil) or the word “shortening” are considered trans fats.

Add peas, beans, and nuts to your shopping list. These items are generally low in cost and pack a punch when it comes to vitamins, protein and fiber. Add beans to whatever items you can think of: chili, salsa, rice dishes, mash and add to burger mix or tacos. Add peas to rice or pasta dishes. Use nut butters without the hydrogenated fats and added sugar.

Look for whole grain foods. Check out food labels to help you choose more whole grain foods each day. Look at both the Ingredient List and the Nutrition Facts panel and try to choose foods that list a whole grain as the first ingredient. Ingredients to look for on the label include: whole wheat, 100 percent whole wheat, whole barley, whole oats, cracked wheat, graham flour, whole cornmeal. Also look for a “whole grain” claim on the package labels. The government has approved a health claim that recognizes the health benefits associated with diets rich in whole grains. The health claim reads: “Diets rich in whole grain foods, and other plant foods and low in total fat, saturated fat, and cholesterol, may help reduce the risk of heart disease and certain cancers.” See Fiber Up! section for more information. See http://www.mypyramid.gov/ to learn more about the new Food Guide Pyramid and how we need to be getting half of the grains in our diet as “whole grains.”

Look for “100 percent whole wheat” or “whole wheat” on bread labels. Most wheat breads are made with “wheat flour” which is refined from white flour (75 percent) and wheat flour (25 percent). The outer nutritional layer of the wheat seed is not present, nor is the benefits of fiber and nutrients. Breads that list “whole wheat” or “100 percent whole wheat” contains the outer bran layer of the wheat kernel which is rich in fiber, and the inner germ of the wheat kernel, which contains vitamin B-6, vitamin E, copper, folate, magnesium, and zinc.

Use canola oil or olive oil as your primary oil in the kitchen. These types of oils are more desirable oils to add to your family’s diet. Canola oil contains both monosaturated fatty acids and alpha-linolenic acid (an omega-3 fatty acid) which are both heart healthier choices. Olive oil is a monosaturated fat and contains a cholesterol-lowering substance called “squalene.”

Shop the health food section or your local health food store. Support and get to know the products in your local health food store. Many regular grocery stores will have a health food section and may even carry organic produce, milk and other products. Although price for some products may be an issue, if more people support organic produce and healthier food choices, we should see prices respond over time and lower.

Don’t buy sodas and junk food for the home. OK, so an occasional purchase of these items may be fine, more families seem to have these in their homes all the time and some allow their children unlimited access to these foods. Since most families eat out a significant amount of time, these foods become available regularly at restaurants or schools (for the older children in middle and high school). Most of us will have access to these foods outside the home, so we should limit the access around the home. Any little bit helps in preventing the trend to increasing rates of childhood obesity.

Article courtesy of Dr. Christine Wood a practicing pediatrician in San Diego with interests in healthy nutrition for children and the environmental and nutritional impact on health and disease. She is the author of the book, How to Get Kids to Eat Great & Love It! (3^rd printing).

Fighting Media Influence On Your Kids

admin — Tue, 04 Aug 2009 01:28:46 +0000

Christine Wood, M.D.

www.kidseatgreat.com

The American Academy of Pediatrics now urges no television watching for children under two years of age and a maximum of one to two hours a day of good quality TV and video or computer games combined for older children. More TV time means a higher risk of obesity in children.

My recommendations are to work hard to limit television under two years and time watching television or other computer games, etc. to no more than 2 hours combined.

Here are some general recommendations to help you set limits with your kids.

Set clear limits on video, computer games and other forms of media.
Have tokens that are given for 20 to 30 minute allotments of time that can be given at the beginning of the week to control total time on media.
Choose public television over commercial programming.
Tape programs for children and fast-forward through commercials.
Have a library of favorite videos or check them out from the video store.
Look for television channels that do not run any advertising for foods or products.
Avoid having a television or computer or gaming system in the child’s room.
Watching television often creates unrealistic expectations in the mind of the child and creates an appetite for passive entertainment, junk food, and name-brand “must-haves.”
Research shows that violent programs and computer games can lead to more aggressive behaviors in children. Viewing repeated acts of violence desensitizes their perception of violence. Even during family programs, commercials may show violent previews for other programs and movies. With more concerns about real-life violence in children and teens, it gives us more reason to be watchful parents about the content and time spent watching television.
Develop television substitutes such as reading, athletics, physical conditioning, and instructive hobbies, as well as allow them time for imaginative play.
Allow discussion with children about the intent of commercials – they do not always have the best interest of the viewers in mind and they are marketing tools to create buying habits.

Have TV-free nights or weeks (if you dare!). Have family game nights or take a family walk at the park. Mom, Dad and the kids will be healthier!

Picky Eaters

Barry — Fri, 24 Apr 2009 04:43:30 +0000

By Christine Wood, MD

Picky eaters in preschoolers are one of the most common feeding problems I am asked about in my pediatric practice. How many times have you faced these scenarios in your home?

The toddler who takes two bites of food and then says “all done!”
The child who will only eat five varieties of food and so you prepare those foods day after day.
The child who says he wants food x, then after you prepare food x, he states he wants food y, and then after you get food y, he says, “No” he wants food z!
Having daily mealtime battles where you find yourself bribing, coaxing and nagging bites of food into your child’s mouth.

The first goal to is not to create mealtime battles. Battles at the dinner table will usually only make a picky eater pickier. It’s not worth the battle! Realize that toddlers in that 1 to 3 year range have small appetites and don’t seem to need to eat as much. Their appetites can vary day-to-day and from meal-to-meal. Life is just too exciting and there are higher priorities around other than sitting at the dinner table. As you see in all aspects of a toddler’s behavior, they are seeking a new level of independence and control. If you are trying to control them from touching the TV set, they see it as a game will try to do it and look right at you while they are doing it! If you are trying to control every bite of food, they see it as their job to do the opposite. Developmentally, they are generally quite capable of self regulating food intake and parents must sometimes learn to respect their natural appetites and variations. Sometimes what the parent feels is “picky eating,” may be “normal eating” for that child.

If you are dealing with older children, you need to set up some guidelines. The one bite rule can be effective for most kids. They need to at least try the bite of all foods offered, and if they don’t like it, they don’t need to eat more. As parents, we have to hide our concern about whether they eat it or not.

Below are a few ideas to handle the picky eater:

Never coax, bribe, punish, nag. Avoid the battles! Hide your anxiety and concern about eating!
Keep introducing new foods over again. Don’t avoid it just because they didn’t like it once, they may change their mind.
Don’t dictate how much you think your child should eat. Let your child decide how much they will eat.
Change your buying habits if you find your child is “stuck on” certain unhealthy foods.
Offer fruits as dessert. Use it on its own as dessert or add it to ice cream, pudding or cake. Make your own fruit popsicles (have your child help you, it will have more value to them) out of fresh fruit, yogurt, juice or milk.
Avoid excess juices, sodas and milk as substitutes for eating real food. Limit juice (1-6 years old < 6 ounces/day; 7 years old + < 12 ounces/day) and milk
Avoid frequent snacking habits. Avoid snacks in the car or while standing around and playing. Use a snack plan.
Disguise foods and combine foods they like with those they don’t like.
Keep portion sizes realistic. For preschoolers, one serving of fruits or vegetables amounts to about 1 tablespoon for each year of age. That means a 3 year old, should be served about 3 tablespoons of peas.
Try not to use dessert as a reward. For those stubborn kids who try to hold out for dessert, offer dessert with the main meal. Of course, make sure it is a small, reasonable serving. Most kids will not get full with a small dessert and then they are free to “indulge” in the rest of the meal.

www.kidseatgreat.com (sign up for teleseminars and lifestyle coaching)

Brighter, Brainier Babies with Healthy Fats

admin — Fri, 24 Apr 2009 01:41:36 +0000

By Christine Wood, M.D.

www.kidseatgreat.com

What parent doesn’t dream of having an intelligent baby and child? Are there things that a mother can provide in her diet and in her baby’s diet that may promote a smarter baby? Studies have shown that breastfed babies have higher IQ’s than those babies fed formula. One of the nutrients that has received attention in breast milk as having a role in improving infant brain development is a class of essential fatty acids (EFA) called, omega-3 fats. These beneficial fats are long chain polyunsaturated fatty acids and two of them have been studied in infants: docosahexaenoic acid (DHA) and arachidonic acid (ARA). Contrary to popular belief, the body does need fat. It must be the right kind, though.

Let’s look at the adult brain compared to the fetal brain. The adult brain is about 2 percent of total body weight and uses 20 percent of total energy. The fetal brain is about 16 percent or more of body weight, uses about 70 percent of energy for growth. The brain is made of about 60 percent fat. The fats required for the nerves found in the brain are primarily DHA and ARA. Since breast milk is made of 40 to 50 percent fat, we see how Mother Nature built in the right components for brain development.

There is an infant brain growth spurt from the last trimester of pregnancy until about 18 months of age. DHA accumulates in the infant brain during this period at a rapid rate. The accumulation of this fat depends on the pregnant mother’s intake of this important nutrient in her diet. After the baby is born, if the mother is breastfeeding, the amount of DHA in breast milk will depend again on her dietary intake of this nutrient. DHA is found in the diet in high amounts in fatty fish (like tuna, mackerel, anchovies, salmon, herring, sardines) and in flaxseeds, flaxseed oil, canola oil, fish oil, and walnut oil. Unfortunately, there is growing concern that many of our fish today are contaminated with mercury which may be harmful to infant brain development. Studies have shown that mercury exposure in infants and young children can cause problems with attention, learning and behavior. (See “Fish Caution During Pregnancy and Breastfeeding” to learn more.)

Investigators are discovering the importance of different fats on infant brain development. How these fats affect attention, problem-solving ability, IQ, and visual function is the emphasis of recent research. Consider these studies:

DHA appears to be important for visual development in premature infants.^{^[i]}
A study from Australia showed that supplementation of infant formulas with a dietary omega-3 did improve visual function to the level of those found in breastfed infants.^{^[ii]}
Another study showed that supplementation of formula with DHA and ARA from birth to 4 months of age resulted in higher problem-solving scores at 10 months of age.^{^[iii]}
The improved intelligence and academic performance of breastfed babies compared to formula-fed babies may be partially explained by the increased DHA content of breast milk.

As you can see in the box Essential Fatty Acids: Benefits and Food Sources, there are many other studies on the role of essential fats in adult and childhood health.

If you are pregnant or breastfeeding, you should make sure you are including these fats in your diet. Look for food sources as listed in the box and be generous with the plant-based forms of this fat (nuts, oils, flaxseeds and beans). My recommendations are one tablespoon of flaxseed oil and a fish oil supplement with DHA and EPA. The total omega-3 as fish oil (DHA plus EPA) should total about one gram a day. I recommend both because the flaxseed oil has a component that converts into the ARA, which is also an important part of the essential fats for infant brain.

If your baby is formula-fed, you should note that most formulas now contain these essential fatty acids. The DHA and ARA have been recently approved for use in infant formulas in the United States. The British Nutrition Foundation and the Joint Expert Committee on Human Nutrition of the United Nations Food and Agriculture Organization and World Health Organization (FAO/WHO) have recommended that DHA and ARA be included in all infant formulas. Studies show particular benefits for premature babies for their brain development and visual acuity.

Infants and children can safely receive these essential fatty acids in the form of flaxseed oil and other food sources listed. Most children are not big fish eaters and so their intake of these essential fats can be very low, so supplementing their diet with these fats may be beneficial for their immune and cardiovascular system.

All in all, these fats are something that everyone should be receiving in some form as our diets of today have changed and generally contain a high level of fats that are not good for our bodies and not enough of these good essential fats. Starting infants even before they are born will help them start out right for life!

[i].Birch DG, Borch EE et al. Retinal development in very-low-birth-weight infants fed diets differing in omega-3 fatty acids. Invest Opthalmol Vis Sci. 1992;33:2365-2376.

[ii].Makrides M, Neumann MA, Gibson RA. Are long-chain polyunsaturated fatty acids essential nutrients in infancy? Lancet. 1995;345:1463-1468.

[iii].Willatts P, Forsyth JS et al. Effect of long-chain polyunsaturated fatty acids in infant formula on problem solving at 10 months of age. Lancet. 1998;352:688-691.

Brighter, Brainier, Breakfasts

admin — Thu, 23 Apr 2009 01:37:06 +0000

By Christine Wood, MD
www.kidseatgreat.com

Do you ever skip breakfast because you are in a hurry or just not hungry? While 99 percent of 3^rd graders say they eat breakfast, the number drops to 85% when these students reach the 8^th grade. Breakfast feeds the brain and has been proven to enhance school performance. Remember that after sleeping all night, our body and brain has gone without food for probably 10 or 12 hours. If your next meal isn’t until lunch, it can affect your school performance.

Did you know?

Children who skip breakfast exhibit poorer attention and concentration and perform lower on tests than those who ate breakfast.
Children who skip breakfast are often more deficient in their total nutrient intake of essential vitamins and minerals.

Following are some quick and easy breakfast ideas:

Layer fresh fruit, low-fat yogurt, and cereal for a breakfast parfait with some nuts like almonds or walnuts. These nuts have healthy fats, called omega-3 fats that help brain function.
Stuff a whole-wheat pita with cottage cheese and fresh fruit.
Put yogurt and berries in the middle of two whole-grain toaster waffles.
Spread peanut butter on whole-wheat bread and top it with slices of banana.
Top a bagel with low-fat cream cheese and thinly sliced apples or hummus.
Melt a slice of low-fat cheese over a scrambled egg on top of an English muffin.
Top a whole-wheat tortilla with scrambled eggs and salsa and roll it up for a breakfast burrito. Add some black beans for more fiber.
Make a batch of low-fat, whole-grain muffins and freeze them for breakfast on the go.
Try a healthy smoothie with soy protein powder, fresh or frozen fruits. Add a tablespoon of peanut butter or a tablespoon for flaxseed oil for more of those healthy fats.
Find healthier cereal choices by examining the nutrition label. Features of a healthier cereal to look for are: less than 6 grams of sugar, fiber content over 5 grams and protein content over 3 grams per serving. You may not find all of these in one cereal, but the more you can strive for the better. You may combine a current less healthy cereal with the better choice to get used to a healthier variety.

If you have a hard time planning your breakfast when you first roll out of bed, plan your breakfast the night before and get out what you can to make it easy for you to prepare in the morning. If you are absolutely crunched for time, take a bar and a piece of fruit with you to eat on the way to school. Talk to your parents about what type of food choices would be easy for you in the mornings and ask for their help to keep them available for you in the house. Remember, eating good food helps develop healthy minds and bodies!