• Children and Weight: A Growing Problem

    By: Michelle Place, CRNP-P

    March is National Nutrition Month

    A HUGE issue

    One in three children in the United States is overweight. More alarmingly, about  18.4% of (over 12.5 million) children and adolescents aged 2-19 years are obese. This number has almost tripled in the past 30 years.

    Obese children are more likely to become obese adults and being overweight in childhood means that obesity in adulthood is likely to be more severe. There are a myriad of health issues that go along with being overweight.

    What does it mean?

    Body mass index (BMI) is a measure used to determine if children are overweight or obese. It is calculated using a child’s weight and height. BMI does not measure body fat directly, but it is a reasonable indicator of body fatness for most children and teens. A child is considered overweight if their BMI is at or above the 85th percentile and lower than the 95th percentile on the growth chart when compared with children of the same age and gender. Obesity is defined as a BMI at or above the 95th percentile on the growth chart for children of the same age and gender. http://www.cdc.gov/obesity/data/childhood.html

    Click here to calculate your child’s BMI:

    http://apps.nccd.cdc.gov/dnpabm

    What can we do about it?

    The cornerstone to decreased weight gain is limiting caloric intake and increasing physical activity blah, blah, blah.

    Below are ten practical suggestions for simple lifestyle changes that have been shown to make a difference  in helping children stay healthy (and may accidentally benefit you as well!).

    1. The first step is admitting there is a problem.  Thirty-two percent of American children fall into the category of  being either a little or very overweight, however, in a recent poll only 15% of parents stated that their children should be classified this way. In addition, only 20% of parents are worried that their children could become overweight or even obese as adults despite the fact that an estimated 69% of American adults are overweight. It seems that it is easy for parents to acknowledge the fact that obesity is a problem on a national level but most have difficulty seeing the problem in their own homes. http://health.usnews.com/health-news/news/articles/2013/02/25/poll-many-americans-dont-see-their-kids-as-overweight
    2. Give your kids a good head start. A recent study published in the journal Pediatric Obesity looked at the influence of infant feeding practices on obesity in toddlers. The results indicated that only 5% of babies who were exclusively breastfed for the first 6 months were obese at 2 years of age while those who were formula fed were twice as likely to be. They also found that babies who were started on solid food before 4 months of age and those who were put to bed with a bottle were much more likely to be obese at 2. It is never too early to start healthy practices to avoid obesity later in life. How you feed your baby now does make a difference for later. http://www.dailyrx.com/toddler-obesity-risk-linked-family-feeding-practices-six-months-old
    3. Don’t forget the most important meal of the day. Skipping breakfast is associated with increased weight gain. A study published in the April, 2013 issue of  The American Journal of Clinical Nutrition showed that adolescent girls who ate breakfast felt less hungry and more full than those who skipped it. Furthermore, girls who ate breakfast that included 35 grams of protein felt even less hungry and had lower levels of the hormone that stimulates hunger than those who ate a normal-protein breakfast. As a result these girls did less high-fat, high-sugar snacking later in the day. http://www.medicaldaily.com/articles/14409/20130326/high-protein-breakfast-benefits-controlling-appetite-reduced.htm (includes a link to suggestions for breakfasts that are high in protein)
    4. Smaller more frequent meals are better. Children and adolescents who eat more frequently have a lower chance of being overweight than those who eat fewer times/day. An analysis of data from many studies was published in the April, 2013 issue of  Pediatrics. Researchers found that kids, especially boys, who ate 5-7 smaller meals were less likely to be overweight than those who had 3 squares a day. http://pediatrics.aappublications.org/content/early/2013/04/03/peds.2012-3241.full.pdf
    5. Make water your beverage of choice. Consumption of sugar-sweetened beverages like sodas, juices, sports and energy drinks has risen in the past 20 years according to a report in the April issue of the American Journal of Preventive Medicine. Children who drink sugar-sweetened beverages consume more calories than other children and a large proportion of these extra calories come from these drinks. In addition, children who drink sugar-sweetened beverages eat more unhealthy foods than other children.

    Infants do not need juice. Most people would not imagine putting soda in their baby’s bottle but fruit juice is essentially the same thing. Juice is full of sugar and does not add any nutritional value. Babies who have never tasted juice do not know what they are missing and will happily drink water to quench their thirst. You go to the grocery store and are in charge of what is in the pantry. If you stock your kitchen with healthy food choices that is what your children will eat. http://consumer.healthday.com/Article.asp?AID=674293

    1. Turn off the TV.  The results of a study published in the April, 2013 issue of Pediatrics showed that more time spent watching TV was connected to an increase in teenagers’ BMI. No such link was found for computers or video games. Increased weight was not associated with just using the TV – having it on – but with time spent actually paying attention to the television. This may result from watching food advertisements on TV or because teens eat more when they are distracted while paying attention to their favorite TV programs. http://pediatrics.aappublications.org/content/early/2013/04/03/peds.2012-1197.abstract
    2. Use smaller plates. According to the AAP, allowing young children to serve themselves at mealtimes produces autonomy in eating as well as an improvement in social and motor skills. A recent study published in Pediatrics showed that using larger, adult-sized plates when children served themselves from a buffet-style lunch line resulted in them putting more on their plate, and ultimately consuming a greater number of calories, than when they served themselves on smaller dishware. This may be due to the fact that on the larger plates portions look smaller to the naked eye. In general, children under the age of 3 years will stop eating when they feel full, those over 3 tend to eat more if there is more on their plate to eat. http://pediatrics.aappublications.org/content/early/2013/04/03/peds.2012-2330.abstract
    3. Add family mealtime to your busy schedule and keep them at the table. Another recent study showed that children whose families engage with each other over a 20-minute meal four times a week weigh significantly less than kids who leave the table after 15 to 17 minutes. Researchers found that families who say that shared mealtimes are an important part of family life and have special meaning for them are less likely to have a child who is obese or overweight. Families who talk more together and interact more positively during the meal are also more likely to have children with normal weight. http://www.medicaldaily.com/articles/13977/20130122/spending-extra-three-minutes-dinner-table-help.htm
    4. Resign your post as president of the “Clean Plate” club. Many parents insist that their children finish all the food on their plate even after their child states that they feel full. In addition, treats are often restricted until they have licked the platter clean. Researchers at the University of Minnesota found that these practices lead to bad eating habits going forward. Pushing your children to eat everything on the plate encourages them to respond to what is on the plate rather than paying attention to their own hunger cues. This can lead to overeating. Also, restricting treats makes them taboo. Children become obsessed with sweet treats resulting in overeating them when given the opportunity. It is better to encourage eating all foods in moderation. http://thechart.blogs.cnn.com/2013/04/22/pushing-kids-to-eat-may-cause-obesity-later/

    10. Cozy up to the sandman. Getting a good night’s sleep provides a lot of benefits such as improving school performance and decreasing irritability but, did you know it can also lead to a reduction in weight? A recent study found that the less sleep teens got, the more likely they were to be overweight or obese. Plus, teens who were already obese appeared to gain more weight for each hour less of sleep. The researchers predicted that increasing sleep time to 10 hours every night could reduce obesity among teens.

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