Wednesday, September 12, 2012

Simple Solutions for Preventing Childhood Obesity

The conversation about America’s waistline has been going on for quite some time. And, unfortunately, we're not just talking about adults anymore.

In the past four decades the percentage of obese children has doubled for those between the ages of 2 and 5 and more than quadrupled for those between the ages of 6 and 11. In the 1970s, the percentage of obese 2-5 year-olds was 5% and 6-11 year-olds was 4%. Now those numbers are 10% and 20%, respectively. 

Being overweight or obese can affect more than a child’s self-esteem. It can lead to type 2 diabetes and cardiovascular disease, two very serious conditions that decrease quality of life and life expectancy.

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How do I know if my child is overweight or obese?

The follow chart indicates where your child might fall based on their weight percentile given to you by the pediatrician:
Underweight—less than the 5th percentile
Healthy weight—5th percentile to less than the 85th percentile
Overweight—85th percentile to less than the 95th percentile
Obese—Equal to or greater than the 95th percentile
BMI calculators are another rough indicator of where your child is at. A child and adolescent BMI calculator can be found here. (And if you’re interested, you can find an adult BMI calculator here). Remember: every child is different and these charts/calculators only provide a rough estimate; always consult with your pediatrician if you have any questions or concerns.

Now what do I do?

Before we point our finger at the parents of overweight children, let us remember that while individuals choices do play a role, the structure of the American society today is far less conducive to healthy, active living than it used to be. This means that as parents we must work harder to instill these habits in our children! And with all the documentaries, reality television shows, newspaper articles, and books constantly offering completely different culprits and solutions to the problem, the challenge of making our homes a healthier place can seem incredibly daunting.

But the bottom line is: YOU CAN DO IT!

And it’s probably a lot easier than you think. Just because you don't have a degree in nutrition or run for an hour every day doesn't mean you can’t live an active, healthy life! Often times it is the little things that makes the biggest difference

By now you’re probably asking: How do I do it?!

The American Academy of Pediatrics (AAP) has proposed a few simple solutions to help foster healthy, active living in the home. These steps are: 
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  1. Role modeling. Parents and family members should model healthy, active living. So much of what children learn comes from what they observe.
  2. Routines. Establish and maintain healthy routines that include eating the evening meal as a family, getting an appropriate amount of sleep, limiting screen time to less than two hours per day, and getting daily physical activity. The recommended amount of sleep for preschool-aged children is 10.5 hours a night for infants 12 hours are recommended.The AAP also recommend keeping televisions out of children's bedrooms as a way to reduce screen time and help children learn healthy habits. For a toddler, daily physical activity should add up to at least 60 minutes of moderate to vigorous activity per day. This time can be split up throughout the day, but at the end of the day should be at least 60 minutes. This might mean setting aside dedicate time each day for "active play." If you need some ideas or activities to help get your child moving and having fun check out Help Me Grow's Pinterest or some of the links at the bottom of this post.
  3. Building a team. Parents should engage and encourage family and friends to participate in their lifestyle, especially those who will be caring for the child. This also includes child care providers.
These are really great starting points for parents looking to make create a healthier home environment but for many parents, diet is still a huge question mark. A healthy diet is a crucial aspect of keeping our children healthy. 

What are the caloric guidelines for my child?

Estimated calorie needs for children ages 2-3 years:
Sedentary: 1,000 – 1,200 kcal per day
Moderately active: 1,000 – 1,400 kcal per day
Active: 1,000 – 1,400 kcal per day

Estimated calorie needs for girls 4-8:
                Sedentary: 1,200 – 1,400 kcal per day
                Moderately active: 1,400 – 1,600 kcal per day
                Active: 1,400 – 1,800 kcal per day

Estimate calorie needs for boys 4-8:
                Sedentary: 1,200 – 1,400 kcal per day
                Moderately active: 1,400 – 1,600 kcal per day
                Active: 1,600 – 2,000 kcal per day            

Low-nutrient, energy-dense beverages, desserts, and snack foods are the biggest struggle for most parents who aim to give their child a balanced diet. One study found that 82% to 89% of preschoolers consumed one or more such foods in a day. The same study noted, “Preschoolers’ nutrient needs are high, relative to their energy requirements, so there is little room in their diets for low-nutrient, energy-dense foods without exceeding energy requirements or consuming inadequate amounts of essential nutrients.” Meaning, there is less room in their diets for sweets and extra fats than their adult counter parts. This includes fats from sweetened beverages, apple sauces, snacks, and higher fat milk and milk products.

How do I know what to feed my child?

The Federal Dietary Guidelines for Americans of 2010 offers the following key recommendations as part of a healthy eating pattern (while staying within caloric needs):
§  Increase vegetable and fruit intake
§  Eat a variety of vegetables, especially dark-green and red and orange vegetables and beans and peas
§  Consume at least half of all grains as whole grains. Increase whole-grain intake by replacing refined grains with whole grains
§  Increase intake of fat-free or low-fat milk and milk products, such as milk, yogurt, cheese, or fortified soy beverages
§  Choose a variety of protein foods, which include seafood, lean meat and poultry, eggs, beans and peas, soy products, and unsalted nuts and seeds
§  Increase the amount and variety of sea food consumed by choosing seafood in place and some meat and poultry
§  Replace protein foods that are higher in solid fats with choices that are lower in solid fats and calories and/or are sources of oils
§  Use oils to replace solid fats (such as shortening or lard) where possible
§  Reduce intake of sugar-sweetened beverages
§  Monitor intake of 100% fruit juice for children and adolescents, especially those who are overweight or obese
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Okay, that’s a lot to remember, but here is a quick summary: “A healthy eating pattern focuses on nutrient-dense foods—vegetables, fruits, whole grains, fat-free or low-fat milk and milk products, lean meats and poultry, seafood, eggs, beans and peas, and nuts and seeds that are prepared without added solid fats, sugars, starches, and sodium.”

Don't forget: What your child drinks is just as important as what they eat.

The following are recommendations for milk and milk product intake for children based on age.

For children between the ages of ________ the recommended intake of fat-free or reduced-fat milk and milk products is ­­­­_______.

Fill in the blanks with the following:
a.       2-3 years, 2 cups
b.      4-8 years, 2.5 cups
c.       9-18 years, 4 cups

The AAP recommends whole milk for children under the age of 2 because of “their relatively higher need for fat to support rapid growth and development.” However, for children under 2 who have a family history of obesity, lipid disorders, or cardiovascular disease, fat-free or low-fat milk is recommended. After the age of 2, the AAP recommends that all children transition to fat-free or low-fat milk.

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Parents should also aim to completely (or nearly completely) eliminate sugar-sweetened beverages from their child’s diet. The consumption of sugar-sweetened beverages, which contain few essential nutrients and provide excess calories, are directly related to higher body weight. Considering this, parents can still choose to incorporate, on occasion, sugar-sweetened beverages into their children’s diets. However, this should be done with caution and only when the child’s other nutrient needs have been met.

The artificial vs. natural sugar content of juice can complicate the problem of trying to eliminate sugar-sweetened beverages. Unless the package label indicates “100% juice” it is not 100% juice. A label such as “100% Daily Value for vitamin C” does not mean that is 100% juice.

Resources and References for Parents

I have included some resources that I used for this post along with others where you can find more information on some of the topics discussed. Click on the title and it will take you directly to the website. Have fun and remember, doing something is better than doing nothing!

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