A family approach to tackling one of the most serious issues in pediatrics.
It’s the holidays, a time when visions of sugarplums dance in children’s heads. Surrounded by the lure of sweet indulgences and without a mature understanding of the food-health connection, kids can go crazy on empty calories.
Most parents try their best to teach their families to make good food choices. But they don’t want them to feel deprived of the goodies other kids enjoy. Parents can be in denial about the health threats that extra pounds can have on children and teens. How can you tell if your child is simply carrying a little extra “baby fat” that he will soon outgrow, or if those pounds are an indication of something more serious?
“If you think your child has a weight problem, begin with your child’s doctor,” says Dr. Skip Brown, Medical Director of Outpatient Clinic Operations at UTMB Bay Colony Pediatric Center. “After the age of two, we begin assessing a child’s weight using the Body Mass Index (BMI.) The child’s growth both by height and weight should be consistent. If it’s not, we’re finding that children can’t be too young to begin addressing this.” Brown adds that the “Granny” approach—also known as, “He’ll grow out of it because his dad was big at that age, too”—is not an accurate predictor. “If there’s a problem, it calls for the entire family to make different choices. This requires some conviction on the part of everyone because obesity among children has become one of the most serious issues in pediatric medicine.”
Everyone knows that the key to maintaining a healthy weight is to eat nutritious food and to exercise. But is it really that simple? “I hear this often,” says Brown. “My patients’ parents will say that their grandpa ate like a horse and was never overweight. The difference is, Grandpa probably did a fair amount of vigorous daily physical labor as opposed to being sedentary. If we don’t compensate for our food intake with exercise, then we simply cannot avoid weight gain.”
For young patients entering the clinic, Brown says that he begins by taking the entire family’s dietary history. “We never give patients a long list of foods that are now off limits. We start with just a few very manageable changes. First, we tell kids they can eat anything, but only one helping. Since many kids drink their calories in the form of sugary sodas and juices, we tell them they can drink whatever they want except sodas and juices.” If the entire family can embrace these two small changes—and Brown says that in most cases, they can—then they’re already on their way to a healthier lifestyle. “We try to convince the parents that they can make the difference,” continues Brown. “We’re not wrapped up in what’s on the plate. We don’t tell parents that the kids can never have any more French fries, nor do we talk about calories or fat grams. We just advise parents to limit their child’s portion size and sugar intake. Some very simple interventions can have a great result and, if nothing else, adherence to the plan will keep additional pounds from creeping on.” Nutritionists are available to consult with patients who want to fine-tune their menu plans.
The other part of the family-approach plan is to introduce exercise. “We advise 150 minutes of outdoor exercise a week,” says Brown. “It’s great if the family can do this together, but it’s not always possible. The goal is to reduce screen time. We try to convince the whole family to get on the team, because if they all do, this can absolutely work.”
Many of us blame our “big bones” or our grandmother’s large body type for our own weight issues. We look at our grandparents and believe that in a few years, we’ll inevitably look just like them. “Certainly genetics play a role,” says Brown. “But we can also have the genetics to predispose us to heart disease. That doesn’t mean we just give up. We can do a great deal to prevent many diseases, or at least delay them.” He adds that, in the case of obese children, chronic diseases associated with middle age are accelerating at an alarming rate. “Addressing prevention needs to start with the children, because the disease burden is going downward instead of upward.”
Obesity-related conditions can be serious, including changes in the liver due to excess carbohydrates, early risk of diabetes, and hypertension. “I have a lot of parents who want me to check their child’s thyroid, but weight gain is almost never because of the thyroid,” he explains. “In fact, I can’t think of a single case! And even so, hypothyroidism (or underactive thyroid) might account for only a few pounds, but not obesity,” continues Brown. “There are very simple interventions—I can’t overstress the difference it makes just eliminating the sugary drinks and controlling portion sizes.”
The most effective way to ease a child toward a healthy BMI is to set a good example within the family. Research supports Dr. Brown’s method to focus on health and good nutrition rather than counting calories and fat grams. “Kids do better when parents are accountable,” says Brown. “Structure at mealtimes, exercise, and eliminating the sugar can result in success pretty quickly. We tell the families, “Look! You only changed a few things and you’re already on your way!”
To get through the holiday food feasting, focus on getting your kids involved in local volunteering, cooking healthy snacks and treats together, and moving with daily sports and activities. As you do more together as a family, your healthy example will speak louder than any words to your children. And they will follow your lead.
UTMB Health Pediatric Specialty Clinic is located at 2785 Gulf Freeway, Suite 200 in League City. For more information visit www.utmb.edu/pediatrics.
The hard facts about soft drinks
- Consuming 2-3 cans of regular soda each day can result in one extra pound of weight gain per week.
- Children suffer from caffeine dependence in much the same way as adults, and withdrawal symptoms (irritability, loss of focus) are also similar.
- The Coca-Cola Company purchases more sugar than any company in the world. Each can of Coke contains approximately 16 teaspoons of sugar, ten more than the daily recommended allowance of sugar for children.
- To burn off a single regular soda, a 100-lb. person would have to bicycle for 30 minutes.