Health Topics

Pediatric Obesity

By David Dungan, MD

The potential health impact on the United States in terms of dollar costs is in the hundreds of billions of dollars if these children and teens with unhealthy weight continue to be overweight as adults.  Talking about and doing something about unhealthy weight for children and teens is not glamorous, it isn’t appealing, and it is not easy to talk about or face, as we often know it is a reflection of how the family lives as a whole.  It will not be easy, but it must be done.  What I would like to do is provide some guidelines for a parent and family to follow to help children reach a healthy balance with their weight.

It is important to have a healthy beginning.  If you are pregnant or planning a pregnancy, remember to keep a healthy weight during the pregnancy.  Work with your obstetrician in this area; remember that mothers who gain excessive weight with their pregnancy have a higher rate of obesity in their offspring and higher weight babies, who have a higher rate of unhealthy weight as they become children. 

Once the baby arrives, the best feeding for the infant is breast feeding.  Many studies have shown the obvious benefits, but did you know that children who are breast fed until at least 4 months of age have a significantly lower rate of unhealthy weight as toddlers and children?  In addition, if the mother takes in a balanced healthy diet, the breast milk takes on the flavors and characteristics of those foods, giving the infant an early preference for accepting those foods later on.  If breast feeding does not work for whatever reason, do not despair.  Following your infant’s cues with formula feeding to avoid overfeeding and behaviors that trigger excess feeding can be very helpful.  Talk with your pediatrician about some of these ideas.

Once the infant becomes ready for solid foods, around 6 months or slightly earlier, it is important to avoid high sugar and high density foods from the start.  These foods will stimulate certain brain receptors to upregulate and drive the desire for more of those foods over the ones that have better health benefits.  Keep offering a consistent balanced blend of whole grains, vegetables, nonsweetened fruits, and protein, and the infant will accept these foods over time.  It is not unusal for the infant to take 3-4 times of presentation before they finally accept a certain food, so don’t give up!

As your child enters the toddler years it is normal for the appetite to be inconsistent, picky, and often only one “good” meal will occur each day.  Do not fall into the trap of the “they have to eat” mentality.  First, it is a battle you will never win.  Second, it places unneeded emphasis on food as a reward or punishment that alters a toddler's view of what food is.  Present consistent balanced foods on a regular schedule and model the same behavior yourself!  When your child is hungry they will eat, and they will imitate what you do, so be the example!

Having a consistent family meal time with food prepared at home as the child grows into the grade school years and beyond is very important in keeping your child at a healthy weight balance.  Limiting the exposure to fast food and processed foods markedly reduces exposure to unnecessary calories and is important as part of a healthy weight strategy.  Regular exercise in regard to outside play through recreational sports, playing at the park, throwing and catching a ball, or going for a family walk will increase the amount of calorie expenditure that improves energy balance.  That means that healthy weight depends on the balance of energy taken in (what is eaten) and energy spent (level of activity and movement).  It seems simple, but it really is that straightforward!

A quick and easy thing to remember to help you follow healthy family living is 5,4,3,2,1,GO

5 servings of fruits and vegetables a day

4 servings of water a day

3 meals a day

2 hours of screen time or less to reduce passive inactivity (this includes ALL forms of electronics, games, TV etc.)

1 hour of exercise or play every day (can be in smaller time frames but should add up together to an hour or more)

GO!  Let’s get healthy together!

Other resources that can help you find assistance as you work toward a healthier family life include:

We Can:  http://www.nhlbi.nih.gov/health/public/heart/obesity/wecan/

ProActive Kids Foundation:  http://proactivekids.org/

YMCA of Chicago:  ">http://www.ymcachicago.org/locations/

Chop Chop:  http://www.chopchopmag.org/

American Academy of Pediatrics:  http://www.healthychildren.org


Topics and Subtopics: Children's Health & Health & Diet

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