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Focus on healthy eating and exercise
Families need to focus on a healthy lifestyle regardless if a child is overweight, says Beth Passehl, MS, program coordinator III for Fit Kids at Children’s Healthcare of Atlanta. In the six-week Fit Kids program for parents and overweight children, families learn how to establish good healthy diet and exercise patterns. The focus is not on weight loss, but on healthy living. Often parents will remark that their slim child can eat junk food all day long and not gain weight. To this, Passehl responds that even if he or she doesn’t gain weight, it is not a healthy habit.
"Our philosophy is that the habits you instill in the family have to be good healthy habits that are health-focused and not weight-focused. [This way,] everybody can adhere to them and should adhere to them because they are the right things to be doing for your body," says Passehl.
Often the health habits of overweight children are not that different from children of average weight, she says.
In today’s society children are bombarded with opportunities for sedentary activities, including surfing the Internet, playing computer games, e-mailing friends, and watching television. Also, in most families, both parents work, so when a child comes home from school, there is no one home to supervise their playtime.
Food is accessible, very cheap, and easy to come by. Anyone can walk down the street and find food, says Passehl. In addition, many schools have vending machines that don’t always have a lot of nutritious choices. "There is amazing availability and temptation to eat the foods that are less nutritious and less healthy on the whole," she says.
Good health habits do much more than prevent weight gain, agrees Jeanne McDaniel, MS, RD, LD, CSP, a clinical nutritionist at Children’s Healthcare of Atlanta Scottish Rite Campus. Physical activity increases bone density. Also, when children are inside the house watching television, they are not getting the sunlight that produces vitamin D.
Parents should limit the amount of soft drinks their children consume daily and keep them for special occasions, says McDaniel. Soft drinks can cause an imbalance between the calcium and phosphorus intake by introducing a lot more phosphorus. It makes the ratio between calcium and phosphorus out of balance and can decrease bone density, she explains. This could lead to more bone fractures.
It is important to help families become aware of what they eat and drink and how much time is spent in front of the computer and television. In the Fit Kids program, one of the things that parents are asked to do is track how often they serve sweetened beverages on a weekly basis. Children are so used to drinking soda and juice that sweetness is the preferred flavor, says Passehl.
She suggests parents start serving water between meals and snacks rather than a sweet beverage. Water is better for the body, and it helps to change the habit of drinking too much soda. It is also important to help families scrutinize their relationship with food. Parents with overweight children tend to tell them not to eat certain foods and then a struggle develops. In response to that struggle, children often overeat because they eat quickly or sneak food and they tend not to be in touch with their bodies or how they are feeling. "They eat too fast, never even tasting their food, so they don’t enjoy it and also they don’t get in touch with their own internal cues of hunger and fullness," says Passehl.
Families need to learn that exercise isn’t just a segment of the day, but increasing physical activity in a lot of different ways. Not only can parents park their car further from the mall entrance when the family is on a shopping trip, but also do five- to 10-minute activities such as dancing to a CD, says Passehl. "Families don’t have to rely on a facility or equipment or driving somewhere to be physically active," she says.
Parents must be good role models because if children don’t see their parents being active, they won’t exercise either. When a parent says that he or she is not active but they want their child to be active, Passehl tells them that they have to change.
While some children lose weight when they participate in Fit Kids, that is not the goal of the program. The main goal is weight maintenance. It is hoped that they will stop gaining and thus grow into their weight, says Passehl. At least one parent attends the six-week course with the overweight child, which consists of a 1½-hour class once a week. Usually physicians refer the families into the program. About 10 to 12 families are enrolled at a time. Follow-up phone calls several months after the classes end have found that about 40% of the families make lasting lifestyle changes with improved eating habits and more physical activity.
For more information on the Fit Kids program or good nutritional choices for children, contact:
• Jeanne McDaniel, MS, RD, LD, CSP, Clinical Nutritionist, Children’s Healthcare of Atlanta, Scottish Rite Campus, Clinical Nutrition, 1001 Johnson Ferry Road, Atlanta, GA 30342. E-mail: Jeanne.McDaniel@choa.org
• Beth Passehl, MS, Fit Kids, Program Coordinator III, Children’s Healthcare of Atlanta, 1655 Tullie Circle, Atlanta, GA 30329. Telephone: (404) 785-7236. E-mail: Beth.Passehl@choa.org