ASK THE PEDIATRICIAN

Doctor, how do we change?

When I see a family in my office whose child is overweight or obese, I am asked this question by parents. The parents often are perplexed. Many times parents have tried to help their child with diets and forced physical activity, but have thrown their hands up in surrender because the child has rebelled against this drastic change in lifestyle. How I usually approach this is to remind them that the change does not have to be drastic, it has to be gradual, and should involve the entire family, including members who have no weight issues.

Dr. Goutham Rao is the director of the Weight Management Center at Children’s Hospital of Pittsburgh. In his book, Child Obesity, A Parent’s Guide to a Fit, Trim, and Happy Child, he describes five strategies that families can gradually instill into their lifestyles that will help children attain and maintain a healthy weight. When I speak to families about his strategies, I stress that these strategies are not just for overweight children, but also for children who are at an ideal weight. I feel that his advice, based on science, is important for all families to follow, not just families with children who are overweight.

Below are his five strategies and other advice that can gradually be implemented into your family’s life that will promote healthy lifestyles for you and you children.

Increase Physical Activity. I personally find this the most essential aspect of leading a healthy lifestyle. The CDC (the Centers for Disease Control) recommends that everyone get at least 30 minutes of moderate aerobic exercise most days of the week. As a matter of fact, children should try to get 60 minutes dispersed throughout the day. This can include walking, running, playing on the playground, swimming, riding a bicycle, etc. The HEALTHY Armstrong website has many activities around Armstrong County that your family can partake in to increase physical activity.

Reduce Screen Time. The American Academy of Pediatrics recommends that children less than two years should not watch any television and that all other children should not watch television and play video games for more than two hours a day. I feel that this is cumulative throughout the week. A child can only have 14 hours a week of screen time. This means if a child watches two hours of TV and plays one hour of video games on Monday, she is only allowed 11 more hours the rest of the week. One thing that I think that we can be flexible with is computer time for homework.

Eliminate Soft Drinks. Multiple studies have shown that soft drinks have contributed to unhealthy lifestyles. As Dr. Rao mentions in his book, soft drinks are “liquid candy”. If you think about it, soft drinks are sugar and water. There is no nutritional value to soft drinks and therefore your family is consuming empty calories. Your child should be drinking milk (preferably 2% or less) and water. However, to suddenly eliminate soft drinks from a child that may have been consuming one can of soda a day, may cause him to crave more of it. What I usually advise parents to do is to decrease the soda consumption gradually. For example, if your child is drinking one can of soda a day, decrease it to every other day for a certain period of time. Then decrease to once a week. Then finally eliminate soft drinks totally. I usually don’t recommend replacing regular soft drinks with diet soft drinks because I feel that the craving is still there and when your child becomes an adult he may revert back to regular soft drinks. I also remind parents that sports drinks can be included as soft drinks, especially if your child is not physically active.

Reduce Fast Food Consumption. Dr. Rao recommends that families should not eat fast food more than once a week. Also, never super-size your meals. This advice is pretty much self-explanatory. Fast food tends to not be healthy and the number of calories ingested can be incredibly high.

Try to Eat Family Meals. This one can be a hard one. Dr. Rao demonstrates in his book that when families sit at the table to eat, they eat healthier. Home cooked meals tend to be healthier. Also, when children sit at the table, they do not overeat. Dr. Rao recommends that families should eat at least four meals together in a week.

Get Plenty of Sleep. Studies are showing that people who do not sleep well, tend to become overweight. Could it be that people who are tired do not have the energy to exercise? Or, is there some biochemical reason for us to gain weight if we do not sleep? In any case, getting sleep is a necessary part of a healthy lifestyle.

Eat Five Servings of Fruits and Vegetables a Day. This is another one that is pretty much self-explanatory. One thing that I have discovered as both a pediatrician and as a parent is if you give children fruits and vegetables as snacks, they will eat them.

The advice that I have given to you above can be difficult to implement into your family’s busy life, but at least attempting the above will lead to a healthier lifestyle and will also teach your children how to live healthy. When they are adults, they will then continue what they have learned from you. The HEALTHY Armstrong website has a lot more ideas for your family and can be a wonderful resource. Be healthy!!

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