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The Toughest Talk You’ll Ever Have with Your Child

For a few years – OK, maybe more than a few – I worried that my daughter Samantha was getting fat. After all, she was consistently in the 95th percentile for her weight, and I knew that a BMI (body mass index) between the 85th and 95th percentile meant a child was at risk for being too heavy.

It’s easy for women to get a little crazy about their weight, so it’s no wonder that we become a bit unhinged when it comes to our kids. Our pediatrician reassured me that she was fine because she’d been in the 95th percentile since she was a toddler and had a naturally muscular build. And today, at 14, her BMI is normal, so perhaps he was right.

Still, I couldn’t help but be concerned – especially when I saw her chomping down her fourth slice of pizza or noshing on candy with reckless abandon. Telling her I was worried about her weight felt cruel, a remark that could spawn body image issues and trigger an eating disorder. But staying silent seemed equally wrong, as if I were giving her permission to pack on the pounds.

Clearly, being appropriately concerned yet not overly neurotic was going to take some restraint. Turns out I’m not the only parent who feels uncomfortable discussing these matters. A recent survey found that most parents would prefer to talk about sex, drugs and alcohol than chat up their kids about weight.

So rather than get embroiled in a complicated conversation about BMI and calories, I chose to keep it simple and focus on one thing: good health. And rather than zero in on Samantha, I made these weighty discussions a family affair that included her thin-as-a-rail sister, Annie. We talked about trying to log an hour of exercise every day, eating plenty of fruits and vegetables, and limiting – but not necessarily omitting – junk food from our diets. My friend did the same thing with her three boys.

Teaching my kids portion control was a little trickier. To rein in their temptation to overeat – the root of the nation’s weight problem, I think – I told them to try putting off until tomorrow the second helping you want today. “After all,” I said, borrowing a line from Scarlett O’Hara, “Tomorrow is another day.”

It was a simple lesson – one that my kids got right away. “Guess what, Mom?” Samantha said to me one day. “I didn’t take the second cupcake today because I remembered what you said about there always being another time.”

Inside I cheered. But will these lessons stick? Will they succumb to the freshman 15? Will they keep it off as adults? Only time will tell.

December 26, 2012 | Filed Under Community | 1 Comment 

Child Health & Safety News Roundup: 07-16-2012 to 07-22-2012

Welcome to Pediatric Safety’s weekly “Child Health & Safety News Roundup”- a recap of the past week’s child health and safety news headlines from around the world.

Each day we use Twitter to communicate relevant and timely health and safety information to the parents, medical professionals and other caregivers who follow us. Occasionally we may miss something, but we think overall we’re doing a pretty good job of keeping you informed. But for our friends and colleagues who are not on Twitter (or who are but may have missed something), we offer you a recap of the past week’s top 20 news-worthy events.

PedSafe Headline of the Week:

Food Choking Risks in Young Children: What Every Parent Needs to Know http://t.co/HjiQ9vjG

July 24, 2012 | Filed Under Awareness | Leave a Comment 

Children, Follow My (Healthy Eating) Cues

Feeding behaviors are solidified early in life. In general, children are wonderful examples of listening to their hunger and satiety cues. Both of my children are great examples. My son is a really big eater in the morning and into lunch time and then has a tendency to pick the rest of the day. While other days, he eats very little. My daughter, on the other hand, eats a small amount at breakfast and then slowly picks up throughout the day. Some days, she seems to eat the amount a grown woman would eat! But I trust she is accurately listening to her own body as she remains active and her weight is following a healthy growth curve.

Unfortunately, many parents confuse children when they tell them to eat because it is meal time. Parents think, “Surely they should be hungry because they haven’t eaten in several hours.” And not only do some parents make children eat, some make them clean their plates. I recently wrote a letter to a well-known, elite school here in Dallas when the mother of one of my pediatric patients (who happens to be a physician) told me they still practice the clean plate club at their school. Really?! I thought everyone has figured out by now that this is not a good thing to do if we want to encourage healthy eating. The clean plate club trains the body to “untrust” its physiological signals to eat or not to eat. This approach may have started back in the Depression when food was scarce, but I see many adult patients that are still trying to unlearn what they were taught by their parents. “Do not get up from this table until your plate is clean.” Or, “If you want that dessert, you better eat everything on that plate.” Dietitians cringe at the thought, although I truly believe parents are very well-intentioned.

One of the best food behavior gifts we can give our children is the gift of trusting in their own hunger and fullness cues. I credit my own mother for allowing me and my siblings to make our own decisions to eat or not, and I firmly believe this has been one of the foundations to my healthy relationship with food. We ate as a family at the table without distractions (this is key), which helped us in listening to our individual cues. Because of mom, I can have my favorite food under my nose and if I am not hungry, I have no desire to eat it.

Hunger Scale by Paula Ryan, MS, of Healthiest Regards Blog

Paula Ryan, MS, author of the Healthiest Regards Blog, posted a great hunger and satiety scale that I wanted to share with readers. It’s one of the best I have seen because it also lists the consequences of waiting too long eat, or not stopping when the body says it has had enough. If you find yourself eating in the absence of hunger or waiting way too long to eat, consider printing this scale off and going back to the basics. Many people eat for reasons other than hunger – like when they are stressed, mad or sad. Deal with those issues directly instead of turning to food. It may be easier said than done for some, but this can be a start to a healthier YOU in 2012. And a healthier you means a healthier family because the children are watching – and doing what you do.

January 5, 2012 | Filed Under Community | Leave a Comment 

More Than a Meal: Benefits of Eating Together

Recently, I was honored to speak at the Texas PTA Leadership Conference in Austin, TX on the importance of family mealtimes. The benefits of family meals go far beyond nutrition. Did you know that young people who reported eating dinner with their family 5 or more times per week were much likelier to report receiving either all A’s or mostly A’s and B’s in school? Other key items from research include:

  • Mealtime conversations help children acquire and improve the language skills that are critical for school success. Children learn new vocabulary, sentence structure, and how to share their point of view with other people.
  • Conversations at the family table taught children more vocabulary than they learned from their parents reading books to them.
  • Elementary school children who did well in class and on achievement tests were those who generally spent larger amounts of time eating meals with their families.
  • Eating meals with their family was a stronger predictor of academic success than whether they lived with one or both parents.
  • The more often families eat together the less likely teens are to smoke cigarettes, use illegal drugs, abuse alcohol, become depressed, develop eating disorders, or get pregnant.

Nutrition Benefits

We can’t deny the family mealtime benefits on your child’s current and future nutrition. They include:

  • More likely to have a healthy weight.
  • Less likely to become or stay overweight.
  • Less likely to develop an eating disorder.
  • Family meals during adolescence had a lasting positive influence on the quality of their diets and meal patterns, such as eating breakfast. In other words, having family meals with your teenagers improves their chances of eating right in their 20’s.
  • Young people who eat more often with their families have higher intakes of fruits, vegetables, grains, and dairy foods.
  • For teens, more regular family meals mean fewer fried foods and soft drinks. These adolescents also have higher intakes of key nutrients like calcium, iron, vitamins A, B6, C, E, and folate, as well as fiber.

Keeping It Simple

The great thing to know is that the meal does not need to be complicated to have all of these great benefits. If you are super strapped for time, these ideas don’t even need a recipe:

  • Flank steak with tossed salad and frozen vegetables
  • Pasta with frozen or canned shrimp, sautéed in olive oil with onion and garlic
  • Cheese omelet with tossed salad
  • Tuna salad in a whole wheat wrap made with reduced-fat mayonnaise
  • Black beans and brown or wild rice with frozen veggies
  • Spinach salad with grilled chicken, mandarin oranges, and slivered almonds
  • Peanut butter and banana sandwich on 100% whole-wheat bread
  • Hamburgers (made with lean ground beef) on whole-grain buns, with boiled potatoes and frozen vegetables

Add some skim/1% milk as a beverage, add quick veggies as needed and serve fresh fruit as a dessert – and you have a very well-rounded stress-free meal. Remember, eliminate all distractions and make all mealtime discussions pleasant and friendly. Involve your kids in the recipe selection, shopping and preparation for maximum impact. And if you are not eating at least 5 meals as a family, consider adding one per week. Dinner is a great time, but breakfasts and lunches work as well.

Eating together is one of the best things we can do as a family to enrich the quality of our children’s lives. Commit today to make family meals a priority in your home and watch all the great things that will follow.

December 2, 2011 | Filed Under Community | Leave a Comment 

Say Yes to Halloween Candy…But Only on Halloween

The reality is that the Halloween tradition is about children receiving candy as they go door to door in their Halloween costumes. Halloween only occurs once a year, so I say, let the children enjoy some candy. Don’t get me wrong. I love the healthier ideas out there, especially the toy and sticker alternative. But remember, candy is not the root of all evil – it is the frequency in which it is consumed that could pose a problem.

We live in a world where our children are already around lots of candy, so we must teach them proper behaviors around eating it. I see Halloween as a wonderful training opportunity on proper eating behaviors. So let the kids enjoy their Halloween candy, but don’t let it be consumed endlessly after the holiday. I allow my children to have more candy than usual on Halloween. In fact, I let them have all the candy they want this one night per year. My daughter has already learned firsthand that too much candy will give her a tummy ache. We had a great discussion when she was feeling sick after eating too much icing one time that too much candy will make her body feel bad.

After Halloween comes and goes this weekend, the frequency of candy consumption will go back to how it normally is at our home – a maximum of once or twice per week. So, my take on Halloween? Let the kids have their candy. And remember to use this time to teach them about the place that candy should have in their lives every other day of the year – as an occasional treat.

**************************************************************************************************************************** Editor’s Note: We are all concerned about childhood nutrition these days, which makes Halloween a particularly “tricky” holiday. But there’s more than one way to skin a black cat!…as we see from two different perspectives on Halloween treats. While today’s post talks about letting kids have their candy on Halloween (as long as moderation prevails after the holiday), another post looks at trading candy for healthier alternatives. We hope you find some useful ideas to safely satisfy your “ghouls”!

October 26, 2011 | Filed Under Community | 4 Comments 

Is Your Family Overeating?

It’s no secret that obesity has become a major health problem in the U.S. — for both adults and kids. Roughly one in five children between the ages of 6 and 11 is obese, according to the Centers for Disease Control, and many more are overweight. So what’s to blame? Lack of exercise and poor food choices are prime suspects. But so is portion control — which for many families has spiraled out of control.

In the last 20 years, people’s idea of a serving size has ballooned, according to the National Institutes of Health. Two decades ago, the average bagel was 3 inches wide and 140 calories; today, it’s 6 inches wide and 350 calories. Back then, cheeseburgers had 330 calories; now they’ve nearly doubled. And the average serving of soda has more than tripled — from 6.5 ounces and 85 calories to 20 ounces and 250 calories.

“The media keeps telling us we need to eat more; everything is just bigger when you see it,” says Dr. Virginia Keane, associate professor of pediatrics at the University of Maryland Medical School. “And we have all-you-can-eat restaurants. We’ve lost control and community knowledge of what’s a normal portion.”

A portion is a fistful — the eater’s fistful, according to Keane. (If you or your child is very active, you may need more. If you’re inactive, you may need less.) Just by reducing your food intake to that amount, you’ll help your family lose weight or at least maintain it. And it’s easier than you think. Here are some suggestions for keeping portions in check:

Cook and eat at home.

The simplest way to avoid supersized portions is to prepare and serve your own meals. The key, according to Keane, is to cook only the amount you’ll need for that meal (no leftovers!) and serve everything on individual plates, not family style. The only exceptions: vegetables and salad. There’s no limit on veggies (as long as they’re not drenched in butter or doused with full-fat dressing), so everyone can take what they want.

Go halvsies.

If you’re at a restaurant, split dishes between two adults. If the kids’ meals are twice the appropriate portion size, do the same with them. If your family tends to eat whatever’s in front of them, ask to have half the portion put in a to-go container before it even hits the table.

Snack smaller.

When you sit down in front of the TV or computer, don’t bring that bag of pretzels or cookies with you. Instead, scoop out a small amount and put it in an individual bowl — and don’t let yourself go back for more. Put the rest of the bag on a top shelf or at least out of sight. Better yet, cut up some fruit and put it in individual bowls. Or pass out fruit roll-ups or cheese sticks — one per person.

Downsize, don’t supersize.

Instead of getting the double-patty cheeseburger with bacon, order the plain junior cheeseburger instead. If your value meal comes with medium fries and drink, opt to go a la carte and order smalls. Ask for a kid-size portion of ice cream instead of one, two or three regular scoops. If it doesn’t feel like enough, remind yourself that that’s what size a serving of ice cream used to be anyhow.



July 27, 2011 | Filed Under Community | 1 Comment 

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