Childhood obesity: Healthy eating is key to combating weight

• Children's Health • • Obesity • Apr 26, 10

When Danielle Puckett was 4, her mother tried to put a lock on the refrigerator door.

“She just started going in the refrigerator and getting anything and everything,” said Danielle’s mother, Dawn Keller. It was then that she began to notice her daughter was becoming overweight. “She was drinking a lot of whole milk. We started cutting back on what we gave her.”

That didn’t really help, though — Danielle would just sneak the food she craved, and she put on weight steadily. She weighed 105 pounds by age 5, 150 pounds by age 10, and 250 pounds by age 15, her mother said.

“After I passed the 200-pound point, I started feeling out of breath a lot and losing my energy,” said Danielle, 18, who currently weighs 385 pounds and is 5 feet 4 inches tall.

Three years ago, she joined Penn State Milton S. Hershey Medical Center’s Pediatric Multidisciplinary Weight Management Program, where she and her mom learned about dietary and exercise plans.

They heard all the nutritional advice — bake, don’t fry; go for the fruits and vegetables, not chips and candy — but putting it into practice every day is another matter.

“I did try to cook healthier for a while, but ...,” Keller paused, “it’s hard to change.”

Butter still goes on the noodles; cheese tops the rice; and the Susquehanna Twp. family loves fried food, especially homemade french fries.

Danielle’s family is typical, said Dr. Ronald Williams, director of Hershey’s program. “Many families get motivated in the room, but somewhere between our door handle and their car door handle, things change,” he said. “A lot of the behaviors are there and have been engrained for years, and it’s very hard to change.”

Danielle has succeeded in changing her snacking habits, replacing chips with granola bars or fruit, she said. And she tries to eat smaller portions. Because of her efforts, her weight has been stable for a year and a half.

Jacqueline B. Sallade, a licensed psychologist in Lewisburg, advises families struggling to change to start out making small alterations in their diet and to not give up if they have an off day. “Your goal isn’t perfection; it’s striving to do better. If you ate cake today, then tomorrow stick to salads,” she said.

Williams tells his patients to decrease their meal size by 15 percent after their first visit, eventually getting it down by 30 percent and always stressing healthy eating so that eating disorders do not become an issue. Combined with a gradually increasing exercise prescription, Williams said obese children can begin to slowly lose weight. Exercise is critical to keeping it off, he added.

Still, only a small percentage of his patients lose the weight they hope to, which is one reason that children sometimes spend years under his care. Several years ago, for example, Danielle lost 75 pounds but then gained it back.

Heredity, which Williams said certainly plays into Danielle’s size, makes it harder to lose weight. In Danielle’s case, gastric bypass surgery might be the most effective remedy, Williams said. Danielle applied for the procedure but was recently turned down because of ongoing psychological problems that doctors feel might interfere with her ability to successfully navigate the surgery and its effects.

The difficulty obese children face in losing weight highlights the need for families to strive for healthy lifestyles before the problem sets in, experts said.

Teach children early to stop eating when they’re full; give smaller portions at meals; stop using treats as rewards; and start cooking healthy foods rather than relying on processed foods or fast food restaurants, dietitians said.

Parents need to think ahead about meal plans, said Diane Harris, registered dietitian at Holy Spirit Health Systems in Camp Hill. “Plan quick and easy meals that take 10 to 20 minutes to make, such as skinless, boneless chicken breasts done in a pan with some seasonings. Or, on a free day, make several meals ahead and freeze them,” she said.

She urges parents to involve their children in the process, from taking them grocery shopping — a great place to start teaching them how to read nutrition labels — to enlisting their help in cutting up the fresh vegetables for supper.

Experts also said it’s important to eat together, even if it’s just a couple of nights a week. “When you sit down, try to stay for 20 minutes. You’re not eating that whole time, but you’re letting your food digest and you’re having conversation as a family,” Harris said.

It’s important to bake, broil or grill and avoid frying foods, Harris said. If your kids love chicken fingers, it’s easy to make your own, dipping breast meat in egg whites and bread crumbs and baking them in the oven.

What kids drink can be just as important as what they eat when it comes to caloric intake. Sodas and fruit juices are the culprit, Harris said. Get your child a cool, bright water bottle and start pushing water, she said.

Snacking patterns might also be playing a big role in childhood obesity, according to a University of North Carolina study that looked at more than 31,000 American children from 1977 to 2006.

The study found that, in 1977, 74 percent of children ages 2 to 18 said they snacked between meals, but the number jumped to 98 percent by 2003 through 2006.

With many kids coming home to empty houses, it’s important to have healthy, appealing snacks such as cut-up fruits, trail mixes, low-fat cheese sticks and yogurt readily available, said Carol Clelland, a registered dietitian with PinnacleHealth System in Harrisburg.

Moderation is a key word when it comes to changing the way kids eat, she said. “We teach kids how to eat ice cream. A serving size is a half cup. Or better yet, have frozen yogurt,” she said. “Split a candy bar or save half for later.”

Most kids are willing to make the changes if the parents are willing to make the effort, said Clelland, who works with families on healthier eating habits in PinnacleHealth’s KidShape program.

Finding comfort in something other than food when circumstances become stressful or overwhelming is a key to addressing childhood obesity and impacting the low self-esteem that often comes with it, Sallade said.

Keller, 36, who said she weighs 260 pounds, said she wasn’t overweight when she was younger, but now she eats when life events overwhelm her. That’s a habit she passed onto Danielle, who said, “Eating always made me feel better.”

Sallade encourages looking for other outlets for stress, such as journaling, calling a friend or making a concrete plan to address the stressful situation that is prompting the urge to eat. “We’ve got to learn not to numb our feelings with food. Food may distract you from your problems, but it won’t solve them,” she said.

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By Body and Mind staff
pennlive.com