The Care and Feeding of Children: Beating Childhood Obesity with Realistic Nutritional Recommendations
by Julie Janeway, Karen Sparks, MBE, and Randal S. Baker, MD, FACS

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It’s no secret that childhood obesity is the most recent bandwagon everyone is hopping on, but what good does it do to waive your arms, agree earnestly with experts and call loudly for change if no one puts forth a plan to actually make changes? Correct. It does no good at all. So, how do a mom and dad really understand the childhood obesity issue, and more importantly how do they actually acquire some skills to help change their kids’ behaviors? Read on.

In the October 2006 edition of OAC News, Dr. Jacqueline Jacques did a fabulous job relating the causes and considerations of childhood obesity. If you missed the issue, please visit the OAC Web site and click on the OAC News tab located under the “Resources” link. This article picks up where Dr. Jacques left off.

The Childhood Obesity Epidemic

As was correctly stated in the October article, approximately nine million U.S. children over the age of six are now obese, and the numbers are on the rise. The U.S. Centers for Disease Control and Prevention state that the percentage of overweight young people in the United States has roughly tripled since 1980 to about 18 percent.

Children are less active than ever before, eat more processed food and have poorer eating habits. But this doesn’t have to be a permanent condition. Parents can start by examining and understanding what their children are eating, where they are eating, when they are eating, why they are eating and how many extra calories a day they are consuming that can be cut out.

Consuming Extra Calories

According to the Harvard School of Public Health’s Dr. Y. Claire Wang, kids today are suffering from an energy gap – meaning they take in more calories than they burn through growth and daily living. The average child takes in up to 165 extra calories per day which is about the amount in one can of soda. The heaviest children and teens are taking in as many as 1,000 calories more per day than needed, which is almost as much as two Big Macs.

From 1988 to 1994, children aged two to seven consumed between 110 and 165 calories more than they needed each day resulting in a weight gain (not related to growth) of almost one pound a year. Similarly, from 1999 to 2002, obese children 12 to 17 years old took in an average of 678 to 1,017 extra calories per day, amounting to an entire excess weight gain of 58 pounds.

The study, published in the December issue of the journal Pediatrics, concludes that prevention is the most important factor in reversing this trend. If government, community, schools, families and food and beverage industries don’t start working together, we’re going to see the first generation of children having a shorter life span than their parents.

According to a report presented at the American Heart Association meeting in Chicago in November 2006, children with risk factors for heart disease, including high cholesterol and diabetes, are showing signs of narrowing and hardening of the arteries, a condition normally associated with adults. The researchers from McMaster University in Hamilton, Ontario, Canada, concluded from a study of 3,630 children that an increasing number of children suffer from these and other risk factors for cardiovascular disease, including the risk factor of obesity.

Children’s Diets and its Affects on the Body

So our children are not only heavy, out of shape, missing out on many of the wonderful things that come with childhood, having poor self-esteem and possibly having hardening arteries and seriously increased risk for cardiovascular disease, but their terrible diets may severely affect their learning opportunities as well. The junk food they eat during the day also alters the way they think, feel and react. It affects their entire emotional state.

Changing Eating Habits

So how do we change what they eat? One way is to educate children so they understand their unique body. One child may eat large portions and their body stays slim. Others may eat less and be larger. The most difficult situation to manage is when siblings have different body types. Parents need to do a good job helping their child accept their body and instilling in the child a level of accountability for what they eat, as well as for the portions.

Children should also be active and sweat several times each week. Far too many children today are sedentary, which when coupled with poor nutrition habits, creates a recipe for weight issues.

Below, we’ve provided you with a list of 10 foods you should teach your kids to consume with caution. We’ve also given you some realistic, tasty alternatives with which to replace them. Don’t try to replace them all at one time. Start with one, and when you’ve worked that one into your routine, then select another to replace. One by one you’ll be taking steps to healthier kids and a healthier family.

1. Chicken nuggets/tenders: These little tidbits are compressed fat, high-fructose corn syrup (HFCS), sodium and some form or parts of what might have been identified at one time as chicken. Many times the chicken nuggets are left over parts and skin pressed into a shape with the salt and HFCS to hold it together and then deep fried in hydrogenated oil. All this and we haven’t even added in the HFCS or mayonnaise based dipping sauces that also includes more sodium, fat, and sugar.

Alternative:Grill chicken breasts and cut them into dipping size pieces or one inch cubes. If you have time on your hands, pound the chicken to a thinner consistency and use basic shape cookie cutters to cut it after cooking. Use marinara sauce, mustard, homemade salsa, yogurt based sauces or ketchup that doesn’t contain HFCS for dipping. You’ll still have crunchy and delicious kid-friendly chicken, but without all the extra calories and fat.

2. Juice and juice flavored drinks: Yes, juice is good for children in moderation, and when it actually is 100 percent juice. It contains vitamins, antioxidants and other good things, but isn’t as good for kids (or adults) as whole fruit because it doesn’t have the fiber. The calories in juices are mostly from sugar and carbohydrates, and that can lead to obesity, tooth decay and other problems. Additionally, drinking calories rather than taking them in through foods does not satisfy hunger. It only adds to calorie counts. The American Academy of Pediatrics recommends four to six ounces of juice per day for kids under the age of six, and eight to 12 ounces for older kids. Juices that aren’t 100 percent juice are full of HFCS and artificial colors and flavors. Just say, NO.

Alternative: Water is always the best option for quenching thirst. To get kids to drink water, try adding no-sugar flavorings on occasion, or add just a small splash of fruit juice to get them started. Be a good role model and drink water yourself, and drink milk too. Low-fat milk is filled with nutrients, calcium and protein which are all good for growing kids as well as adults.

3. Chips: Cheesy curls, taco chips, ripply chips or whatever you might want to call them, they are nicely contained little bags of saturated fat, sodium and other chemicals. For the most part, leave them on the store shelf. Chips and their like have more sodium than any child should consume, and the low-fat and baked kind often contain olestra which may cause other health issues for children.

Alternative: When kids want to snack and they want to snack on something crunchy, try cut up vegetables with a bit of cheese or peanut butter, air-popped popcorn, trail mix (no marshmallows and limited chocolate) and graham crackers. When you make your own popcorn you can control salt and butter additions, and you can experiment with other toppings like parmesan cheese, dill, red pepper and others. Homemade trail mix can also control salt, fat and sugar intake. A few chips here and there really isn’t going to hurt your child. Just consider keeping them for special types of occasions.

4. Prepared lunchmeat and hot dogs: These processed meats are filled with saturated fats, poor quality proteins, nitrates and nitrites, high levels of sodium, artificial colors and flavors and other types of fillers that scare us when we think about their origin. Better options exist.

Alternative: Buy real chicken, turkey, roast beef, tuna, salmon and other meats. Use whole wheat breads and crackers (low fat, low-sodium) and low-fat cheeses for sandwiches and homemade “lunchable” type eats. Make fun shapes and add crunchy veggies in to mix things up. If your kids are absolutely hotdog addicted then try switching to turkey dogs, but read ingredients closely as they can be just as full of chemicals and additives as regular hotdogs. Don’t forget about peanut butter, grilled cheese (low-fat cheese) and other lunch time and quick dinner alternatives. The occasional hot dog at holiday festivities or backyard family BBQ is not the problem; it is the over consumption as part of the weekly dinner menu that can hinder overall dietary intake and cause medical problems for your child.

5. Typical sugary kids’ cereals: Cereals contain exactly as much sugar and other junk as the labels say they do, such as: artificial colors, artificial flavors, sugar of every type and description, HFCS, sodium, overly processed grains without a hint of remaining nutrition, hydrogenated oils and fats, high amounts of carbohydrates and enough chemical preservatives to keep a child pickled through the year 3000. These cereals have virtually nothing to offer your child but a plastic toy that will keep the kid amused for a total of three minutes of his or her life. What they do offer is empty calories, unnecessary fat, tooth decay, upset tummies and arguments with siblings over those useless plastic toys with some added vitamins and minerals to try to compensate for the damage.

Alternative: Look for cereals that are low in sugars (all of them, including HFCS, sucrose, fructose, dextrose,and any other thing that ends in “ose” or “tol”). Try and buy whole grains, but be aware of the fact that there is no regulation that requires any specific percentage of whole grain in the package. A box of cereal can have literally a speck of whole grain in the whole thing and legally label itself as whole grain cereal. Truly organic, whole grain cereals are best, especially with bananas, berries (good antioxidants), raisins, a splash of almonds and some good cold low-fat milk will make kids just as happy. Starting your day with a healthy breakfast high in fiber and protein, while low in sugar, can support better cognitive ability throughout the morning. It can also keep glucose and insulin levels more stable, which may positively impact body fat storage and utilization.

6. Doughnuts and sweet rolls: Speaking of things that are inappropriate for breakfast, especially for kids – doughnuts and sweet rolls top the list. Again, excessive amounts of sugars, starches, carbohydrates, preservatives and artificial everything, not to mention the hydrogenated oil in which they are deep-fried. This class of breakfast offenders also includes toaster pastries, muffins and other pastries. They may look good for breakfast but all they are is a pile of bad nutrition.

Alternative: The old standbys are best: a piece of whole wheat toast with all- fruit spread or some quality peanut butter (not full of sugar); perhaps an egg or a whole wheat English muffin, and a small piece of cheese. Don’t forget the milk – one gram of protein per ounce. Save doughnuts for the very occasional dessert treat, and place a general family ban on pastries and other bakery goods at the breakfast table or for snacks. These should be rare treats for everyone, indeed.

7. French fries: Although they are part of the American culture, they are high in calories, high in sodium and high in fat. Unfortunately, most American children think French fries are a “vegetable.”

Alternative: Potatoes are nutritious. They actually have some nutritive value in their own right, so take advantage of that. If fries are a requirement for some reason, then try baking them with a light brush of olive oil. Don’t forget classic baked potatoes with yogurt sauce, or twice baked potatoes with yummy ingredients like salsa or chili and low-fat cheese. Also, don’t feel like you’re bound to using traditional white potatoes. Yams and sweet potatoes (yes, they are different things) can be made into baked fries, and other dishes as well, for a fun and colorful change of pace. Consuming traditional fast food or restaurant fries (also, school cafeteria fries) on a daily or near daily basis is not recommended, and certainly super-sizing is never the way to go.

8. Fruit naugahyde: This is the roll-up, bite size, stuff that contains a micro amount of fruit or fruit juice but is primarily comprised of HFCS, chemicals, multiple types of sugars and a lot of red dye. It really has nothing to do with fruit, and more to do with farm equipment upholstery fabric.

Alternative: Give the kids fruit! Do something to make it more fun and appealing. Try making a fruit cocktail, fruit kabobs, funny fruit faces, frozen grapes, freezing fruit pieces in ice cubes, dipping fruit in yogurt and freezing it, putting fruit in jello, putting fruit in homemade trail mix or making your own dried fruit snacks. Add raisins, cranberries, almonds, walnuts, apricots, star fruit or other berries. When you get home from shopping, pre-cut the fruit into small pieces and place it in airtight containers. You may want to place the clear container at eye level in the refrigerator so when everyone in the family sees it, that’s what they grab for a healthy, satisfying snack.

9. Pizza: In theory, not really a bad option. If you choose a good crust made with whole wheat flour; sauce that isn’t full of sugar, HFCS and preservatives; low-fat cheeses; fresh veggies; and meats that aren’t processed, pre-shaped, and filled with nitrates, you’ve got a great meal that can satisfy and make kids happy. Also, you have to know what the correct serving size is as well, and it’s not half a pizza. Unfortunately, most pizza consumed by kids is processed, preservative-filled, fat-filled and lacking in real nutritive value.

Alternative: Make your own pizza with your kids. Let them toss the crust around like an old time pizza chef, slop around in the sauce and sprinkle the cheese. Think about making kid-sized pizzas on whole wheat tortillas, English muffins, or toasted bread. Watch for the HFCS in sauces, and add toppings like chopped chicken, veggies and even pineapple. Once they buy-in to great tasting pizzas like this they’ll choose to walk away from the greasy, slimy, cardboard kind.

10. Soda pop: Last, but by no means least, soda is one of the top three worst things a human being can put in their body. According to several studies, soda and other sugar-sweetened drinks have become the largest source of calories in the American diet, replacing white bread. Numerous studies have shown the strong link between consumption of soda pop and weight gain.

David S. Ludwig, MD, PhD, Director of the obesity program at Children’s Hospital Boston states, “In my estimation, sugary beverages are one of the two leading environmental causes of obesity, perhaps second only to TV viewing in the magnitude of its effect.”

Dr. Ludwig adds that people may be unaware of how these liquids make us fat. They do so because they pass through the stomach more quickly than food. As a result, people don’t feel as full as those who consume the same amount of calories from solid food.

In addition, there’s evidence that the HFCS used in most sodas fails to suppress the production of ghrelin, a hormone made by the stomach that stimulates appetite. HFCS doesn’t seem to trigger the hormones that help you regulate appetite and fat storage, so the body never gets the message to stop eating. Soda pop not only contributes to obesity, but it also affects the body’s ability to process sugar, and the links between soda pop and type 2 diabetes are becoming clearer as research continues.

At a pH of 2.5, the corrosive acid levels in soda are just slightly above that of battery acid at a pH of 1. For comparison, water comes in at a pH of 7. The lower the number, the more corrosive the substance. The pH levels in sodas inhibit the body’s ability to absorb nutrients, essential for growing children. Several researchers are also looking at the link between soda pop and the interference from carbonation with the body’s ability to absorb calcium, leading to more brittle bones, and later, to highly increased chances for osteoporosis. Phosphoric acid in many sodas also competes with calcium for absorption minimizing the calcium one does consume.

Finally, the caffeine in soda pop is completely unnecessary for children or adults. The sugar in soda is mixed with phosphates designed to speed it into your system. The carbonation and acid levels deplete oxygen in the blood which makes us feel like the caffeine is wearing off, and we head for the fridge for another soda to rev us back up.

The truth is it takes the better part of whole day to metabolize the caffeine in an entire can of soda pop out of the system. It’s a terrible cycle that diet sodas don’t correct. Diet sodas are not a realistic alternative and neither are the new “sports” drinks that are virtually repackaged soft drinks with different flavoring systems.

Alternative: Water is always the healthiest alternative, followed by milk and appropriate amounts of real fruit juices. Children need to understand that they have a responsibility to take care of their bodies and that proper hydration is part of that responsibility. If you do one thing for your children, get them off soda. In the long run they’ll be happier, be more attentive in school, they’ll sleep better, have stronger bones, better check-ups at the dentist, breathe easier and absorb more of the good nutrition you’re helping them take in.

Conclusion

When your children come face to face with less nutritious foods, it is important for them to learn to make choices to take care of their own bodies because they want to, and not because the parental “food police” say so.

Be a good role model and display a balanced approach with creative alternatives. The occasional poor food choice is not a problem for a person who consumes a balanced, healthful food intake and exercises as part of their daily life. Helping children create sensible, healthy relationships with food is the key to ending the childhood obesity cycle, and moving us back toward a nation of healthy kids.

About the Authors:
Randal S. Baker, MD, FACS, is a bariatric surgeon at the Center for Health Excellence in Grand Rapids, Michigan. Dr. Baker served for several years as the Medical Director of the Surgical Intensive Care Units at Spectrum Hospital and is an Assistant Professor of Surgery at Michigan State University. He is a member of the American Society for Bariatric Surgery, the American Medical Association and the Society of Critical Care Medicine. He is also a member of the OAC Advisory Board.

Julie M. Hill-Janeway is the co-author of “The Real Skinny on Weight Loss Surgery: An Indispensable Guide to What You Can REALLY Expect!”, and co-owns Little Victories Support Specialists and Little Victories Press. In October 2003, she underwent weight-loss surgery and to date has lost more than 180 pounds. Ms. Hill-Janeway is also a professor at Central Michigan University. She is a member of the OAC Board of Directors.

Karen Sparks, MBE, is a gastric bypass patient having had surgery in December 2003. She is a former Dean of Business Administration and Technology at Baker College, and has been teaching for 15 years in business and technology. She is the co-owner of Little Victories Press and Little Victories Support Specialists serving both bariatric patients and medical professionals and the co-author of “The Real Skinny on Weight Loss Surgery: An Indispensable Guide to What You Can REALLY Expect!



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