The Doctor Is In

Tipping the balance—Help your child maintain a healthy weight

by Nita Shumaker, MD

Is your child overweight…or even obese? Childhood weight problems are reaching crisis proportions. Yet studies show that parents frequently don’t realize their children are overweight.

Tennessee ranks in the top five states in the nation for childhood obesity, with 20 percent of youths, 10 to 17, overweight or obese. Moreover, the majority of American adults are struggling with their own weight issues – and influencing their children to continue the cycle of obesity.

Weighed down Obese and overweight children fatigue more quickly during exercise and may have an increased risk of asthma. While still young, they risk developing cholesterol problems, high blood pressure, and diabetes. They also must deal with the psychological effects and social implications of being larger than their peers.

Studies show that obese children become obese adults. They risk development of heart disease, diabetes, cardiovascular disease, high blood pressure, liver disease, and an increased risk of cancer and joint problems later in life.

Cultural changes The reality is our children are much less fit than we were as children. Most parents assume their children are getting adequate amounts of exercise at school, but many school systems are dropping physical education from the daily curriculum.

Additionally, our children are spending less time outdoors than previous generations as they focus their social lives on indoor activities like texting, “facebooking,” and playing video games. And their exposure to sunshine – and Vitamin D which facilitates the growth of strong bones – is much less than our exposure during childhood. Since 90 percent of bone mass is accumulated before age 19, the lack of sunshine and Vitamin D increases the risk of osteoporosis later in life.

Our children are also eating different foods than we ate as children, partially because Americans are literally being marketed to death. One hour of children’s television programming airs an average of nine commercials for high sugar, low nutrient foods.

Look in your pantry and examine the ingredients of the foods that we feed to ourselves and our children. Most boxed foods have long lists of ingredients – most of which we can’t read or don’t recognize – and many foods have preservatives that can be carcinogenic. Even flavored bottled water can contain phosphoric acid and preservatives.

Clearly, our bodies were designed to eat the foods that God provided – fruit, vegetables, meats, and nuts -- and designed to drink water.

Five tips to lighten up Here are some tips for helping your child maintain a healthy weight:

(1) Provide healthy choices. Buy fewer processed foods that contain high calories, chemicals, and preservatives. Keep more fresh fruits and vegetables on hand. If children are hungry, they will eat the foods available.

(2) Watch your child’s portions. Nutrition guidelines say children need three to four servings of diary a day for calcium. Each serving is a cup (8 ounces) of milk or yogurt, a slice of real cheese, or a scoop of ice cream. After a child eats the recommended three to four servings, more diary servings are too much. The guidelines also recommend only three ounces of whole wheat bread and allow another three ounces of non-whole wheat.

(3) Insist on sports participation year-round, if feasible. Sports help children stay active, learn valuable social skills, and keep busy during afternoon hours when parents may not be at home. If sports participation is not an option, place a pedometer (a small device that measures steps) on your child’s waistband for a few days. The pedometer is a great way to measure physical activity, especially for the less active child. Children need 10,000 steps a day to stay healthy, just like adults.

(4) Limit electronic activities. Current guidelines by the American Academy of Pediatrics encourage parents to limit TV time to two hours a day. Parents should consider including all electronics in those two hours. After the child has participated in electronic activity for two hours, turn off these devices. Instead, encourage your child to go outside to play.

(5) To help determine your child’s risk of being overweight or obese, consult a body mass index (BMI) calculator. While not perfect, the calculator is a valuable tool to help determine if your child needs to lose weight. You can find a BMI calculator for children at http://apps.nccd.cdc.gov/dnpabmi/Calculator.aspx . If a child’s BMI is greater than 25, the child is overweight. If a child’s BMI is greater than 30, the child is considered obese and at risk for multiple medical problems both now and in the future. Be sure to talk to your child’s pediatrician for further help.

Nita Shumaker, MD, Erlanger Chief of Staff, is a pediatrician with the Galen Medical Group. She is also a Clinical Instructor of Pediatrics with the UT College of Medicine Chattanooga. For more information, call Erlanger’s physician referral line at 423-778-LINK(5465).