When Does A "Happy Meal" Become Sad?

This is not a funny picture. It is the kind of picture that McDonald's executives would rather you not see. I do not see two cute little chubby boys here. I see two young addicts who are headed for life of sickness and pain unless their parents decide to make some healthy life changes. We would not knowingly expose our child to a deadly virus or bacteria. Yet, many parents allow unhealthy eating habits for their children, putting them at risk for disease. This is the disease that we don't see, disease that lurks under the surface, within the cells, within the arterial walls, and within the bones of our children. This is not as obvious to us, nor will it become obvious until many years down the line, perhaps, long after we're gone.

Since the 1970s, the percentage of overweight kids and adolescents in the United States has more than doubled. Today, 10% of 2- to 5-year-olds and more than 15% of children between the ages of 6 and 19 are overweight. If you combine the percent of kids who are overweight with the percent of kids who are at risk of becoming overweight, about one out of three children are affected.

Nutritional Report Card

Many of today's children are overfed and undernourished. As nutrients fall short and as empty calorie processed foods fill our children up, we see that health risks in their future will be inevitable. They predict that 1 in 3 children born in the United States today will develop Type 2 diabetes in their lifetime. If that child is Black or Hispanic, that risk goes to 1 in 2. This generation of children may have a shorter lifespan than their own parents. It is no secret that we are facing rising trends in the number of children who are overweight as seem by the graph below from the National Health Examination Surveys.

Here are some statistics to think about:

• American children are getting 40% of their calories from extra fat and added sugars.
• Only 1% of children between 2 and 19 years of age met all the Food Pyramid recommendations. Sixteen percent of children met none of the recommendations.
• Nearly 1 in 7 10-year-olds get 50-70% of calories from snacks.
• 1/3 of all calories are now eaten outside the home.
• A survey of nearly 300 students in 3rd, 5th and 8th grades found that students consumed fewer fruits and vegetables, less milk and more soft drinks as they moved from childhood to adolescence.
• Soft drink consumption increased 21% among 2- to 5-year olds over the last 20 years and 37% among 6- to 9-year-olds. Milk consumption has dropped in all age groups.
• Average soda consumption in 13 to 18-year-old males is 3 cans or more a day; 10% drink more than 7 cans a day. Soft drinks are given to infants as young as 7 months of age.
• Nearly 2/3 of children failed to get the Recommended Dietary Allowances (RDA) for vitamin E and zinc. Half did not meet the RDA for calcium and close to 1/3 fell short of the FDA for iron and vitamin B6.
• Nearly 25% of all vegetables consumed by children and teens were in the form of french fries. French fries are the most popular "vegetable" for children under age 5.
• 51% of children and teens eat less than one serving of fruit and day and 29% eat less than one serving a day of vegetables that are not fried.
• The average child between 2 and 5 years of age watches nearly 28 hours of TV a week.

Overweight children are at risk of developing medical problems that affect a child's present and future health and have direct impact on quality of life including:

• high blood pressure, high cholesterol and abnormal blood lipid levels, insulin resistance, and type 2 diabetes
• bone and joint problems
• shortness of breath that makes exercise, sports, or any physical activity more difficult and may aggravate the symptoms or increase the chances of developing asthma
• restless or disordered sleep patterns
• tendency to mature earlier (overweight kids may be taller and more sexually mature than their peers, raising expectations that they should act as old as they look, not as old as they are; overweight girls may have irregular menstrual cycles and have fertility problems in adulthood)
• liver and gall bladder disease
• depression

Risk factors present in childhood (including high blood pressure, high cholesterol, and diabetes) can lead to serious adult medical conditions like premature death, type 2 diabetes, hypertension, dyslipidemia, cardiovascular disease, stroke, gall bladder disease, respiratory dysfunction, gout, arthritis, macular degeneration, and certain kinds of cancers. Preventing or treating obesity in children may reduce the risk of developing these conditions as they get older.

Steps to take:

GENERAL SUGGESTIONS

• Let your child know he or she is loved and appreciated whatever his or her weight. An overweight child probably knows better than anyone else that he or she has a weight problem. Overweight children need support, acceptance, and encouragement from their parents.
• Focus on your child's health and positive qualities, not your child's weight.
• Try not to make your child feel different if he or she is overweight but focus on gradually changing your family's physical activity and eating habits.
• Be a good role model for your child. If your child sees you enjoying healthy foods and physical activity, he or she is more likely to do the same now and for the rest of his or her life.
• Realize that an appropriate goal for many overweight children is to maintain their current weight while growing normally in height.

PHYSICAL ACTIVITY SUGGESTIONS

• Be physically active. It is recommended that Americans accumulate at least 30 minutes (adults) or 60 minutes (children) of moderate physical activity most days of the week. Even greater amounts of physical activity may be necessary for the prevention of weight gain, for weight loss, or for sustaining weight loss.
• Don’t make exercise a punishment. Forcing your child to go out and play may increase resentment and resistance.
• Plan family activities that provide everyone with exercise and enjoyment.
• Provide a safe environment for your children and their friends to play actively; encourage swimming, biking, skating, ball sports, and other fun activities.
• Reduce the amount of time you and your family spend in sedentary activities, such as watching TV or playing video games. Limit TV time to less than 2 hours a day.

HEALTHY EATING SUGGESTIONS

• Be a role model to your children. Don't expect them to make any changes unless you are willing to make some changes in your own life. Kids will pay more attention to what you do than what you say. Spend less time watching TV and playing with the computer and spend more time outside and being active. Eat more fruits and vegetables and less junk food.

• Guide your family's choices rather than dictate foods.
• Eat meals together as a family as often as possible.
• Don't place your child on a restrictive diet.
• Avoid the use of food as a reward.
• Avoid withholding food as punishment.
• Replace soda pop with real fruit juices (no added sugars), lowfat milk and lots and lots of filtered water. Add a slice of lemon or a strawberry to the water. It will make it more fun!
  
• Take a high quality multivitamin every day. Vitamin water is NOT a good choice since the vitamins in it are suspect and it contains way to much sugar.
  
• Aim to eat at least 5 servings of fruits and vegetables each day.
• Discourage eating meals or snacks while watching TV.
• Eating a healthy breakfast is a good way to start the day and may be important in achieving and maintaining a healthy weight.
• In breads and cereals, look for whole grain and whole wheat listed as the first ingredient.
• Find cereals with whole grains and at least 4-5 grams of fiber per serving. Some brands include: Cheerios, Shredded Wheat, Wheaties, Toasty-O's, Grape Nuts, Raisin Bran, wheatena, oatmeal and oat bran. Mix healthier cereals with your child's less healthy cereals to get some benefits of added fiber.
• Eat brown rice instead of white.
• Find whole wheat pasta, amaranth pasta or quinoa pasta (the last two are available at health food stores).
• Add fiber to meals by adding kidney beans, black beans, pinto beans, lima beans. Add them to salads; soups; main dishes like burritos or tacos or chili; mash and mix in with meatloaf and burgers.
• Add wheat bran or Fiproflax (available at most health food stores) to casseroles, meat loaf, baked goods, pancakes, and cereal.
• Add All-Bran cereal to muffin recipes.
• Drink plenty of fluids when you are eating fiber. This will help offset the gas, cramping and bloating that may occur.
• Raw fruits and vegetables with the peels on have more fiber than cooked or canned.
• Dried fruits are good fiber sources, especially figs, apricots and dates.
• Discover other whole grains and find ways to cook them. Whole grains are getting easier to find these days. Look for them at your health foods stores. May stores have bins of raw grains where you can buy a small quantity. Some grains to try: amaranth, barley, buckwheat, kamut, millet, oats and quinoa.
• Don't offer dessert as a reward. Withholding dessert sends the message that dessert is the best food, which may only increase your child's desire for sweets. You might select one or two nights a week as dessert nights, and skip dessert the rest of the week. Or redefine dessert as fruit, yogurt or other healthy choices.

For more tips and ideas, check out the following web sites:


Kids Eat Great by Dr. Christine Wood (pediatrician)



Dr. Green on Obesity in Children


Dr. Greene on Children's Nutrition


American Heart Association - Children and Exercise

Here are some books that might help:

How to Get Kids to Eat Great & Love It!



Ending the Food Fight: Guide Your Child to a Healthy Weight in a Fast Food/ Fake Food World



The Sneaky Chef: Simple Strategies for Hiding Healthy Foods in Kids' Favorite Meals



Healthy for Life: Developing Healthy Lifestyles that Have the Side-Effect of Permanent Weight Loss