Teach Kids to Eat Healthy

By Lynn N. Duke

NYT Regional Newspapers

Marianne Murdock recently counseled a family whose teenage son had a severe weight problem. She knew there was a lot of work to be done when the foursome showed up each slurping on a 20-ounce soft drink.

“I asked him how many of those he drank a day. He said about eight,” said Murdock, director of the Children’s Center for Weight Management, a collaborative effort between Children’s Hospital and the University of Alabama in Birmingham. “The sad thing is, this is not unusual.”

The transition from freewheeling summer days to the structure of the school year is a good time to start children on a better eating plan.

Getting kids to eat healthier food starts by keeping your home stocked with healthy snacks and limiting their access to junk food. But parents often need some guidance, too, if they’re going to be successful.

“Children definitely look at their parents,” said Suzanne Henson, coordinator of the EatRight (sic) Weight Management Program at the University of Alabama, Birmingham. “It’s important that parents be aware of what they make available and what they purchase when they’re out with their kids.”

The first lesson is what’s a proper portion size. In a world of super-size this and mega-size that, few people realize:

• A single serving of protein – meat, poultry, fish, beans – is about the size of deck of cards or the palm of a hand.
• A serving of starch – pasta, rice, potatoes – is the size of a woman’s fist.
• One-half cup is usually a serving of fruits or vegetables.
• Fats – oils, salad dressings, butter, mayo – are measured in tablespoons (about the size of the outer half of an adult’s thumb), not by how much comes out when you tip the bottle or dip your knife.

“We spend a lot of time teaching about portion sizes,” said Dr. Janet Silverstein, chief of pediatric endocrinology at the University of Florida’s College of Medicine. “We try to modify their eating behavior into a reasonable intake for them so they can maintain it all of their life.”

More than 60 percent of children in the U.S. are at risk for being overweight, according to Jan Hangen, nutrition team leader at the Optimal Weight for Life Clinic at Children’s Hospital in Boston. Included in that group are 20 percent of children who are considered overweight with a body mass index (a mathematical formula that takes into account both a person's height and weight) at or above the 95^th percentile for their age, a 300 percent increase since 1976.

“It’s frightening,” Hangen said. “And it’s not taken seriously until the children are at risk for serious complications.”

Those complications include diseases that, until recently, were almost exclusively the domain of adults, like cardiovascular problems and Type II diabetes.

Healthy Cupboard

Even children who aren’t battling a weight problem can benefit by nixing sweets and high fat foods for lighter fare. A diet rich in fresh fruits and vegetables, lean meat and fish, and low fat dairy products promotes strong bone growth as well as healthy skin, teeth and hair.

Although kids are inundated with advertising for all kinds of fast food and sugary snacks, parents control what comes into the house from the grocery store. First, limit the amount of junk food in the house, or banish it altogether. Keep healthy snacks – low fat string cheese, cut up fruits and vegetables, low fat yogurt – handy in the fridge, and clear the pantry of anything that’s not nutritious.

“Evaluate the starch and sugar in the cupboard,” Hangen said, “and determine if that food is helping anybody. If not, get rid of it.”

Make sure you have healthy portable snacks, too, so that you’re not stopping in the nearest convenience store where kids are likely to grab a candy bar or bag of chips.

One of the most overlooked sources of excess calories is beverages, Murdock and Hangen said, and not just soda. Fruit juice packs a real caloric wallop, but does little to fill you up since it lacks the fiber found in a piece of fruit. For example, there are 50 percent more calories in an eight-ounce glass of apple juice (120) than a medium apple (80).

Good Habits

And forget the notion that kids will grow into their weight, or lose their baby fat. According to the Surgeon General, “overweight adolescents have a 70% chance of becoming overweight or obese adults…. The most immediate consequence of overweight as perceived by the children themselves is social discrimination. This is associated with poor self-esteem and depression.”

Peer pressure is another obstacle teens face when trying to lose weight. But counselors are quick to give them strategies for handling social situations.

“Don’t go out hungry, have a little something beforehand, and make sure you’re well-hydrated. Then, have some pizza, eat it slowly and stop at one piece,” Hangen said. “The speed of the meal is very important” so your body has a chance to realize that it’s full.

“Also, recognize that everyone cheats once in awhile,” Murdock said. “If you do, OK – but don’t make a habit of it, and don’t beat yourself up over it.”

Hangen urges clients to eat consistently throughout the day, rather than letting yourself become ravenous, and to pay attention to the quality of the food you’re eating. Murdock counsels teens to eat whatever they want for breakfast (even pizza!) just so long as they eat breakfast. She also considers vegetables free foods: eat as much as you want so long as there isn’t any fat on them.

Nourishment, Not Comfort

Another area that parents can affect change is the reward systems they set up. Instead of making food the focus of celebrations, find alternatives. Murdock suggests more time with a favorite hobby, maybe a shopping spree, a trip to the arcade or even money.

And don’t use food to cheer kids up.

“If a child’s had a bad day, don’t comfort them with food, because it becomes a habit that will carry over to adulthood,” Henson said.

School lunches are another opportunity for parents reinforce healthy eating. Rather than leaving them to graze among the cafeteria’s offerings – which increasingly include fast food franchises – pack a lunch you know they’ll eat:  A favorite sandwich, some leftovers, a rollup or even a salad with low fat dressing packed separately. Toss in a piece of fruit and they’re set. Encourage older students to pack their own lunches.

Don’t try to change everything at once. Try making small changes slowly and eventually the results will show.

“It’s so much simpler than people think,” Henson said. “All it takes is a little pre-planning. We plan every other part of our lives, why not plan what you eat?”