What Every Family Needs to Know About Childhood Obesity | ChildUp

A recent study by FIT ? a partnership between WedMD and Sanford Health ? found parents would rather talk to their children about sex, drugs and alcohol than their child's weight issue. In fact, the study found parents of children ages 8-17 admit to avoiding the weight conversation altogether.

Until recently, many parents didn't think childhood obesity was a problem, said Kim Lederhaus, pediatric nurse practitioner at Affinity Health System in Neenah.

"I think that a lot of times they thought that this would just kind of cure itself as (children) grew up and kind of grew out of the condition and thinned out," Lederhaus said. "I think it's hard because a lot of parents didn't really know it was an issue and now it is more of an issue, and a lot of the parents might be obese themselves. For them to start broaching the subject with their child makes them also have to take on the fact they may also have the same issue their child has."

But, simply put, childhood obesity, which affects nearly one in three children, is dangerous and is a topic that needs to be addressed for the health of children and families.

"When you look at the health effects, we see very obese children who have high blood pressure, elevated cholesterol measures, are pre-diabetic with elevated blood glucose levels and even have bone and joint problems," said Shawn Boogaard, clinic health educator at the University of Wisconsin Health's Fox Valley Family Medicine in Appleton.

"Statistics show that most kids who are overweight grow up to be overweight adults," Lederhaus said, adding that children also can develop cardiac issues due to obesity. "The problem with not approaching the issue now is the way we eat, the way we exercise, our lifestyle are things that go with us forever. The longer you adapt these bad habits and not exercising, the harder it's going to be to break and to change."

And the cycle repeats itself.

"It makes a really big difference when we start dealing with these things in childhood with the support of the parents and the family all working together for the same goal as opposed to now they're a young adult and on their own and have to figure out how to change a lifestyle ingrained since they were a child," Lederhaus said.

For children who are overweight, parents ? who control the health-environment at home ? hold the key.

Primary prevention begins in the womb

Pregnancy, Boogaard said, is "where we really should be, as physicians, educating women about healthy weight gain because we know that if you have excess weight in pregnancy that you will have the potential to have a child who is an overweight baby. When you have overweight babies they are at more risk of being overweight children who then are at more risk of being overweight adults."

Americans are distorted when it comes to portion size, which can start as early as infancy. Most likely you've seen parents propping a bottle in their child's mouth or giving the baby a bottle every time they're fussy rather than paying closer attention to when they're hungry, when they're not hungry and when there may be another concern.

In June, the Institute of Medicine of the National Academies came out with a report on early childhood obesity prevention that was a call to action to physicians, daycare providers, schools and others who have frequent contact with young children.

"We have to really monitor growth patterns in children and identify as early as possible even in infancy, weight gain," Boogaard said. "So that's where our portion starts and where the call to action for us in the medical community begins."

Having the "talk"

The best way to broach the uncomfortable topic of weight with a child is to focus on the affects extra pounds have on overall health, not the pounds themselves. It's also critical parents not zero in on that one child in the home setting, although most overweight children, Boogaard said, already know weight is an issue.

"They are being made fun of, I guarantee you that," she said. "They do have trouble in (gym) class and recess keeping up with other kids. They have clothes that are uncomfortable. So those are ways that you can bring it up. ? It's healthy to have a healthy weight. And it's unhealthy to be overweight. That's how we bring it up in clinic because we're concerned."

"I don't always tell a child that they're overweight," Lederhaus said. "I'd rather tell a child your body is not as healthy as it could be. We're going to make some changes so you're body can be healthier. That way you're not labeling your child. You're not telling your child something's wrong with you. It's just we need to do things to be healthy."

There's also research out there about the inaccuracy of merely looking at a child to determine healthy weight.

"When you weigh them and graph it out they may end up in the overweight range," Boogaard said. "Kind of the bird's-eye view is not really an accurate way to identify kinds who may be at risk. So we include the monitoring with the body mass index."

Set the example

Implementing a change at home starts at the top.

"We kind of lay it out there: You can't be sitting on the couch with the remote and say to your kid, 'You need to get outside and be more active,'" Boogaard said. "And you can't be eating away and tell your kid, 'No you've got to stop eating.' So I think (parents are) very willing because most people want to address their own weight issues."

If a family is not invested in the process together, it's very unlikely that the weight of that child is going to improve.

"We have families who say, 'Well, Johnny is skinny. Why should he be punished?' And we just say, 'Wait a minute. Johnny also needs to know about nutrition.' ? So sometimes we have to work with that mindset."

The right stuff

Current dietary guidelines from the U.S. Department of Agriculture encourage most Americans to eat fewer calories, be more physically active and make wiser food choices.

It encourages consuming more healthy foods like vegetables, fruits, whole grains, fat-free and low-fat dairy products and seafood and to consume less sodium, saturated and trans-fats, added sugars and refined grains.

For younger children, the parents buy the food for the house. They are the ones who stock the pantry and give those choices to their children.

"If there's all junk food, but now you're going to eat these carrots instead, it's going to be very difficult for the child," Lederhaus said. "Obviously everything we see in our environment gives us cues to make us hungry or make us want that food."

If it's a family effort, it makes it that much easier on the child.

"I'm not telling a parent we need to change everything," she said. "Why don't we start with just not having soda or limiting juice or putting three-fourths water into a little bit of the juice. And we have a busy lifestyle so why not take fruit and vegetables and put them in Ziploc bags so that we can make it fit in our lifestyle."

Research also supports the importance of sitting down as a family to eat.

Importance of exercise

The biggest factor in childhood, said Kirsten Rice, health and fitness director at Fox West YMCA in Greenville, is that children are going to mimic what they see.

"If their parents live a sedentary life, they're going to live a sedentary life. If their parents are active, then they're going to be active. That is a huge part of it beginning at the initial stages of growth."

In addition to encouraging children to play at home, the YMCA has loads of activities designed just for kids from children's yoga to family group cycling class to Zumbatonic, a special Zumba workout for kids only.

"We offer gobs and gobs of youth sports classes for the little ones all the way up through your middle school kids," Rice said. "There are so many different avenues that don't necessarily have to basketball, football or soccer."

The Neenah-Menasha YMCA also offers FitZone, a youth conditioning center geared for children. The equipment is colorful and kid-sized with easy knobs and handles.

"Normal fitness equipment is made for adults, and that's why we discourage teaching children weights too early because the machines just don't fit their bodies," she said. "That's why we have the smaller scale equipment that works really well."

The National Football League also has gotten on track by developing the NFL Play 60 campaign to encourage kids to be active 60 minutes a day to help reverse the trend of obesity.

Minimizing screen time

According to the Kaiser Family foundation, two-thirds of infants and toddlers watch a screen an average of two hours a day. Kids under age 6 watch an average of about 2 hours of screen media a day, primarily TV, videos or DVDs. And children and teens ages 8-18 spend nearly four hours in front of a TV screen and almost two additional hours on the computer (outside of homework) and playing video games.

"The recommendation is there is zero screen time for children under 2," Boogaard said.

According to the American Academy of Pediatrics' recommendation, the first two years of life are critical for brain development. Electronic media and TV can get in the way of playing, interacting and exploring, which encourages learning and healthy physical and social development.

Screen time for older children is two hours, which should include what they do at school and what they do at home.

"So that's sometimes a family struggle, and we have to support parents in that," Boogaard said.

A healthy future

Childhood obesity is a public health problem and part of the solution also is to find environmental strategies so children have safer ways to walk and bike to school and that there are playgrounds within safe walking distance so kids can be more active."

"Everybody has to chip in," Boogaard said.

"In this day and age our media all says you need to be stick-thin," Lederhaus said. "We don't want our kids to go in the opposite direction either. Obviously we just want healthy kids."

By Cheryl Anderson

Source: Appleton Post Crescent - http://goo.gl/61dEq

Source: http://www.childup.com/blog/what-every-family-needs-to-know-about-childhood-obesity

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