My Turn: The building blocks of obesity and a parent’s role
There has been a lot of attention focused on our “epidemic of obesity” in America, especially over the last decade. First Lady Michelle Obama has made obesity in children a focus of her time in the White House and has made strides with her “Let’s Move” program.
In fact, statistics have shown decreases in obesity, at least among toddlers under 3 years old. Many schools have started banning soda machines and are striving to offer healthier food choices in their cafeterias. But the question is: How did we get into this mess in the first place?
I was a young child in the 1960s, and I remember a very different food culture compared with the one my own children grew up in.
First, my mother cooked almost everything that we ate, packed our school lunches and fed us breakfast every morning. In fact our milk came fresh from the dairy and was delivered to a box on our doorstep.
Our vegetables often came from local farms, as did our eggs. I remember the years where she thought homemade bread would be better for us and that became one of my weekly chores – to make the bread. We used butter until margarine arrived on the scene and was touted as a health food. A Coca-Cola was a 6-ounce treat that only the adults were allowed to indulge in because it was “bad” for the kids, as were coffee and other caffeinated drinks. We were never offered snacks other than a piece of fruit because we were expected to wait for our meals to eat.
And with few exceptions, my friends were slim if not skinny.
Enter the time when my children were young (they are in their 20s now), and see how it changed in a few decades. I remember being surprised when I brought my kids to day care that they were expected to have several snacks during the day. Even more strange to me was that the snack should be a starch such as Goldfish crackers or pretzels. Then we started in Scouts, and snacks were expected at every meeting – even if the children had had lunch a few hours before or were due to eat dinner shortly. (I wonder how many dinners those snacks ruined.) There were many overweight children in the community.
Now come into my practice. When I first started out, I discussed the usual problems: sleep issues, behavioral issues, injuries and illnesses. But I also noticed many of my patients were crossing into overweight and obese profiles on their growth charts.
I even had parents come into my office and tell me how their children didn’t eat enough when they didn’t finish their snacks and that they were too thin. Imagine their surprise to hear that their children were actually overweight. Imagine my surprise when I learned that they thought their children were underweight compared to their friends. I wondered what was happening to cause this change.
A child who would have been considered normal weight by my parents was now a cause of concern for today’s parents.
The biggest issue is what we feed ourselves and our children, and what foods are available. Wherever you go these days, you can get a full meal. Every gas station has a restaurant along with every Walmart and Target. There is a fast food restaurant or several along every road. (McDonald’s was a rare treat in my day, and you had to travel to find one.) Food is available 24/7, right around the corner from your home, prepared for you in large quantities with excessive calories.
One dinner at your favorite restaurant exceeds 1,500 calories, and that’s only the main course. Remember that an adult woman should eat about 2,000 calories per day and an adult man about 2,500. Then think of how many children are sitting at a restaurant with an adult meal in front of them. That is definitely their entire calorie needs for the day in that one meal. So what is a parent to do, and what advice is a pediatrician to give?
1. If you must feed your child fast food, it should be a rare treat. Opt for the best choices on the menu for your child and yourself. There are salads and yogurts, as well as grilled chicken at most fast-food restaurants.
2. When going out to eat, again check for the heart healthy/lower fat and calorie options. Consider splitting an entree and avoid the appetizers. Again, the salads are great – just get dressing on the side.
3. Give healthier snacks. Be a label reader and look for snacks with 4 to 8 grams of protein and less fat and sugar. Look for natural ingredients. If you can’t pronounce it, it’s probably a chemical.
4. If a meal was just eaten within an hour or dinner will be ready in an hour, a snack isn’t necessary. Your child will eat much more of the healthier meal if they avoid filling up on a snack.
5. Soda and juice are never necessary, and excessive milk intake isn’t good either. Three servings of dairy a day are plenty, and water is great for the rest of our fluids. Eat your fruits whole rather than drink them in juice that has added sugar.
6. Also, find out what normal serving sizes are for your child’s age and go by that. Go to the site ChooseMyPlate.gov for the most up-to-date dietary information for your children.
Genetics probably does play a role in obesity, but we can all try to be the healthiest we can be for our genetic build. I like to joke that my Irish ancestors survived the potato famine, which is probably one reason I have to be careful about what I eat. The ability to binge may have been a genetic survival advantage when food wasn’t readily available and you had to eat as much as you could when the food was there. Obviously this isn’t a problem for most of us today, so we must adjust our eating to the world we live in.
(Dr. Patricia Edwards of Bow is a pediatrician and president of Concord Pediatrics in Concord.)