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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.)

Thanks Collie.

You left out something . . . PUT DOWN THE VIDEO GAME CONTROLLER, GET UP OFF YOUR BUTT AND GET OUTSIDE AND GET SOME EXERCISE!!!

This article leaves out one key issue. Pro choice. If a person chooses to eat fast food or whatever food they want to it is their right/option to do so. It is NOT up to the Government/Michelle Obama or Mayor Bloomberg to dictate what people eat/drink. Pro choice seems to only apply in one area to the Progressive/Liberal movement. Obesity might be an issue with a lot of people, but the Government has no role to ban items. The only thing banning soda at school does is make it so Children have to walk over to the store next to the school to buy it. This probably eliminates any potential profit schools might make ... which would make it so taxes would need to be raised to cover the cost they are losing. Live free or die has a lot of meanings one of which is being able to consume whatever it is you would like to consume. We definitely do NOT need another program by an already bloated Government to deal with this issue.

"Government has no role to ban items." Really? Unsafe products? Dangerous drugs? So one way you define "freedom" is by the number of bad choices, whether dietary or otherwise, our "entrepreneurial" economic system can devise and then entice us to swallow via slick advertising? Does the advertising reduce even slightly one's freedom to choose intelligently? Not only do we fight for our right to party, but also to down that 32 oz Coke. (Failing that, be sure to order two 16 oz. Cokes.) Want fries with that? I'm not sure the Founders had in mind Coke and Pepsi, or 24 hour convenience shopping in their conception of freedom and liberty. Their concept was possibly a bit less trivial, at least in theory.

It is no surprise to me Bruce that you blame slick advertising as the reason folks make bad choices. That is how the left thinks. Folks are incapable of making any choices that benefit them according to the left. We have a growing population of folks that need govt protection, because they evidently are victims of a disease that prevents them from making better choices. Born without the choice gene no doubt. Up to the govt to try and mandate human behavior. How has that thinking worked in regards to folks getting out of poverty, requiring less abortions, or becoming better parents? It has not, just the opposite, we have more folks making more bad choices. So the govt does not make a difference when they mandate anything in regards to human behavior. Yet they want to keep mandating safety nets. Obese folks do not read food labels, exercise, or work. Then they have kids who follows suit. Obesity is a disease, qualifies for disability. Having kids you cannot afford is also a disease, Basically any poor choice is a disease. Fear not, the govt is there to provide a safety net that will allow you to continue making those poor choices.

We cannot even get parents to feed their kids when they are getting govt assistance. We cannot get parents to read to their kids at bedtime, and we cannot get parents to insist their kids get away from video games and their cell phone. I see 2 year olds on computers playing games. They get into school and the teacher cannot compete with a video game. Kid cannot sit still, has no attention span, and then is coded and drugged. The source of our obesity issue with kids is parents. For me, that is abuse of your children. The left thinks the fix is for everybody else to parent, like teachers. You cannot change behavior, by telling parents that everybody else will take over their role of parenting. That is what we do. A bad parent when I was growing up was very rare, as were obese kids. What has changed is that we have developed a victim society. Victims have to be taken care of by teachers, and the govt. Nobody achieves, everybody gets a trophy. We seem to believe that every bad parent deserves to be relieved of their responsibility. Nothing can be done, nothing can be done to get folks out of poverty. We just make poverty more comfortable and generational. Allowing your kid to become obese is abuse. Not only are you abusing them healthwise, you are abusing them mentally. We have a lot of issues with how we raise our sons, and our daughters these days. We glorify bad behavior, and as a result, we are in decline. Mental illness is on the rise, why? Could it be the food we eat? How about the kids that are hooked on sugar. Watch them consume sugar and then watch them react to that sugar. They get the sugar high and then come down and get depressed. Yeah they do. We have given up. Problems are not fixed, folks are not held responsible, and our kids are a mess. That is the society we have created. I have never seen so much dysfunction. We are living in a society that is in decline on all levels. And you cannot teach common sense. But you can start changing things. That is if you are willing to hold folks responsible. Lousy parents run the show at school. Yeah they do. We expect nothing of them. I do not have to read to my kid, I can threaten the school that I will sue if they do not provide a tutor, I do not have to teach my kid to ride a bike, the school will provide a physical therapist, and I do not have to feed my kid either, the school will. We have solved nothing. We just spend more money to solve nothing.

Awesome letter RabbitNH. You nailed it right on.

Thank you Dr. Edwards for the most commonsense article I have seen to date on Obesity. I was remembering back to my childhood, long before yours. Everything was home cooked, no fast foods full of chemicals. Three meals a day and no snacks. We were too busy playing outdoors and doing active things to even think about snacks. Sweets were rare. A piece of cake, brownie or perhaps pie, if my mom had time to make it. Homemade ice cream, "yes". Sunday was church day and the family went and returned home for Sunday dinner, usually pot roast and lots of veggies. Salads were big in our home also. There was none of this fellowship fat eating after church. Who started that stupid trend anyway. Very expensive and people do not need to eat after church. Go home and have dinner with the family. Eating out!! The nightmare from hell. Don't do it. Way too much food. Good grief, they give you enough to feed yourself for a week. This is not just about kids who are too well-fed but adults who need to seriously rethink how they are doing things. Eat healthy, eat much less and move more. Don't need a gym or fancy diet plan, just good ole commonsense. Great article!!!!

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