Kids and Weight Gain

What irony! In a culture where low-calorie soda flies off of supermarket shelves, and, on any given day four out of 10 Americans are dieting, the population is getting fatter. And kids are too! The number of overweight children in the U.S. has nearly doubled in the past decade. Twenty-five percent of children, or one out of every four, are now classified as either overweight or at risk for becoming overweight.

To make matters worse, a recent study of overweight children found evidence of diabetes risk in children as young as age five. Researchers reported that children ages five to 10 already showed signs of insulin resistance, high cholesterol, and high blood pressure, all of which are factors associated with type 2 diabetes, which normally strikes adults. The U.S. Surgeon General warns that a childhood obesity epidemic is occurring in our country. So what can child caregivers do?

For most of adults, excess weight is the result of unhealthy eating habits--specifically, eating too many calories--and not getting enough physical activity. The same holds true for children. Diet and exercise habits form early in life, so it makes sense to start obesity prevention efforts early

Because the family is the child's first teacher, educational efforts should include a family partnership approach; family "buy in" is critical to success. Family "buy in" usually starts with proving that the child is really overweight, or at risk of becoming so. When it comes to young children, looks can be deceptive. That is why it is important to accurately determine if the child is really overweight, or if she only appears to be.

Growth Charts

Growth charts, like the ones used by pediatricians, are helpful in determining whether a child is overweight or underweight for height and age. Although they seem very simple, they are a critical measurement tool to track a child's changes in height and weight over time. Growth charts also allow you to compare the child's growth pattern to those of other children of the same age.

Even growth charts have made technological advances in recent years. New growth charts help to more closely pinpoint when a child is starting to become overweight. Intended for children aged two and up, the assessment includes calculating the child's body mass index, or BMI (a measure of body fatness) using either a mathematical formula or a BMI calculator. The child's BMI is then plotted on the graph to see if he actually is overweight for his age or if looks are deceiving, as grandma used to say.

However, caregivers may need training to learn how to accurately weigh, measure, and graph youngsters. It may be helpful to invite a public health nurse or childcare health consultant into your program to help weigh, measure, and graph all children in your program (staff, too!). You may wish to present the results of each child's BMI to their parents realizing that the parents of an "overweight" child might be offended.

Dietary Habits

The next step is to help parents examine the child's dietary behaviors. "Junk food" and fast food are often culprits when it comes to weight control in kids because they usually contain large amounts of fat and/or sugar. Likewise, overweight children often shun vegetables and fruits, which are low in calories and provide a variety of vitamins and minerals along with dietary fiber.

If a child is overweight, or if you have concerns that she is becoming so, try these tried and true kid-trimming tips and encourage parents to do the same at home:

• Because early intervention is the key, it is important to note that breast-fed babies tend to be thinner adults. So, a good first step toward "fat-proofing" children is to inform pregnant women of the many nutritional and emotional benefits of breastfeeding.
• Children are great imitators so adults should set an example by eating nutritiously and staying active. It is important that child caregivers eat the same menu as the children in their care.
• Train children to "eat thin." That means limiting dietary fat--yes, that includes fast food. Prepare foods fresh, baked, broiled, steamed, poached, or roasted, rather than fried. Do not use excess butter, margarine, mayonnaise, or salad dressing since they consist mostly of fat.
• Do not use food as a treat or reward for good behavior. Using a sweet dessert to reward a clean plate can promote overeating and lead to unhealthy attitudes about food and behavior. It is better to serve a fresh fruit with the meal and allow children to eat each food in the order they prefer.
• Avoid using eating as a recreational activity. When children see adults turn to food as a solution to boredom, anger, sadness, or frustration, they may develop similar unhealthy dietary behaviors.
• Eliminate "junk food" from the snack menu. Healthy snack choices include fresh fruit, plain popcorn, whole wheat crackers, rice cakes, and raw fruits and vegetables. (However, remember to watch out for choking hazards with young children.)
• Offer water to children regularly. Beverages like soft drinks and fruit-flavored drinks are high in calories and low in nutrition. Diet drinks may not have calories, but often contain caffeine and are not as healthy as water. A thirsty child will drink water if soft drinks are not available.
• Get kids involved in planning their own fitness programs. Let them help with food shopping and meal preparation. Incorporate their ideas when planning outings, and encourage them to take responsibility for their own health.
• Develop a physical fitness program within the childcare environment. Children should participate in vigorous activity for at least an hour each day. Brief, intermittent activities are best for young children as this prevents boredom and can be accommodated in the busy childcare schedule. Talk with parents and let them know how often and what kind of activities are included. Fun activities such as jumping rope, climbing, and throwing a ball are all part of a physical fitness program. Let the children help choose the activities for each week.

Be sure that children in your childcare program are offered opportunities to be physically active throughout the day. Frequent, vigorous activity, both in and out of childcare, are important to keep that heart healthily pumping and that waistline under control.

INTERNET RESOURCES

Body Mass Index, National Heart, Lung, and Blood Institute, www.nhlbisupport.com/bmi

Child Care Nutrition Resource System, www.nal.usda.gov/childcare/

Food and Nutrition Information Center, U.S. Dept. of Agriculture, www.nal.usda.gov/fnic.

Helping the Overweight Child, www.niddk.nih.gov/health/nutrit/pubs/helpchld.htm

RESOUCES

American Academy of Pediatrics, 141 Northwest Point Blvd, Elk Grove Village, IL 60007-1098; 847-434-4000; www.aap.org

National Center for Nutrition and Dietetics, American Dietetic Association, 216 W. Jackson Blvd., Chicago, IL 60606-6995; 800-366-1655; www.eatright.org

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