Step By Step: Kids Trimming Down
• NOTES from Part 2 •

Pediatrician — Stewart Gordon, MD

Excess weight contributes to many medical conditions, including high cholesterol, high blood pressure and diabetes. One of the ways to see if a child is overweight is to measure his or her Body Mass Index, or BMI.

The BMI adjusts the weight for height using the formula BMI equals Weight in kilograms divided by Height in meters....squared. To find out how many kilograms your child weighs...take his weight in pounds and divide it by 2.2. Your answer is your child’s weight in kilograms.

To find your child’s height in meters, multiply his height in inches times 2-poing-54. Divide 100 into your answer and you have your child’s height in meters. Now you are ready to find the BMI by multiplying the height in meters times itself and then dividing your answer into the weight in kilograms. Once you’ve gotten your answer, you can get a BMI growth chart from the CDC’s website or your doctor to keep track of how your child is doing.

The chart will not only tell you if your child is overweight. It will also tell you whether he or she is at risk of becoming overweight. Every child is different and we have to look at more than just the numbers to determine who is or isn’t overweight.

• If both parents are obese, there is an 80% risk that the child will be overweight.
• If one parent is obese, there is a 40% risk that the child will be overweight.
• If neither parent is obese, there is only a seven percent chance the child will be overweight.

Remember, your child’s pediatrician is a great resource in helping you make this determination. The main reasons to treat childhood obesity are to help our children feel better about themselves, and avoid serious illnesses.  

Psychologist — Denise Sellers, Ph.D.

People trying to live a healthier lifestyle should focus on three basic goals: a healthy diet, exercise and drinking lots of water. Many people who are overweight focus primarily on losing their weight. That goal can seem impossible. You should concentrate instead on your diet, exercise and drinking lots of water and fewer sweetened beverages. It’s fine for “weight loss” to be the long term goal. But, your behavior has to be the focus of your “short-term” goal. To stay focused:

• Be specific about exactly what you plan to do. Instead of saying “I will exercise more,” say “I will exercise for 20 minutes three days a week.” This way, you know exactly when you have reached your goal.
• Your goals should be something you can control. You may not be able to control exactly what time you will have dinner each night, but, you can control whether you choose to have a snack after dinner.
• You should phrase your goal in a positive way, saying what you will do, instead of what you won’t do. For example…say “I will eat fruit for snacks”, instead of saying “I won’t eat candy.”
• Set easy goals. Make sure your goals are only a little harder than what you know you can accomplish. As you meet your goals, you can make them more difficult. This may sound funny, but, we want you to feel good about what you’re doing. Reaching your goals help.

Parents you should work with your children on a set of rewards for meeting goals. Those rewards should be the result of meeting goals, not for losing weight.

As you set your goals and work toward accomplishing them, you’ll be faced with many challenges, especially when it comes to changing your relationship with food. It is important to have a set time for both your meals and snacks. Some kids may think they feel hungry between snack and meal time. Often what they are feeling is not hunger, but a craving.

Hunger

• An emptiness or grumbling in your stomach.
• A decrease in energy and tiredness.

Cravings

1. You’ll see a food you like and then want to eat it.
2. Someone will offer you food. And, you will want it, even though you are not hungry.
3. You’ll smell food as you pass a restaurant or bakery and want it.
4. You’ll see food advertised in newspapers, magazines or on television and want it.
5. You’ll eat before bed, simply because you are in the habit of doing it.
6. You’ll have a large dessert after a large meal because it’s customary.

Eating because of a craving is one of the easiest ways to consume too many calories and put on extra weight

Parents and children, you also need to be aware of urges to eat. Some of those urges will be external. Others will be internal.

External urges to eat

1. Being in environments that trigger a desire to eat; a party, a movie theater, or a special event, like a circus or restaurant
2. The sight or smell of food
3. Being around people who are eating
4. Activities will make you want to eat: watching television, studying or reading.

Internal urges

1. Hunger, cravings, or certain moods.
2. Some people eat to overcome boredom, sadness or burnout.

As you become more aware of your eating habits, you need to recognize:

• where you eat
• what you eat
• how much you eat
• how fast you eat
• how often you eat

You will move a lot closer to living a healthier lifestyle when you learn to eat for only the right reasons.

Registered Dietitian — Heidi Schumacher

Food Labels

Food labels provide a lot of information for people who are trying to lose weight, information about fat and sugar content and the fiber and minerals in food. The federal government requires nutrition information on almost all processed foods. But, first you must understand how to read the labels to get the vitamins, minerals and even fat you need to stay healthy. The labels will also tell you which foods to eat less of. People trying to lose weight should look for products that are low in fat and sugar but high in fiber, vitamins, and minerals.

Calories

The fat and sugar we take in reveal themselves in the form of calories. Calories are energy we obtain from food. If we don’t burn off excess calories by working, playing, or doing exercises, they turn into body fat.

Beverages and Sugar Content

A major source of calories for children is beverages. In fact, more than half of our children’s sugar intake comes from beverages alone, not food.

20-ounce soft drinks are favorites among families on the go. It doesn’t matter if it’s a Coke, Pepsi, or other generic brand. With a quick glimpse at the label, you might think that it contains 100 Calories. Upon closer inspection you will see that there are two-point-five or two-and-a-half servings of drink in the containers. Most people buying a 20 oz. bottle of soda will drink all of it within a short span of time, taking in not 100, but 250 calories. So not only do you need to look at the number of calories that are listed on the bottle, but also the number of servings.

Some of you may wonder where all these calories come from. That’s where sugar content labels come in. This label shows 27 grams of sugar. Remember that a 20-ounce bottle of soft drink is equal to 2.5 servings or 67 grams of sugar for the whole container. That’s the equivalent of 14 teaspoons of sugar. That’s how much sugar you take in when you drink a 20 ounce bottle of Coke. A very common sugar additive in these “artificial beverages” is high fructose corn syrup. Not only are the beverages full of sugar from the high fructose corn syrup, but they also lack nutritional value in the form of vitamins that are found in natural, 100% fruit juices.

Water is the best beverage. We should drink on average, 64 to 80 ounces of fluid per day. Most of that fluid should come from low-fat milk, 100 % all natural fruit juice, or plain water.

Compare diet drinks to regular drinks. Notice that it says no calories and no sugar. Talk to your pediatrician and dietitian about the use of artificial sweeteners.

Cereal (Sugar and Fiber Content)

Cereal is another common source of sugar. Look for breakfast cereals with less than 15 to 20 grams of sugar per serving. More importantly, use breakfast cereals to help meet part of your child’s daily fiber needs. Look for breakfast cereals that contain more than 3 grams of fiber per serving. An added benefit of cereals containing fiber is that it will help to slow down your body’s absorption of sugar.

The Fat in Butter and Margarine

Margarine and butter are also common staples in most homes. One of the concerns with regular margarine and butter is the fat content. That’s where most of our calories come from in many spreads. The label will tell you that a serving of butter or regular margarine is roughly one tablespoon. That one tablespoon of butter contains over nine grams of fat or 100 calories. That takes up 14-percent of the total fat intake an adult should have in one day, the “DV or daily value” area on your label indicates this. Keep in mind, however, that one tablespoon is not a whole lot, and we usually eat much more than that with our meals. One stick of butter or margarine contains almost 100 grams of fat and1000 calories. There are eight tablespoons of butter in each stick.

Keep in mind the harmful effects some fats can have on our bad cholesterol levels. Most margarine is made from “hydrogenated or partially hydrogenated vegetable oils.” Hydrogenation is the process in which liquid vegetable oils are made harder. This process creates “trans fats” and saturated fats, both of which can raise your bad cholesterol levels and clog your arteries. This clogging process begins as soon as you are born. When buying margarine, look for the ingredient “liquid vegetable oil” instead of “hydrogenated vegetable oil” and/or look for margarines that say “trans-fat free” in addition to being lower in total fat.

The word lite/light can also help you spot healthier margarine. Federal laws prevent the use of “light” on labels unless the product contains one-third fewer calories or 50-percent less fat than the original product. Low is also used to describe calories, meaning less than 40 calories per serving.

While we worry a lot about fat, no one should be on a diet that’s fat-free.

Children, especially, need about 60 grams of fat a day. This value ties in with the percentage value on the food label. A good amount of your daily fat intake, however, should come from the “heart-healthier fats” or the monounsaturated fats, such as nuts, olive, canola or peanut oils, and avocados. A much smaller percentage should come from the saturated fats found in high-fat dairy products and animal fats.

Our families consume a lot of fat from fried or baked foods because they contain a lot of oil. Remember that even when cooking with a healthy olive, canola, or peanut oil they still contain 2000 calories and 200 grams of fat a cup. A small amount goes a long way.

Exercise Physiologist — Melinda Sothern, Ph.D.

The way you move plays a major role in the rate in which you burn calories. There are some activities that are also more effective than others in building strong, flexible muscles that will give your children much more endurance.

Think of your body as a car, with three different engines. All three engines work at different speeds; burning varying amounts of energy.

Let’s call the first engine, engine number one. That’s when you shift into high gear to do fast-paced or rigorous exercises like running fast, lifting a heavy weight, or doing gymnastics stunts. You expend a lot of calories during a short amount of time while operating on engine one. But you can only do intense, vigorous exercise for very short periods of time, especially if you aren’t use to it. An untrained child will not be able to operate in this mode for long. Engine one generally works best for skilled, powerful athletes; weight lifters, jumpers and sprinters.

That’s not to say your child should never shift into engine number one. However, the child needs to know that if he uses that engine, he shouldn’t come to a complete stop when he gets tired. The child should simply shift to a lower gear.

Engine number two comes next. You use this engine when you walk, jog or ride your bike at a brisk pace, not too fast, not to slow. A child who hasn’t trained can usually operate on engine number two for about three to five minutes. Aside from causing the child to tire quickly, engine number two causes him or her to burn glucose, a sugar that the body produces from carbohydrates. As the body burns off glucose, lactic acid builds up in the muscles, creating a burning sensation. The energy from your muscles is also being zapped, causing fatigue. While it may be difficult for an overweight child to start off with engine number two, it is important to perform high-energy activities that strengthen the muscles. The longer a child can operate on engine number two, say five to six minutes, the more anaerobically fit he becomes.

That leaves us with engine number three. That’s where your child and you want to begin when you start trying to get in shape and lose weight. Engine number three allows you to dance, walk, jog or climb stairs slowly. You can also do other activities like swimming, dancing, and field sports like soccer, softball and volleyball. The great thing about engine number three is that you can keep going for long periods of time without tiring out. After about 20 minutes of activity, your body will begin burning off more stored deposits of fat. The longer you move with slow to moderate speed, the more calories and fat you will burn off. Your child will burn off even more calories, if he or she hasn’t eaten for several hours before beginning an exercise routine.

The child should be able to gradually build up to use engine number three for longer periods of time. He or she should also be able to use engines number one and two for longer stretches of time. But, it’s a process you can’t rush. The heavier the child, the longer it will take for him or her to keep his or her engines going for longer periods of time.

Sometimes children will complain of discomfort. Parents you need to be patient and understanding. Remember, excess weight is physically disabling. Children need encouragement, not criticism.

Perhaps the best way to get your children to practice on each of their engines is to get them to exercise to music. Select music with three different tempos, fast for engine number one, medium-paced music for engine two and slower music for engine number three. After several minutes of playing music with a slower beat, change to a song with a faster beat, and then one with a very fast tempo.

• NOTES from Part 2 •
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LEGAL DISCLAIMER: This information is for general information purposes only and does not address individual circumstances. It may not be right for you and should not be relied upon in making decisions about your health. Always consult your doctor for medical advice.