Step By Step: Kids Trimming Down
• NOTES from Part 4 •

Pediatrician — Stewart Gordon, MD

One of the main questions many people battling obesity ask is whether it is in their genes. Researchers are spending a great deal of time trying to answer this question. Scientists at the Pennington Biomedical Research Center in Baton Rouge, Louisiana are among them. The center’s director, Dr. Claude Bouchard talked extensively about the research.

Claude Bouchard
Director, Pennington Biomedical Research Center:

“We have in the population of kids and adults probably five-percent of them, we don’t know exactly how many, but it is a small percentage who are obese because they have a clear genetic defect. One gene is totally incompetent, not capable of producing protein that it normally does. The absence of that protein changes metabolism, affecting the regulation of appetite, satiety, or energy expenditure. In the long term these children become obese, generally severely obese. That’s five-percent. It doesn’t explain the whole obesity epidemic.

Over and above that, we clearly see some family lines. These family lines are not determined by one gene, in our genetic language, we say they depend on multiple genes and multiple genes acting directly, but also interacting among themselves, one facilitating the effect of the other. And, these genes in turn interact with the environment. So it’s a very complex picture.

When we talk about predisposition to become obese; if the environment is obesigenic, it has the kind of conditions that favor the development of obesity. This genetic disposition may be strong, weak, very light. It depends on the amount of susceptibility genes that you carry. For example for those families where obesity is very prevalent and severe it is quite likely that you have many of these predisposing genes that are acting. And in families where most people are lean, it doesn’t mean they don’t have any of these genes, but they may have a few copies only.

There are people who believe that everybody in an environment like the United States where the obesogenic environment is the strongest that we’ve seen on earth, 100 percent of us will become obese one century from now, two centuries from now. Energy expenditure is reduced to a minimum and food is available in abundance. It’s good and it’s cheap, this favors us eating more than we expend. Our whole environment has been designed to decrease the amount of work that we do.

The war began with the advent of agriculture. We invented the wheel and it lasted for a millennium. We have won the war. We are not using our muscles, or barely, just a little bit. The problem is that we have diseases associated with this sedentary lifestyle and obesity is one of them. Our cities are built that way. Our buildings are designed to reduce the amount of physical work. So at the end of the day, there are always 300 to 400 calories that we have not expended and that plays a role in our biology. If we were able to recover them by walking here to go to the store, taking the steps in the building for a couple of floors, adding them up over a period of years, it makes a huge difference.”

Some people are at higher risk than others. That’s why the American Academy of Pediatrics is urging doctors to look at family history in predicting the long term risk of obesity.

But it’s something Families can monitor too. Children who grow up in impoverished neighborhoods are more likely to feel unsafe going out to play...thus “not” getting the exercise they need. These same kids are less likely to have fresh fruits and vegetables, while they are more likely to eat fried foods that are loaded with saturated fat. They are also more likely to drink carbonated beverages, loaded with sugar. Parents you can also look at your family tree. Does your family appear to be more prone to gain weight either because of genetics, your cooking and eating traditions and-or a lifestyle where you just don’t move around enough? If so, you will want to pay much closer attention to your kids’ eating habits and make sure you live an active lifestyle.

In addition to this, pay attention to the psychological, social, and cultural issues that could have a negative impact on your children’s weight. There will be some conditions that you can control. Others you can’t. But, the more we all know, the more ammunition we have in trying to keep our children within a healthy weight.

Psychologist — Denise Sellers, Ph.D.

The things you say to yourself can make you feel good or bad about just about everything you do. Positive reinforcement is much better than negative thoughts. It’s important to identify situations that tempt you to eat unhealthy foods and what you can say to yourself to feel good about making healthy choices.

Children, there will be days when you will walk into the school cafeteria and see pizza loaded with meat and cheese. The ingredients may or may not be the healthier brands. Under ordinary circumstances, you might say, I can’t resist pizza. Besides, I have so much weight to lose, one piece won’t matter. With that kind of negative thinking, you will eat the pizza and feel bad about yourself.

However, with the opposite approach, you might say, “even though I like pizza, I can resist it. I’ll have a salad instead and stick to my plan.” Then you will feel good about yourself for choosing the salad.

I’ve prepared a list of examples of positive self-talk for you when you have to make these important choices. Use these suggestions and make some of your own up to help you stick to your plan and feel better.

• I “can” do anything I want to do badly enough.
• I “do” anything I want to do badly enough.
• Yes, I “can” stay on my eating and activity plan.
• Yes, I “do” stay on my eating and activity plan.
• I look great since I’ve lost weight.
• I look and feel so much better.

And, this one is very important.

• One slip is not the end of the world.
• So I slipped. I’ll make up for it by riding my bike or taking a long walk, or skipping dessert at my next meal.

Children remind yourselves:

• I can resist temptations such as school parties, holidays, friends-over-night-pig-outs.
• I resist tempting situations all the time.
• I like being active.

As you make progress, you need to remind yourself by saying:

• I am much more active and physically fit.
• My parents, relatives and friends are proud of my success.
• I am proud of my accomplishments.
• I look great.
• I feel great.
• I am great.

These changes will help you with both your self-esteem and body image. Self-esteem is the way you feel about yourself. Body image is the way you feel about your body. Positive self-esteem and body image help promote total health. I want you to

• Make a list of three things you like about the way you look. Then, I want you to list three other things you like about yourself.
• Write down what you think your parents like about you.
• Write down what you think your friends like about you.

Sometimes when we have poor self-esteem or body image, it’s hard to find things we like about ourselves, and things we think other people like about us. Now write an example of negative self-talk you have about yourself. For example, you may want to say, “I have big legs.” Then, turn those negative statements into more positive statements. My legs “will get” or “are getting” stronger and more muscular. When you tell yourself positive things, you feel better and think of yourself in a more positive way.

Shifting now to parents, there are many things you can do to encourage and support your children. We call the process by which you support your children the A-Factor: attention, attitude, accountability, and availability.

• We want you to give positive attention to your children’s behavior. Many parents are used to giving negative attention to their children, or noticing bad behavior. We want you to “catch your child being good.” Your primary charge is to be positive, upbeat, encouraging and empathetic and help build your child’s belief in himself. Hold back the criticism when your child loses ground. Help him identify healthier options and acknowledge to him that he is successful.
• Perhaps the most substantial change we ask you to make is in your attitude. Regardless of whether your past responses have been positive, negative or neutral, now is the time to reframe your attitude so that you are the “healthy food movement.” This means cheer for vegetables and boo fast food commercials.
• Then there is accountability. You have to hold yourselves accountable for what your children eat. Understand that if you don’t keep track of both what you and the child eat, your child won’t monitor what he eats either. You are a big part of you child’s success or failure.
• And finally, make adjustments so that you are available to meet your children’s needs. Find the time for conscientious food shopping and cooking. You also need to launch more activity around the house. Being there does make a difference. Your child cannot do it alone and needs help from you.

Registered Dietitian — Heidi Schumacher

Long, before Americans recognized our growing tendency to become overweight, parents encouraged kids to eat their fruits and vegetables. Now that two-thirds of American adults are overweight, we’re putting extra emphasis on fruits and veggies. They are naturally low in sugar and fat. They also provide us with a great source of essential vitamins, minerals and phytochemicals, substances in plants that protect us from diseases.

For people watching their weight, fruits and vegetables are loaded with fiber which makes us fill full faster, and digest our food more efficiently. Take beans for example. Kidney beans and chickpeas are also great sources of protein, which allows them to be used as a substitute for meat.

Parents, it’s important to serve a variety of vegetables. For example, dark-green leafy vegetables like spinach, romaine lettuce and broccoli provide us with vitamins and minerals that you won’t get in other vegetables. If you have a picky eater who doesn’t like vegetables, offer him or her lots of options. A child who doesn’t like regular green beans might eat them barely steamed, served with a dip, or marinated in fat free dressing and served cold. Children also enjoy stir-fried vegetables prepared in a wok.

Stir Fry Recipe

Use a small amount of oil, half cup of water, a half cup of half soy sauce, about a tablespoon of corn starch and what ever vegetables you like. Mix your water, soy sauce and corn starch. Put the oil in the skillet or wok. When the oil is hot, add vegetables. Add water, soy sauce and corn starch mixture when veggies are near the consistency you like; cooked more or less. Allow to finish cooking. Serve hot.

You can also disguise vegetables in casseroles and in soups. Some kids would even prefer getting their veggies from vegetable drinks which is fine.

Keep in mind, the food pyramid encourages you to eat 3 to 5 servings of vegetables each day. A serving could be a cup of raw leafy vegetables or a half cup of cooked or chopped raw vegetables for older children and adults. In addition to vegetables, we should eat 2 to 4 servings of fruit each day.

A serving can be a medium apple, a banana “or” an orange. It can be a half cup of chopped, cooked or canned fruit or a hand-full of dried fruit. Fresh fruits are packed with vitamins. However, canned fruit, packed in its natural juice, frozen, and dried fruit can be almost as good. Canned, frozen and dried fruit will have a longer shelf life. It’s also often cheaper. Frozen fruit can be added to cooking such as in muffins and pancakes, while canned or dried fruit can make a quick and convenient “to-go” snack.

Parents you can also use juice as one of your serving of fruit. It is often used as a fruit substitute for breakfast. But beware, much of what’s advertised as fruit juice is only five or ten-percent juice. Look for 100 percent juice.

Try to avoid those aides, punches and other beverages that are loaded with sugar, especially if your child is battling a weight problem. And, when you buy 100 percent juice, you should limit the amount your children drink. Even though it’s very nutritious; it is still high in calories. Encourage your children to drink water with meals and to quench their thirst throughout the day. And, remember, as long as the children are filling up on fruits and vegetables, they are avoiding the temptation of chips, cookies, ice cream and other snacks that may be high in sugar and fat.

Exercise Physiologist — Melinda Sothern, Ph.D.

Children can tone up or tighten their muscles through weight and strength training. The benefits of strength training include improved strength and endurance, lower blood pressure, higher resistance to diseases, a lower risk of bone and joint disorders, especially back problems, and an improved self-image. The best way to tone up is through weight lifting or using the limbs to lift other parts of the body. This should be done at least once or twice a week. Children should not begin lifting weights until they are at least six or seven years old.

Parents you have to be careful in working with your children. Some boys and girls may be tempted to use weights that are too heavy for them. Strenuous lifting, pushing, jarring and pulling can cause injuries to growing bones and developing joints. You should talk with your child’s physician about the appropriate weight for his or her size and body type.

Generally speaking, the child should begin by lifting a one pound weight in each hand.

Lifting Weights

• Children, you should grip the weight handles “lightly” to prevent an increase in blood pressure.
• Keep the rest of your body still while focusing on a particular area.
• The stomach should always be sucked in.
• It’s important to fully extend and contract your muscles without locking the joints.
• You should breathe normally...using a two-to-four -second count to lift and lower the weights.
• It’s important to rest from one to two minutes between each set of eight to twelve repetitions.

Once you have learned to lift weights properly, you should not increase the amount of weight you train with, until you can do 12 continuous reps in perfect form. You should only increase the amount of weight you lift by one to two pound intervals. Not only is it good for you to lift weights, but you should also practice simply lifting a limb or other part of the body to strengthen the muscles in that area.

Leg Extensions

• For example, you can strengthen your quads by sitting in a chair with your arms at your sides.
• Bend your knees at a ninety-degree angle with your feet flat on the floor, and your lower back flattened.
• Slowly extend both legs from the knees, while keeping your upper legs stationary for two to four seconds.
• You should not lift your hips or extend your legs fully until your upper front thigh muscles are completely contracted.
• Do not lock the knees. And, keep your ankles and feet relaxed.
• Take about four seconds to return to the starting position.

This should be done eight to twelve times.

Leg Curls

Leg Curls are good for “strengthening” your back thigh muscles and “stretching” your front thigh muscles.

• Stand up straight with your stomach muscles tightened and your hips and knees slightly bent.
• Hold on to a chair or something for support. Slowly raise the heel of one foot toward the back of your hip for a count of two to four seconds.
• Keep your upper leg and knee stationary.
• Then gently squeeze your heal toward the back of your upper leg, fully contracting the upper back thigh muscle. Slowly return to the starting position....making sure you don’t lock your knees.

Repeat this routine for eight to twelve times on each leg.

Low Row

To work the upper back, try the low-row exercise.

• Sit upright, leaning straight forward from the hips. Keep your back straight and your shoulders down.
• Then pull your shoulders back. Pull an exercise band to the upper abdomen over a period of two to four seconds.
• If you don’t have an exercise band, simply squeeze your shoulder blades together.
• Then take two to four seconds to return to the starting position, keeping the back stationary.
• You should do eight to 12 repetitions of this exercise.

Crunches

Crunches are great to tighten your abdominal muscles.

• You should lie on the floor with your arms behind your head.
• Interlock your fingers behind the base of your neck.
• Bend your knees at a ninety degree angle and put your feet flat on the floor.
• Keep your chin tilted straight back while relaxing your head in your hands throughout the movement.
• You should press your lower back against the floor and hold your abdomen in while lifting your upper body from the trunk on the count of two.
• You “should not” roll your head and shoulders forward.
• You “should” look up at the ceiling, keeping your head relaxed in your hands. On the count of two, return to the starting position.

Do ten to twelve of these movements.

Modified Pushups

Modified pushups are great for working your chest muscles.

• To do them, you should stand two to three feet from a wall, a sturdy table or chair....
• Place your feet slightly apart.
• Then lean forward at a 45-degree angle, using your hands to brace yourself against the surface.
• Slowly, bend your elbows and lower your chest until your face comes close to touching the surface.
• Now push with your hands, extending your arms, and return to the original position.
• Keep your head in line with your body. Keep your legs straight and extended throughout the exercise.

Repeat this sequence eight to 12 times.

Parents, these exercises are great for both children who are overweight and those who aren’t. Other ways for children to tone up include normal play, climbing trees, swinging on monkey bars, carefully jumping on a trampoline, swinging on a swing set, skipping rope, playing hopscotch, participating in gymnastics, dancing and learning martial arts.

• NOTES from Part 4 •
Home • Information • Biographies

LPB Home

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.