Overweight kids, overweight adults – Why baby fat might not be harmless

Earlier this month, the World Health Organization (WHO) released its 2014 Cancer Report.  According to the report, cancer is expected to increase by more than 70% over the next 20 years.  The WHO links this increase primarily to lifestyle choices including obesity, tobacco, and alcohol.

This report only looks at the expected increase of cancer, and does not examine all of the other negative outcomes associated with lifestyle, such as type 2 diabetes and heart disease.   Most of us think of these as adult health problems, but, as it turns out for many people, obesity starts in childhood.

We all know that obesity comes with health risks, but many of us are not aware of how prevalent obesity is these days – especially in kids.  Another study, published in the New England Journal of Medicine earlier this year, looked at rates of obesity Kindergarten and 8th grade.  It found that more than 25 % of kindergarteners are either obese or overweight, and by 8th grade this rose to 37%.

The most shocking part of this study, however, is that kids who are overweight when they enter kindergarten are more than 4 times as likely as their peers to be obese when they are 14- years-old. It turns out, most children become overweight or obese during the preschool and elementary school years and then stay that way as they get older.  This means that we, as parents, need to start paying more attention to what and how we feed our young kids.

These studies both point to a disturbing truth: that seemingly harmless or cosmetic changes in childhood can have such profound effects on adult health.

Parents have a tendency to excuse why their young children may be overweight.  I often hear things like, “she is just big boned,” or “It’s just a little baby fat,” or “He’s just really strong.”  While I know these parents mean well and truly believe their children will thin out as they get older, the more recent data suggests the exact opposite.  We need to take back control of our children’s eating habits and prevent obesity from the beginning.  We owe it to our children to give them the healthiest start possible.

Here are some suggestions on how to decrease the meal time battles and create healthy eating habits from the start.

1)     Family meal times: Eat dinner together as much as possible.  My husband and I really struggled Baby-Fatwith this at first.  We have had to make a real effort to eat dinner earlier, and sometimes it means only one of us is able to get home from work in time for family dinner.  Family meals allow the child to try a greater variety of food and often prevent families from feeding a kid meal and then an adult meal later in the evening (see number 2).

2)     No short order cooking: Make one meal only.  Try to offer something at the table your child likes and then allow him to decide what to eat.  They may not eat or try everything – and that is OK.  Your child is learning that not all food is for everyone. No separate kid food and adult food.  This will also lessen the time you spend in the kitchen creating separate meals.  This should start as soon as your child is eating table foods.  At first, you may have to modify some of the foods by pureeing, softening, or cutting to an appropriate consistency for your child.

3)     Model positive eating habits: Children learn most of their eating habits and preferences from their parents. Choose healthy foods such as fruits, vegetables, and whole grains. If you struggle with making healthy choices at home, try to decrease the amount of “junk” food you buy at the grocery store.  It is harder to give in to impulse when junk food is not in the house. That being said, it is OK sometimes to choose treats and deserts – but moderation is key.

4)     Allow children to serve themselves:  We struggle with this a little at our house.  It is frequently messy and often the food is initially too hot.  But, on nights when we bring all of the food to the table and allow our son to dish out his own food, we find he eats a wider variety and is so proud to be “a big boy.”  Last week we had roasted asparagus with dinner – not usually a two-year-old favorite.  We allowed him to use the tongs to serve himself and, to everyone’s surprise, he ate and enjoyed the asparagus!

5)     Decrease snacking:  Sometime in the recent past adults came to the conclusion that children need to be snacking all day long.  Every activity we go to involves some kind of snack for kids and parents are always pulling little bags of goodies out of their diaper bags.  Kids do need to eat a little more frequently than adults, but it seems like food has become a substitute for teaching children how to regulate themselves when out in public.  Children should eat 3 meals with 1-2 snacks daily.   Snacks should be small portions and should generally be healthy foods such as carrots and hummus or fruit and cheese.  Snacks should not be replacement meals.  It is OK for kids to feel hungry sometimes.

6)     Involve kids in cooking and meal preparation:  My two-year-old loves to cook.  He stands at the counter every night and “helps” make dinner.  We have allowed him to participate since he was old enough to sit on the floor and bang the pots and pans.  At two-years-old, he is able to help measure and mix ingredients.  He often will use our scraps to create his own pretend dinners while we cook.  Does it get messy – YES. Does is sometimes take longer to make dinner – YES.  But, he is so proud of the foods he helps to make and can’t wait to try the finished product.

7)     Kids decide “if and how much”:  Ellyn Satter, a registered dietician and nutritionist, has written excellent books on feeding kids.  One of the central tenets to her philosophy is that parents decide “what, where, and when” kids eat.  Kids decide “if and how much.”  When parents stop micromanaging every aspect of kids eating and simply offer healthful foods, kids will do a great job of self-regulating their diet.

Sarah Lenhardt, MD About Sarah Lenhardt, MD

Sarah J. Lenhardt is an Instructor in Pediatrics at Washington University School of Medicine. She cares for children at St. Louis Children’s Hospital, Missouri Baptist Medical Center, and at Progress West Healthcare. She attended the College of Saint Benedict in St. Joseph, MN and Creighton University in Omaha, Nebraska. Dr. Lenhardt completed a residency in Pediatrics at the University of Minnesota and worked as a general pediatrician in Minnesota before joining the faculty at Washington University. She is a board Certified pediatrician and a member of the American Academy of Pediatrics. Her special interests include preventative care, integrative medicine, and breastfeeding. Dr. Lenhardt enjoys spending her free time with her husband and 1 year old son.

Comments

  1. I really disagree with number 7. 3 out of my 4 kids regulate themselves very nicely. But one of my kids will really just eat and eat all day if we let him. It’s like he has no off button and he has ALWAYS been that way. We really have to limit his food intake and if he is still hungry after a meal we say- If you are still hungry you can have more veggies or some fruit. He is 5 years old and we are really worried about him.

  2. Great points. Love the choices and independence that you offer your child. Thanks for writing this!

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