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Parent Trap

Marketers want your kids to eat more junk food. You want to see your kids grow up strong and healthy. How will your family face the challenge?

"Mommy, I'm fat." Coming from your son or daughter, it's a statement guaranteed to make you cringe – and then to leave you wondering what you should say or do next. If you've experienced this scenario, or can see it coming, you are not alone. And even if your kids aren't overweight, you may be concerned about their nutrition and whether or not they are getting enough exercise.

Any way you look at it, our kids' health is in a sorry state of affairs, and overweight tops the list of many parents' concerns. Last December, the U.S. Surgeon General reported that, in the past two decades, overweight and obesity in adolescents has tripled. The problem is so serious that Tommy Thompson, Health and Human Services secretary, has predicted the childhood obesity epidemic is likely to undo many of the public health gains we've made in recent years. Obesity is not a problem unique to the United States; many populations around the world – including Europe, Australia and Asia – are getting fat, too.

Global statistics are one thing, but your main and immediate concern is your child. Maybe you know they aren't eating well or getting enough exercise. Maybe you can see they are out of shape. Maybe they've let you know they aren't happy with their bodies. You want to help. But how?

The first step is building your understanding of the scope of the problem, and why it is occurring. Is it because parents are less caring or thoughtful about food than they were a generation ago? Absolutely not. Based on my experience as a registered dietician, I'd say that today's parents are every bit as concerned about food and meals as their parents and grandparents were. In Boston, several online grocery services failed because they made their users feel disconnected from the food selection process – a responsibility most felt was an important part of parenting – and surveys show that most families try to eat together as often as possible because they recognize its importance. Still more parents are working outside the home now, and working longer hours, and that has indelibly impacted family cooking, dining and activity habits.

At core, of course, kids are gaining weight because they're not getting enough exercise and they are eating too many high-calorie, highly processed foods. First let's size up the exercise problem. Sixty-five percent of adolescents report participating in 20 minutes of vigorous activity three out of seven days. That's a start, but it falls substantially short of the 60 minutes of moderate exercise recommended daily. Only one state, Illinois, includes physical education from grades K-12. The American Academy of Pediatrics found the average child or adolescent is watching three hours of TV a day – and that doesn't include videos or video games. Sixty-five percent of 8- to 18-year-olds have a TV in their bedroom. Unfortunately, TV watching has largely replaced our kids' (and many of our own) active pursuits.

Then there's the American diet. The American food industry produces 3,800 calories worth of food daily for every man, woman and child. Most active men need only 2,800 calories per day, women around 2,000, and an 8-year-old child may need 1,800 calories. Not only is there a tremendous amount of food easily available, it is actually cheaper these days.

In the 1950s a family might have spent 21 percent of disposable income on food; today it is only 11 percent. As a result of modern farming methods (i.e., agribusiness) and advances in manufacturing technology, food can be prepared and sold for less. Cheap (i.e., highly profitable) foods are aggressively mass-marketed, while high-quality, healthy foods and practical nutrition messages are not. Why? Because food companies stand to profit far less from delivering simple, unprocessed foods than they do from highly processed, highly flavored ones. They are also trading on busy parents' lack of time by marketing "time-saving" ready meals and snacks that require little or no preparation.

Think about it: Your kid clamors for the national-brand sugar cereal in the brightly colored package, then devours half the box in a single sitting. When was the last time anyone begged you to buy bulk oats?

With an annual communication budget of $1 million, the "5-a-day" nutrition-education program is the largest publicly funded public-health initiative in history. In contrast, Coca-Cola and McDonald's collectively spend over $11 billion per year on advertising. With forces like these competing for your kids' attention, simple, nutritionally sound foods don't stand a chance. Combine low activity, an overabundance of unhealthy foods and beguiling advertising, add the finding that only 3 percent of all Americans are eating even four of the five recommended servings of fruits and vegetables, and you can see why our kids are in so much trouble.

Having the (Other) Talk
Many parents dread talking with their kids about weight and fitness issues even more than they dread the infamous "birds and bees" chat. Some fear they will cause an eating disorder or other self-esteem problems. Other parents don't want to raise what is already a sensitive issue or source of pain for their child. But if you miss the opportunity to talk about food with your kids, you're ignoring one of your chief responsibilities as a parent.

Also, consider the risks of not talking: Overweight children are more likely to have high cholesterol, high blood pressure, and type-2 diabetes. Overweight kids are more likely to experience social discrimination. Given the horrific weight statistics, it is irresponsible for us not to talk to our kids about food and fitness.

If you're not sure how to approach the issue, start by putting the focus on health instead of appearance. Second, do not let your first response to weight gain be one of control. I recently overheard a mother respond to her son's weight gain by saying, "I'm just going to cut back on how much he eats." This may sound like a reasonable idea, but it's actually a recipe for disaster. Control and strict elimination of favorite foods can backfire, creating a scarcity mentality and stronger craving for the forbidden foods – the exact opposite of what parents want to accomplish. Worse yet, a controlling parent may cause a child to sneak food or doubt his ability to self-regulate, thereby creating an even bigger problem.

A 1996 survey of 9- and 10-year-old girls found 40 percent were already on diets. Whether parentally initiated or self-imposed, that seems wrong. Diets are rarely a lasting solution for weight problems anyway. The more effective approach? Instilling healthy eating habits for life. Which brings up a final point: Don't single your overweight child out for "special treatment" while letting the rest of your kids (and your spouse) lie around and eat whatever they like. Commit to familywide nutrition and activity standards, and you'll all stand to benefit in the long term.

You're Not the Boss of Me
It is not a parent's job to control how much food a child eats in a sitting, but to determine how well he or she eats overall. Most children don't respond well to nagging and bossing. Instead of being a dictator, try being a coach. Coach your child toward the goal of good health by guiding the areas you should be responsible for.

Start with these four tips:

1) Learn how to prepare healthy foods and aim to serve at least two organized and predictable meals at home every day (send a healthy lunch to school). Young kids love routines; it makes them feel secure. Regular meals can help kids self-regulate their eating. The structure of regular meal times can also help parents guide kids toward better eating habits.

Need more reason? According to a White House report by the Council of Economic Advisors, teens who eat dinner with their parents five times a week are less likely to drink, smoke, use drugs or be involved with violence or early sexual activity. Kids who eat with their parents also have a lower incidence of suicide attempts and better grades.

2) Make a list, with the help of your child, of appropriate snacks. Snacks high in sugar, salt, fat – or a combination of these – are designed to stimulate the appetite. Many processed snack foods are actually engineered to be addictive (artificial flavors and flavor enhancers like monosodium glutamate often have a hand in creating that "can't eat just one" phenomenon). As a result, these kinds of snacks will be very difficult for a child to self-regulate.

If your children have unlimited access to snacks and drinks made with high fructose corn syrup, more than 400 mg of sodium per serving and more than 5 grams of fat per portion, you may be serving them foods that are simply irresistible. Help them out by preplanning wholesome snacks, and then get yourself out of the role of being the "food police." When your child is old enough to understand, explain the difference between whole and processed foods and help him or her see how junk-food marketing and advertising are designed to brainwash them into making bad choices. While it may not turn them off potato chips and sodas entirely, most kids appreciate knowing the truth, and that awareness will stick with them as they get older.

3) Serve your child at least five fruits and vegetables daily. This increases the chances your child will learn to like vegetables. Let your child help decide what vegetables to serve and ask everyone at the table to start abiding by the "One Bite Rule."The One Bite Rule means everyone tries a taste of every food served. They don't have to eat it, just try it. This makes it safe for kids to try new foods and fulfills your responsibility to offer a balanced menu. Research shows kids do eventually warm to new foods (and even learn to like veggies) if you keep offering them. Also, if your kids are getting enough good nutrition, their bodies will be better able to cope with the onslaught of less wholesome foods they're bound to ingest when left to their own devices.

4) Limit screen time to two hours per day. Too much TV and video gaming leads to a sedentary and unsatisfying life – one that promotes weight gain. The more time kids spend watching TV or other media the less time they'll spend in motion (and, studies show, the more likely they are to report feeling "less content" overall).

Do your kids a favor: Limit TV and get them moving. Help them develop athletic and creative interests. Show them how to enjoy the outdoors, reading and self-made entertainments. They will be far happier and healthier for it.

Toward a Lighter, Brighter Future
The one good thing about the obesity crisis is that it clearly indicates that something has gone very wrong with our food supply, our children's health, and how – as a nation – we think of food and children.

In the past decade, as I raised my own children, I have seen and had to navigate a food supply that has been altered dramatically since I was a child. Our shelves are filled with empty-calorie food – products that in many cases are falsely marketed to parents as being nutritious. Words like "lite," "fat-free," "contains real fruit," "wholesome" and "all natural" are often totally misleading. They have become the sheep's clothing that disguises a great many chemically laden, nutrient-devoid wolves.

I am convinced, and many experts agree, that this new food environment plays a huge role in the childhood obesity epidemic. The change in our food supply and family food traditions may also explain why some young people feel disconnected from their community. A YMCA parent and teen survey found that the top concern among teenagers was not having enough time together with their parents!

For centuries, human beings have gathered together to share food, whether it was around an open fire or a family table. Today, this is more the exception than the rule. The introduction of the microwave and other conveniences make it possible to eat in isolation at any time. The changes brought about by the prevalence of two-parent working families have made it harder to eat relaxed family meals together. And the TV has obliterated many opportunities for intimate family activity and interaction.

But we can change this. In a professional journal called Family Networker Magazine, one psychotherapist describes how she assigns the eating of family meals together as homework for her clients. She sees it as a strategy for helping families reconnect. That's the kind of a homework most of us could benefit from, and in my own practice, I frequently offer similar assignments. I ask families to rethink what they know about losing weight and to evaluate what food means in their family. I suggest to parents that being more thoughtful about what and when they feed their children will not only help them reach a weight that is appropriate for their age and height, it will also strengthen their relationships.

By creating a health-conscious home environment and instilling healthy family eating habits, you can help your children feel not just more physically fit and healthy, but more secure and confident, more loved and cared for. You can use the power of food to help your children and your family be the very best they can be. And you can start with your very next meal.

Serve Real Food
If you want to help your children eat well and be healthy, fill their plates with real food! Learn to prepare it and teach your kids how, too.

"Real food" is minimally processed food that still carries most of the nutrients it was grown with and that is not loaded with salt, sugar, fat or chemical additives. Daily (or as close to daily as you possibly can) offer your child the servings suggested below. These are the minimum portions most children need to be well nourished. To satisfy hunger and calorie needs, offer extra servings from the fruit, vegetable and grain/starch groups, both at meals and for snacks.

Eileen Behan is a registered dietician with 25 years of experience. A member of the American Dietetic Association and the mother of two, she is the author of the book Fit Kids: Raising Physically and Emotionally Strong Kids With Real Food (Pocket Books, 2001) as well as five other books on nutrition.

The Five Food Groups
Fruits/Vegetables
Two servings of fresh, frozen, canned or dried fruit and one serving of real juice, such as pineapple, grapefruit or orange juice. Labels should indicate the fruit contains some fiber and has no added sugar. Fresh fruits are best.

Three servings of any type of vegetable, the more varied the color the better. Serve fried vegetables no more than once per week (if at all). Start with small portions: one tablespoon for each year of age.

Grains/Starch
One to two servings at every meal or snack. A serving is a slice of bread, 1/2 cup rice or noodles or a small homemade muffin or a bowl of cereal. Read labels and look for bread, cereal, rice, crackers or other starches that carry 1 to 3 grams of fiber per serving and less than 4 grams of fat. Look for cereals that have less than 10 grams of sugar per serving. Seek out whole grains whenever possible.

Protein
Two small servings every day such as lean meat, fish, poultry, beans, peanut butter or eggs. Baked, broiled or boiled are best.

Calcium
Two to three servings on most days. The Nutrition Facts Labels on good choices (such as milk and yogurt) will list 300 mg (or 30 percent) calcium for each cup. Fortified soy milk, fortified juice and raw almonds can also be good sources of calcium. Cheese is another good source but tends to be higher in fat and sodium.

Fat and Oils
Don't eliminate butter and margarine (but if you use margarine choose soft-tub products low in trans-fats). And don't totally cut out oils, salad dressings or mayonnaise. Not only do fats offer flavor and satisfaction, kids need the essential fatty acids these foods contain, and a certain amount of fat is necessary for the body's absorption of fat-soluble vitamins (e.g., A, D, E and K). However, you shouldn't serve fats in big gobs either. When cooking, use plant-based oils such as olive oil instead of butter or lard. Avoid hydrogenated and partially hydrogenated fats whenever possible.

Hold On Loosely
Effective parenting requires guiding your child toward healthy food choices and ensuring they get adequate nutrition. This is not the same thing as controlling everything your child eats.

Here are some pointers

• Serve a wide variety of food (see "Serve Real Food" above).
• Know how much your child needs to eat from each food group.
• Ask your child to try a bite of each new food but allow her to choose her portion sizes.
• Don't critique eating habits at the table. It will only ruin mealtime.
• Don't obsess about your kids' weight. Make optimal health – not appearance – the goal, and don't keep a scale in the family bathroom.
• Be a role model. If you eat healthily, exercise regularly, maintain a balanced life and a healthy body image, your kid is much more likely to follow suit.
• Remember, food is a powerful tool. Used correctly, it can have positive effects on your child's physical and emotional health. Ignored or handled poorly, it can do lasting damage.

Exercise: Make It Fun
Looking for a meaningful way to connect with your kid? Would you like to help your child raise her self-esteem, or perhaps find a quick fix for your teen's black moods? It's easy: Take them out for a hike, swim, walk, bike ride – or whatever activity you can think of that raises the heart rate and creates a little sweat. Remember that kids are motivated 100 percent by fun; they will not exercise because "it is good for them." Encourage nonperformance sports such as walking, hiking and swimming, and be sensitive – an overweight child may tire more quickly and need frequent rests.

Exercise Do's and Don'ts
Do's

• Do make it fun and lively.
• Do reduce sedentary activities in favor of active ones.
• Do take a family walk on weekends and before or after dinner.
• Do keep active toys and sports equipment (balls, bats,Frisbees, jump ropes)around.
• Do volunteer to coach or assist in team sports.
• Do spend time outside with your kids (vs. just "sending them out to play").

Don'ts

• Don't compete with your child (no matter how friendly you think it is).
• Don't become obsessed with exercise(yours or your kids'): too much of a good thing can cause resistance, backlash and other serious problems.
• Don't compare your child's size, shape or athletic ability to other kids'.
• Don't use exercise as punishment.
• Don't perpetuate the "no pain, no gain" fallacy.

Weighty Concerns
The overweight child is more likely to be at risk for weight-related health problems, including high cholesterol, high blood pressure, diabetes, and sleep and breathing disorders. Also, some kids have trouble with bone development because of excess weight. The problem parents worry most about, however, is the social consequences of obesity. As early as age 6, kids associate obesity with the characteristics of being lazy and sloppy. An overweight child may be seen by his peers to be less desirable as a friend. Overweight kids are often perceived as being older, and adults may unfairly place greater expectations on them for mature behavior. Surveys show that young people applying to elite schools have a lower acceptance rate if they are overweight, even when qualified.