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Family Nutrition: Overweight toddlers and children: To restrict or not to restrict?

I was asked this specific question a lot in the last two weeks from clients, friends, and a physician group I work with.  We’ve all heard that our children are the first generation that will not outlive their parents.  Fifteen percent of children in the United States are considered overweight and another fifteen percent are at risk of being overweight.  There’s a lot of scary statistics out there and it's starting to cause some panic.
Here are my thoughts.  I feel strongly that it’s important to catch irregular eating, unhealthy habits, or weight gain in kids earlier than later.  When I say early I mean as early as two believe it or not. There’s a reason that pediatricians and dietitians recommend changing from whole milk to skim after the age of two, as brains no longer require the extra fat intake for development. 
If your child is in the toddler years or beyond and eats multiple servings of food, is ‘addicted’ to junk food, or there is concern of weight gain or excess weight for height,  it is time to initiate a change. Waiting can cause psychosocial issues in addition to putting your child at risk for heart disease and diabetes later in life.
To start, it’s important to take a true look at your child’s intake throughout the day. Does it seem excessive? If your child asks for more servings, is he truly hungry or is it habitual?  Are you certain your child knows what hunger or fullness feels like?  What do their meals look like? Do they eat fruits and vegetables or is his or his/her plate full of processed carbohydrates?
Once you take a good look at your child’s meal it’s time to initiate changes.  You can do this on your own or working with a dietitian.  An initial change I always recommend is to increase consumption of vegetables.  Non starchy vegetables are loaded with vitamins and minerals and are low calorie at about 25 calories for ½ cup cooked. If your child doesn’t like vegetables try a bunch until you find some he or she likes.  Make a rule that everyone at the dinner table must at least try everything on their plate.  If your child likes dipping sauces, go ahead and use that but monitor the portion size.  If you find that you’re consistently serving up quick meals that include processed foods, figure out a way to make a fresh spin off of some favorites.  There are many resources out there, to include websites and cook books. Training your child to eat can be a lot like the Ferber sleep method in my opinion.  Although it may be horrible while you are in the moment, it persistence pays off and it can be a beautiful thing.
Evidence Based Management of Child Obesity by the Department of Public Health at Oxford University includes six ideas to take into consideration with overweight or obese children.  I fully agree with all of them.
1)      Create a goal to maintain or gain appropriate growth weight slowly
2)      Teach healthy habits rather than restrict
3)      Sustain lifestyle activities
4)      Be aware that psychosocial problems have important consequences
5)      Behavioral treatments should be individually designed
6)      All treatments need to be accepted by all family member

If you are concerned about your child, start early.  The changes you initiate now will be important for the remainder of your child’s life.  Be a positive role model and help break this growing epidemic.  Have you had any experience with changing your child’s habits, diet, or lifestyle activities?  Let’s hear them. 

Breaking the cycle of childhood obesity


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