According to the Los Angeles County Department of Public Health, the ongoing epidemic of childhood obesity is both a national and local crisis. Nationally, obesity rates among children have tripled since the 1970s; in Los Angeles County more than one in five students in the fifth, seventh, and ninth grades are now obese. A study published on January 30 in The New England Journal of Medicine addressed the childhood obesity epidemic and noted that if a child was overweight in kindergarten, he or she was likely to become obese by the fifth to eighth grade.
Parents of children who are on the slippery slope towards obesity need guidance on how to combat the problem. Fortunately, experts are available. One such expert is Natalie Digate Muth, MD, MPH, RD, FAAP. Dr. Muth, national spokesperson for the American Council on exercise (ACE), is both a board-certified pediatrician and registered dietitian; she is a true warrior in the fight against childhood obesity. I consulted with Dr. Muth to obtain the latest information regarding childhood obesity.
Dr, Muth noted that the January 30 publication in The New England Journal of Medicine and the subsequent media attention that has followed in its wake is a screaming wakeup call to parents, pediatricians, preschool teachers, daycares, policymakers, and child advocates. For many children, by the time they start school it is already too late. We need early intervention, and we need it now.
So what should we do? First off, pediatricians need to step up. The typical child will see a pediatrician at least 13 times before he has his fifth birthday. At every well child visit, starting from the newborn visit, the pediatrician and parent should have a conversation about the child’s growth, including where the child falls on the growth chart in weight-for-length for children under two years old and body mass index for those older than age two. If the child’s weight is elevated, pediatricians need to have the courage and the skills to have the conversation. It is never too early. If a pediatrician doesn’t bring it up, the parents should.
Secondly, and most importantly, parents and other caretakers need to develop knowledge and skills in how to go about feeding kids. They need to:
- Make sure that healthy foods are readily available and that unhealthy foods are not. A hungry child will eat.
- Resist the temptation to force kids to eat their vegetables. This just makes kids like the nutrient powerhouses less.
- Disband the “clean plate club” once and for all. Forcing a child to clean his plate just teaches him to not listen to his body’s signal of hunger and fullness.
- Stop preparing separate meals for picky kids! The breaded chicken, macaroni and cheese, and cheese pizza are not healthy for the child and this catering to picky eaters just makes it even less likely a child will ever come around to enjoying healthy, balanced meals.
- Avoid food rewards for good behavior, such as for eating vegetables (see #2) or being brave when getting shots at the doctor’s office.
- Continue to introduce previously rejected foods. It can take 15-20 times for a child to accept a previously disliked food. With repeated exposures, the child will come around
- Allow an unhealthy snack every now and then. Restriction just makes the junk food more appealing.
- Create opportunities for kids to get outside and be physically active at least 60 minutes every day
- Make healthy foods taste good. After all, taste is the number one predictor of whether a child will eat a food.
- Model healthy eating and physical activity
Dr. Muth notes that, ultimately, the eating patterns of young children are heavily influenced by the food environment at home, in daycare, and in preschools. Unlike a teenager who can easily consume foods outside the purview of a parent, a young child is mostly at the mercy of what foods a parent and other caretakers make available and how these adults influence what a child eats.
About Dr. Muth
Dr. Muth practices pediatrics in Vista California. She was an undergraduate at UCLA, earned a Master in Public Health (MPH) at the University of North Carolina, and subsequently attained her medical degree at the University of North Carolina. She then returned to UCLA for specialty training in pediatrics.
Her public service activities include:
- Girls on the Run of the Triangle, Durham, NC
- Board of Directors, 2006-2007
- Grants Committee Chair, secured grants totaling more than $30,000, 2006-2007
- Head Coach, 2004-2006
- IMPACT (Improving Meals and Physical Activity in Children and Teens)
- Hillsborough, NC, Co-creator and program leader, designed and implemented a 12-week school-based nutrition and physical activity program for fourth graders and teens
- The “Teddy Fund”, the San Diego Foundation, San Diego, CA
- Started the donor-advised fund to support programs which aim to improve the health and well-being of babies, kids, and teens
- “Little Chef Cooking School”, Venice, CA
- Developed and implemented an obesity prevention program in which low-income Hispanic 6-10-year-old children and their parents learn to cook together and eliminate mealtime food battles