How to Raise Healthy, Happy Kids

Childhood obesity's effect on our next generation

A Q&A with Dr. Kari Hegeman, pediatrican at Dean Pediatrics West

Q: Since you started in the field, what changes have you noticed in children’s weight trends and their daily diets?
A:
Over the past ten years I’ve seen a decrease in trans fats; an increase in whole grains, organic and local foods; and a lot of processed and convenience-style foods—instead of plain Kraft macaroni and cheese it will have organic noodles or hot dogs will be nitrate-free. So what I see are some fad-types of changes [by the food industry] but a persistence of convenience and processed foods. Judging by weight and body mass index para-meters it’s obvious obesity and overweight kids continue to be a big problem.

Q: What are the current guidelines for diet and exercise for children?
A:
According to the American Academy of Pediatrics:
• Eat five servings of fruit and veggies a day.
• Get at least one hour of physical activity per day.
• Limit screen time to less than two hours per day.
• Limit sugar-sweetened beverages.
• Eat breakfast daily.
• Switch to eating low-fat dairy and increase calcium intake.
• Increase intake of fiber and whole grains.
• Eat family meals.
• Breastfeed children during their first six months of life.

Q: What are the most common concerns that parents come in to see you about with their child’s diet and weight issues?
A:
It’s very rare for a parent to come in and say, “I’m concerned about my child’s weight.” We’re not there yet, because parents worry about making their kids feel bad. We usually have to point it out, based on their BMI. Out of ten kids, I see two to three kids that are overweight. I think with Michelle Obama’s Let’s Move! campaign, obesity is losing its stigma and parents are starting to come back in for visits on weight management.

Q: What are common misperceptions that you see in the field of nutrition and exercise for kids?
A:
I think there’s a misperception that macaroni and cheese is a complete source of nutrition as long as it’s organic and whole grain. Those are buzzwords used in labeling.

I hear a lot, “He or she is in sports”—because [a child] is actively involved in organized sports they can’t possibly have a weight issue. It helps to be involved in sports, but it’s harmful to be over-scheduled. [A child] shouldn’t be eating at 9 p.m from McDonald’s because they had practice. Nutrition and exercise should be part of a child’s schedule. Just like getting them to soccer practice is important, it’s important to sit together for a meal.

Parents have a hard time saying no to their kids. I think there’s a misconception that if they don’t provide what the child wants than they’re going to waste away. Although you might make your child happy in the next ten minutes,
perhaps you need to see the bigger picture that it’s not good for their health.

Q: How can parents set a good example for their kids in healthy eating habits?
A:
It’s fun for kids to get involved in [meal] planning. Just about anything homemade is good. It takes effort, but you’re being aware of what you’re putting into your body. Not everyone has the time and resources to make every meal homemade—there are single and busy parents. [But] even if it’s just breakfast you’re sitting down to together, having family meals is important enough to carve some time out even in the busiest of days. It is one of the few things that makes a difference in pediatric obesity.

Q: How do you work with kids and parents to set up a reasonable diet plan?
A:
If the patient comes in for a well exam and they are over the ninety-fifth percentile in weight we try to pinpoint what’s going on. So for a patient who came in recently we talked about her diet and exercise, and asked her and her mom where improvements could be made. I gave her a diet log and talked about those AAP standards. I suggested she pack a lunch instead of buying a school lunch. We talked meal planning and eating with the family. And we discussed anytime foods—fresh fruit and veggies— and having them readily
available, and decreasing [consumption] of sugar-sweetened beverages.

Research shows that family involvement is the best way to reduce BMI over a sustained amount of time.

Shayna Miller is associate and style editor of Madison Magazine.

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