Childhood Obesity- What can I do as a parent?

Obesity- the ever-growing problem in America, but children too?

While most of the population is familiar with adult obesity, it is often unrecognized the amount of children who are classified as obese. According to McCormack and Meendering (2016), “31.8% of youth in the United States aged 2 to 19 years are overweight or obese (and nearly 17% are obese), a recent meta-analysis indicates that odds of obesity among rural youth are 26% higher than for urban youth. Why?

The research from the studies analyzed by McCormack and Meendering (2016) indicated that rural youth often consumed more calories, 2-3 cups of dairy, and less than 2 cups of fruit each day. The study also indicated that urban youth tend to consume more vegetables than rural youth. From the many surveys analyzed on if children were meeting the physical activity recommendations, the majority indicated that rural children were more frequently meeting the activity recommendation when compared to urban and suburban children. While the results conflict, it is likely that rural children still have a higher percentage of obesity due to the composition of the diet.





Overweight and obesity are defined using growth charts produced by the Center for Disease Control and Prevention. The charts noted to the left and right- however there will be different charts for stature-weight for age and BMI based on gender and age of the child.




As a parent learning your child is obese can be heartbreaking, but how do you handle that situation properly? Should you allow the child to continue to “grow into their weight” or should interventions be made? While these two choices seem to be polar opposites, they can also work together to form a positive solution for a child or teenager. By making overall healthier choices in the household and at school, continued growth will help balance out the child’s weight/body mass index.

The most difficult situation is when your child approaches you with “I’m fat!” What is the best way to handle that situation? The Academy of Nutrition and Dietetics, specifically Denny (2014), released 6 tips on how to handle this situation.

1. Don’t Talk, Do Something- this means don’t just talk to the child about weight problems, begin making lifestyle changes as a family.
2. Don’t Play the Blame Game- the worse children feel about their weight or are bribed into losing weight the more likely they are to develop an eating disorder
3. A United Front- have the whole family on board to make changes and be a support system.
4. Talk with Your Health Care Provider- they can help provide ideas on how to make these positive changes and assess your child’s weight.
5. Seek Advice- registered dietitians who specialize in pediatric weight management are a great resource
6. Focus On the Big Picture- the key is health, not weight. 

Exercise can also be a crucial area, as mentioned above, to maintaining a regular weight. Schools and communities across the country are working together to provide fun, safe environments for children to play/exercise. Many schools are also providing recess or physical education classes to help meet exercise recommendations. By making physical activity fun, children are more likely to participate and want to join in.

In some cases getting children on board to make diet and exercise changes can be difficult because of the many other external influences they face between school and other activities. Peers, school systems, and even after-school care facilities may not always abide by specific nutrition guidelines or recommendations. In some situations, students are able to get additional portions of food after the initial meal. As a parent it can be difficult to work around games, homework, and other busy schedules, but there are many resources available to make it easier.

The US Department of Agriculture (USDA) previously created the MyPyramid guidelines that showed how many servings of each food group we needed per day. Around 2011 the USDA announced a change in the pyramid to a plate. MyPlate shows visually how much of each food group should be included each meal. The plate is divided into four sections: grains, fruits, vegetables, and protein. The key goals to focus on through MyPlate are: “Make half your plate fruits and vegetables. Focus on whole fruits. Vary your veggies. Make half your grains whole grains. Move to low-fat and fat-free dairy. Vary your protein routine. Eat and drink the right amount for you (USDA, 2016).”

The website for MyPlate is www.choosemyplate.gov. Aside from nutritional information, the website also provides resources on physical activity and dining out. MyPlate Super Tracker is an option to enter the foods consumed and amounts to track your normal caloric intake throughout the day. This can help when planning meals and trying to make healthier choices. For national nutrition month (March), the USDA introduced a new addition to the website. MyPlate Challenges allows friendly competition to encourage healthier choices and physical activity. While this enhancement only runs through March, it can easier be continued outside of the website. There are also many other helpful aps and websites to check out (MyFitness Pal, FitBit, and the Academy of Nutrition and Dietetics just to name a few).

To wrap up all this information into one sentence would be impossible, however there are some key messages to take away if you are a parent or plan on becoming a parent in the future. Families set the pace for healthy lifestyles and children model behaviors after what they see. Set a good example with healthy food choices and do physical activity as a family, like kickball. More than likely the child will grow into their weight, but it never hurts to eat a well-rounded diet. There is an abundance of resources available through healthcare providers, dietitians, and the internet (just make sure it’s a reliable source!) to help you throughout this journey.


Resources:

Denny, S. (2014, January 6). How to Talk to Kids about Weight and Obesity. Retrieved from http://www.eatright.org/resource/health/weight-loss/overweight-and-obesity/how-to-talk-to-kids-about-weight-and-obesity 

Hoelscher, D. M., Kirk, S., Ritchie, L., & Cunningham-Sabo, L. (2013). Position of the Academy of Nutrition and Dietetics: Interventions for the Prevention and Treatment of Pediatric Overweight and Obesity. Journal of the Academy of Nutrition and Dietetics, 113(10), 1375-1394. 

Mccormack, L. A., & Meendering, J. (2016). Diet and Physical Activity in Rural vs Urban Children and Adolescents in the United States: A Narrative Review. Journal of the Academy of Nutrition and Dietetics, 116(3), 467-480. 

Back to Where it All Began...

In case you didn’t know, March is celebrated as National Nutrition Month. Dietitians are known as the “nutrition experts” and are celebrated the second Wednesday of the month on National Registered Dietitian Nutritionist Day. Because National RDN day falls on today (March 9, 2016), I wanted to take you back to where it all began…

Nutrition has been studied and experimented with since approximately 2500 B.C. The very first known dietary prescription was the avoidance of onions. As time progressed, nutritional deficiencies were discovered, such as scurvy and beriberi, as well as the nutrition therapies that could be used to cure them. The field of dietetics was established in the medical profession in the mid-19^th century, with the occupation of dietitians being established in 1897.  

 Dietitians in the food-service setting of a hospital

The American Dietetic Association, which officially changed its name to the Academy of Nutrition and Dietetics in January 2012, stemmed from an unfortunate cancellation of the annual American Home Economics Association meeting, which was cancelled in 1917, due to World War I obligations. Due to the entrepreneuric mindset of several dietitians, they decided to hold their own meeting in October of 1917. The meeting was held in the basement of the Cleveland Hospital in Ohio, in which nearly 100 dietitians attended and laid the groundwork for the organization that would change the dietetics field in America. The first meeting established a constitution and by-laws, inaugural leadership and determined the qualifications for membership. This visionary group of women, led by led by Lenna F. Cooper and the organization's first president, Lulu C. Graves were about to impact the world and update the role nutrition and dietetics, as they knew it. One year later, in November 1918, World War I had ended, but the story of our beloved dietetics field was only just beginning.

Dietitians at the first American Dietetic Association Convention in October 1917 in Cleveland, OH

In 1919, a publication was produced by the ADA, outlining the roles and responsibilities of dietitians. This statement was sent to the American Hospital Association, the American Medical Association, hospital managers, and training schools with dietetics programs informing healthcare members of the up and coming roles that dietitians were needed and determined to play in the role of the healthcare team.

On October 24, 1940, an authorized seal for the organization was adopted by the Executive Board and presented to members. The seal contained three symbols which represent the characteristics of the profession: a balance scale, representing science as the foundation and symbolizing equality; a caduceus, representing the close relationship between dietetics and medicine; and a cooking vessel, representing cookery and food preparation. Around the main design is a shaft of wheat, representing bread, the staff of life, and stylized acanthus leaves, representing growth and life. Over the design is a cornucopia, representing an abundant food supply. Beneath the design is the motto, Quam Plurimis Prodesse ("To benefit as many as possible"). Around the edge is the name of the organization and the date of its founding written in Roman numerals.

When the name was changed to the Academy of Nutrition and Dietetics in 2012, a new seal was also adopted to coincide with the evolving changes made to the organization and profession. According to the Academy, “the new name complements the focus of the organization to improve the nutritional well-being of the public, while communicating the academic expertise of Academy members and supporting the organization's history as a food and science-based profession. The Academy of Nutrition and Dietetics quickly and accurately communicates our identity—who we are and what we do. The field of nutrition has changed over this century, and we're evolving to meet these needs.”

The new seal was used on stationery and all official publications, and copy of the seal was embroidered on linen by Beula Marble, president of ADA (1939-1940), and presented to the headquarters office in Chicago, where it remains today. The seal is still in use on Registration Status Certificates for both registered dietitians and dietetic technicians, registered, as well as on the gold Member Pin.

Today, the field of dietetics ranges from clinical dietitians, to community dietitians, food-service managers, corporate wellness dietitians, private practice and everything in between. The possibilities within this field are practically endless. Dietetics is a field that never accepts complacency from its members. With food trends on the rise, physical assessments being incorporated into practice, medical advances being made and research to be done, dietitians are required to constantly be on their toes and learning more, doing more. 

With the Academy approaching its centennial year, much has evolved over the years, but our purpose remains the same- “to benefit as many as possible.” As time goes on and science advances, we are able to learn and study areas of nutrition that were not even known to exist when the ADA began in 1917. Through the vision of our founding members, their strife to be seen as crucial members of the healthcare team, in correlation with continued practice and the determination of our members today, the field of dietetics is determined to be successful. To train up a generation of passionate professionals whose goal is to work alongside the government to make healthcare not only more affordable, but to prevent diseases that can be avoidable through nutrition and diet education and awareness.  

Thank you to all the RDN’s who work to make our world a healthier place!

 

Shelby Pierceall, UCA Dietetic Intern

Resources: 

The Academy Website- http://www.eatrightpro.org/resources/about-us/academy-vision-and-mission/academy-history

"The First Fifty: A Pictorial History of the Academy of Nutrition and Dietetics, 1917-1967." The Academy of Nutrition and Dietetics. 2015. 

Sodium {unlike Na-thing else}

 

Sodium seems to be a hot topic lately for many Americans. With the increase in amount of consumers with hypertension, now up to 70 million Americans, low sodium diets are being pushed by many healthcare professionals. Now that people are beginning to realize how much a small amount of sodium affects the body, people are becoming more aware of the amounts they put in their own foods. You may find it alarming to realize that consuming ¼ teaspoon of table salt provides 600 mg of sodium--this is almost ⅓ of the daily sodium allowance for a 2 gram sodium diet! By decreasing sodium intake to 2-2.4 grams per day, most people will see improvements in the blood pressure due to the large amounts of sodium that we are currently exposed to.

 

Good to know….

Aside from eating a diet filled with nutrient-rich plant foods, you might consider current research findings for lowering blood pressure. As summarized in the journal article, studies are still continuing on whether there may be other things helpful in lowering blood pressure:

Potassium- shown to counteract the effects of sodium in some short-term trials; the results are not conclusive, but potassium should still be considered when combined with other elements in the diet.

Dietary magnesium- shows some ability to reduce blood vessel constriction.

Nitrates- converts to nitric oxide in the body and can improve endothelial function, promote vasodilation, and reduce blood pressure even in relatively small amounts in a healthy diet.

Flavonoids-- a variety of different flavonoids seem to improve endothelial function, increasing nitric oxide production and vasodilation, and inhibiting blood vessel constriction.

 

Tell me about blood pressure:

 

Blood pressure measures the force pushing outwards on your arterial walls.

Systolic: The top number, which is also the higher of the two numbers, measures the pressure in the arteries when the heart beats (when the heart muscle contracts).

Diastolic: The bottom number, which is also the lower of the two numbers, measures the pressure in the arteries between heartbeats (when the heart muscle is resting beats and refilling with blood.

 

Blood Pressure Category	Systolic mm Hg (upper #)		Diastolic mm Hg (lower #)
Normal	less than 120	and	less than 80
Prehypertension	120 – 139	or	80 – 89
High Blood Pressure (Hypertension) Stage 1	140 – 159	or	90 – 99
High Blood Pressure (Hypertension) Stage 2	160 or higher	or	100 or higher
Hypertensive Crisis (Emergency care needed)	Higher than 180	or	Higher than 110

Source: American Heart Association

 

Who may be affected by high blood pressure:

 

Age	Men (%)	Women (%)
20-34	11.1	6.8
35-44	25.1	19.0
45-54	37.1	35.2
55-64	54.0	53.3
65-74	64.0	69.3
75 and older	66.7	78.5
All	34.1	32.7

Source: Center for Disease Control and Prevention

 

 

 

When it comes to making your plan to conquer hypertension,  be sure to focus on the foods that you can have...instead of harping on the foods you can NOT have. Food and nutrition should be a positive experience, even when working with a nutrition related disease or condition.

Blood pressure savers:

Dark green leafy vegetables--spinach, Swiss chard, arugula, etc. {rich in potassium, magnesium, nitrates, and flavonoids}

Nuts and seeds {rich in potassium, magnesium, polyphenols}

Berries {sources of the flavonoid anthocyanin, and vitamin C}

Winter squash, sweet potatoes, tomatoes, bananas, citrus fruit, fresh or dried apricot, and raisins {rich in potassium}

Legumes {rich in potassium and magnesium}

 

Blood pressure assistants:

Cocoa and chocolate {provide potassium and magnesium, rich in polyphenols-flavanols}

Green and black tea {boost of flavonols}

 

DASH Diet:

Great for promoting eating a variety of foods in order to help lower blood pressure.

 

I would encourage you to keep track of your sodium intake to see just how much you are getting from your diet. You might be surprised by all of the hidden sodium in some of your favorite foods! If you do have hypertension, I would highly encourage you to meet with your healthcare professional to discuss changes in your diet or medications.

 

Main Article:

Collins, K. (2016). Power on the plate. The Journal of the Academy of Nutrition and Dietetics, 116(3), 15-18.