Hannah had a mocha coconut frappuccino for breakfast; a pepperoni pizza, French fries and a soda for lunch; an Oreo blizzard for an after-school snack — and then a small bag of potato chips and a half a box of chocolate chip cookies; and her mom’s best fried chicken and mashed potatoes for dinner. (She didn’t eat the green beans or the salad.) She had a bowl of frosted cereal for a late-night snack.
Hannah, age 15, has a BMI in the 96th percentile.
“If you don’t feel guilty prohibiting your child from smoking, you should not feel guilty about limiting food intake, governing food choices and encouraging activity in order to guide your child toward more healthful habits.”
BMI is the body mass index, which is weight in kilograms (km) divided by height in meters squared (m2). Because children are growing, the BMI is compared to other children the same age and gender (that is, which percentile they are in), unlike adults, where a fixed number is used for comparison.
Catherine McNeal, MD, PhD, Pediatrician, offers some tips on achieving your child’s optimal BMI. BMI is generally considered a marker for future health problems.
“In our current culture, it’s very hard to lose weight, and it’s particularly hard for a child to lose weight. But it’s important, as weight tracks the best of any risk factor in childhood. If you’re overweight or obese as a child, you’re much more likely to be overweight or obese as an adult,” cautions Dr. McNeal.
To work on lowering your child’s BMI, it helps know how he or she may have gained excessive weight in the first place.
Reasons for Pediatric Overweight & Obesity
Sugared beverages. “One of the top factors leading to the rise in obesity rates is the increase in marketing sugared beverages,” says Dr. McNeal.
The biggest offenders are:
- Fruit drinks and juices
- Sports drinks
Start with infants and toddlers. “Babies don’t need sugared beverages in their sippy cups and bottles. They need milk or water,” says Dr. McNeal.
“In my office,” Dr. McNeal says, “I’ll show a parent and their child how much sugar is in a bottle of regular soda and they are astonished. They may say, ‘My child doesn’t drink soda; she drinks juice.’ Then I’ll show her a picture of the juice — which has the same amount of sugar as the soda.”
All that sugar is just empty calories, providing little or no health benefit.
Eating out. When we choose to eat out or bring take-out food home, we very often take in double or triple the calories than when we eat food made at home, says Dr. McNeal.
“Even menu items labeled as “Snack Wraps” are 350 calories, which is meal size. Combine that with a soda and French fries and you can easily have a 1000-calorie meal. That’s the amount of calories many children need for an entire day,” explains Dr. McNeal.
“Also, kids’ portion sizes are more like adult portion sizes these days, both at home and eating out. I see kids who are in grade school eating the same size portions that their parents do, but they don’t need as many calories as an adult,” notes Dr. McNeal.
Not eating breakfast. “Breaking the fast [fast means not eating while you’re sleeping] is very important to your body metabolically,” Dr. McNeal says.
“If children go without food for a prolonged length of time, their bodies tune down the metabolism a little bit, and it becomes harder for them to lose weight. Plus, they’re hungrier when they do eat,” Dr. McNeal explains, “so they consume more calories than when they eat the normal three meals and one or two small snacks per day.”
Less activity. “Many children are less active than they were even a decade ago. Parents don’t want their kids to walk to school any more. Schools offer less PE and recess time. Children have less after-school play time and more screen time,” says Dr. McNeal. Many children don’t burn off the number of calories they take in.
Solution: Be a Good Role Model
“I encourage parents to model healthful behaviors for their children. And since children don’t have the buying power, parents can very effectively control access to food in the house as well as outside the home,” Dr. McNeal says.
Parents often feel guilty when restricting their children’s access to food. But that same parent would have no qualms about prohibiting smoking, Dr. McNeal says.
“You’d never let your eight- or nine-year-old smoke. Studies show that pediatric overweight and obesity are greater risk factors for developing cholesterol buildup in the arteries than smoking at that age,” Dr. McNeal says. Obviously, smoking is a bad habit, but poor nutrition in childhood can be equally devastating.
“If you don’t feel guilty prohibiting your child from smoking, you should not feel guilty about limiting food intake, governing food choices and encouraging activity in order to guide your child toward healthier habits,” Dr. McNeal says.
Just as you teach your children not to lie, cheat or steal, teach them how to be healthy over their lifetimes, Dr. McNeal encourages.
The solution is straightforward:
- Start with small changes
- Provide healthful foods and beverages in age-appropriate portions
- Even if your child doesn’t seem to like a fruit or vegetable one time, keep trying to introduce more fruits and vegetables in different and creative ways
- Encourage your child to be active at least an hour a day; a child dirty and sweaty from playing is a healthier child
- Be the role model for healthful behavior
“Your child may try to nag you or manipulate you,” Dr. McNeal cautions, “to get the fast-food or the soda she wants or to watch TV rather than go out and play. That’s why it’s hugely important for you to model healthful behaviors at home.”
And make sure Hannah comes in tired from playing before dinner. She may want to eat those green beans and the salad. And she may even learn to like them some day!