Stephenie Wallace, Md, Child Obesity

in the United States were looking at about 17 percent are young people who are 12 to 18 are obese and the numbers have been stable for the last several years as the CDC has been monitoring them for us but we definitely in this generation are seeing great rise in that number from previous generations and that has all of us public health medical doctors very concerned about the future health health of our children. First you have to start off in knowing what if you have a problem or should there be concerned that starts with doctors, family doctors, pediatricians any practitioner that works with children and the best screening tool for that as a body mass index and the next tool is really a family medical history interview with the parents and guardians to tell us what kind of medical problems are in the family that will help us identify those who are overweight or obese and then those children who are normal weight. The second important thing to do is really just for all of the parents all the teachers anybody who work with children to be mindful of the activities that we have in our lives surrounding our children regardless of what their weight status is it's sometimes easy to forget that even our normal weight children need to have you know messages sent to them about how to have a healthy lifestyle an example here in Alabama for a while we were 6th in the nation for the state with the highest prevalence of overweight and obese 10-17 year olds and then when they turn to be adults we were number two in the nation so for me as a preventionist and a medical doctor even though we are not the highest or second highest when our kids are younger something happened and our adults become heavier some of those normal-weight kids are now becoming heavy heavier adults to help children in their battle or prevention of weight excess weight gain as you can see it it can even start in pregnancy if mothers carrying babies who have not yet been born could be mindful of the weight gain that they have when they're pregnant that can mean a lot for the young person as they're born and are going through their life, we don't quite understand the hormones and all the signals that that are developed during pregnancy that go towards childhood obesity but hopefully in coming generations we will and then with our toddlers and babies breastfeeding is always very helpful option both for maternal weight gain during pregnancy as well as a protective factor for our children when they're young we could talk about introducing foods to our toddlers definitely introducing them to a healthy variety of fruits and vegetables a big trick is start with the non sweet foods first, humans naturally have a palette for sweet items though if we start with non non-sweet fruits and vegetables then they're more likely to want to take them in in and you know keep them very active many of our young ones, even those under the age of 5 are watching more TV than what's recommended for kids exercise is really free play, so make sure you build in in their schedule just the time to run around and play things like jump rope in freeze tag it doesn't have to be expensive one of the more common ways that kids get extra calories through their diet comes through sodas but people can forget that sweet juices often can have a lot excess sugar, so more than a glass a day is probably more than enough and if you could even even go to zero for those kids who have already been identified with the excess weight problem that would be best. Moving forward in the life of a child we go to an elementary school next where back to school is a big factor schools can get a pretty bad rap when it comes to the battle against obesity and they, many school systems have done a lot to help our lunches be heathier. I know the recent study at a Pediatrics talked about those kids who eat, middle school kids eat school lunches tend to have more of an obese BMI in their rating. But there are some healthier options and I think parents can review the school lunch menu and talk about those healthy choice options. Often times the school system will identify the healthy options and you might be able to guide your young person to make the choices particularly when they're out of your sight Again I can't emphasize electronic devices as the kids get older and the tablets and the video games become more of a problem and more TV becomes a option I often will say to my parents what are your habits in terms of your diet and activities? if my young person and that I'm counseling doesn't eat a lot of fruits and vegetables I wonder which of the parents or grandparents or whoever is a significant role model in their life also doesn't eat fruits and vegetables and its hard to ask our young person to do something when you yourself aren't doing it same thing with exercise even thought their exercise may be very different than adult exercise they may be interested in playing tag and riding their bike you know even hearing about you going for a walk or running in your neighborhood will remind them that hey it's important to mommy for mommy to exercise should be important for me to also go outside and get some exercise then i get to my teenagers where I've spent a lot of time in my practice working with this can be a bit of a challenge because our teenagers spend more time outside of the guidance of our parents with their school and activities again if you brought them up with the idea of what are healthy choices where we refer to sometimes at sometimes food foods like sweets concentrated sweets, sodas candy which are okay in special occasions but shouldn't be an everyday part of our diet so discussing in their schedule you know if you've got a party with the Girl Scouts coming up and your young person wants to participate and have you know some pizza with the rest their classmates and feel like they're part of the group then perhaps let's talk about other ways in our schedule for that week where we can be a little healthier so that we feel more comfortable allowing our child and our child will feel very good about having sometimes food on a special occasion Sleep, I don't know how many times I'm counseling are young people what time you going to bed and can it be north of midnight but if it can at least be 8 hours of sleep definitely those young people who get eight to 10 hours of sleep tend have a lower weight and if there are any interruptions in sleep such as snoring, that's a good conversation to have with your pediatrician talk about things. I'm going to mention again I can't say enough about electronic devices as cell phones become a part of our teenagers lifestyle Finding another alarm clock to wake them up and removing the cell phone from their purview at night so they really do go to sleep and not constantly texting their friends friends at at night and then exercise. Unfortunately, particularly with our young women as they get to middle school their interest in athletics can wane and so becoming creative with ways that they can continue to get at least sixty minutes of exercise every day it can be a vigorous walk it can be dancing it doesn't have to be at a gym working out hard it can be a lot of family-friendly time if your teenager is watching you do it then they're more likely to want to get up and do it themselves teenagers often times the middle school high school it can be a little rough when it comes to yourself your body image and bullying even our young people who are of normal weight this can definitely be a concern. and I have to remind our parents what are we saying to ourselves about diet and our weight because our young people particularly our girls are watching what we as older women are saying about ourselves and they're picking up the clues and going to mimic us so we we adults have a strong role in prevention excess of weight gain and good body image in our children. I mentioned schools earlier talking about the community walking to school, biking to school its and novelty now, was a mainstay in going to school generations ago. If you're in a a position to do that that will be great find out what's going on in your physical education class. Some physical education classes are doing a great job at keeping our young people very busy many schools are having to focus on healthy eating healthy activity and I know the school lunchroom gets a bad rap many of our families really do depend on that for nutritious meals and I believe the schools are doing their best given some of their resources that they're having and so maximize that in discussing with your teachers and your student particularly about what choices they can make when they're at community activities, many communities particularly in the state of Alabama they're doing what they can. You can find plenty of farmers markets available usually there are a lot of people there very interested in a healthy lifestyle a lot of free activities going around the the area this time of year is great because there are a lot of family fun festivals. Plan your weekend a week ahead and figure out what's free and fun that at least get you outdoors. Go for a walk, go for a hike it doesn't have to be complicated with the gym in fact most kids would rather not be in the adult gym they'd rather be outside and playing and even if its you sitting outside watching them free play that's a winner in my book. Let me empower my parents of teenagers I know this time of year in a young person's life you feel very lost that little person that you grew up with is no longer staring in front view and they roll their eyes and they may not always be the respectful young person you were aiming for but let me tell you as a practitioner that works primarily with teenagers they really are listening they really are watching our parents are really their biggest role model and a guidance so continued ongoing conversations with our teens whether it's about healthy eating and exercise but other aspects of their lives in terms of making healthy choices for themselves sit down and have a onversation with them you would be surprised what happens when they're not around you and they really do repeat what they hear from you model what they see from you and they're listening even though they're not gonna give you that indication on the first time around