-- Winter 2005 Edition --

Obesity and Fair Lawn's Kids   By Linda Rosen, Certified Medical Exercise Specialist    “Obesity is the number one health problem facing American kids today.  I have read those words too often recently. According to the Centers for Disease Control and Prevention, currently 15 percent of American children and adolescents are overweight. “And it’s happened very fast – in just one generation” Jan Hangen, nutrition team leader at the Optimal Weight for Life Clinic at Children’s Hospital in Boston, told Lifetime Magazine. According to the Centers for Disease Control and Prevention, almost a third of mothers with overweight children are not even aware that their kids are too fat. There are tools to help. If a parent is concerned they should ask their doctor to plot the child’s body mass index on a growth chart to judge whether the overall growth pattern is normal.   The best way to help a child at risk is for the entire family to change their diet. Children as well as adults need a variety of whole grains, fruits, vegetables, calcium rich foods and lean protein. Quoting from the article in the August 2004 issue of Lifetime Magazine, “children are biologically programmed to like sweet-tasting foods, so why have them around”? As we all know, when something is labeled “forbidden” we only want to find a way to have it so don’t banish treats altogether. Explain to the kids that they’ll feel better and have more energy if they eat healthy foods most of the time.  Starting healthy eating habits early in life is important. According to Lifetime Magazine” a recent study of more than 3,000 babies and toddlers, ages 4 to 24 months, found that most caregivers stopped trying to introduce a new food to a child after just a few attempts, but it could take as many as 15 tries before the child accepts it. Perhaps that’s why 19 percent of the 4 month olds were picky eaters, while 50 percent of the 2 year olds were pushing away all but a few foods they knew they liked.” Be patient and keep offering healthy foods. They will eventually start eating it.  With all the concern over childhood obesity, parents do need to remember that it is very dangerous to put a child on a diet if he or she does not need it. It is common for kids to get a little pudgy before a growth spurt and to be hungrier. Reducing a child’s caloric intake too much can actually stunt their growth. If a parent is concerned about their child’s weight they should not rely on their own judgment, but take the child to their doctor.  Children need to move, they need physical activity. According to the National Institute on Media and the Family, a nonprofit organization in Minneapolis, computers, video games, and television take up an average of four and a half hours every day for children between 2 and 17 years old. Not only are these sedentary activities, but also kids are snacking while doing them. Less TV time and more activity is what the entire family needs.  What is Fair Lawn doing about childhood obesity?   Karen Tileston, the school nurse in Westmoreland and Lyncrest elementary schools has been a school nurse for 18 years, the past 15 in Fair Lawn.  When I asked her if she has seen a change in the size of the students since she began her career, she answered with a definitive “yes.” As Ms. Tileston says, the increase in the availability of fast food and children being more sedentary contribute to that. The national average of obese children in elementary schools is 15 percent. According to Ms. Tileston, Fair Lawn meets the average with 12-15 percent of our elementary school students being “overfed,” the preferred word to obesity. She told me that the state advocates that schools refer a child who is over the 95th percentile in weight to a health professional. There are children, as she says, that are over the 95th percentile in weight, but also in height. Those children are not referred because their height to weight ratio is proportional.   Ms. Tileston shares the concern of many concerning the lack of nutritious breakfast foods offered to children in the cereal aisles of our supermarkets. She offers suggestions on healthy breakfasts to the parents, as do the kindergarten and first grade teachers concerning snacks. The teachers speak to the parents at “Back to School Night” and often send notes home with suggestions for nutritious snacks that can be sent to school as well as eaten at home.   Ms. Tileston has met with school principals and the Food Services Coordinator to change some of the lunch offerings in the elementary schools in order to make them more nutritious. There also have been changes made to the dessert offerings. Lunches are cooked in the middle schools and high school kitchens and delivered to the elementary schools on a daily basis. In addition, the school nurses and physical education teachers have been working with the PTOs and PTAs in town to develop ways to encourage better nutrition and increase activity.   Healthy lifestyle and good eating habits must start when children are very young. I spoke with Rona Klein, director of the pre-school at the Fair Lawn Jewish Center. Mrs. Klein has 25 years experience in pre-school as a teacher and director. She has seen changes in lifestyle and the size of children over the years. “For the most part our children are pretty trim, but I have had obese students in the past,” she says.  Mrs. Klein agrees that unfortunately children are much more sedentary today. When the pre-school teachers ask the children what they did over the weekend or on vacation the typical answer is, “I played video games,” or, “I watched television.” Mrs. Klein claims that regardless of what the parents did with them, what stays in the children’s minds is the video game. In addition she told me that parents use video games as a reward or punishment so that these activities become primary in the child’s life. This sedentary lifestyle is a sign of the times. Children don’t play outside by themselves anymore. Parents are much more cautious today. It is easier for parents to have their children in front of the television. It is safer.  I asked Mrs. Klein what changes she sees in the pre-school to combat the obesity epidemic. “Snack time has changed over the years,” she said. “Cookies and crackers are not the norm anymore. The school used to give packaged snacks full of hydrogenated oils, trans fats, high in simple carbs.” She believes it was easier that way. Teachers could not afford to take the time away from the children to cut up fruit and vegetables or prepare healthy snacks on a daily basis. Now some of her classes have the parents providing the healthier snacks. They take turns bringing in more nutritious snacks. And for the classes where the parents do not provide snacks for the entire class she sends home a suggested list of snacks for the children to bring in individually. Animal crackers and graham crackers are given as dessert with the school lunches. These are low in fat and the children like them. As Mrs. Klein says, “They’re entitled to some sugar. The worst thing you can do is to omit all sweets. They will find a way to get them. We want the children to learn limits, to know that everything is OK if you eat it in moderation.”   Dr. Rona Riegelhaupt, a pediatrician in Fair Lawn for 16 years, told me that “clearly a good number of children are overweight,” and that doctors are “more aware of detecting it early thanks to the new growth charts that came out in 2001.” As mentioned in the first paragraph, these allow the doctors to plot the Body Mass Index (height to weight ratio) of a child so that they can see if a child is overweight at a younger age. Teaching parents and kids to make better food choices for a healthier lifestyle is very important to Dr. Riegelhaupt. “I try so hard as a doctor to give positive reinforcement and to tell parents to look for small changes,” she said. “Anything positive is very important. Less of a weight gain this year than the year before is a good sign.” She added, “The BMI charts allow me to show the kids conclusively what effects they’ve had on their BMI over the course of a year.”   When I asked Dr. Riegelhaupt if she thinks parenting today is different than in the past she answered, “parents today don’t want to exert as much ‘NO’ power.” They don’t like to say, “No, you can’t have this or that.” But, she added that if you say “no” too much, the children would sneak the junk food. She adds, “It’s hard for parents today. No one is to blame. Everything is supersized, portion sizes are unbelievable.” There is an overall lack of knowledge about portion size and there are many pressures outside the family that contribute to the obesity problem. We discussed how years ago children weren’t going to as many birthday parties as they are today. Now they have them every weekend with cake, cookies and pizza. She believes parents need to make good food choices when the children are very young and be conscious of what they keep in the house. In her practice she tries to help them through education and reinforcing positive changes. She’ll ask a child what he ate for lunch, and if it was nutritious she’ll applaud him or her. If the child made poor choices she’ll explain why, and what else he or she could have eaten that would have been healthier. Again, it is about making good food choices when they are very young, and having the children involved.  Dr. Riegelhaupt’s concern about the obesity problem continues to grow. She told me that once a doctor identifies that a child is in the obese range it is very hard to help. “There is no obesity center, a comprehensive place that will help. Parents need support and education.” She adds, “it needs to be hospital based but it is preventative care and insurance won’t cover it.” She said that many insurance companies won’t cover nutritionists so it is hard on families. It becomes extremely costly. She believes we shouldn’t have to wait for a child to be diagnosed with Type II diabetes before they can get help.    Read About Warren Point's Creative and Award Winning Program To Get Their Kids Into Shape      If you have questions concerning a child’s weight, please contact your doctor. See Linda Rosen's Previous Columns Common Sense (Fall 2004) Questions and Answers on Fitness  (Summer 2004) Atkins in Fair Lawn  (Spring 2004) Walkability and Obesity (Winter 2004) Get Out and Walk  (Fall 2003) Get In The Water  (Summer 2003) Yard Work Can Really Hurt Your Back (April 2003) Exercise Equipment  (February 2003) Great Places To Walk  (December 2002) On The Tennis Court - Part 2 (October 2002) On The Tennis Court - Part 1 (August 2002) Core Exercises (June 2002) Keep Your Belly In  (April 2002) Improving Your Posture  (February 2002)