Eating right for the family

July 29, 2009

Little by little,Vilmary Hernandez is taking steps to make sure her kids don’t mimic her eating habits — she never did like fruits or vegetables. This means a choice of grapes or raisins — instead of a donut or piece of cake — for her 9-year-old son Josean’s snack. And his sister, Yisari, 4, who didn’t eat cheese, has discovered Mickey Mouse-shaped cheddar cheese. Hernandez, 35, has made a decisive choice to provide healthier foods for her children. This translates to lots of fruits and vegetables, one percent milk, a switch from white to wheat bread, brown instead of white rice, and a family making adjustments. So far, it’s working. Her new commitment is helping buck the alarming trend in childhood obesity, which affects neither of her kids. “Now, instead of buying cookies and ice cream, I’m buying fruit and wheat crackers. It’s a little hard,” Hernandez says, just before the start of her nutrition class on portion control, led by a Hospital of Central Connecticut (HCC) registered dietitian. Her family is one of several in New Britain getting a grip on healthy eating and exercise, thanks to free, nutrition and Zumba dance classes held earlier this year and sponsored by HCC’s New Britain Asthma Initiative (NBAI). The nutrition and dance classes aim to help trim the incidence of childhood obesity. With childhood obesity an epidemic — in Central Connecticut and nationwide — HCC pediatricians and dietitians are trying to effect positive change for families through education and motivation. Their goals: To help cut the obesity rates and avoid long-term health consequences.

The numbers are up
Like a scale, research tells it like it is: Children and adolescents in the United States are increasingly overweight and obese. “Statistically, in the last 10 years, obesity has really skyrocketed,” says HCC-affiliated pediatrician Leslie Beal, M.D. Coinciding with the increase in numbers is the decrease in age onset of obesity. A study in the April issue of Archives of Pediatrics & Adolescent Medicine says nearly one in five American 4-year-olds is obese. According to the Office of the Surgeon General, nearly 13 million children
ages 2 to 19 in the U.S. are overweight. The Centers for Disease Control and Prevention reports that research conducted from 1976-80 and 2003-06 by the National Health and Nutrition Examination Survey shows a marked increase in obesity in children and adolescents, ages 2 to 19, with the greatest jump, 5 to 17.6 percent, for ages 12 to 19. More Mexican-American boys, ages 12 to 19 are obese, followed by black boys, then non-Hispanic white boys, according to the latest research. For girls ages 12 to 19, non-Hispanic black girls had the highest rate, followed by Mexican-American girls, then non-Hispanic white girls. Many overweight kids look at their condition and think they’re just big, says Beal, adding that the standard of what is acceptable, even from parents, has changed. “A normal-weight kid might be seen as skinny. An overweight kid might be seen as OK.” Pediatricians are seeing the consequences of childhood obesity. It’s linked to many medical conditions and can contribute to mental health and social problems. This includes a greater incidence of Type 2 diabetes, insulin resistance or prediabetes, high blood pressure, high cholesterol, metabolic syndrome, early puberty in girls, asthma complications, and orthopedic conditions like arthritis in the knees and hips. Some of this can lead to early coronary artery disease or plaque within the heart’s arteries. Obesity can also affect a child’s mental health. “If you’re 3-years-old, going to preschool and are overweight, kids may make fun of you,” says HCC pediatrician Ellen Leonard, M.D. This can lead to low self-esteem, which can blossom into childhood depression and trigger more eating.

Taming the gains from fast foods and more
These days, the lure of cheap fast food value meals makes them enticing. You can get a lot of food for a good price. But along with that burger, fries and soda come high calories and fat. Of course, not all the blame goes to fast food. There is no single cause of childhood obesity, says Leonard. It’s a “combo” package including poor food choices, bigger portion sizes, and lack of or not enough exercise. “I think the economy is having a huge impact on obesity,” adds registered dietitian Kara Moscato. “People are looking for more bang for their buck. Fast food alternatives and less healthy foods tend to seem cheaper than your more healthy foods. This is not necessarily true.” Combine poor food choices with less activity and the weight settles in. For example, says Leonard, more single women are running the homestead, which means they have to work. Fearing for their children’s safety while at work, moms might not want their kids outside. That means more kids are in the house, not outside playing. “If you live on a street with no yard and the parent is working two jobs, and is a single mom, they can’t always be as active,” Leonard says. “There’s a huge connection in kids between having a TV or computer or video games in their room and how overweight they are.”

To help get a grip on childhood obesity, the NBAI, YMCA of New Britain-Berlin, and Human Resources Agency of New Britain, Inc. Head Start coordinated two sessions of free nutrition and Zumba classes earlier this year for families with children who are obese or at risk of becoming obese. Other parents who expressed interest, including Hernandez, were also welcomed. Hernandez and daughter Yisari joined nearly 20 other moms and kids in swinging to Latin and Caribbean music during the Zumba classes.“I love it,” Hernandez says. “I feel more motivated to do it.” By starting exercise at a young age, kids can make it a habit and prevent conditions like diabetes, high blood pressure and high cholesterol, says HCC exercise physiologist Jim Pugliese, a certified health fitness specialist. “Exercise is as important for kids as adults, if not more, since it’s more preventative at that stage in life.” Exercise fuels the body by supplying blood to the body, Pugliese explains. “It gives them more energy, helps to keep them awake, pay more attention, and sleep better, too.” U.S. government guidelines recommend children ages 6 through adolescence get at least one hour of daily physical activity. This should include, at least three days weekly, aerobics like walking or running, muscle-strengthening activities like push-ups, and bone strengthening exercises such as running. “Anything that gets you up and moving around vs. sitting is better,” Pugliese says. If kids are homebound, he suggests video game exercise programs as an option. Other indoor possibilities — perhaps not always popular with kids — include helping parents with the vacuuming and dish washing.

The power of choice
Besides learning the health benefits of eating healthier, Hernandez now knows it doesn’t always cost a lot. For example, a bag of carrots is equivalent to a bag of potato chips, pricewise, and fruits and vegetables are cheaper when in season. Also, a granola bar is a healthier option than potato chips, and low-fat milk is better than whole milk. Smart shopping is one of many tools Hernandez picked up from the nutrition classes to help prevent obesity. Others include choosing healthy fats, eating healthy when dining out, following the food guide pyramid and using portion control.
Here are several tips:

• Set some goals with the child. Maybe this means no second helping most days, and/or a limit on soda intake.
• Portion control. Today’s portions and plates are bigger. A plate should not be larger than 10 inches. If you eat out of a portion-controlled container vs. the box the food came in, you tend to eat less.
• Read food labels. In most cases, the fewer ingredients listed, the fresher the product. Also, look at the amount of calories per serving size.
• Choose good fats. Saturated fats are animal fats, a natural source, while trans fats are manufactured fats and common in baked goods. Both fats raise your risk of heart disease; keep intake as low as possible. Good fats are unsaturated, such as canola, safflower, sunflower, olive and peanut oils.
• Don’t like celery? Not everyone does. Just don’t complain about foods you don’t like in front of your children who will pick up on it.
• Limit foods with much sugar and/or high-fructose corn syrup. These sweeteners can add a significant amount of calories. Better to get sugar through complex carbohydrates like pasta, whole-grain breads, oatmeal and beans since it sustains energy longer than sugar through candy or other sweets.

Beal admits it can be hard for families to commit to healthy lifestyles after years of bad habits. “The big thing we would like to emphasize is it’s a family affair. You can’t just say ‘don’t eat junk.’” Hernandez is off to a good start. “I learned how important it is to eat healthy, how to change my eating habits, the harm that eating fatty foods may cause, and the harm it may do to my body, like bad cholesterol and heart conditions,” she says. For young Yisari, this shift has meant things like Saturday morning dance class with Mom and new foods, like fruit cocktail and cheddar cheese. “Little by little,”says Hernandez, “I know I can do it.”