Pediatrics in Brevard: Kids with healthy eating habits will grow into healthy adults
March is National Nutrition Month, and the goal is to bring awareness of healthy nutritional recommendations to all Americans from infancy to old age.
Our American lifestyle has changed over the generations, and so has our weight.
The obesity epidemic appeared in the 1980s for several reasons, and despite government initiatives, the obesity rate is surging.
Obesity is defined as a Body Mass Index (BMI) of greater than 95% in children, and a BMI of 30 kg/m squared or greater in adults.
It takes into consideration age, and the ratio of height versus weight.
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Adults have an obesity rate of 2-in-5 people with 19 states having obesity rates of over 35%, which was unheard of 10 years ago.
The National Health and Nutrition Examination Survey (NHANES), CDC/NCHS reported children between 2-19 years of age have an obesity rate of 19.7% which climbed from 17.8% since 2018.
So, why are American’s gaining weight?
Some dietary factors that are linked to the rising obesity rate are due to ultra-processed foods that are high in calories, salt, sugar and saturated fat but incredibly low in whole foods, such as vegetables, fruits and lean proteins.
Sugar-sweetened drinks are one of the main causes of weight gain, which is often found in vending machines at children’s schools.
Unhealthy eating and obesity can increase the risk for many health-related problems such as insulin resistance or metabolic syndrome, heart attacks, high blood pressure, strokes, Type 2 Diabetes, high cholesterol, some cancers, polycystic ovary syndrome, increased idiopathic intracranial hypertension and asthma.
In addition, obese children are at increased risk for bullying which can lead to anxiety and depression.
To make things worse, ads on social media by the multimillion-dollar diet industry also have led us to believe that a pill, injection or fad diet is the answer to quick weight loss and improvement to health.
Although adjunctive drug therapy may help, eating a healthy diet at every age is vital in the long term and must start in youth.
Of course, nutrition is one factor in weight management but so is exercise, quality sleep, stress reduction and assessing for metabolic causes such as thyroid abnormalities or medication side effects.
In addition, social factors such as food insecurities or the inability to consume healthy foods due to a lower income or insufficient resources have affected many families with rising food prices in our economy.
Studies have shown that eating fresh, canned or frozen fruits and vegetables can be more economical than eating out at fast food restaurant or consuming processed foods.
The focus today will be on nutrition in our youth, but it takes the whole family making changes to their diet to make a difference.
What can we do to help provide more nutritious meals for our families? Children who are taught from an early age about healthy nutrition will likely develop long term habits and therefore prevent some of the diseases associated with obesity by the time they are middle aged.
A program at Boston Children’s hospital geared toward treating and preventing obesity is multi-faceted but the best diet found to control weight even in children was the low glycemic, lower carbohydrate diet. Dr. Ludgwig and Dr. Ebbeling and their associates found that refined or simple carbohydrates, rather than just excess calories, were a leading cause of the obesity epidemic.
Foods like white bread, white rice, white pasta, most breakfast cereals, highly processed snacks such as chips and crackers and even sugary yogurts cause a spike in blood sugar shortly after consuming.
The pancreas excretes insulin to control the blood sugar. When too many simple carbohydrates are consumed, it causes the insulin level to spike in the blood stream.
In a brief time, hunger returns when the blood sugar level drops and causes increased craving for more food leading to weight gain and possibly slower metabolism.
Another benefit of a low- carb diet is that it increases a hormone called adiponectin, which promotes sensitivity to insulin and lowers plaque formation in the arteries better known as atherosclerosis.
The low–carb diet also caused a 15% reduction in lipoprotein(a), a risk factor for cardiovascular disease, which previously was thought could not be altered by diet.
What is a healthy diet for infants and children?
During infancy, breastfeeding for the first six months to 12 months of life has been shown to decrease obesity in children.
If unable to breastfeed, then iron fortified infant formula for the first year of life is recommended.
The American Academy of Pediatrics (AAP) recommends waiting to introduce supplemental solids until six months of age which includes lean proteins, vegetables and fruits.
Grains such as oats, rice or barley may also be included. However, fruit juices and sugary snacks are not appropriate.
In toddlerhood, continue to provide at least five servings of fruits and vegetables.
Protein such as fish, chicken and meat as well as beans are proper in small portions approximately the size of the toddler's palm.
Low fat milk, rather than whole milk, should be offered after age two and limited to 18-24 ounces per day.
The goal in toddlerhood is to offer three meals with two healthy snacks such as cut up fruit and veggies.
Let the child decide how much they eat and recognize that they may not always be hungry!
Eating meals at the table from an early age allows parents to model healthy eating and has the added benefit of increasing social skills in the toddler.
By the time children enter school, their choices for breakfast or lunch become more of a challenge.
The food plate method is one way to instruct children about portions and healthy eating.
Approximately half the plate should include vegetables and fruits and one-quarter of the plate a whole grain food and the otherquarter a protein.
A dollop of healthy fat can be added as well. It is recommended that everyone consume whole foods rather than over processed foods.
Foods such as beans, fruit, vegetables and whole — kernel grains are slow — digesting carbohydrates that keep you full longer.
Lower glycemic or lower sugar fruits would include strawberries, blueberries or raspberries.
Green vegetables such as spinach and kale are extremely healthy.
Serve healthy high-fat foods such as avocados, nuts and olive oil and full fat yogurt without added sugar.
High protein foods can be animal or plant based.
When considering a snack try to pair a slow-digesting carbohydrate with protein and fat such as celery and peanut butter or apples with cheese.
Avoid prepackaged chips and crackers. Water should be the drink of choice.
Portion size is important and American’s supersize everything, including our plate sizes and portions of food.
Learning what a portion size is for a particular food is helpful and can be found on the food labels.
It is interesting to know that a serving size for ice cream is a half a cup and many soda bottles have three servings in the bottles making for over 700 calories (about 56 minutes of running) if consumed as one serving.
A serving for meat/protein is 3 ounces, or the size of a deck of cards. A serving for some fruit would be the size of a tennis ball or a serving for one cup of vegetables or whole grains would be a person’s fist.
Use the tip of the thumb for serving sizes of dressings or butter and one ounce of cheese would be equivalent to 4 dice.
Pediatric health care providers often recommend the 5-2-1-0 plan for healthy living.
For children and teens, encourage five servings of fruit and vegetables per day that should fill up half the plate of food.
It is recommended that children spend no more than two hours on electronics per day and engage in at least one hour of exercise per day.
Zero calories should be consumed in drinks. In addition, mindful eating or being aware of each bite while slowing eating down is recommended.
It takes at least 20 minutes from the start of a meal before the brain processes one is full.
Make mealtime enjoyable with no heated discussion or nagging about eating everything on their plate.
Also, do not use food as a reward but rather emphasize the importance of good nutrition as fuel for our bodies.
Education about healthy nutrition can be taught by parents at an early age while grocery shopping.
Teaching young children about food groups and helping them choose a new vegetable to try for dinner is one way to get children involved with meal planning. Avoid buying prepackaged snacks.
While food prices have gone up significantly, buying fruits and vegetables in season has been shown to be economical.
Enjoying the fresh air outdoor markets where local produce is sold often cheaper than store bought produce.
Parents should continue to follow their pediatric providers advice at their well child checkups and consider seeing a dietician who can provide enormous help with meal planning in the home.
For more information, consider suggestions offered at the Boston Children’s New Balance Foundation Obesity Prevention Center, which includes health recipes to try!
Margaret Nemethy, ARNP, PPCNP-BC, has been a Certified Pediatric Nurse Practitioner for more than 27 years. She presently works out of the Pediatrics in Brevard, Melbourne office.
This article originally appeared on Florida Today: March is National Nutrition Month: Healthy eating prevents disease
