Every week Good Morning America’s parenting contributor Anne Pleshette Murphy answers e-mail questions from GMA viewers. Read on for solutions to everyday parental problems.
Q U E S T I O N:
I was unable to view your piece on overweight children and addressing the issue. My stepson, who is 12, lives with us. He has a concerning weight problem; is sneaking food and lying about it, etc.
My husband feels that if we address the issue again (we have times before) that it will force him to eat even more. Kindly send me the tips and advice that was mentioned in your television piece. I would be most grateful.
— Kate in Frankfort, Ky.
A N S W E R: When we were preparing the segment on overweight kids, I spoke at length to Susan B. Robert, Ph.D., author of Feeding Your Child for Lifelong Health (Bantam Books, 1999).
I would highly recommend her book and also the Web site she and her colleagues at Tufts University monitor. It can be found at www.feedingyourchild.com.
In the meantime, here is some of the advice she provided when I interviewed her about the challenge of helping a preteen lose weight:
"The bottom line is the same it has always been — namely, for either adults or kids to reduce weight they have to eat fewer calories than they expend," Robert said. "Research studies have shown that exercise programs have a small (I could even say trivial) effect on weight by themselves (although they are good for maintaining weight you have previously lost), so if you need to lose weight you need to eat less. You absolutely can't lose any meaningful amount of weight without making dietary changes."
For kids, there are important issues about how you approach reducing calorie intake to prevent harm.
First, they should never go hungry — it impairs schoolwork, stops growth etc. Second, they also need to eat a diet that is fundamentally healthy, meaning one that has all the vitamins and minerals needed for normal development and growth. This is why kids should NEVER be put on Atkins-type diets, which do not include many of the high-nutrient foods such as fruits, grains, legumes, which are foods that kids need.
What kinds of foods?
So with kids you come to the issue that you have to reduce calorie intake for them to lose weight, but they can't go hungry and they can't eat weird diets that cut out major classes of healthy foods. In the past, this would have led all doctors to simply recommend a standard low-fat diet (though in fact, most MDs know so little about treating obesity that they tell their parents not to worry).
But new research (which Robert said she is sure will be incorporated into the new government dietary recommendations that are due out in Sep 2001) is showing that there are three things you need to think about when it come to hunger-reducing foods that help kids (and adults) eat less
Caloric density. Several research studies, including from my own lab have shown that foods with few calories per ounce of food (i.e. low caloric density) reduce voluntary intake. Simply choosing low fat foods doesn't necessarily get you to low caloric density foods, because there are now lots of low fat foods on the market that have a ton of calories just because they contain no water (baked chips, low fat cookies, candy etc).
Glycemic index: low glycemic index carbohydrates release glucose into the bloodstream more slowly and reduce hunger more effectively than high glycemic index carbs.
Foods with a low or moderate glycemic index and caloric density include most vegetables and fruits (except potatoes, yams, and bananas) and all beans. Lean meats, poultry, seafood, and low-fat dairy products are good, however, don't serve more than the normal amount for your stepson's age.
Fiber is very important for reducing hunger. Partly this is because fiber (at least, soluble fibers such as in oat bran, vegetables, fruits) lowers the glycemic index, but soluble and insoluble fiber also has additional effects on top of glycemic index, probably relating to the way it is fermented in the lower intestine.
If you put all this together, what it means is that hunger-suppressing diets are ones with lower caloric density, lower glycemic index and plenty of fiber. This is summarized in the new obesity piece on our Web site.
For every popular kid food there is an alternative that is better in these respects, and so by changing the foods parents keep in their house, send to school in lunchboxes etc, they can reduce what their children eat spontaneously, just because they are less hungry
Of course, changing what a child eats takes a while. You have to tap into the way kids think and behave about food to alter their actual food preferences.
But it is not as hard as many people imagine, and the Web site summarizes good strategies at different ages. Any parent who is reluctant to try changing the kinds of foods they feed their kids just needs to think about how grateful their kid will be in five years when they don't have to worry about a weight problem.
Other issues about food patterns:
Variety. Research from Roberts' lab has also highlighted the importance of variety. Variety affects intake from birth through to old age, we seem to be hardwired to eat a varied diet and if you satisfy that variety instinct with cookies, chips, Popsicle etc, your kid will have no interest in healthful variety.
What this means is that, if you keep a low variety of unhealthy stuff (i.e. one kind of fancy cookies, never any other kind or brand), your kids will eat many fewer than if you buy two different kinds each week. And if you keep a high variety of healthful stuff, it will be viewed more positively.
Simply changing the balance of variety in your house is probably the single most effective way to change eating patterns to a more healthy kind and get your kids eating the good foods you want them to eat. Kids are very place-specific about food, so you can make big changes at home and if you are consistent about what you keep in the house they won't pester you for stuff they eat outside (where it is much harder to have control).
Research, again from my own lab (sorry! — we are the No. lab for obesity/diet research right now) is showing that uncontrolled eating is an important explanation for overweight.
People who eat when they are not hungry, take any food opportunity that comes their way (offer of a cookie from a colleague etc), eat because they are nervous/upset etc are much more likely to become overweight. So we also have to teach our kids about moderation when it comes to the unhealthful things they encourage in the outside world.
If you host a BBQ and have marshmallows for the kids to roast, set limits on how many for each person. If you visit friends, eat some of the chips but don't be greedy.
Dietary changes for an overweight child have to be made by the whole family; otherwise it will backfire when the kid starts sneaking food, feeling unloved etc.
It is critical to be patient when fixing a child's weight problem. They can't cut calories substantially (otherwise, whatever kinds of foods they eat they will get hungry), and the 10 percent - 15 percent reduction that you induce by changing food patterns will result in gradual weight loss. This is fine, it is what you want, and depending on how overweight your child is it will take two months to a year for weight to normalize."
Kate, the other person you might contact is Keith Zucker, director of Camp Kingsmont. Your stepson is the perfect age for this summer program. Perhaps he would like to attend: Camp Kingsmont, Stockbridge, MA 01266, 1-866-KINGSMONT, or call toll-free 1-866-546-4766 or check the Web site: http://www.campkingsmont.com
I hope this helps!
— Ann Pleshette Murphy