SLIM DOWN: A Healthy Approach to Preventing Childhood Obesity

Here’s an interesting fact: animals do not become overweight in their natural habitat. In the wild, cats are not fed Meow Morsels Select from a crystal bowl and must prowl and hunt for their meals. A fat cat makes a poor hunter. Even large animals, elephants and water buffalo, are not obese in the wild in the sense that they do not reach a weight that is physiologically detrimental to their health.  Bears fatten up before hibernating but this too is a normal physiologic mechanism that aids in their survival.

            Why do I bring this up? Because I’d like to make the point that humans no longer live in their natural habitat, and the explosion of obesity is a direct result of this fact.  Humans have not evolved in the last 100,000 years, yet we moved from our hunter-gatherer roots (our natural habitat) through the agrarian period, past the industrial revolution and into the information age.  But our physiology is still that of hunter-gatherers.

            Of course I’m not suggesting we all return to the forest to eat berries and trap squirrels. Yet we have to be mindful that we are living in an environment which is conducive to accumulating weight to a point that impairs our well-being. And we are raising our children in this challenging and unhealthy environment.

            So what can a parent do to try to buck the trend and help keep their children achieve a healthy weight? Over the years, as a board certified pediatrician, I’ve developed an acronym that I use as a mnemonic device in counseling my patients.  It captures a range of behaviors and habits that lead to healthier living. The goal, I always stress, is not to shoot for an arbitrary pre-selected weight, but to incorporate healthy habits.

            The acronym is SLIM DOWN, and I’ll go through each element briefly.

S = Sit at the table to eat

Perhaps as a result of the hustle and bustle of our lives, perhaps due to the pull of entertainment that attracts us like moths to a patio light, children nowadays eat in all sorts of unusual places: in the back seats of cars, in their bedrooms at their computer, on the sofa as they watch TV… I believe this is an unhealthy trend. First, kids are missing out on the significant social interaction of a family meal. Second, they are distracted when they are eating.  Distracted eaters have difficulty gauging satiety clues and tend to overeat.  Try to eat at least one meal a day as a family.  Your children can model their eating habits from you, you’ll be better able to monitor your child’s food choices, and there are countless other benefits stemming from the social interaction.

L = Limit screen time

From television to video games and computers, children are more sedentary than ever. Even reading a book burns more calories than sitting on the couch watching TV.  The best way to limit screen time is to give your children other options.  This may require going in the backyard to play catch with your child, or going to a park for a walk. Unfortunately, many children live in neighborhoods that are inherently unsafe which makes outdoor activity nearly unfeasible.

I = Include exercise as a daily routine

This doesn’t necessarily require participation in sports though certainly that is a good option for some children.  Riding a bike, playing in the park, walking the dog, just playing outdoors are all forms of exercise.  The key is to select an activity that is fun so that children look forward to it.

M = Motivate with rewards, not punishment

We can all use a pat on the back sometimes. Don’t use threats or demean your children when they resist incorporating new habits. Learn to use the carrot rather than the stick.  Set achievable goals and provide appropriate rewards to encourage your child.

D = Dine restaurant style, not buffet style

At a restaurant, you order an entrée and the waiter brings it to you (by the way, the size of dishes at many restaurants are way too big!).  If you finish everything that is on your plate, it is understood that the waiter will not bring you a second helping.  You ate what you ordered, that’s it! (Unless you order more food, which you probably shouldn’t.) At a buffet, on the other hand, if you like the fried chicken, you can go back in line and get some more, and why not pick up some more shrimp while you’re at it, to make sure you get your money’s worth?

            At home, the buffet setting happens whenever there is food available for second helpings; bowls on the table filled with delicacies within arm’s reach. Convert your home meals into a restaurant experience. Start by cooking less – it’ll save you money!  Plate appropriately sized portions. If your family members eat everything on the plate, guess what?  That’s it!  If you really misjudged the portion sizes, you can always bring a bowl of fruit to the table.

O = Offer fewer, better snacks

Grazing is the eating pattern of large mammals. When humans graze, they become large mammals.  Kids graze when they are constantly eating snacks.  Some children get the majority of their calories from snack foods (including drinks) rather than from their scheduled meals. Also realize that there is no Recommended Dietary Allowance for Flaming Hot Corn Chips. Your child can do without some food choices altogether.

            The best way to achieve this is to simply not buy massive amounts of food that require little or no preparation.  Your child might be able to quickly microwave some macaroni and cheese, but will not cook a chicken from scratch.  Food choices start at the grocery store, and if your purchases are strongly influenced by your child’s preferences (or tantrums), plan to go to the supermarket alone.

W = When in doubt, walk.

Many communities are designed in a way that discourages walking.  Distances to schools, stores and entertainment venues are prohibitively far or dangerous for pedestrians. Yet, by simply walking more, we can help burn a significant number of calories.  Park your car at the far end of parking lots.  This forces you to walk a little farther and your car will get fewer dents and dings. Take the stairs instead of the elevator if you need to go up or down less than three floors. Go for a walk at the local mall (leave your credit cards at home). Whenever the opportunity presents itself, walk.

N = Never talk the talk if you don’t walk the walk

The best way to teach your child is to be a role model.  They may not listen to everything you say (don’t be so sure) but they will notice everything you do.  Don’t expect your children to pick up any habit you are not willing to incorporate yourself, first.  And the key word is, “first”.  You want your child to exercise?  Start by getting into an exercising routine.  Then, invite your child to join you.  You want to wedge your child away from the computer?  Then get off the computer (but not until after you check out my book, Suffer the Children: Flaws, Foibles, Fallacies and the Grave Shortcomings of Pediatric Care available for Kindle on amazon.com).

           

What if your child is doing all the things I’ve listed above and is still not losing weight?  That’s fine!  First off, many children who are at an unhealthy weight don’t need to lose weight – they just have to stop gaining weight.  So a prolonged period with no weight gain (as long as it is done through healthy habits) is a great outcome.  And either way, if your family adopts the strategies I’ve suggested, you will have picked up some healthy lifestyle choices.  Remember, it’s not a number you’re shooting for. Your goal is healthy habits.  Best of luck!

Peter Palmieri, M.D., M.B.A.