Food problems weigh heavily on children; FAMILY MATTERS


One in five children in America today is overweight, according to the American Academy of Pediatrics, and childhood obesity is on the rise. This is a serious problem because many overweight children have accompanying health problems such as hypertension and early onset of diabetes. They also have low self-esteem.

What is behind this disturbing trend?

The increase in overweight children has been attributed in part to the increase in TV watching and media games. While preteens sit in front of a television or computer screen, they tend to snack or even gorge on fast food. And the time spent indoors takes away from time spent on sports and other physical activities.

Another suspected cause is the disappearance of regular family mealtimes. Many children are left to fend for themselves from an early age, "grazing" the refrigerator or visiting fast-food outlets without adequate guidance, structure or social reinforcement for healthy eating.

Dr. Kelly Brownell, director of the Yale Center for Eating and Weight Disorders at Yale-New Haven Hospital in Connecticut, said he fears that we are in the midst of a national epidemic, given the rapid rise in numbers of children -- and adults -- who are dangerously overweight.

In response to this problem, Brownell and his colleagues at Yale-New Haven have set up an innovative children's clinic called "Bright Bodies." A group made up of a dietitian, a pediatrician, a nurse practitioner, a social worker and an exercise physiologist tries to reach out to overweight children and rescue them from their unhealthy behavior.

Diets don't work by themselves, but the combination of eating good foods and exercising regularly does.

The "Bright Bodies" children take part in a program that blends exercise with an education about food and nutrition. They are then able to make their own choices within the limits of healthy, nutritional foods.

In groups, the overweight children share experiences and ideas about themselves and their poor self-images. The goal is to get them to realize that they can take back control of their lives and their diets.

These peer groups work.

"When I was overweight, I didn't feel good about myself," one boy in the program says.

Now that he has taken control of his weight -- and lost 47 pounds -- his positive self-image is evident: "My [clothes] size is on the rack now," he says proudly, "not in the 'big people's' sizes!"

The best way to combat the problem is to help children avoid becoming overweight in the first place. This is where parents can have a major impact.

Problems often develop when children form a poor relationship with food -- and this can start early if a parent pressures a baby to eat. As early as 8 months, a baby is able to pick up finger foods and feed herself. Her excitement over being in control of her food choices is easy to see. Her face lights up as she decides which bits to eat and which to discard.

I always urge parents to encourage this autonomy and reduce their expectations about what a child should eat. Don't expect her to eat everything you give her, because she won't. Give her two bits at a time, made up of nutritious foods, and let her choose. And trust her to know when she's had enough. When she begins to play with or throw the food, end the meal.

A parent's job is to offer healthy food -- not to make a child eat. This is especially true in the toddler and preschool years, when many children are picky eaters. If parents can relax -- and avoid being drawn into battles over uneaten vegetables or other foods -- they will be rewarded later.

A child will usually learn to eat such foods when they get a bit older, by modeling on parents. That's why it's so important for families to have meals together, in a relaxed, fun atmosphere free of pressure.

"Parents can be good role models for their children," Brownell says. "They should try to eat in a healthy way themselves and try to have a healthy attitude about their own body weight."

Physical activity is the other part of the equation. Parents today need to help their children discover active, satisfying ways to spend their time -- away from television and computers. Ride a bike or take a walk with your child. Make physical activity fun. And be sure to take part in it yourself.

When adults enjoy exercise and healthy foods, their children will usually learn to as well. And that's one of the most important ways to get a child on the path toward a healthy body -- and a healthy relationship with food.


For more information on children and nutrition, visit the following web sites:

Questions or comments should be addressed to Dr. T. Berry Brazelton, care of the New York Times Syndication Sales Corp., 122 E. 42nd St., New York, N.Y. 10168. Questions of general interest will be answered in this column; Dr. Brazelton regrets that unpublished letters cannot be answered individually.

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