The childhood obesity octopus is out to ruin our children’s future! What can we do to stop it?

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Artwork by: Sierra B.
©2010 Littlestomaks.com

The author of this book Michelle May, M.D., is a contributor to my Ask the Expert column. That is why when she told me that she had published this book, I was immediately interested even though it did not directly apply to toddlers. I think Dr. May has a very interesting thesis here which flies in the face of typical advice on diet and weight loss. Her own personal and professional experience make it all the more credible. No wonder, it was hardly a surprise to me when she told me that this book was recently selected by TIME.com as one of the Top 10 Notable New Diet Books of 2010 and won the National Book Award for Best Health Book! I am so happy for her and wish her continued success.

Overview

Dr. May’s main message in this book is for you to answer a simple question Am I Hungry? It is amazing that children know this notion very well and eat only when they are hungry. Yet, adults no longer have that sense because they tend to eat in response to their emotional needs, not necessarily the sensation of hunger. In this book, she teaches the notion of the Eating Cycle and explains what it means in the case of overeating, restrictive eating (diets) and instinctive eating (eat when hungry and stop when full). The eating cycle is based on 6 fundamental questions – Why, When, What, How, How Much and Where – which will help you determine your eating patterns and underlying drivers.

In short, she wants you to develop a clear understanding of your own personal eating cycle, and not simply obsess over what you eat and how much you eat.

That is why the title of her book is so powerful. Once you understand your own eating cycle, you can pretty much eat what you love without feeling guilty. Balance, variety and moderation along with awareness of where you are on the Hunger-Fullness scale will help you get to the weight you desire and, more importantly, stay there.

Here are a few practical tips I really liked in this book -

• Great point of view on mindful eating – it means eat with intention and eat with attention
• A very practical and intuitive Hunger and Fullness scale to help you judge when you need to eat. I also liked the balloon analogy. Bottom line, eat when you are hungry, don’t wait until you are starving and stop eating when you feel full and not stuffed!
• Each chapter ends with a list of strategies you can immediately apply.
• The FEAST method to understand why you feel like eating when you are not hungry (Focus-Explore-Accept-Strategize-Take Action)
• Strategies to deal with difficult emotions, particularly anger, and not let them lead to overeating.
• Triggers for overeating and how to recognize them.
• Provides a tool to understand feelings and how they drive actions – TFAR (Thoughts-Feelings-Actions-Results)
• Very good overview of the fundamentals of nutrition in common sense language – carbs, fats, proteins, vitamins, metabolism etc.
• The whole book is sprinkled with nuggets of wisdom called Mindful Moments – very practical, scientifically balanced nutrition advice.
• Personal stories from clients and Dr. May’s analysis and advice based on principles of mindful eating.
• Collection of healthy recipes with practical suggestions under Chef’s Notes, Doctor’s Notes and Family Notes.

10 things I learned from this book I did not know before

1. High-fat, high-sugar processed carbohydrates can temporarily activate the pleasure centers in the brain by triggering the release of serotonin and beta-endorphins. No wonder, they are so addictive!
2. Hormones produced when you feel stressed actually accelerate storage of fat.
3. Your taste buds are most sensitive when you are hungry and when you start eating. That is a great tip for fully enjoying the food – eat when you are hungry!
4. Medical research has proven that even a 5% weight loss can significantly improve your health! Small is indeed beautiful!
5. Many people are chronically dehydrated and don’t even know it!
6. Excessive salt can lead to more water retention.
7. The more you weigh, the more fluid your body needs.
8. Basal metabolism consumes the largest portion of energy. Basal metabolism is the amount of energy (calories) your body needs to support vital bodily functions like heartbeat, breathing, brain function, even eating and digesting.
9. Muscle cells burn more energy than any other type in your body. They also require more energy for maintenance.
10. The American Heart Association recommends that you limit your intake of saturated fat to less than 7% and trans fat to less than 1% of your total daily calories.

What I did not like so much

• I think a 10-point scale for assessing the sensation of hunger or fullness may be a little difficult for most people to fully internalize because it is hard to tell a 1 – 2  point difference. For me, the balloon analogy for your stomach of 1 being empty, 5 being a gentle natural shape and 6-10 being overstretched works better. The scale could be simpler with only a 4-5 levels.
• There are a lot of tables and sometimes the information tends to be repetitive.
• I would have loved to see a chapter on how you can apply these principles not only to yourself but to your whole family including children.
• I love pictures, so it would have been nice to see pictures of the recipes.

Recommendation

I think Dr. May’s book is based on a very powerful idea, one that asks you to be first in tune with your inner self instead of prescribing a miracle diet. This book is a great resource for anyone trying to not simply lose weight, but change their entire outlook on food and eating! I think this book can be very effective if you:

• fully understand the fundamental principles of mindful eating first
• make an effort to apply the tools – Hunger/Fullness scale, FEAST, TFAR etc
• practice strategies for mindful eating
• keep a journal to track your progress

This is not a quick read rather a handy reference that should occupy a prominent and rather permanent place on your bookshelf.

Overall, I give it a big thumbs up! Visit Eat What You Love, Love What You Eat to download the first chapter, read other reviews, listen to an interview and learn how to order.

Leave me a comment if you found this review useful.

©2010 Littlestomaks.com

Ask The Expert is a weekly column on Littlestomaks.com. The idea is to have a reader-submitted question answered by a nutrition expert or a pediatrician. Feel free to submit your question in the comments section below.

This week, Registered Dietitian Rebecca Scritchfield offers advice on what do do if your child eats as many as 10 times a day.

Question: My daughter wants to eat about 10 times a day. Is this healthy as long as she’s not overeating?

Answer:

In general, kids are way better than adults at scanning their hunger and fullness feelings and they rarely tend to overeat if they eat balanced meals. If you are concerned about the frequency of your child’s meals, please be sure to check with your pediatrician. The growth charts will indicate if there is a reason to be diligent about making sure your child gets enough calories for healthy development.

If your child is growing at a normal rate, then I’d say that eating 10 times a day seems a little too often. If your child is awake 12 hours a day, that means they’re eating nearly every hour.  Even the “littlest stomak” eats every 2 hours.

If a child is eating 10 times a day most days of the week, double-check how you provide foods:

• Are  you giving your child enough food at the three usual mealtimes? Toddlers need about 200-300 calories for a meal or snack to meet their daily calorie needs.
• Is there variety on the plate – carbohydrates in fruit provide “quick energy” and protein and fat in foods like peanut butter and eggs give “lasting energy.”  If you provide just carbs, your kid may need to refuel faster than if you provide a little of all the nutrients.
• Do you give your child enough time to eat? Little stomaks have little mouths and they need more time to chew and digest their food. They can’t scarf like their parents (nor do you want them to build that habit). Make sure they get to build autonomy with the length of time the eat. Don’t let them eat in front of the t.v. or computer. Teach them early to really enjoy their foods.

If you are struggling with this, I would try adding more calories and see if that brings the meals and snacks frequency down to about five to six times a day. You can add calories without adding volume by doing things like adding natural peanut butter to oatmeal or adding olive oil to pasta noodles and sauce. Visit My Pyramid for Preschoolers for meal and snack ideas and determine the calories your child needs.

©2009 Littlestomaks.com. All Rights Reserved

Disclaimer – Information provided in Ask The Expert column on Littlestomaks.com is intended to give you general guidance on a question related to toddler nutrition. It is not meant to be treated as medical advice. You are welcome to contact this expert for a detailed consultation on your specific situation to determine what actions, if any, you should take regarding nutrition and health of your toddlers. We do not recommend you to take any action based solely on the information presented in this column. Experts have agreed to provide their professional opinion on toddler nutrition related questions on a voluntary basis and no compensation is offered to them by Littlestomaks.com.

Greetings!This week is the World Breastfeeding Week. Organized by the World Alliance for Breastfeeding Action (WABA), the focus this year is In Emergencies, Breastfeeding is a Lifeline. I never thought about breastfeeding this way, but it makes sense. Children and infants are most vulnerable during a catastrophic emergency – whether natural or man-made. According to WABA estimates, child mortality can be 2 to 70 times higher than normal under these conditions due to diarrhea, malnutrition and respiratory illness. They believe that by supporting breastfeeding in non-emergency situations, we can be better prepared to save the lives of young children during emergencies. Here is a great post by my blogger friend Annie on this subject by Annie on PhdInParenting.

Here again are 5 interesting nutrition stories of the week that caught my eye. Enjoy and drop a comment to let me know what’s on your mind.

Millions of kids vitamin D deficient – here we go again!

It seems like our appetite for reporting vitamin D deficiency in kids is insatiable! In yet another study published recently in Pediatrics, researchers report an alarming prevalence of vitamin D deficiency in kids 1-21 years old. They find that 9% (about 7.6 million) children are deficient and 61% (about 50.8 million) have insufficient levels of 25-hydroxyvitamin D. This news got a lot of coverage this week, mainly because the numbers seem so high. Also, in the same article, these researchers highlight a link between low levels of vitamin D and increased risk of cardiovascular disease. This sounds really scary, and no doubt, makes a perfect headline for an attention-grabbing story.

I have a few problems with these types of studies. First, they rely mainly on the level of 25-hydroxyvitamin D in blood. There is no consensus among experts when it comes to estimating deficiency or insufficiency in children. Second, the biochemistry and processing of vitamin D is very complex, something I don’t claim to understand at all. But I am certain of this – it cannot be as simple as just the blood level of 25-hydroxyvitamin D which relates to cardiovascular health or bone density. But the real reason why I get frustrated is that these studies do not answer the “so what?” question a parent might be concerned about. Drink milk and vitamin D fortified OJ, let your kids out to play, not watch too much TV – well, that is old advice and should be followed with our without such sensational news.  Should you ask your pediatrician for a 25-hydroxyvitamin D test? Should you take supplements? There is no real, practical and actionable advice from these “experts”.

My 2 cents – when you hear this type of news, take a deep breath and don’t panic. Take a quick look at what your child is getting on average – milk, OJ, cereals, fish, eggs, cod liver oil etc. How much outdoor activity in the sun he gets on average. Take a long term view on this but continue to watch the diet and activity level regularly. If you still have doubts, ask your pediatrician if a supplement is needed.

No one wants to hang out with overweight kids

Why are overweight kids so picked on? A very interesting post from Dr Joanna Dolgoff – one of our Ask the Expert contributors – provides some insight. Appears that kids have more sympathy for children with handicaps, and would rather be friends with them, than hang out with overweight or aggressive kids. Deep down, overweight kids are blamed for their condition. They should be able to change it by losing weight is a common belief. I wrote about this in my post on childhood obesity because this kind of negativity leads to low self-esteem and a downward spiral of physical and emotional health problems among overweight and obese kids. Stereotypes about obesity form early in life it seems.

FDA and USDA get a budget of $125 billion

That is a giant number! Extra funding is supposed to go for improving food safety and farm subsidies. What surprised me though is the estimate that almost half of the budget for the two agencies is set aside for food stamps and Government nutrition programs. What kind of a return on investment can we expect from this level of spending? I find it ironical that on one hand we spend extra on healthcare in managing obesity-related diseases, while on the other, we have to also budget a huge amount fighting hunger and poverty. These two problems are two sides of the same coin in my opinion, but I do not yet see a comprehensive policy (and budget) to address them. We know that there is poor communication and cooperation between different Government agencies – the right hand does not know what the left is doing, but both want to get bigger and fatter and demand more funding! And as far as food safety is concerned, the approach is to focus on compliance rather than prevention. This smells of more bureaucracy to me!

So many cooking shows, so little cooking

Michale Pollan wrote a very good – although very long – article in the New York Times magazine this week. Out of the Kitchen, Onto the Couch takes us through the history of cooking shows starting with Julia Child to the likes of present day Iron Chef and Rachel Ray. We watch the Prime Time food network for entertainment value these days, not to learn anything about cooking the food ourselves! Pollan makes two great points – one, that the food industry along with the Television has been quite successful in taking over the “cooking” part from us by providing us with relatively cheap, readily available, packaged nutrition (poor nutrition I must admit). And second, that we are now quite comfortable ordering fancy items at restaurants and our appetite and desire for an ever increasing array of foods seem never ending. The less we cook, the more we eat and the more weight we put on. So how can we get back to cooking? We don’t have time for cooking, but we have time to watch a cooking show. Seems to me it is a matter of priority and attitude. I think we need to invoke Nike’s Just Do It! for preparing our own food. Not necessarily from scratch, as a lot of purists might want you to, but enough so that you can control what goes inside your body.

Check out this cookbook review and giveaway

Here is a shout out for my blogger friend Jenna of Kidappeal. She has done a great review of Vegetables Get the Royal Treatment by Jill Nussinow (aka The Veggie Queen!), and she is giving away a copy of this book to one lucky winner selected from the comments on the post. It is very simple to enter – all you need to do is to leave a comment about your favorite vegetable and your favorite ways to prepare and eat it. Check it out, the contest ends on August 16th.

Enjoy your weekend! And let me know what you think.

Photo source -Raphael Goetter on Flickr via everystockphoto
©2009 Littlestomaks.com

5 simple changes you can make to prevent childhood obesity

This is a guest post by Jacque Miller, who is a nutritionist, human behavior specialist and a certified lifestyle educator. She passionately supports local and national issues regarding small business, education and health and wellness. She is an active member of the Blended Healthcare Consortium. Jacque has survived the deadly grip of cancer, even in the face of a terminal diagnosis. She shares her experience in her book, The Lopsided Gal, and travels nationally, teaching individuals and families the art of dealing with crisis and taking charge of their own health. More information can be obtained by visiting Healthystyle Choices.

It is common knowledge in the health industry that we are approaching the possibility that we might outlive our children.  I can’t help but think that we have to bear the weight of the responsibility because of the choices we have made in how we feed our families. The fact that childhood obesity rates have tripled over the past two decades should give parents everywhere pause.

I feel making a better choices is a good place to start for most families.  I know that is hard for most of us because it involves a behavioral or lifestyle change but the extra pounds that kids start with sets them on the path to health problems that were once confined to adults, such as diabetes, high blood pressure and high cholesterol and higher risk of certain cancers later in life.  Let’s take a look five possible causes that are easy to correct with little effort but the results can be life changing for us and our children.

• Overfeeding: Supersize me has become a natural option in our society that is killing us.   We do not eat to live today we live to eat.  We overeat at nearly every meal!  Think about the size of our stomach and then look at the size of the plate we eat from that is mounded with food.

One solution: If you are going to eat out, order smaller portions or share meals.  If you order a full order ask for a to go box when you order and split your meal into that box as soon as it is served and only eat the half left on your plate.  Save the other for later.  Eat from a smaller plate or bowl at home to help you cut down on portion size.

• Eating too fast: It takes about 20 minutes for our brains to get the message that we are full but we continue to eat at a pace that doesn’t allow us to stop eating until we are ‘stuffed’.

One solution: Put your fork down between bites, chew your food 30 times before you take another bite, you have probably heard your grandmother say that but it works.  Eat 5-6 smaller nutritious meals a day instead of 3 major meals.

• Providing high calorie beverages to satisfy thirst; using food to solve problems, relieve stress, or as a reward:  Eating in this country is a social function instead of a physical requirement.

One solution: Water or some other nutritious drink is a better option than high calorie soda that we automatically think of when we are thirsty.  The term Comfort food has taken on a new meaning to our health as it always involves high calorie, nutrient deprived choices.   A better reliever of stress is exercise yet we chose the cookie jar.   When we teach our children that they can have an ice cream if they finish their homework it is setting them up for thinking that food is a reward whenever they do well.

• Not providing enough opportunities for exercise: unfortunately if the kids don’t see us making exercise a priority in our lives than why should they think it is important for them either.

One solution: Find something the family can do together even if it is a walk each evening.  Many community centers offer family play options and there are innovative Gyms/clubs out there that are starting to offer family plans as opportunities for families to exercise together.

• Personal behavior and dietary habits: we are often too lazy to attempt changing our behavior even when we know it is better for us.  Time is the big excuse I hear from a lot of my clients.  I don’t buy it!  In the time it takes to load the family up, decide where you want to go and who wants to go to which fast food joint, go through the drive through and come home you can prepare a healthy meal and have more quality time together.

One solution: Learn to do bulk cooking so time is not an issue when preparing a healthy meal for the family.  Take a cooking class or work with a nutritionist to help set up a healthier pantry and kitchen so that it isn’t  ‘a chore’ to prepare meals.  Make fixing a meal a family affair and learning experience for the entire family.

Understanding the causes of childhood obesity and the ways in which it can be treated will help you help your child feel better about themselves and their future health.  In my practice the results when working with obese children are always much better when the adults buy into the program and join the obese child or family member in the lifestyle changes that we teach.

Some food for thought:

• Teens whose parents drink soda every day are nearly 40 percent more likely to drink soda every day themselves than teens whose parents do not drink soda.
• Teens whose parents eat five servings of fruits and vegetables daily are 16 percent more likely to do the same than teens whose parents do not eat five servings a day.
• Nearly half of adolescents (48 percent) whose parents drink soda every day eat fast food at least once a day, while only 39 percent of teens whose parents do not drink soda eat fast food at least once daily.
• 45 percent of teens whose parents do not eat five servings of fruits and vegetables daily eat fast food at least once a day, while only 39 percent of teens whose parents eat five servings a day eat fast food at least once daily.

Childhood obesity is real. Let us do all we can to make sure our children grow up healthy without the burden of extra weight.
Photo Source: stopmango on Flickr
©2009 Littlstomaks.com

Ask The Expert is a weekly column on Littlestomaks.com. The idea is to have a reader-submitted question answered by a nutrition expert or a pediatrician. Feel free to submit your question in the comments section below.

This week, Registered Dietitian Laurie Beebe recommends a simple method to stop your child from overeating and develop long-term healthy eating habits.

Question: How can I model healthy eating behavior for my kids without emphasizing ‘dieting’ at this young age?

Answer:

Recently, a client of mine asked me this question:

“My husband and I are both active and in good shape, but sometimes I eat a bit too much, especially in the evening, and go to bed feeling bloated.  I notice that my 3 year old and 5 year old also want second helpings sometimes and afterwards there are times they complain of a stomach ache.  How can I model healthy eating behavior for them without emphasizing ‘dieting’ at this young age?”

In my opinion, one of the best things you can do for your children is to teach them healthy eating habits while they are growing up.  They don’t need to have any information about what eating too much will do to their future health at this age; only that it might give them a tummy ache!  Just as you need to discover that the signal “you are full” does not reach your brain for 15 minutes after you really have had enough, this is something you can teach them, too.  Show them that you are setting a timer for 10 minutes when they ask for second helpings (especially if you allow them extra portions of foods that are low in nutrient-density, like desserts).  Let them know that their body needs time to realize they are full and if they keep on eating their only signal is a tummy ache when it is too late.  Assure them that if they still want more food in ten minutes then it is theirs, but you want to be sure they don’t get sick from eating too much.  (You don’t need to remind them in ten minutes by asking, “Did you still want more macaroni and cheese?” but do give them a small amount if they come to you for more when the timer goes off.)  Chances are, they will be distracted by some games or toys and forget about the desire for more of the tasty food when the impulse passes.

This is a healthy lesson they will learn for life and they will grow up, not with an idea that “food that tastes good is bad and makes us fat and sick”, but merely “I need to stop and think whether or not my body feels hungry before I take an extra helping”.

©2009 Littlestomaks.com. All Rights Reserved
Disclaimer – Information provided in Ask The Expert column on Littlestomaks.com is intended to give you general guidance on a question related to toddler nutrition. It is not meant to be treated as medical advice. You are welcome to contact this expert for a detailed consultation on your specific situation to determine what actions, if any, you should take regarding nutrition and health of your toddlers. We do not recommend you to take any action based solely on the information presented in this column. Experts have agreed to provide their professional opinion on toddler nutrition related questions on a voluntary basis and no compensation is offered to them by Littlestomaks.com.