Sedentary and Overweight Kids? 10 tips to turn things around – Part II: Nutrition
I hope that these last 5 tips help you and your children to enhance not only the quality of the food you eat, but your health and quality of life in general.
If you missed part I, you can find it here.
Part II: Nutrition
6. Eat a Healthy Breakfast every day.
Many of my obese patients do not eat breakfast. I’m not entirely sure why, but I suspect a big part of it is that they’re trying to restrict calories; it’s often easiest to restrict first thing in the morning. Little do they realize that by skipping breakfast, they are not only impairing their ability to function through the day, but they are severely undermining their health in general.
How can skipping breakfast be so counterproductive? Consider that upon waking in the morning, the body recognizes that it has been 8-10 hours since last being nourished and, understandably, it expects a hearty meal. So it sends a message to the brain in the form of a hunger sensation. Denying the body the nutrition it expects and requests at this very important time of the day results in the body taking strong action in an attempt to compensate. To begin with, every afternoon the unheeded hunger signals begin to overwhelm one’s will power. Unfortunately the signal to eat is so strong at this point that there is a tendency to ‘give in’, overdo it and eat far more calories than needed. Furthermore, daily morning deprivation of food leads the body to believe that food must not be readily available. As a consequence, the body slows itself down (in scientific terms – it lowers its metabolic rate). By slowing down it lowers the amount of energy (or number of calories) required to function. As the body slows, one begins feeling more sluggish, sleepy, inattentive, moody, and unmotivated. Furthermore, as days and weeks pass with recurrent missed breakfasts, the body, in it’s slower state, needs less and less calories to function. As a consequence one begins gaining weight more quickly despite eating the same number of daily calories. Combine this slower metabolism with afternoon overeating and voila … the perfect storm: a vicious cycle spiralling out of control towards excess accelerated weight gain.
These patients look at me as if I have gone completely off the deep end when I suggest that they will have to eat themselves out of this problem. I encourage them to completely give up on restricting, forget about their weight, and to simply focus on one goal: eat as much breakfast as it takes to feel full every single day. In the vast majority of cases, these patients come back after one month of regularly eating breakfast feeling far better, more energetic, performing better at school, and with a stable (or sometimes even reduced) weight. And the positive effects only improve in the ensuing months as the vicious cycle reverses.
7. Use the Plate Method
The plate method is a practical way to serve balanced nutrition at every meal. To use the plate method, simply divide the meal plate into 4 sections: two sections are filled with veggetables, one section is filled with a protein serving and the final section is filled with a grain or starch serving. Sometimes a glass of milk is added to represent a dairy portion.
It looks like this:
The US government has adopted this approach recently in their new “choose myplate” educational campaign. It offers tremendous resources, many of which have been developed specifically for children and youth. Check it out at www.choosemyplate.gov.
8. Eat Your Fibre!
Fibre plays a critical role in achieving good body composition and good health in general. Those who eat little fibre tend to be more overweight and tend to make lower quality, higher calorie, and higher volume food choices. They also tend to feel less full at the end of meals, and feel overly hungry well before their next scheduled meal. On the other hand people who eat more fibre tend to have healthier weights and tend to choose more healthful, appropriately portioned foods. They feel full more reliably towards the end of their meals and their fullness sensation persists longer beyond each meal.
Fibre absorbs bad cholesterol (low density lipoprotein, or LDL) from the gastrointestinal tract. It acts like a sponge sopping up whatever LDL it encounters along the way. The LDL is then excreted in the stool. This may be why those who eat more fibre tend to have lower LDL levels which is strongly correlated with lower risks of suffering from diabetes, heart disease, stroke, and peripheral aretery disease.
Fibre also helps slow down the rate at which the body absorbs sugar from the gut into the blood. In so doing, the delivery of sugar to the cells is slower, more consistent, and optimally regulated. Less fibre in the diet results in larger swings in blood sugars – too high just after meals and then too low just prior to the next meal. These dramatic swings in sugar levels, if persistent over years, lead to erratic and excess eating, relentless accelerated weight gain, and earlier onset of type 2 diabetes.
See our fibre handout for more information about dietary fibre and for tips on how to increase your child’s daily fibre intake.
9. Beware the Portion Distortion
Over the past 30 years or so, our perceptions of normal portion sizes have changed dramatically. Everything from the diameter of our bowls and plates to the sizes of forks and spoons to the volumes of our fruits to how many ounces fill our cans of Coke and cups of coffee have increased significantly. For some interesting examples, check out this blog post by Liz Monte. Scientific studies have demonstrated quite convincingly that the ‘normalization’ of larger portion sizes has lead to overeating and excess weight gain in our societies. So it stands to reason that if we re-redefine ‘normal’ (i.e. reduce) portion sizes of food we serve to our children, so too will their eating habits normalize, caloric intake reduce, and body composition improve.
For grains and starches: one serving of pasta or rice (approximately 1/2 cup) is approximately the same size as one half of a tennis ball. A bagel the size of a hockey puck actually represents two servings. A pancake or waffle serving is approximately the same size as a DVD. One serving of dry cereal (approximately 1 cup) should be about the same size as a baseball.
For dairy products: one serving of yogurt (3/4 cup) would be around the size of a tennis ball. One serving of cheese (50g) would represent approximately 6 dice or a slice of cheese approximately the size of 2 business cards.
A serving of chopped up fruits or vegetables (1/2 cup) is equivalent to the size of a baseball. A lightbulb-sized piece of Broccoli or cauliflower represents approximately 1 serving.
Meats and alternatives: one portion of meat ( 90 grams) is approximately the size of a deck of cards or the palm of an adult’s hand. A serving of nut butter (approximately 1/4 cup) is equivalent to the size of a golf ball.
Using the above suggestions along with the guidelines from Canada’s Food Guide, your children will be well on their way to more sensibly sizing up their portions.
10. Teach Your Kids to Trust and Respect Their Hunger and Fullness Sensations
To help your children better get in touch with their hunger/fullness cues, there are 2 fundamental rules to follow
1. If hungry, then eat.
Seems so simple, but most diets and weight loss programs fail, among other reasons, as a consequence of not respecting this concept. They encourage you to deny one of humankind’s most powerful drive: to nourish. For healthy-minded people, there’s no defeating hunger. Attempting to deny one’s body the nutrition it requests invariably results in overeating but a few hours later. The few individuals whom I’ve met that are able to defeat their hunger are struggling with far more disturbing eating problems (such as anorexia nervosa). The idea is to eat sufficiently to satisfy your hunger, not more and not less. Furthermore, the food should be delicious, balanced, and nutricious.
Often more challenging and complex is rule #2:
2. If not hungry, don’t eat.
How often do we fix up a snack to watch TV, only minutes after finishing supper? Why do we eat enormous tubs of buttered popcorn with candy and pop when we go to the movies? Why do many of us eat when we’re sad? bored? celebrating? Trick-or-treating? These are sophisticated questions with answers deeply rooted in our social, political, and psychological history. Though remarkably complex, it can be addressed quite simply: before eating, stop for a moment and reflect on how hungry you feel. If hungry, then by all means enjoy something delicious, nutricious and balanced. If not hungry, then think twice before indulging.
This principle is very applicable to children. Young children and infants need the space and autonomy to identify their hunger/fullness cues and learn how to manage them effectively. This means trusting them to request food when hungry, allowing them access to food once requested, and to taking away the food (or stop feeding them) when they indicate that they are full. For older children, the most important thing you can do is be an effective role model. Show your children that you are also making the effort for yourself to eat healthfully. Fill the house up with nutritious and delicious foods. Try not to leave snacks lying around the house to temp your children to eat in moments of boredom. Teach your children that holidays like Thanksgiving and Christmas can be more about celebrating, spending time with family, enjoying one another’s company, than gorging on extreme quantities of food.
By learning to respect and trust the body’s hunger and fullness signals, and by choosing healthy tasty foods, you and your children will instinctively, intuitively, intelligently, and optimally nourish your bodies.
I hope these tips have been helpful and would be excited to get your feedback. Are there other tips you wish to share? Are there other topics you would like me to write about going forward? Do feel free to comment below.
If you live in Toronto and would like nutrition support for your child, feel free to learn more about the Kindercare Pediatric’s clinical nutrition programs.