Friday, April 4, 2014

Kind of Like a Melon

Only three weeks late (yay Amy!), I brought my son in for his four year wellness check. Imagine my surprise when our doctor said that he was in the overweight category based on his body mass index (BMI). If you’re wondering what BMI is and what category you or your child fits in, there's good info online. Anyway, my son has chubby cheeks and is what you'd call a sturdy kid—kind of like a melon that weighs more than you think it will. But I would not have thought he was overweight. My husband didn’t think it was a big deal, but (being a health professional specializing in nutrition, physical activity and obesity prevention) I thought it was important to address. The kid already eats a good amount of veggies, whole grains, and fruit (as long as none of it touches…). The doctor suggested reducing snacks and making sure he gets enough physical activity. We live about fifteen minutes from the in-home daycare the kids go to, and my husband gives him a snack on the way home from daycare. Then, since I don’t get home until six most nights, the kiddo gets another snack while dad fixes dinner and watches the baby. So he's getting three snacks after lunch—definitely too many eating opportunities. You would think I would’ve picked up on this since I have been trained in dietetics!
Since that doctor’s appointment, here are some of the things we’ve been working on:
  • Giving him carrots or smaller portions of the snack on the way home, and then no snack right when they get home. My son is not thrilled about either of these changes, and is sure to express his emotions. It’s tough, but worth it to set up healthy eating habits for a lifetime.
  • Making sure he gets some good wiggle time every evening (well, almost), which he likes much more than the dietary changes. Kids should get 60 minutes of physical activity each day. Some of his favorite indoor activities are imaginary races with various friends; dancing to his favorite music—his current is the soundtrack to a certain blue train #1; kid-friendly yoga that I get at the library; pretend ice skating; Simon Says that includes jumping jacks and other active things (good for a parental giggle); counting to see how many jumps in a row he can do or how many times he can run up and down the hall; and running down the hallway and jumping on a bunch of pillows. The last one makes me cringe a bit, but we have a strict red light (stop)/green light (go) rule so he avoids collisions with his sister and the dog.
  • Working with daycare to avoid giving him a lot of sweets—when my daughter was born we switched from a center-based facility to an in-home daycare. More on that in another blog post!
Our best statistics, which aren’t perfect, say that about 25 percent of preschoolers are overweight or obese in Washington. By the time they are adults, about 61 percent are obese or overweight, and 27 percent are obese. A recent study published in the New England Journal of Medicine that followed kids throughout their early years showed that kids who were overweight by age five were much more likely to be obese by age eight. It is hard to believe my son is in one of these categories. We’re talking about a kid who considers fruit leather to be a really special treat, and asked what soda pop was the other day. I’m so thankful my doctor pointed it out early. If she wasn't reimbursed for counseling on BMI, I wonder if we would have even caught it. Your doctor can now be reimbursed for providing counseling on overweight and obesity because of the Affordable Care Act, so make sure you make your well-visit appointments and ask about BMI at your next appointment.

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  1. We're dealing with a similar situation with our son. I know the "not my kid" feeling. Thanks for the great tips and advice on how you're dealing with this. Very helpful!

  2. When you quote statistics or studies, could you reference the source? I'd love to see the full "recent study that followed kids throughout their early years."

    1. Thank you for the feedback. I sure will. I put a link to the research article in the post. You can find the abstract here: You need to be a subscriber to New England Journal of Medicine to see the full article.

  3. Glad to see a blog like this!