Tips for Keeping Children at a Normal Weight and Healthy

I do not claim to be the best parent on the block. But, my children do enjoy good health and I've made a study of how to keep children at a good weight. People who bring overweight teenagers to see me, pay $1,500 dollars to make the appointment. I offer them a money back guarantee, and I've never been asked to refund that money (so hopefully, I do have a few tips).

My son, Trey (pictured here), recently thanked me for making it easy to stay fit. He simply eats what I put in front of him and follows me around and he has an eight-pack abdomen. Here are some of the things that I do with my three sons (ages 11, 14, & 15) to help them stay healthy:

I buy enough junk food to last two days (one box of Little Debbie's junk food) and put it up and out of sight in the highest cabinet. I buy one carton of ice cream a month. No other sweets, or colas, or white bread comes into my house. If it does, it goes in the garbage can. At Halloween, all candy left over after a week goes in the garbage can. I allow sweets in the house during the month of December if someone gives us something, but all the baking I do is healthy (for example peanut butter, with honey and bee pollen, made into a ball for candy).
I do not keep any alcohol in my house. None. Ever. I don't have any great moral convictions against alcohol but drunk drivers alone kill a little over 100 people per day in this country and I like for my patients to know that they will always find me sober if they call. I like for my children to be able to say the same thing. Also, I don't want my teenagers ever sneaking a drink out of my stash and doing something crazy.
I do not own a television. We can watch movies on a widescreen television (use computer hooked to projector for very large image). But, I'm in charge of this (since I control what movies come into the house). Ads for junk food do not influence us because we never see them unless we are visiting someone and they happen to turn on the T.V.
I allow them to have some crazy video games but to be able to use the games ad lib for one day when they must finish a book of at least 200 pages, write a summary in their journal and then show the summary to me. This limits the video games to about once a week at most.
I keep plenty of nuts and fresh fruits within reach and in plain view and allow them to eat freely any time, even if I'm cooking dinner. Why should I teach them so save their hunger and over eat at supper time (like most Americans). A more healthful diet is to spread calories out over the day.
I take them with me when I go to the YMCA to work out. If they want to read a book, or swim, or just sit in the pool, I do not care. But, I figure if they get in the habit of going regularly it may stick with them. My father started taking me to the Y when I was 14 and I never stopped. This teaches them that there are many people who work daily to stay healthy and still are successful at work and with their families. Since 80% of the people in the USA are overweight, without this influence, they learn obesity-causing behavior as the norm (by definition, if you are of normal weight in the country, then you are in the minority).

Here's a link to a New England Journal Article and audio interview about childhood obesity that should be read by every parent.

Remember, the best thing you can do for your child's health is to stay healthy and model healthy behavior.

Here's the 3-Day Fat Burn (for adults, but will teach you much about how to feed your children).

Here's my #1 Weight Loss Secret (for adults and children).

Below is my son, Trey, making a quick snack for lunch (with one of his 8-Pack recipes):

Peace & Health,

Charles Runels, MD

P.S. The following is a quote of the conclusion of an article in the New England Journal Feb 11, 2010 (what is most frightening is that nearly 30% of the popluation studied is obese--and this is similar to the rates in the African American and Hispanic children in the US--and that in this group of children, their risk of dying young is doubled):

Discussion

It is well known that obesity, glucose intolerance, hypertension, and hypercholesterolemia in adulthood increase mortality rates. We conducted the present study to determine whether the presence of these risk factors in childhood predicts premature death. The rate of death from endogenous causes in the highest quartile of childhood BMI was more than double that in the lowest quartile, and the rate in the highest quartile of childhood two-hour plasma glucose levels during a 75-g oral glucose-tolerance test was 73% higher than that in the lowest quartile. Although neither blood pressure nor cholesterol level in childhood, when included as a continuous variable, significantly predicted premature death, childhood hypertension increased the risk of premature death from endogenous causes by 57%. The absence of an association between premature death and cholesterol levels may be due partly to the low proportion of deaths due to cardiovascular disease in this cohort (13.3%). Treatment for any of the predictor traits during childhood or during adulthood did not appear to explain the pattern of association (data not shown). No childhood risk factor that was examined significantly predicted rates of premature death from external causes. Childhood obesity predicted premature death from endogenous, but not external, causes. The study was not powered to analyze effects on more specific categories of cause of death. Including only liver-related causes of death in the analysis reduced the magnitude of the association of premature death with childhood BMI and with the 2-hour glucose level, but the direction and pattern of associations were similar to those observed when all endogenous causes of death were included. We considered whether the relationship between childhood BMI and premature death reflects associations with adiposity or some other component of body mass. Our study began before the availability of modern adiposity measures such as dual-energy x-ray absorptiometry. However, we previously reported relationships between BMI and adipose mass and between adipose mass and the cardiovascular risk factors in this population19; in that study, BMI and adiposity were strongly correlated (r>0.96), varying little with age and sex, and BMI and adipose mass were similarly correlated with the cardiovascular risk factors. Thus, the observations for childhood BMI reported here are likely to reflect a positive association between adiposity and rates of premature death. In a study involving 508 U.S. adolescents (13 to 18 years of age) who were born between 1922 and 1935, overweight (>75th percentile of the sample distribution) was associated with increased rates of death due to coronary heart disease.20 Two studies have assessed the relationship between body weight and mortality in European birth cohorts from the early 20th century.21,22 In a study of 2299 Welsh children born between 1937 and 1939, there was no association between childhood BMI and death from cardiovascular causes.21 However, there was an association between childhood BMI and death from all causes; the lowest rate of death was seen in the next-to-lowest BMI quartile and the highest rate of death in the highest quartile, suggesting that, as in the case of adult Pima Indians,23 a U-shaped relationship exists between obesity and mortality. In the second European study, involving 504 overweight children and adolescents admitted to hospitals in Stockholm between 1921 and 1947, weight gain between puberty and young adulthood was associated with cardiovascular disease, diabetes, and death from all causes.22 A limitation of these studies is that obesity was uncommon during the study period. For example, of the 2299 children in the Welsh study,21 only 92 (4.0%) had a BMI above the 90th percentile for the age-specific and sex-specific distributions of the 1990 British population, and British children in 1990 were leaner than their contemporary counterparts.24 In the Arizona Pima Indians, unlike most other ethnic groups, childhood obesity has been common for decades.25 It has been estimated that at the turn of the 21st century, approximately 15% of U.S. children between the ages of 6 and 19 years (11 million children) were overweight or obese,26 a prevalence that is unlikely to decline in the near future27 and that is triple the prevalence among children of the same age in the 1960s.28,29 In the present study, 1394 children (28.7%) were obese (BMI, 95th percentile on the 2000 CDC growth charts). This prevalence is similar to that observed in contemporary Hispanic and African-American children.27 Thus, although we studied a population with high rates of obesity and diabetes, our findings may reflect the future burden of premature death among contemporary children from other ethnic groups and may be more generalizable than the findings in previous studies. In this study, we compared mortality rates with several clinical risk factors as variables. Adjusting the obesity models for the development of diabetes in adulthood did not significantly alter the risk estimates, whereas adjusting the glucose models for subsequent diabetes did attenuate the association between childhood glucose levels and premature death. Hence, dysregulated glucose metabolism in childhood may be a mediator of the effects of childhood obesity on mortality rates, but it does not appear to be the sole or dominant factor; however, the association between childhood glucose intolerance and premature death does appear to be mediated by the development of subsequent diabetes. The pattern of the relationships between the risk factors and observed mortality supports the view that childhood obesity is an early metabolic derangement, whereas most of the other risk factors evolve later. In fact, the predictive power of a risk score for type 2 diabetes (including measures of obesity and insulin, blood-pressure, glucose, and lipid levels) in children is almost entirely dependent on abdominal obesity, whereas in adolescents, the risk profile has evolved to include obesity, hyperglycemia, and dyslipidemia.30 Our findings complement those in our previous study, which showed that type 2 diabetes, when it occurs during adolescence in this population, strongly predicts subsequent renal failure and death.2 Although there was no significant association between childhood hypercholesterolemia and death before 55 years of age in this young cohort, an elevated cholesterol level in childhood may emerge as a significant risk factor and other causes of death may predominate if the cohort is followed to older ages. Cholesterol levels, however, are lower in American Indians than they are in most other ethnic groups,31 a finding that may partially explain the absence of association for this trait. The relationship between BMI and high-density lipoprotein (HDL) cholesterol is relatively strong in Pima children (r=–0.3 to –0.6), but the relationship between BMI and total cholesterol is weaker (r=0.1).19 The effect of BMI on premature death might be attributable in part to low HDL-cholesterol concentrations, which were not measured in most of the study participants. Nevertheless, we speculate that low HDL-cholesterol levels are likely to mediate rather than confound this relationship. It is possible that the relationship between childhood BMI and mortality is confounded by unmeasured lifestyle factors. Nevertheless, obesity can be both the cause and the consequence of adverse lifestyle factors such as physical inactivity, excessive caloric intake, and specific nutrient preferences. Thus, such factors may be important components of the causal pathway between obesity and death. It is also possible that genetic factors have pleiotropic effects on BMI and mortality. Childhood obesity is predictive of excess mortality in several divergent settings,20,21,22 indicating that obesity itself is causally related to either death or other commonly related factors. Even if preventing childhood obesity does not affect the risk of death, increased physical activity and modification of diet are likely to have long-term benefits. The lack of specific data on such factors is a limitation of this study. In summary, obesity in children who do not have diabetes is associated with an increased rate of death from endogenous causes during early adulthood, an association that may be partially mediated by the development of glucose intolerance and hypertension in childhood. In contrast, the cholesterol level in childhood is not a major determinant of premature death in this population. Childhood obesity is becoming increasingly prevalent around the globe. Our observations, combined with those of other investigators, suggest that failure to reverse this trend may have wide-reaching consequences for the quality of life and longevity. Such evidence underscores the importance of preventing obesity starting in the early years of life.