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PREVENTING OBESITY

Obesity is addressed here because it is on everybody’s mind. Parents really do matter when it comes to obesity. You provide the genes and the parenting style, and you create the food environment. We live in a world of good-tasting, inexpensive food, and we eat anywhere and at any time. A child can become overweight in any family, and your child is at greater risk than any other generation in the history of mankind. Between 1963 and 1970 only 4–5 percent of children ages six to nineteen were overweight, but in 1999–2002 that figure increased to 16 percent. This increased risk is very real: 66 percent of adult Americans are considered overweight. Many mothers attribute their own weight gain to pregnancy, but research shows that all Americans, regardless of whether they have children or not, can expect to gain weight unless they eat well and move more. Your health care provider will be concerned, too, because excessive weight increases the risk of health problems that include diabetes, high blood pressure, cancer, and heart disease. Obesity can damage a child’s self-esteem and have a negative social impact. If you are concerned about your child’s weight, do not restrict. Instead, protect.

The rise in obesity has occurred because we are eating too much of the foods that do not promote satiety. “Satiety” is the word for feeling full; the feeling occurs when both hunger and appetite are satisfied. Hunger is the physical sensation that signals humans to eat and it occurs in response to a drop in blood sugar. Appetite is a psychological sensation, and it is linked to emotions, social cues, and the sight and aroma of food. Appetite may kick in even when we are full. For example, adults can eat a big meal, then see a delicious chocolate dessert and decide to make room for more. When we are sick we can experience hunger sensations but have no appetite because of the illness. Your child’s satiety is influenced by a full tummy and the rise in blood sugar and hormone changes that signal fullness. Eating in response to true hunger is a good thing, but eating in response to appetite when not hungry is dangerous because it leads to overeating.

Your child lives in a world where food is available at almost every turn, and many of these foods are salty, fatty, or sweet. These do not satisfy hunger but are eaten in response to appetite. The foods that actually satisfy hunger and cause a sense of true fullness have plenty of water, fiber, and nutrients. Water in food is important because it adds volume without adding calories. Foods with a high water content include fruit, vegetables, low-fat dairy, cooked grains (such as oatmeal), and beans. Fiber adds weight but no calories, and foods that weigh more in our tummies tend to cause fullness. Protein as found in lean meats, dairy, and legumes also satisfies hunger. Unfortunately, many of the foods marketed to your child as snacks carry none of these important nutrients and therefore are not likely to satisfy true hunger, so be cautious.

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The antidote to a food culture that is promoting foods in excess is the same simple principles that promote good nutrition. Eat three meals and planned snacks, and include a fruit or vegetable at every meal. At this early age obesity is not an issue, but poor eating habits are. Put the focus where it belongs. Do not restrict your child’s menu, but do design it to protect him from overeating. You must eat well, too, to set a good example and for your own health.

It is important to note that many parents apply diet principles to their children that are more appropriate to a healthy diet for adults. Adult diet principles do not apply to infants and toddlers. In fact, they can be detrimental to their health. For most adults a low-fat, high-fiber diet will be an improvement because total calories are lower and nutrients are greater. The same menu for children can result in a calorie and nutrient intake that is too low, because the foods that are high in bulk will fill up a child’s tummy long before they have met their nutritional needs.

The most important principle to focus on at this early age is variety in color, flavor, and textures. If a variety of foods are not introduced now, they are likely to be perceived as foreign and refused when older. If you follow these basic guidelines, you will be successful at feeding your child well.

• Start your child on a flexible but structured meal schedule—three meals and two or three snacks.

• Offer three or more different food items at every meal and make at least one of these items a fruit or vegetable. Include a fruit or vegetable at most snacks.

FOUR ACTIVITIES OF BIRTH TO THREE MONTHS FOR YOUR BABY

Games for 1- to 3-Year-Olds