27 Actionable Childhood Obesity Prevention TipsJun 15, 2022
27 Actionable Tips To Prevent Childhood Obesity
As a father of four children ages 7 to 14, it's heartbreaking seeing children succumbing to chronic illnesses and diseases that commonly afflict my much older patients. I see parents who tell me their 13 year old has diabetes, or their 10 year old has a cholesterol or high blood pressure. As a cardiologist and certified personal trainer, I feel that I must educate the public on this topic. Unfortunately, there is so much misinformation out there on this topic. Childhood obesity rates continue to rise, despite our efforts.
Here's a quick Video I did on Childhood Obesity:
How to Talk About Weight Loss With Your Children Without Giving Them An Eating Disorder
Why is Obesity a Common Problem in the U.S.?
Obesity has become the number one health risk in the United States. It used to be smoking, but less than 20% of the population smokes now. According to the CDC, obesity rates among adults have soared to 41.9% and the childhood obesity rate is now approaching 20%. 1, 2
The reasons for the obesity epidemic are multifactorial. We have a severe lack of information and education on obesity as well as less emphasis on activity. Couple this with high density hyperpalatable foods, and you have a recipe for disaster.
Take a look at the childhood obesity maps below based on CDC data from 2007 and more recent data from 2019.
Below is the map from 2019. Notice that far more states have obesity rates in the darker blue and purple colors. Most states have childhood obesity rates above 10% ad some are very dark blue with obesity rates above 20-24%
How to Help Prevent Childhood Obesity?
The most important way to prevent obesity is with education. Unfortunately, this is also the most difficult and resource intensive way to help prevent obesity. The internet is littered with misinformation and it is very accessible. Almost every fitness guru online is touting some new diet, supplement, or magic pill to combat obesity. Unfortunately, none of these gimmicks work long term. Sure, almost anything will cause weight loss short term, but long term and permanent weight loss is not easy.
The public is under an enormous media onslaught of misinformation. Whether it be from the mass media or random Facebook gurus, our lives are full of weight loss advice being handed out left and right.
Education will be the cornerstone of any successful obesity prevention program.
Causes of Childhood Obesity?
1. Cause: Misinformation and Education
We need to revamp the childhood education system in the US to provide better weight loss guidelines, tips, counseling and practical applications. Sure, you have to eat less food, but how do you approach that practically? How do you teach children and teenagers to eat the correct amount of calories? How do you teach the public to eat healthier, when they are under the impression that healthier means more expensive. We need to teach a wholesome and comprehensive nutrition strategy and it has to start in pre-kindergarten.
2. Readily available, cheap, hyperpalatable food
The second biggest issue is the over availability of calorie dense, hyperpalatable food. Just look at the vending machines in the schools and the school lunch menus.
Hyperpalatable foods are tasty and easy to over consume. A good example of a hyperpalatable, calorie dense food is potato chips. It's crunchy, salty, leaves a yummy residue on your hands, full of calories, and very easy to overeat. You can't eat just one! Imagine if instead of potato chips you had to eat one boiled potato? It's a tenth of the calories, super filling, but just doesn't taste as good, and isn't as fun to consume. You don't have a yummy residue leftover on your hands to lick off.
3. Reduction in activity
Although gym memberships have increased since the 1980s, Americans are still less active. Fitness trackers and step counters have shown a trend towards less activity. While exercise is not necessary for weight loss, it can help keep weight off that you have already lost. This is important for weight maintenance.
We don't have a weight loss problem in the US. Millions of Americans have lost weight. We have a problem with keeping it off. We need to focus on teaching parents and children proper fitness and exercise routines and how to use them effectively for weight maintenance.
4. Crash diets
The biggest problem is that everyone wants a quick fix, crash diet. You see ads online all the time for 30, 60, and 90 day weight loss programs. These may work in the short term, but rarely cause long term, sustainable weight loss. We need long term solutions, not crash diets. Fitness influencers need to stop worrying about their bottom lines with their next 30 day challenge, and start teaching people how to actually lose weight permanently and sustainably.
Fad diets are not going to fix the childhood obesity problem. Are we really going to teach children not to eat cereal, fruits, bread, and pasta because it's the latest trend on Instagram? Or to eat organ and liver meat only because some buff guy on YouTube says that's the best way to eat?
Along with crash diets, Instagram gurus are always pushing overly restrictive diets. You can't eat bread, can't eat anything except from 1-4pm, have to avoid gluten, can't drink pop or eat pizza. These overly restrictive diets cause people to have a very bad relationship with food, and you can not stick to them long term and revert back to your old eating habits. We need to teach people to eat foods they enjoy, but within reason and that no food is off limits.
5. Focusing on cardio
Too many people believe you can run off your calories and lose weight with excessive cardio. They sign their kids of for sports and activities and think that will fix the problem.
Again, this works for a few months, but isn't sustainable long term. You should sign your kids up for activities that you enjoy. You shouldn't sign them up because you think it will make them lose weight.
You need a calorie deficit to lose weight, and for the vast majority of kids, that will mean eating less food. It's very easy to reduce "calories in", it's not that easy to increase "calories out".
Exercise activity only comprises about 5% of your totally daily energy expenditure, and it's very difficult to increase it past that amount. We also now believe in the "constrained model of exercise", which states that no matter how much more exercise you do in a day, the amount of calories you can burn with exercise is capped. So whether you jog for a mile or thirteen, your body will adapt and your calories burned will be constrained and limited to a certain amount.
If we begin teaching these concepts and frameworks from an early age, we can hopefully reverse the rising obesity trends and hope to eliminate obesity on a more permanent basis.
6. Screen Time
Young children are busy playing video games, playing on their phones and tablets, and are not involved in regular physical activity. We are seeing health problems and cardiovascular disease at a much younger age.
7. Sedentary Lifestyle
The World Health Organization, the American Academy of Pediatrics, and the American Heart Association recommend 150 minutes of aerobic activity to help prevent heart disease and other chronic diseases. Healthy eating (with controlled calories) reduces health risks. We need to establish healthy habits and give young people easy access to more wholesome foods and active play.
8. Social Isolation
One of the biggest contributors to childhood obesity is social isolation. Children don't feel they can go outside and play or interact with other kids. Obese children are especially prone to this due to low self esteem. Health care professionals and parents need to work together to help eliminate sedentary activities and lower the risk of obesity. Children need a good role model! This can be parents or other older siblings and friends.
I talk about the weight loss mindset. This is an important step in childhood obesity prevention. The parents and children both need a healthy weight loss mindset. Healthy lifestyles and behavior change begins with the parents and trickles down to the children.
27 Ways To Prevent Childhood Obesity
1. Provide plenty of vegetables, fruits, and whole-grain products
Children need a wholesome diet composed of a variety of food choices. The sooner we get them used to fruits and vegetables, the more likely they are to eat them when they are older. Older children are less likely to suddenly start wanting to eat healthier foods if they didn't get used to it when they were younger.
Fruits and vegetables are the candy of the forest and are among the most nutrient and antioxidant dense foods available. They are also high volume which increases satiety. Imagine eating an entire bowl of iceberg lettuce or broccoli? You will have eaten a large volume of food, with very few calories. I don't like the term "unhealthy foods". I like to teach children to eat anything they want, just in moderation.
2. Include low-fat or non-fat milk or dairy products, including cheese and yogurt
Kids need protein and fat packed meals. Greek yogurt and dairy products provided needed nutrients and protein. They can be quite tasty and flavored as well. There are plenty of kid friendly, flavored yogurt drinks and bowls. Find something they like and encourage it.
3. Lean meats, poultry, fish, lentils, and beans for protein
Along with Greek yogurt, lean meats are great sources of protein. Most American children and adults don't get sufficient protein to support muscle growth, bone deposition, and strength. We need to find creative ways of increasing protein intake. Protein also helps prevent muscle loss during a calorie deficit if your child is trying to lose weight.
4. Encourage your kids to drink lots of water
Water can be very satiating. It will stretch your stomach and trigger satiety signaling sooner. This will help prevent overeating. It's important to start every day and every meal with water.
5. Limit sugary drinks
One of the biggest misconceptions is that fruits drinks like apple juice and orange juice are good for your kids. Sure, they can be. But not if they are packed with extra sweeteners and sugars. Natural fruit juices contain lots of vitamins and minerals. Just be careful because liquid calories can be deceiving and will not fill you up. You could drink a 250 calorie Gatorade and not feel satisfied at all. Why not eat an apple or orange instead? It's less processed and harder for your stomach to get at the sugars.
6. Reduce Overall Body Fat
If your child has a "pot belly" or wants to lose belly fat, the only way to do that is to just lose overall body fat. You can't spot reduce fat in one area. Belly fat is stubborn and can be the last to go. But we shouldn't focus entirely on body image and physical appearance.
Abdominal obesity is called visceral fat and is very metabolically active. Visceral fat imparts 10X cardiovascular risk compared to those with similar BMI (similarly overweight) but have fat deposited in other areas or more evenly distributed.
Losing weight is also the most effective ways to reduce inflammation, insulin resistance, and cardiovascular mortality. Studies have shown that regardless of what diet you want to follow, if you lose weight, your cardiovascular mortality and inflammatory markers all improve. In other words, if you lose weight, you will live longer. Regardless of which diet you want to follow. It's important to have your child or teenager follow the diet that feels the least restrictive to them. 3, 4, 5
7. Increase Activity
Increasing activity levels will reduce inflammation, insulin resistance, cardiometabolic syndrome, and reduce cardiovascular mortality. This happens even in the absence of weight loss. Studies have shown that overweight individuals can reduce their cardiovascular risk to that of their lean counterparts when they began an exercise program, even if their weight doesn't change. 6
8. Exercise for Fitness not Fatness
Sign your kids up for sports. Whether it's recreational basketball or travel soccer, sports and activity will have a profound effect on your child's long term health.
It is very important to exercise for fitness, not fatness. You will be disappointed if decide to start a new exercise program thinking it will cause a tremendous amount of weight loss, but then you don't lose any weight. We need to focus on the health benefits of exercise, as opposed to weight loss. Physical activity has been shown to independently reduce the rates of heart attacks and strokes.
We need to stress this point to our children. We are exercising to improve our health, not our looks. You don't want to give your child an eating or exercise disorder.
You don't want a child to starve themselves all day and come home and run 10 miles on a treadmill hoping to lose weight and look better. That is not how it works and is very psychologically traumatizing.
9. Eat Wholesome Foods
Adopting a more wholesome, less processed diet will help reduce cardiovascular mortality, regardless of anything else. The Mediterranean diet has been shown in multiple studies to lower cardiovascular mortality, as well as reduce the incidence of approximately 12 different types of cancer. 7, 8 Kids will generally follow the lead of the parents for most things, just make sure you are setting a good example.
10. Start Slowly
You should start making changes slowly. Radical, sweeping changes are very difficult to adopt and maintain long term, especially for children. Start by increasing fruit intake, then add nuts, in a few weeks eliminate pop and sugary drinks. If you do this gradually you will notice a huge difference. It's much easier to make small gradual changes than sweeping ones.
Start by having your kids go on a brief 5 minute bike ride. The next day make it 10 minutes and so on. Kids love spending time with you and will love anything you suggest to do together. So just get out there and do something.
If you make sudden, radical changes, you will not be able to make this a lifelong change. It doesn't matter if you eat whole grains or white bread, it just matters that you are not eating as much as before. Food quality matters, but food quantity is the most important factor when it comes to weight loss. Slowly change your children's food preferences.
11. Calorie Deficit
The only way to lose weight is to get into a calorie deficit. This can be tricky in children. You don't want them obsessed with tracking calories and judging food. You want them to develop a healthy relationship with food. You don't want to assign food a moral value. Food is neither inherently good nor bad. It's just food. Use it to fuel your goals.
Watch my video on how to talk to your children about weight loss without giving them an eating disorder. See the video embedded above.
12. Name Your Diet
The name of your child's diet doesn't matter. A calorie deficit will cause weight loss regardless of which macronutrients you choose to emphasize. 9 They can eat more carbs, no carbs, only fat, only protein... whatever their heart desires. As long they are eating less calories, they will lose weight and all of their cardiovascular markers will improve. When they control your calorie intake, they will see the difference over time. Fat loss depends on the calorie deficit only and not exercise.
13. Lift Weights
Yes, this is safe in children. I am a certified personal trainer, and I lift weights with all my kids, even my youngest child back when she was only 3 or 4 years old. Yes, it's not super heavy, but it's resistance training and it's fun.
Make sure you focus on resistance training and not just cardio. Lifting weights will slowly increase your basal metabolic rate because you will be carrying around more lean body mass (muscle). This is one way to increase metabolism. As a bonus, you will like the way you look when more fat comes off.
Increased lean body mass has also been shown to be more protective and showed reduction in all cause and cardiovascular mortality. 10 This will increase your muscle mass and increase your metabolic rate. Strength training will help mitigate weight gain.
14. Fruits and vegetables
Your kids may not like these, but they are good for them. Fruits and vegetables contains tons of antioxidants and are incredibly nutritious. If you add in one fruit and one vegetable per day, you will slowly transform your diet and make it more wholesome and more healthy.
15. Aerobic Exercise
Find an activity they enjoy, and find creative ways of doing it. Biking, walking, snowball fights, digging, tag, hide and seek, soccer, football, almost anything will work. They can even start by walking. Make it a nightly family walk.
Do this every evening when you get home from school or work. Try to get at least 7500 steps per day. This is the step count needed to be considered moderately active. The American Heart Association recommends at least 150 minutes or aerobic activity per day. If you get in 7500 steps per day, you are meeting this basic requirement.
16. Eat Slowly
It takes about 20 minutes for your stomach to tell your brain that you are full. I tell my patients and teenagers to eat half their plate, wait 20 minutes, and then decide if they want to eat more. Most of the time, they are full and don't need to eat more.
17. Track It
Tracking your caloric intake with an app like MyFitnessPal helps you stay on track. Others use food journaling to help them be more aware of how much they are actually eating. Tracking calories by itself has been shown in studies to subconsciously cause people to eat less. This is one really easy way to find out how much you are eating so that you have more data to decide if you should eat more. This may be tricky in children, but they should be able to write down what they ate that day. Remember, don't "punish them" or make them feel bad because they had ice cream. This is meant as education and awareness, not to hold them responsible.
Sleep is highly underrated, but it has been shown to enhance recovery and promote health. Studies have shown that a lack of sleep increases stress hormones, which in turn increases fat storage. 11 Make sure your kids are getting enough sleep. We recommend that teens get 7+ hours of sleep and adults get at least 6 hours of sleep. If your kids are under 10 years old, they could even need 8-10 hours of sleep! Reducing stress levels helps with weight loss and prevents weight gain.
19. Meal Prep
One way to control your kid's intake and cravings is to prepare food ahead of time, like packing lunch for school. For example, some people will cook 5 chicken breasts and 2 cups of rice and prepare them in small serving containers to take to work. This helps you keep your calories in check. For kids you could make sandwiches ahead of time and place them in Ziplock bags to take to school. Find healthy and nutritious snacks for your kids.
20. Stay Hydrated
When your stomach stretches out from water intake, you are likely going to eat fewer calories from other calorie dense foods. Plus the stretch of the stomach fires the vagus nerve and other signaling pathways that make you feel full and turn off hunger signaling.
21. Skip Sugary Drinks
One of the easiest ways to reduce children's caloric intake is to eliminate all calorie based drinks. Whether it's pop, Gatorade, apple juice, mocha lattes, or any other drink that is full of calories. Liquids just don't fill you up as much and it's easy to over consume calories from liquid drinks.
22. Follow The 80/20 Rule
Dieting is hard enough, don't punish your children for not being compliant all the time. Johnny had a pizza party? Ate ice cream? Too much stir fry? Don't worry about it. Tomorrow is another day and they can easily get back on track. Don't beat your kids up about it! They need to have a healthy relationship with food. Not use food to punish themselves. Don't go starving your kids the next day!
23. Play Keep Away
If your kids have issues with binge eating or can't stop eating once they see a bag of Doritos, then keep the Doritos out of the house. There is nothing wrong with enjoying Doritos. But if that is a trigger food for your child and will cause her to eat the whole bag or consume too many calories, then it's best to leave it at the store.
24. Eat Breakfast
A lot of teens (and adults) think that skipping breakfast will cause weight loss. It can in some cases, but it isn't necessary. Your body is usually depleted from your overnight fast and the extra calories will give you a boost of energy and fuel you the rest of the day. If you workout, it's even more important. It's also important to eat breakfast before school, so their brains are primed and ready to learn (instead of thinking about food all day).
25. Lean Protein
Kids need protein for muscle growth. You need to make sure they are consuming enough protein to prevent muscle loss and even to help build healthy muscles. The best way to increase protein intake is to find sources of lean protein. Things like egg whites, Greek yogurt, cottage cheese, protein powder, protein shakes, chicken, tuna, turkey breast are all great sources of lean protein.
26. Cut the Fast Food
Sure, you can lose weight eating fast food. Absolutely! But it's harder. Mainly because it's denser and full of calories. A cheeseburger and fries at Five Guys can be about 1500-1600 calories without the drink. And that's only one meal. Lifestyle changes are important and you might as well start now. A healthy diet should be full of fruits, vegetables, nuts, lean meats, olive oil, and other nutritious and tasty foods.
27. Hang Out With Like Minded Families
Hang out with families that have similar relationships with food and exercise. It's very difficult to be teaching your kids the importance of eating a balanced and healthy diet, while their friends are eating poorly. You are the average of the 5 friends you hang out with the most. Right? Pick their friends wisely while you can, until they start choosing their own friends.
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Overall, you have to choose foods that you enjoy and can eat for a very long time. It makes no sense to eat kale and quinoa for the rest of your life if you hate those foods. If you actually enjoy more wholesome food choices, then by all means, go ahead and add those foods to your diet. If you don't enjoy those foods, it may be hard to sustain this long term.
Studies on heavily restrictive diets have not shown good long term outcomes. You should follow a diet plan that feels the least restrictive to you.
If you want to learn more about sustainable, long term weight loss without restrictive diet plans, you need to grab my Actual Weight Loss book. I cover all of these topics in depth and even give you a free exercise program with video demonstrations as well as a comprehensive diet strategy based on science and research!
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