Healthy Tips for Kids From Traverse City Pediatrician

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Childhood obesity is a growing problem in the U.S., and Northern Michigan is no exception. In the past 40 years, the prevalence of childhood obesity has increased 300 percent. That translates to 32 percent of children being overweight (National Health and Nutrition Examination Survey NHANES).

We talked with Dr. Stephanie Galdes DO, FAAP, a physician at Kid’s Creek Children’s Clinic in Traverse City, about how parents can help their kids lead active, healthy lifestyles by following the 5-2-1-0 Let’s Go! program, which was originally developed through the Barbara Bush Children’s Hospital in Maine.

  • 5 or more fruits and vegetables per day
  • 2 hours or less of screen time (no screens in the bedroom, no screens under 2 years old)
  • 1 hour of physical activity
  • 0 sugary drinks

When talking about childhood obesity, what do you recommend to parents?
“I really address it as a family problem instead of just focusing on the obese child. Oftentimes obese children have obese parents, but not always. As we talk about nutrition changes, I advocate if the child cannot drink pop, neither can the parents. If I am promoting increased aerobic activity I try to make them family activities everyone can do together.”

What are fun activities families can do together?

“The goal is 60 minutes per day—and this is additive—so you can do six 10-minute bouts of activity throughout the day, and that adds up to 60 minutes and counts. I like getting families outside, so walking the pets or hiking trails throughout Traverse City. On rainy days, I say have a family dance party and get the heart moving. For winter: snow angels and building a snowman. Choose activities that get us moving (hopscotch, hula hoop, basketball, tag). Move away from the screens and indoor activities. Simple family changes: park in the back of the parking lot and walk further to the store, take the stairs and work on counting with your kids.”

What are the dangers of childhood obesity?

“Immediate comorbidities or dangers of obesity include type 2 diabetes, hypertension, hyperlipidemia and nonalcoholic fatty liver disease (occurs in 10–15 percent of obese adolescents), sleep apnea, depression and low self-esteem. We often see metabolic syndrome (central obesity, hypertension, glucose intolerance and hyperlipidemia) which increases the risk of cardiovascular disease and mortality. The Harvard Growth Study found that boys who were overweight during adolescence were twice as likely to die from cardiovascular disease later in life as those who had a normal weight. Also, we see an increase in inflammatory disorders in obese children than in non-obese kids.”

Do you think childhood obesity is a large issue in Grand Traverse and surrounding counties? Or do you think this region is “healthier” than others?

“No, I think Grand Traverse is equally affected, and it’s an important issue in our county. We are lucky here in that we are surrounded by safe neighborhoods and ample opportunities to get outside and explore our natural resources and be active in our lakes, bays, forests, etc., but it is still a major issue.

“I treat obesity every day in the office and am constantly educating families on healthy lifestyle changes. In part, it has to do with our current ‘on the go’ lifestyle, where we drive from activity to activity, eat more processed food and sleep less. The food industry has also really influenced eating habits. Fewer families routinely prepare meals at home and rely on packaged processed meals, which tend to have higher levels of calories, simple carbohydrates, fat and preservatives. Kids are also consuming a large amount of high-carb beverages including sodas, sports drinks and juice. Half of U.S. children consume fast food daily.”

Tips for Parents: 

Below are some of the things Dr. Galdes likes to focus on. For more information and ideas, go to letsgo.org or healthychildren.org.

In a nutshell:

  • Watch portion sizes. They have increased dramatically over the past few years. Using a smaller sized serving spoon and smaller plates help children take appropriate servings of higher calorie foods. When you go out to eat as a family, recognize the portion sizes and discuss eating half and taking the other half home to enjoy later.
  • Eat breakfast. Skipping meals, especially breakfast, has been associated with obesity. Since mornings can be time-constrained, look for healthy on-the-go breakfast options.
  • Cook with your kids. Children take pride in being helpers, so let them mix the bowl or add ingredients to what you are making, and they’ll be more likely to eat what they helped create (more info).
  • Count the colors. The more colors on their plate the healthier, so make it a game or competition and have them count how many colors are on their plates. (e.g., two green vegetables, one orange, one yellow)
  • Give your children the chance to make some decisions, when applicable, on what they will be eating for dinner. (e.g., Would you like green beans or peas for dinner tonight?)
  • Limit juice to 4 ounces or less a day and avoid sugar-sweetened drinks like soda and energy drinks.
  • Don’t eat directly from the package. High-calorie snacks should be repackaged at home in smaller bags or containers.
  • Turn the TV off for dinner. Studies have shown that people consume more food when watching TV than those who do not. Take that time to reconnect with your family at dinner.

Here’s why: 

Limit unhealthy choices for snacks and celebrations; provide healthy choices. Snacks are now a bigger part of kids’ diets than in the past. In fact, more than 27 percent of a child’s daily calories come from snacks, and unhealthy snack choices are a major factor linked with childhood obesity. Serving healthy snacks to kids supports lifelong healthy habits, and helps reduce the risk of developing chronic health conditions. Research also shows that healthy snacking can improve kids’ behavior, focus and attention, while unhealthy diets actually decrease academic performance.

  • Take a few minutes to wash and cut your fruits and vegetables when you get home from the store.
  • Place a colorful bowl with fresh fruit on the counter.
  • Place pre-cut vegetable sticks or fruit in bowls on the lower shelves in the front of the refrigerator.
  • For older children, freeze blueberries or grapes on a cookie sheet, then place in a plastic bag or container. This is a refreshing treat that is also healthy for them.
  • More ideas.

Limit or eliminate sugary drinks; provide water. Research shows that sugar-sweetened beverages contribute to childhood obesity. Consumption of these drinks has increased dramatically since the 1970s and is now estimated to comprise 10–15 percent of kids’ total caloric intake for the day. Yet for all the calories, these drinks offer no nutritional benefits. In contrast, water is a free, no-calorie, easily-accessible option that is linked to a number of health benefits.

Prohibit the use of food as a reward. Using food as a reward for good behavior and academic performance is common, but studies show that the practice puts kids at risk for excess weight gain and obesity. Food rewards tend to be high in sugar, salt and fat, and tend to be offered multiple times a day, priming kids to establish lifelong unhealthy habits like eating outside of meal and snack times and developing a preference for unhealthy foods.

Provide opportunities to get physical activity every day. Kids who are physically active on a daily basis are less likely to be overweight or obese and are less likely to develop risk factors for chronic diseases and several types of cancer. Research also shows that children who are physically active tend to have better grades, school attendance and classroom behaviors, and have reduced feelings of anxiety, stress and depression—all leading to healthier bodies and minds.

Limit recreational screen time. Multiple studies have shown that excessive screen time is associated with overweight and obesity in children. In addition to displacing physical activity, when screen time includes TV viewing, children are exposed to commercials for unhealthy foods. Excess screen time has cognitive effects as well, putting kids at risk for lower reading scores, attention problems and problems learning.

Get enough sleep. Children who do not get enough sleep are at an increased risk of obesity. Parents can encourage good sleeping habits by forming a nighttime routine with small children. Avoid putting small children to bed with bottles or cups, and remove TVs from bedrooms to encourage good sleep hygiene.

Screen timeThe American Academy of Pediatrics recommends limiting screen time to 2 hours or less per day. This may be challenging for parents to implement, because children increasingly do more than one thing at a time (homework and texting) and because the limits between entertainment and education are often blurred, especially when using a computer.

#shapeupnorth


Shape Up North is a community collaboration dedicated to helping northern Michigan residents benefit from healthy eating habits and an active lifestyle. Living a healthier lifestyle can and should be an enjoyable adventure. Small changes in habits at school, work, and home can have long-lasting, positive effects on your health. With an abundance of great local foods and a four-season playground right outside your door, you and your family can lead a healthy, fit, and fun life.

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