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SOLVING CHILDHOOD OVERWEIGHT

Posted Nov 04 2009 10:05pm

  By Marie Dufour, RD – The last hospital patient I saw as a clinical dietitian was a 20-year old African-American girl.  She weighted over 400 pounds and was dying from lack of oxygen, her chest so heavy that she could no longer lift it to breathe.  That broke my heart just as much as did the teenagers asking me about bariatric surgery to save their lives.  With my little food guide and nutrition pamphlet, I felt quite alone and ineffective, having only one shot at nutrition education.

Reversing childhood overweight requires a complex, multi-faceted approach, not necessarily focusing on weight loss, but on behavioral change.

Sporadic nutrition education is ineffective, as demonstrated once more by an Australian intervention aimed at promoting weight loss in 258 overweight children ages 5 to 9.  Family physicians volunteered to provide four individual counseling sessions to overweight children and their families.  After 3 months, the children in the intervention group showed no change in eating habits, physical activity and water consumption.

This study fuels the debate of whether or not individual and sporadic intervention by family physicians is worth the cost.  The intervention cost investigators $1,100 per child, versus $67 in traditional setting, and although children were to attend four sessions, the mean attendance rate was only of 2.7 sessions. 

Let’s set aside the topic of physical activity, and look strictly at nutrition.  Children and their parents have lost touch with appropriate nutrition for two major reasons: lack of education and a toxic environment.  This can be reversed with structures already in place, repeated exposure to health-conscious messages, and an effort from food distributors to identify non-toxic products on their shelves.

 - Child education: nutrition needs to be taught as a mandatory school subject, year after year and starting early.

- Parent education: through television nutrition and healthy cooking shows, newspapers and magazine articles, written or produced by Registered Dietitians.

- Grocery stores health-promoting stance:

          - “Light” circuit shopping, away from “Heavy” aisles;

          - Decentralized produce carts located in parking lots and at curbside;

          - In-store light cooking shows;

          - In-store free dietitian consultation;

- Hospitals and medical groups proactive policies:

         – Nutrition education pamphlets to all members;

         – Free nutrition screening and dietitian initial consultation upon enrollment;

         – Healthy Living Health Fairs (Nutrition and physical activity);

- Business participation:

         – Healthy cafeteria menus, including nutrition labels on menu items;

         – Free initial nutrition evaluation; free healthy nutrition support groups;

         – Employee education via web-based “Nutrition Spots;”

         – Insurance discount for participation in nutrition education workshops.

- City programs:

         – Healthy Camps: nutrition, physical activity, healthy cooking;

         – Healthy Cooking for Moms, Dads, & Families community classes;

         – Health-promoting infrastructures: sidewalks, parks, and security;

         – Pro-health policies: produce cart licenses, no-Fast-Food zones near schools.

 Each of us has a role to play.  Whether a business owner, a city worker, a teacher or a health worker, each of us can create a climate and an environment where we can rear healthy and lean children. 

          Don’t wait for “THEM;”  What will YOU do?

Filed under: Lifestyle, community nutrition, diet, public health, childhood obesity, city action, community nutrition, diet, healthy eating, healthy lifestyle, healthy living, kids' health, Marie Dufour RD, men's health, nutrition, nutrition counseling, nutrition education, nutrition policy, obesity, pro-health policies, public health, solving childhood obesity, weight control, weight loss

  By Marie Dufour, RD – The last hospital patient I saw as a clinical dietitian was a 20-year old African-American girl.  She weighted over 400 pounds and was dying from lack of oxygen, her chest so heavy that she could no longer lift it to breathe.  That broke my heart just as much as did the teenagers asking me about bariatric surgery to save their lives.  With my little food guide and nutrition pamphlet, I felt quite alone and ineffective, having only one shot at nutrition education.

Reversing childhood overweight requires a complex, multi-faceted approach, not necessarily focusing on weight loss, but on behavioral change.

Sporadic nutrition education is ineffective, as demonstrated once more by an Australian intervention aimed at promoting weight loss in 258 overweight children ages 5 to 9.  Family physicians volunteered to provide four individual counseling sessions to overweight children and their families.  After 3 months, the children in the intervention group showed no change in eating habits, physical activity and water consumption.

This study fuels the debate of whether or not individual and sporadic intervention by family physicians is worth the cost.  The intervention cost investigators $1,100 per child, versus $67 in traditional setting, and although children were to attend four sessions, the mean attendance rate was only of 2.7 sessions. 

Let’s set aside the topic of physical activity, and look strictly at nutrition.  Children and their parents have lost touch with appropriate nutrition for two major reasons: lack of education and a toxic environment.  This can be reversed with structures already in place, repeated exposure to health-conscious messages, and an effort from food distributors to identify non-toxic products on their shelves.

 - Child education: nutrition needs to be taught as a mandatory school subject, year after year and starting early.

- Parent education: through television nutrition and healthy cooking shows, newspapers and magazine articles, written or produced by Registered Dietitians.

- Grocery stores health-promoting stance:

          - “Light” circuit shopping, away from “Heavy” aisles;

          - Decentralized produce carts located in parking lots and at curbside;

          - In-store light cooking shows;

          - In-store free dietitian consultation;

- Hospitals and medical groups proactive policies:

         – Nutrition education pamphlets to all members;

         – Free nutrition screening and dietitian initial consultation upon enrollment;

         – Healthy Living Health Fairs (Nutrition and physical activity);

- Business participation:

         – Healthy cafeteria menus, including nutrition labels on menu items;

         – Free initial nutrition evaluation; free healthy nutrition support groups;

         – Employee education via web-based “Nutrition Spots;”

         – Insurance discount for participation in nutrition education workshops.

- City programs:

         – Healthy Camps: nutrition, physical activity, healthy cooking;

         – Healthy Cooking for Moms, Dads, & Families community classes;

         – Health-promoting infrastructures: sidewalks, parks, and security;

         – Pro-health policies: produce cart licenses, no-Fast-Food zones near schools.

 Each of us has a role to play.  Whether a business owner, a city worker, a teacher or a health worker, each of us can create a climate and an environment where we can rear healthy and lean children. 

          Don’t wait for “THEM;”  What will YOU do?

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