Spring Quarter 2005

CHILDHOOD OBESITY LESSON PLAN AND RESOURCES
A Healthy Mind and Healthy Body

The number one health problem in America today is obesity. North Carolina’s children are experiencing a Childhood Obesity Epidemic!

DID YOU KNOW?

According to the national Kids Count Data Book, North Carolina ranks 39th in the nation-among the 12 worst states-on the health and well being of children. Research also indicates that children are adopting sedentary lifestyles as early as age three!

Piaget

Piaget's first two stages of intellectual development (sensorimotor and preoperational) indicate that developmentally appropriate health instruction and cognitive and behavioral skills building are important. Parents and teachers need to spend time addressing preoperational concepts, for example, distinguishing between different vegetables and fruits by color, shape and taste. This prepares older children for more concrete operations such as choosing high-fiber and low-fat foods.

FitTogetherhttp://www.fittogethernc.org/

Fit together, a partnership of UNC Center for Public Television, BCBSNC and the NC Health and Wellness Trust Fund, is one of the most comprehensive state obesity prevention campaigns nationwide. The Fit Together approach is unique in that it emphasizes both individual and community action to prevent obesity. The Fit Together Web site connects individuals to local resources such as fitness programs, exercise facilities and counseling on nutrition and healthcare. It also spotlights North Carolina communities that successfully promote healthy lifestyles.

All Living Things Change

Change happens everywhere and all the time. All living things change: people, plants and animals. Some things change quickly and some things take a long time to change. Even things that are not living change. The slow change of mountains, deserts and oceans is difficult for young children to grasp. The following suggestion talks about how you can explain change to your children.

Talk with Your Child

Every morning you may wear the same jeans, but one day you look down and see that your pants look smaller. Your jeans did not get smaller; you got taller. Your are growing and you are changing. We plant seeds in the garden, and as we care for them we can watch as they change. Foods change when mixed together and cooked, baked, or frozen. Fresh foods do not last forever. When they get old, they rot and change. Water can be frozen so that it changes into ice.

Water can be heated so that it becomes steam or vapor. Everyday the weather changes. Days change into nights and nights change back into days. Clocks and calendars are used to measure these changes.

All living things change: Have each child and teacher bring in his/her own baby picture. Place them on display. Take pictures of everyone in class. Match the pictures. Discuss how people looked when a baby and how they look now.

Fresh foods do not last forever: Bring in a banana and a tomato. Watch each day to see if there are any changes. Have children make comments about what they observe. Do they change the same way? Do they change in the same amount of time?

Overall Goals:

• Participants will understand that good health in its broadest sense is a process rather than an end.
• Participants will explore the causes and consequences of childhood obesity
• Participants will explore how to help their children live a healthy lifestyle.
• Participants will be introduced to state and national standards regarding healthy living.

According to a report recently released by National Institute for Health Care Management Foundation, researchers believe that giving kindergartners at least five hours of physical education time per week - the amount recommended by the federal government - could potentially reduce the prevalence of obesity and overweight among girls by 43 percent.

Ice Breaker

Resource:

Never Take a Pig Out to Lunch and Other Poems
Nadine Bernard Westcott 64 pp. New York: Orchard Books, 1998

ISBN: 0-53-107098-0 Age: 4-8 years
Abstract: A collection of 50 poems and traditional rhymes about food and eating.

Ice Breaker Procedures:

1. Read one poem and discuss the messages included within the poem and why children learn well through the use of rhyme and repetition.
2. Select poems to be read and discussed in the small groups. Have participants look for messages and discuss how they would use the poem to introduce healthful living messages in a fun way to their children. Each group will select a reporter (reports out to the group as a whole), a note taker (records what the group discusses), coach (keeps everyone participating) and a timekeeper (keeps group moving to meet the time limit).
3. Have each group’s reporter share with the whole group

Discussion Guide:
Preventing Childhood Obesity Through Healthy Eating and Exercise

The number of overweight and obese children in the United States is growing at a phenomenal rate. On the whole, kids are spending less time exercising and more time in front of the TV, computer, or video game console. And today's busy families have fewer free moments to prepare wholesome, home-cooked meals, day in and day out. From fast food to electronics, quick and easy seems to be the mindset of many people, young and old, in the new millennium.

Since the 1960s, the number of overweight kids and adolescents in the United States has nearly doubled. Today, 10% of 2- to 5-year-olds and more than 15% of children between the ages of 6 and 19 are overweight. And a whopping 31% of adults are also obese. Studies indicate that overweight and obese adolescents have up to an 80% chance of becoming overweight and obese adults, especially if one or more parent has the same condition.

Overcoming overweight and obesity in your own children means adapting the way you and your family eat and exercise and the way you spend time together. Ensuring that your children lead a healthy lifestyle begins with you, the parent, and leading by example.

Is Your Child Overweight or Obese?
Although you may think that your child is overweight or even obese, only a doctor should make that determination (calculating your child's body mass index, or BMI, can be a good indicator).

To determine BMI, the doctor divides the child's weight by his or her height squared, or wt/ht 2. ( Important: To use this formula for BMI, the child's weight and height measurements must be in kilograms and meters, respectively. If you use pounds and inches, multiply the result by the conversion factor 703.) This calculation helps the doctor determine whether the child's weight is appropriate for height.

Children ranking higher than the 97th percentile for age are considered obese. Kids with a BMI score between the 85th and 97th percentile are considered overweight or at risk for becoming obese (or extremely overweight). And children who fall between the 5th and 85th percentile are considered normal weight.

For example, a 13-year-old boy who's an average 5 feet, 3 inches tall would rank as follows:

Above 141 pounds = obese
124 -141 pounds = overweight
88 - 123 pounds = normal weight
Below 88 pounds = underweight

There are exceptions, of course, like for those who are very muscular (because extra muscle adds to a person's body weight - but not fatness). It's important to remember that BMI is usually a good indicator - but is not a direct measurement - of body fat.

If you're worried that your child or teen may be overweight, make an appointment with your family doctor to find out for sure. Your doctor will need to evaluate your child not only for obesity, but also for the medical conditions that can be associated with obesity (see below).

Before adopting any kind of diet or weight-loss plan, talk to your child's doctor, who may refer you to a registered dietitian or a weight management program. Depending on the child's weight and age, the doctor or specialist may not emphasize immediate weight loss but may focus, instead, on decreasing the rate of weight gain as the child grows

Source:Overweight and Obesity

The Truth About Fats

Like carbohydrates in recent years, fats have been wrongly accused of being "bad." Although some are definitely better than others, certain kinds of fat are actually good for you and your child and are an important part of a healthy diet.

What Is Fat?
Fats, or lipids, are nutrients in food that your body uses to build nerve tissue (like the brain) and hormones. Your body also uses fat as fuel. If fats that you've eaten aren't burned as energy or used as building blocks, they're stored by the body in fat cells. This is your body's way of thinking ahead: By saving fat for future use, your body plans for times when food might be scarce.

Fat gives food flavor and texture, but it's also high in calories, and excess amounts of fatty foods (as with excess amounts of any food) can cause many health risks. For children and adolescents, desserts and snacks (including potato chips, chocolate, cakes, doughnuts, pastries, and cookies) are a significant source of fat. Kids also get fat from whole milk products and high-fat meats, such as bacon, hot dogs, and non-lean red meat.

Of course, fast food and take-out meals tend to have more fat than home cooking; and in restaurants, fried dishes are the highest in fat content. Fat also often "hides" in foods in the form of creamy, cheesy, or buttery sauces or dressings.

Still, though, fat is an important part of a healthy diet when your child eats the right kinds of fats (especially those from certain kinds of fish) in recommended amounts.

Why Some Fats Are Healthy
Although many of today's children are much less physically fit than previous generations and the percentage of obese children has more than doubled in the United States since 1976, fatty foods certainly aren't the lone culprit behind the obesity epidemic.

No t exercising, being sedentary (watching TV, spending time on the computer, and playing video games), and eating larger portions of foods than we need take the lion's share of blame for the obesity epidemic. Of course, lower-fat diets have been recommended to promote good health and help people prevent obesity and maintain a healthy weight.

But the benefits of fats, in general, are often overlooked. They:

• Are essential to growth and development (Young children, especially, need a certain amount of fat in their diets to help the brain and nervous system develop correctly. That's why toddlers need to drink whole milk, which has more fat, whereas older kids can drink low-fat or skim milk.)
• Can’t always be manufactured by the body, so they have to be eaten
• Fuel the body
• Aid in the absorption of some vitamins (Vitamins A, D, E, and K are known as fat soluble, meaning they can only be absorbed if there's fat in a person's diet.)
• Are the building blocks of hormones
• Are necessary for insulating all nervous system tissues in the body
• Help people feel full, so they're less likely to eat as much
• Can protect against heart disease

However, there's confusion about the amount of fat that should be in a healthy diet, for both kids and adults. Fat has more than twice as many calories as protein or carbohydrates (1 gram of fat provides 9 calories, whereas 1 gram of both carbohydrates and protein provide 4 grams each). So fat is, therefore, a great source of energy but also adds twice the amount of calories to a meal.

There are many different "diets" that suggest different amounts of fat - or even no fat - as being healthy. However, some experts think the low-fat/no-fat revolution has gone too far, overlooking the complex nature of fats and how they work in the body. In fact, the new dietary recommendations emphasize healthy percentages of calories in the diet from fats for kids, teens, and adults.

What Are the Types of Fats?
To help you figure out how to size up fat in your child's diet, here's a look at the three major types:

Unsaturated fats: Found in plant foods and fish, these fats are seen as neutral or even beneficial to heart health. The best of the unsaturated fats are:

• Monounsaturated , found in avocados and olive, peanut, and canola oils
• Polyunsaturated , found in most vegetable oils
• Omega-3 fatty acids , found in oily fish such as albacore tuna and salmon

Saturated fats: Found in meat and other animal products, such as butter, shortening, lard, cheese, and milk (except skim or nonfat), saturated fats are also in palm and coconut oils, which are often used in commercial baked goods. Eating too much saturated fat can raise blood cholesterol levels and increase the risk of heart disease.

Trans fats: Found in margarine (especially the sticks), commercial snack foods and baked goods, and some commercially fried foods, trans fats (also called trans fatty acids) are created when vegetable oils are hydrogenated (meaning that hydrogen atoms are added to the fat molecule so they remain solid at room temperature). Like saturated fats, eating too much trans fat can raise cholesterol and increase the risk of heart disease. By 2006, food manufacturers must list trans fats on food labels. For now, keep an eye out for "hydrogenated" or "partially hydrogenated" oils on the ingredient list.

Looking at Labels
When you're out shopping for food, picking up products, and perusing labels, it's important to understand that food companies want their foods to seem healthier, low in fat, or low in calories, so they may make their serving size smaller than the portion size most people would normally eat. For example, a bag of corn chips might list five chips as a serving size. But you'd have a hard time finding anyone who would eat only five chips. That's why it's always important to compare serving sizes.

When it comes to fat, labels can say many things. Low-fat, reduced fat, light (or lite), and fat-free are common terms often splashed across food packages. But the government has strict rules about the use of two of these phrases. By law:

• Fat-free foods can contain no more than 0.5 grams of fat per serving.
• Low-fat foods may contain 3 grams of fat or less per serving.

Reduced-fat and light (lite) foods are a little trickier, though, and you may need to do some supermarket sleuthing. Light (lite) and reduced-fat foods may still be high in fat. The requirement for a food to be labeled light (lite) is that it must contain 50% less fat or one third fewer calories per serving than the regular version of that food.

Foods labeled reduced fat must contain 25% less fat per serving than the regular version. But if the regular version of a particular food was high in fat to begin with, a 25% to 50% reduction may not lower the fat content enough to make it a smart snacking choice. For example, the original version of a brand of peanut butter contains 17 grams of fat and the reduced fat version contains 12 grams. That's still a lot of fat!

Do not expect the label to tell all. The percentage of fat in a food isn't always listed on the label. But it is easy to calculate. Divide the number of calories from fat by the number of total calories and multiply by 100. For example, if a 300-calorie food has 60 calories from fat, you divide 60 by 300 and then multiply by 100. The result shows that that food gets 20% of its calories from fat.

How Much Fat Should My Child Get?
Although the tendency for some parents is to try to cut fat altogether or excessively limit it, it's crucial for fat to stay a part of your child's diet. Despite the bad press, fat is not the enemy. In fact, restrictive diets aren't recommended for kids.

For young children, especially, fat and cholesterol play important roles in brain development. And for kids below 2 years old, fat should not be restricted. Starting at 2 years old, children should eat a varied diet with about 30% to 35% of calories coming from fat. For ages 4 to 18 years, the recommendations are about 25% to 35% of calories.

Fit Fats and Your Family
Although eating adequate amounts of fat is an important part of a healthy diet, it is true that many kids today do eat too much of it. And excess fat in a child's diet may lead to weight gain. Kids who carry excess weight into adulthood have greater risk of heart attacks, high blood pressure and early death, and have a higher incidence of depression and orthopedic problems.

So here are some ways to keep your child's fat intake in check and within the recommended healthy levels:

• Offer naturally low-fat foods, such as fruits and vegetables, whole grains, and lean meats, as well as low-fat dairy products.
• When cooking meat, opt for broiling, grilling, or roasting (on a rack). These methods allow the fat to drip away during cooking, which cuts down on calories, too. Frying, on the other hand, keeps foods in their own fat or requires added fat.
• Resist low-fat crackers, cookies, and other snacks that may be high in calories and easy for your child to overeat.
• Pack school lunches and meals for family outings, instead of going to fast-food restaurants or relying on your child to make healthy choices in the school cafeteria.
• Try planning your child's meal ahead of time to eliminate reliance on fatty foods.
• When you dine out, help your children make balanced choices that don't include large amounts of fat. For example, make a green salad part of your order and use low-fat dressing on the side. Encourage choosing mustard instead of mayonnaise on sandwiches. Choose stir-fried or steamed dishes rather than fried. If your child wants to skip the burger and just have fries at a fast-food restaurant, suggest that he or she order only a small portion of fries and have it with a salad.

Probably the most effective way to teach your child healthy eating habits is to set a good example. Make nutritious food a priority in your life by limiting visits to fast-food restaurants and by teaching your child how to prepare meals and snacks healthfully. Simply be a good nutritional role model. If your child sees you eating junk food, it's likely that he or she will, too. Establishing sensible eating habits, choosing foods wisely, and exercising regularly are the keys to long-term good health.

Reviewed by: Barbara P. Homeier, MD
Date reviewed: January 2005

Jay Jay The Jet Plane