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  HEALTH SENTINEL

Dieting Starts From The Crib


by Dr. Philip S. Chua.

October 1, 2010
As we have written in this column before, in our culture, a chubby kid is somehow considered a healthy child. Most TV commercials today use plump and rotund children in their food and vitamin ads. This sends a wrong and dangerous message, and a disservice to the public, especially to our youngsters. Nothing is farther from the truth. Overweight children, as shown by countless studies, are more likely to develop a cluster of health problems and their complications, compared to their peers with normal weight. The greater the weight excess —the higher a child’s body mass index (BMI), a measure of weight in relation to height — the greater the risk of acquiring the so-called metabolic syndrome early in life, which includes type 2 diabetes, high blood pressure and other cardiovascular diseases. Obesity, in children or in adult, is pandemic and a significant health danger.

The Risk Factors and Some Alarming Stats

The risk factors that characterize this syndrome are elevated triglycerides (blood fats), blood sugar, and blood pressure, low HDL (High Density Lipoproteins, the good cholesterol), and abdominal obesity. These precede the development of type 2 diabetes and cardiovascular diseases.

Two out of every 3 Americans are overweight, and about half of them have gone on, or on their way, to being obese. About 15% of children between ages 6 and 19 (that’s one out of 6) are overweight, and another 15% are on their way there. Two decades ago, there were only 5% overweight kids in the USA. Among those 20 and older, 30% are overweight today compared to 15.1% twenty years ago. From 1996 to 2001, there were 2 million obese teenagers and young adults. Interestingly, about 1 out of 4 dogs and cats are tipping up the scale too. And our statistics in the Philippines, except perhaps for the pets, are catching up with those of the western world. Diabetsity is upon us, globally, but this is preventable to a significant extent.
About 39% of children who are moderately obese and almost 50% of those severely obese develop the metabolic syndrome. Obviously, we are not over-feeding only ourselves to death but also our children and our pets.
The increase in the incidence of diabetes has also catapulted: from 2.8% in 1980 to 4.2% in year 2000. This and cardiovascular illnesses parallel the rate of the increasing waistline of America. Fifty percent of all obese adults have high blood pressure. One does not have to be a rocket scientist to figure out that excess body weight predisposes people to the metabolic syndrome in both children and adults.

Not Only For Aesthetic

The extra pounds or kilos are not only disfiguring but a most unhealthy baggage that takes its toll in terms of the development of otherwise preventable illnesses, like high blood pressure, heart disease, stroke, infertility, osteoarthritis, gall bladder disease, and many forms of cancer.

“Obesity is not a cosmetic issue and preventive measures ought to be implemented to stop further weight gain,” said Sonia Caprio of Yale University School of Medicine in New Haven, Connecticut, in a study published in the recent issue of the New England Journal of Medicine.

Timing of the Strategy

The best time to start this strategy for health and disease prevention is during childhood, starting from the crib. That’s when the brain is more receptive to teaching and when preferences and habits are just beginning to develop. The standard practice where the Pediatrician prescribes (pre-computed) measured feedings and frequency for the baby is nothing but calorie counting, as in dieting. To be effective, counting calories should indeed start from the crib, and regulated milk formula intake of babies is an accepted worldwide. To do otherwise would be unhealthy for the infant. So, whether we realize it or not, mothers in developed and developing countries have actually been doing calorie counting (dieting) starting from the crib for generations. But it is never too late to start, no matter how old a person is. Adopting a healthy lifestyle is always timely, anytime, at any stage in life.

The problem starts when the child gets out of the crib. When the kid begins to walk and to choose, we allow them to eat, without “counting calories,” and cater to the whims of the child, giving them whatever they demand for. And we, parents, do this because we love our children. But, is this love?

The Sensible Diet

We have discussed this issue a few times in this column. I advocate a plain, simple, inexpensive, and sensible formula. The basic principle to maintain a normal weight requires intake of calories (quantity of food) should closely approximate the output of energy (physical exercise, etc). Quantity and quality are essential factors.

Quality: eat foods that have proven scientifically to be healthy foods, which include fish, vegetables, fruits, nuts and grains, low fat/low cholesterol, high fiber diet (minimizing red meats and eggs and dairy products). For adults, skim milk is preferred; for growing children, 2% milk; for infants, breast milk, and if supplement is needed, formula milk as prescribed by the pediatrician. Carbohydrates (the “sweets,” rice, potato, bread, non-diet pop drinks, ice cream, cakes, candies, etc) are a great culprit in weight increase. Low-carb diet is in. People will do well with low-carb diet for weight reduction, but to substitute high fat and high cholesterol (red meats and eggs, etc) for carbohydrates is blatantly unhealthy, tremendously increasing the risk of cardiovascular diseases and cancer. The best diet is still fish and high fiber items like vegetables, some fruits, nuts, and whole grains.

For adults in mild active life, with normal weight, 1500-1700 calories a day should suffice to maintain normal weight. For children with normal weight, 2000 calories a day should be tops, and adjusted accordingly if the child is starting to be overweight for his height and age. Children who are overweight should be checked by a physician, who could prescribe a diet plan. The habit of pushing ourselves away from the dining table less than full will serve us well.

Love Not Our Children to Death

Let us teach our children, starting from the crib, on how to live a healthy lifestyle (by example), and not expose or condone them to acquire the bad and dangerous habits we, ourselves, have developed over the years. We must learn how to say “no” to our children for their own good, even if it hurts us. Instead of trying to be popular with our kids, let’s protect them. We certainly do not want to love them to ill-health and premature death.

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