Monday, February 25, 2008

Rachel Ray on GMA

Rachel Ray was on Good Morning America today, discussing child obesity. She has some great ideas, but I found the segment too general. We need more discussion of specific things that a parent can do to prevent (or treat) obesity. She was promoting a family based approach, which is wonderful. The entire family needs to be involved in treating this problem. Active family activities should be planned for weekends. My family loves to go hiking in different parks or walking in the botanical gardens. We also love to have races. I bring my son to the local track and he rides his bicycle while I run. He always win the race- which he thinks is hilarious. We are having so much fun and he doesn't even realize that he is "exercising". When you act like physical activity is fun, your child believes that physical activity is fun. On the other hand, if you think being active is a chore, your child will also. I recommend sitting down and brainstorming all of the active games you can play with your child.

Here are some of my recommendations... I will list more whenever I blog.

Decrease inactivity! Limit TV, video games, and non-schoolwork computer use to 2 hours per day (total).

Incorporate activity into daily living. For example, walk to school, play outside, ride bikes, use stairs instead of elevators and escalators, park car at end of lot and walk to destination.

Increase vigorous activity! Child should get AT LEAST 45 minutes, 4 times a week.

Encourage organized sports, swimming, martial arts, basketball, speed-walking, biking, and rollerblading. Suggest dancing, hiking, gardening, ice skating, jumping rope, playing tennis, raking leaves, shoveling snow, and weight training.

Set a good example by getting some exercise yourself.

Establish exercise routines.

Make exercise a family activity! Go for a brisk walk after dinner each night.

There are many other fun activities to try. But first, try to think of some yourself. Your children will thank you!

Friday, February 22, 2008

Making a difference- one patient at a time!

I had a new patient today. I get so happy when I see a young person determined to make a healthy change in their life. Many people are overwhelmed about nutrition and dieting. There is always a new study and a new fad diet. It is important to get past all of that and focus on the basics: calories in and calories out. You lose weight when you burn more calories than you take in. It really is simple when you think about it that way. You need to decrease the calories you ingest and increase the calories you burn. And every little thing counts. Taking the stairs instead of the elevator, parking further away in a parking lot, walking instead of driving. In fact, one burns more calories each day through all of the little things than by going to the gym and working out. I always stress to my patients that little changes make a large difference. And little changes in diet help as well. Drink water instead of fruit juice. Use low fat peanut butter instead of regular. Every helps in the weight loss battle.

Thursday, February 21, 2008

Even Weight Loss Doctors Struggle...

Even weight loss doctors struggle with nutrition. I went to a dinner party at a family-style Italian restaurant last night with a bunch of friends. We ordered salad (and I asked for the dressing and cheese on the side) and I ordered whole wheat pasta with grilled chicken. I asked for them to use no oil when preparing my meal. Well- when the plate came, it was floating in grease. I complained to the waiter and he told me, "We didn't use any oil, like you asked. Instead, the chef substituted butter." It was very frustrating- but I nicely sent it back and asked for it to be made without butter or oil. Of course, when dessert came, I ate my fair share. But I would rather use my calories for dessert rather than for butter or oil. It is all about moderation.

A new article came out yesterday about parents and overweight teens. The article states that most parents of obese teens do not realize that their children are overweight. I have to say that I am not surprised at all. In my own practice, some of my heaviest patients don't initially believe that they need to lose weight. And as a general pediatrician, I had some parents upset when I suggested that their (very obese) child needed to lose weight. I think we all see what we want to see- but as parents, we are obligated to remove the blinders. Obesity is not about looks- it is about health. We really need to confront the issue- ignoring it won't help. Many pediatricians are wary of discussing weight with their patients because they don't want to upset them. But you cause many more problems- both physical and psychological- by ignoring obesity. As a nation, we must open up an honest diaglogue about this disease and remove the stigma associated with it. The worst thing a parent can do for an overweight child is avoid the discussion. Please- if you have an overweight child at home- intervene. Let your child know that you will support them in their efforts to get healthier. It can only help.

Wednesday, February 20, 2008

Welcome to my blog.

Hi! My name is Joanna Dolgoff and I am a pediatrician who specializes in child and adolescent weight management. The child obesity epidemic is getting worse every day and many parents feel powerless to stop it. Children are eating more and getting heavier. What can a parent do when their child is constantly exposed to unhealthy foods?

In this blog, I will continually give tips on how you can prevent your child from becoming overweight and how you can deal with your overweight child. I know how difficult this problem is; I have two children (ages 5 and 2) and I also struggle with their nutrition. I will have plenty of examples from my own life to choose from!

From an early age, I have taught my children that some foods are healthy and help us grow big and strong, and some foods are not healthy. When they were very little, we discussed that most healthy foods "grow". We tried to name as many foods that grow as we could think of: carrots, apples, oranges, lettuce, etc. We even included animals in the group- chickens grow, cows grow. When we would sit down to eat, I would ask them which foods on our plate were healthy- it became a game. We also discussed that cookies and cake don't grow- and aren't healthy. What they learned was that if it wasn't somewhat "natural", it wasn't the best food to eat.

I also used a similar technique at snack times. My children like to go to the cafe that is in the same building as their nursery school. Unfortunately, this cafe has every candy bar you can imagine on display, and has very few healthy options. Every once in a while, I allow my children to eat a candy bar for snack. But they may not eat a candy bar as an everyday snack. Many of their friends, however, are allowed these caloric candies. I have explained why they may not eat chocolate so often. They know that chocolate is not good for our bodies. Every day after school, my son, Zachary, asks, "Mommy, are we having chocolate today or a healthy snack?" I usually reply, "A healthy snack." And my kids go straight to the wall with all the snacks and wade through the chocolate bars and potato chips until they find a (lowfat) granola bar or a bag of pretzels. On the occasions that they are allowed to have cookies, they split a six pack. They know that nobody should sit down and eat SIX cookies. Believe it or not- my children do not protest. They have grown up thinking about what they eat; it is second nature to them.

It is not always easy and I am not always successful. There are plenty of times when, despite my best efforts, they will sit down and eat junk. Just yesterday, I found my Danielle, my two year old sitting in the den with a bag of Hershey Kisses that she had "found". But, when I looked closely, I saw that she had eaten two kisses and then turned her attention elsewhere. At least that is a start!

I think the message is that children are never too young to learn about nutrition. We need to start teaching them the basics as soon as possible. They will carry this foundation of knowledge with them throughout their lives.