October 2008

Healthy snacking for kids: Top five tips

Parents can help reduce childhood obesity

The importance of strengthening for kids

West Suburban YMCA staff helps NEW Kids at the Y program participants

Healthy snacking for kids: Top five tips

Jennifer Allen, RD, CD

Snacking is an area where many children can develop unhealthy eating habits. Keep these tips in mind when talking with parents about the snacks their children eat.

1. Snacks are optional.
Kids don't always need to eat a snack between meals. Teach kids to listen to hunger signals and snack between meals only if they feel hungry.

2. Snacks are not meals.
Keep snacks small. A snack should consist of just one serving each of one to two food groups. Snacks should be eaten about 90 minutes to two hours before the next mealtime. When kids are allowed to snack endlessly, they may not eat many of the healthy foods served at mealtimes. To help control portions, you can use a small "snack bowl" at home or preportion large packages of food into "snack bags."

3. Snacks don't have to be "snack" foods.
While crackers, cookies and other prepackaged items often are marketed as "snack" foods, they are not always the healthiest choices for kids. Use the opportunity when kids are hungry between meals to encourage healthy foods – fruits, veggies, whole grains and low-fat dairy products.

4. Snacks should be limited.
When snacks consist only of "snack" foods, kids often get hungry again quickly. In order to make snacks filling, include one fiber-containing item (fruit, veggie or whole grain) and one food that contains lean protein-containing item (nuts, peanut butter, low-fat cheese, yogurt, low-fat milk or lean meat). Some great combinations of these foods include:

• Carrots, celery or apples with peanut butter.
• Whole-grain crackers with low fat cheese.
• A whole-grain tortilla with one slice of lean lunchmeat.
• A 6-oz. smoothie with yogurt or milk and frozen fruit.

5. Snacks should be served at the table.
Kids often overeat when they are sitting in front of the TV or playing video games. Like meals, snacks should be served at the table with the TV off, whenever possible. This helps kids avoid distractions and concentrate on eating.

Get more fun snacking ideas here.

Parents can help reduce childhood obesity

Laure DeMattia, DO

As a busy health care provider, you are aware of the increased number of families struggling with obesity and the health risks associated with excess weight. Several studies have shown that by targeting parents, there is a better chance of reducing childhood obesity. How can we best influence parents and children to partner in addressing this chronic condition? Many times anticipatory guidance is where we can make the most impact for every family, whether they are at risk or already dealing with childhood obesity.

Current recommendations to prevent excess weight gain are to counsel all families to:

• Limit beverages that are sweetened with sugar.
• Limit screen time to less than two hours per day.
• Eat breakfast daily.
• Limit eating out due to increased energy density of restaurant-prepared foods.
• Encourage families to eat together at least five times per week.
• Limit portion sizes because packaging may contain more than one portion.

For children who have health problems that are worsened by excess weight or whose body mass index is greater than the 85^th percentile, the following recommendations also should be addressed:

• Aim to eat more than five fruits and vegetables per day. Start by making attainable goals of a fruit or vegetable at every meal.
• Parents should allow children to self-regulate intake at meals to avoid overrestrictive eating patterns.
• Health care professionals should recommend monthly follow-ups to monitor progress and if no improvement, consider a program such as NEW Kids at the Y with weekly participation and education.

For children with a body mass index greater than the 95^th percentile, the recommendations become more structured:

• Children should eat balanced meals with one to two snacks between meals. Meals and snacks should emphasize low-energy foods. There should be no caloric intake outside of planned meals and snacks.
• Parents should reduce screen time to less than one hour per day.
• Parents should plan and supervise moderate to vigorous physical activity for at least 60 minutes per day.
• Caregivers should monitor the above behaviors through logs or journals.
• Follow-up visits should be scheduled to reinforce the targeted behaviors.
• If no improvements are seen in three to six months or comorbidities are present, medical professionals should consider a referral to a multidisciplinary program.

References
M Golan, S Crow. Targeting Parents Exclusively in the Treatment of Childhood Obesity: Long-Term Results Obesity Research, 2004(12)358-61.

Germann JN, Kirschenbaum DS, Rich BH. Child and parental self-monitoring as determinants of success in the treatment of morbid obesity in low-income minority children. Journal of Pediatric Psychology, 2007 32(1):111-121.

Barlow, SE and Expert Committee (2007). Expert committee recommendations regarding the prevention, assessment and treatment of child and adolescent overweight and obesity: Summary report. Pediatrics 120 (Supplement 4), S164-S190.

The importance of strengthening for kids

Stacy Stolzman, MPT
Tara Cohen, exercise science student

Strengthening is just as important for children as it is for adults. Research shows that children who strength train have long-term health benefits. The nervous, muscular and bone systems will adapt to a 15-minute program two times per week in children ages 6 and older. Bone compression and deformation stimulates new bone growth. As muscles grow stronger, they pull harder on bony attachment sites creating these bone adaptations. Neural changes are responsible for most strength gains in children. Children do not have enough of the hormones (specifically testosterone) that cause muscle hypertrophy.

Many health care professionals believe resistance training may damage growth plates, stunt growth and add excessive muscle bulk. The National Strength and Conditioning Association states that "a properly designed and supervised resistance training program is safe for children and can increase strength." In fact, strength gains of 30 to 74 percent have been reported in pediatric literature. These are similar to adult strength gains. Resistance training is one way for children to begin the habit of exercising and to continue exercise into adulthood.

To ensure the health of adolescent growth plates, keep the volume of training low. Use light loads and high repetitions no more than two times per week with proper supervision. Be certain that the child is mentally and emotionally ready to take training seriously.

Start with simple exercises such as squats, lunges, push-ups, sit-ups, theraband resistance and even machine weights. Then progress by varying the intensity through walking lunges, planks and plyometrics. Even school age children can begin strengthening by using their own body weight through beginner sit-ups, press-ups and pull-ups.

References
William Ebben, PhD, MSSW, CSCS, USAW, assistant professor of strength and conditioning, Marquette University.

www.nsca-lift.org

West Suburban YMCA staff helps NEW Kids at the Y program participants

Sydney Hofer, YMCA of Metropolitan Milwaukee

The West Suburban YMCA, located at 2420 N. 124^th St. in Wauwatosa, is pleased to

Cori Aronow (left) and Christine McBride, NEW Kids at the Y, West Suburban YMCA.

Christine McBride is the West Suburban NEW Kids at the Y Coordinator and Activity Director. She graduated from the University of Minnesota with a bachelor of science in Biology. She is a Wellness Coach at the West Suburban YMCA. In addition to her work with the NEW Kids at the Y program, McBride also teaches Silver Sneakers, Body Vive and a muscle conditioning class.

Cori Aronow is the NEW Kids at the Y Facilitator for West Suburban. Aronow has a B.S. in Education from the University of Idaho. She started as a lifeguard with the YMCA before becoming a Wellness Coach. She also works as a facilitator for the adult lifestyle change program offered at the Y.

Aronow says parents in the program appreciate the support they get from the NEW Kids at the Y staff. "Many parents are looking for back-up support," she said. "The kids need to hear about the importance of exercise and nutrition from someone other than their parents for that information to really sink in."

Both McBride and Aronow enjoy working with children and their parents. They work to create an environment where kids and parents feel comfortable sharing their challenges and successes. "Parents really help each other out," said McBride. "It's also a safe environment for the kids to open up, as well."

McBride and Aronow make a great team, providing the support families need to be successful. When the 12-week program is over, families are encouraged to remain active at the Y and continue in programs that will support their healthy lifestyle changes.