November 2008

Family meals are more than just eating together

Focus on hyperinsulinism

Help your patients lower insulin resistance

Keep moving this winter 

Meet the Northside YMCA NEW Kids at the Y team

Family meals are more than just eating together

Brian Fidlin, PsyD

Between homework, work schedules and after school activities, it can be difficult to find the time to share a meal. However, family meals are more than just eating together. Mealtime can be an opportunity to reconnect as a family, discuss what is going on in each other's lives, share in each other's accomplishments and support one another during difficult times.

On the more realistic side of parenting, while all of those things are true, family mealtime also is a time for parents to teach children table manners and that family members can have different opinions.

Beyond these points, family meals tend to be more nutritious than meals where family members fend for themselves. Children who regularly eat meals with their families tend to choose healthier options (fruits, vegetables and whole grains) and fewer snack foods. Adolescents who engage in regular family meals have been shown to have lower rates of smoking cigarettes, drinking alcohol and using marijuana and other drugs.

Here are some tips to encourage families to include more family meals.

• Ask if the family has a spot where they can gather for a meal. Often, kitchen tables are piled with mail, homework and other clutter. Encourage families to clean this area and make it an inviting place for the family to gather. Remind families to turn off the television during family mealtime.

• For a family meal to occur, a family and a meal are needed. Families need to look on the calendar and schedule family meals. Also, families need to think about what they will eat. It can be fun for the family to plan this together and find the ingredients they need. Some families even find preparing items in advance can make the whole process easier.

• Family meals don't just mean the family eats together. Family members can help in every step from preparation, table setting and clean-up. This also gives parents a chance to teach their children important life skills and praise them for their efforts.

• Remind parents to be realistic – not every meal needs to be a gourmet meal. The important part is spending time together as a family.

Learn more about healthy living habits by visiting www.chw.org/newkids.

Focus on hyperinsulinism

Jennifer Allen RD, CD

Because insulin use in the body corresponds to a rise in blood sugar, eating recommendations for hyperinsulinism suggest avoiding foods that cause blood sugar to rise rapidly. By making better carbohydrate choices as part of an overall healthy diet, the progression of hyperinsulinism can be slowed.

Instead of telling kids that they can never have some of their favorite foods, education should focus on what they should eat more often and what they should eat less often.

Carbohydrate foods to choose more often:
These foods are high in fiber and low in refined carbohydrates and sugar.

Carbohydrate foods to choose less often:
These foods are low in fiber and high in refined carbohydrates and sugar.

Learn more about healthy eating behaviors at www.chw.org/newkids.

Help your patients lower insulin resistance

Michele Polfuss RN, MSN, APNP

Insulin resistance is associated with obesity, acanthosis nigricans and potential development of type 2 diabetes, polycystic ovarian syndrome and cardiovascular disease. With continuous insulin resistance, the pancreas continues to secrete insulin, and hyperinsulinism occurs. More than 50 percent of obese adolescents in the United States have insulin resistance. As the beta cells weaken over time, type 2 diabetes can develop.

The easiest way to measure insulin is a fasting insulin level. To assess insulin resistance a HOMA-IR or QUICKI can be calculated. Both utilize the fasting insulin and glucose within a calculation to determine the insulin resistance.

Risk factors for associated with insulin resistance include:

• Obesity.
• A positive family history of type 2 diabetes.
• Gender (females tend to be at greater risk).
• Ethnicity (African Americans, Hispanics, Asians and American Indians tend to be at greater risk).

Individuals with elevated fasting glucose levels are recommended to have a two-hour fasting oral glucose tolerance test and lipid profile. If impairment of glucose tolerance is found (reading at two hours is between 100 and 200), it is a good predictor of diabetes risk. If reading at two hours is more than 200, it is indicative of type 2 diabetes.

Females should be assessed for menstrual irregularities, hirsuitism, acne and acanthosis nigricans. Symptoms may present in varying degrees. If concerns are present polycystic ovarian syndrome should be considered.

Prevention of overweight and obesity, especially in the high-risk populations mentioned, should be our first priority. Once insulin resistance is found, treatment is targeted towards weight loss through nutrition and increased physical activity. Metformin, an insulin sensitizer, has been utilized in adolescents and has shown promising results as an adjunct therapy to diet, exercise and behavioral therapy.

Keep moving this winter

Stacy Stolzman, MPT
Tara Cohen, exercise science student intern

Aerobic activity is excellent for the heart and lungs. Remind families that this happens when they are breathing harder, sweating and increasing their heart rates.

Aerobic activity makes our hearts stronger and more efficient at pumping blood. Including year-round aerobic activity not only keeps our hearts healthy but our minds and bodies as well. Even during the cold winter months, it's possible to exercise both indoors and outdoors.

As the temperatures drop and the days get shorter, it becomes less desirable to choose outdoor activities for exercise. With proper clothing, walking or running outside still is an option. Fun ways to stay active and get physical activity during the winter months include:

• Playing in the snow.
• Having a snowball fight.
• Building a snowman or fort.
• Sledding.
• Shoveling.
• Going ice skating.
• Playing hockey.

Aerobic snow sports offer exciting options, too.

• Cross-country skiing is a total body, low impact workout.
• Snowshoeing is a sport similar to hiking. While wearing snowshoes, you can walk, run or hike.
• Downhill skiing is the most common winter sport. It improves balance and flexibility while strengthening muscles.
• Snowboarding increases coordination and strengthens leg muscles.

Each of these sports can burn 400 calories per hour with moderate effort.

For kids and parents who are new to aerobic outdoor winter sports, www.winterfeelsgood.com provides resources for all ages. There, you can learn everything you need to know about each sport before gearing up this winter. Online educational "tool kits" offer quizzes and games for kids and information for adults. Pre-sport exercises also are available as handouts to get bodies prepared for new activities.

In addition, check with your local recreation department for winter sports offered.

Meet the Northside YMCA NEW Kids at the Y team

Sydney Hofer, YMCA of Metropolitan Milwaukee

The NEW Kids at the Y staff at Northside YMCA, 1350 W. North Ave. in Milwaukee, is committed to helping kids and their parents make lifestyle changes that will help them live healthier lives and grow stronger as a family unit.

Northside YMCA has a dedicated team that makes the NEW Kids at the Y Program a success.

• Porsche Carmon is the coordinator and facilitator of the Northside NEW Kids at the Y program. Porsche has been part of the team since 2004. She has a degree in Engineering from the Milwaukee School of Engineering and has made the leap into the fitness industry. Her fitness background is diverse: she's been a group exercise instructor, water exercise instructor, wellness coach and is a YMCA-certified personal trainer.

• Richard Kokott is one of several activity coordinators for NEW Kids at the Y. He has a degree in Health Promotion from the University of Wisconsin-Whitewater. He is a YMCA- and ACE-certified personal trainer.

• Rounding out the team are Afton Orth, who has a degree in Kinesiology from the University of Wisconsin-Milwaukee; Britta Gurgel, a senior at Marquette University majoring in Physical Therapy and Exercise Science; and intern Kassie Gomez, a junior at Marquette University majoring in Exercise Science. Together, they develop exercise programs and activities for the kids and parents in the NEW Kids at the Y program, lead group exercise classes and teach families how to use the wellness center.

This team stresses the importance of giving kids and parents the tools to achieve a healthier lifestyle. The emphasis is not on diet; itÕs on lifestyle change. "When you see kids and families struggling, you want to help them with your own knowledge base," said Carmon. "Twelve weeks go by so fast, and sometimes it takes longer for these changes to become habit. But you hope they take away the tools to make those changes so the small pieces add up to a bigger picture of success."

For more information about the Northside YMCA NEW Kids at the Y Program, call (414) 265-9622.