| Good Eating Habits are a Family Affair |
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Memphis, Tenn., Jan. 17, 2000 -- A new study finds French fries, sodas, fruit juices and 2 percent milk are kids most commonly eaten foods. It may also be contributing to 2 to 5 year olds' lack of several important nutrients. (SHNS photo illustration by Michael McMullan)
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By Lisa Jennings
Scripps Howard News Service Looking at the diet of a group of preschool children in the Knoxville area, University of Tennessee researchers found a disturbing trend: The most commonly eaten foods were fruit drinks, sodas, 2 percent milk and french fries. "It's pretty scary if they're having french fries as often as milk," said Dr. Jean Skinner, professor of nutrition at the University of Tennesseee at Knoxville and lead author of the study, which was published in the December issue of the Journal of the American Dietetic Association. What's worse is the children's diets were found to be deficient in several important nutrients, including zinc, folate and vitamins D and E. But this will come as no surprise to any parent concerned about nutrition. In this land of plenty, children grow up in a world where french fries rule; where toddlers barely able to speak can identify fast-food restaurant logos; and where virtually every gathering involves unlimited cake and ice cream, hot dogs or chips. It's a world where even parents with the best intentions and good eating habits find themselves struggling to hold back a cultural tide that would lure their children on the path to obesity, diabetes or heart disease. But as evidence mounts that the chronic diseases that plague us as adults begin in childhood, public health officials are calling for a comprehensive change in the way our children grow up eating. U.S. Surgeon Gen. David Satcher recently called for "a conspiracy to get Johnny to eat right." This conspiracy should include all levels of society, Satcher said. We need to look for ways to promote physical activity and good nutrition at home, in schools and throughout all communities. "We need to glamorize healthy foods and de-glamorize unhealthy ones," he said. Indeed, more and more children are being diagnosed with "adult" illnesses such as type 2 diabetes -- what used to be called "adult onset" diabetes because it used to affect young people so rarely. Now 30 to 50 percent of adolescent diabetes cases are type 2. Obesity rates among children are climbing rapidly, and more children are struggling with high cholesterol, hypertension and other illnesses related to obesity, such as asthma. And the American pattern of caloric excess and sedentary living is largely to blame. We're eating more fast food and fewer fruits and vegetables. We drink soda and fruit-flavored sweet drinks instead of water or milk. We're too busy to cook, so we carry in high-fat, high-calorie meals in huge portions. We watch too much television, drive -- even for short distances -- and sit at computers. And so do our kids. Editorial writers in an issue of the Journal of the American Medical Association (JAMA) devoted to the growing problem of obesity last year also issued a call to arms. "There is a particular need to focus on children and adolescents whose excess weight and sedentary lifestyle will form the basis for a lifetime of preventable morbidity and increased premature mortality," wrote Drs. Jeffrey Koplan and William Dietz. Among their suggestions: - School-based interventions to reduce television viewing and to increase physical activity and healthful dietary choices.
- Returning physical education classes to schools should be a priority.
- Communities should be designed to permit and encourage walking or biking safely. They should include community recreation areas such as playgrounds, jogging trails, pools and parks. "If we don't do it and keep seeing this increase in diabetes, we're going to throw away our longevity game," said Dr. Marian Parrott, vice president of clinical affairs for the American Diabetes Association in Alexandra, Va.
Someone who has diabetes at 19 is far more likely to see heart disease in the 40s, she said. But insurance companies don't cover preventive measures that begin in childhood, such as professional diet counseling. "That requires really long-term thinking, and we don't live in a long-term culture." The problem is that changing the habits of children is not seen as a priority, said Dr. Gerald Berenson, a cardiologist and director of the Tulane Center for Cardiovascular Health in New Orleans. Berenson is also director of the Bogalusa Heart Study, a research project that has followed about 16,000 residents of Bogalusa, La., from birth to age 38, so far. The study has documented the origins of heart disease in young children and the need for early intervention. The team of researchers has developed a comprehensive program that can be used in schools from kindergarten through 6th grade to teach children about good nutrition and healthful living. But the program also includes teachers, parents, cafeteria cooks and others involved in a child's world to promote a healthy lifestyle. (More information about the program, called Health Ahead Heart Smart, can be found on the Web site: www1.omi.tulane.edu/cardiohealth/.) "It's inexpensive and extremely important," said Berenson. But only a handful of school districts have picked it up. "It's just not demanded," he said. Pediatricians have long contended that American children are probably getting all the nutrients they need, despite their chicken-nugget-loving ways. But studies like Skinner's at UT-K indicate that just isn't the case -- comparing actual diets with current recommended daily allowances. The researchers have been following the diets of 72 children from white middle- and upper-middle class families (so that economics was not a restricting factor). What they found consistently was that children were not getting enough fruits and vegetables (good sources of folate) or lean red meat (a good source of zinc). They're also not eating vegetable oils (vitamin E) or quite enough low-fat milk fortified with vitamin D. The researchers have continued to follow the children through their 7th year, though the data for ages 6 and 7 had not been fully analyzed. Skinner said they did bone density tests on the children, and found that, even at such an early age, bone density was affected by lack of calcium. Add osteoporosis to the list of potential future health problems. Ultimately, the culture of bad eating in our society may stem from a culture of bad eating within individual families. And, some argue, it can begin at birth. Carolyn Vaughn, a registered dietitian and clinical nutritionist at Le Bonheur Children's Medical Center, said too often parents think whenever an infant cries, it means the child is hungry. So they feed the child, whether the infant wants to eat or not. And often babies are forced to finish their bottles, even though they may not need to. As a result, "kids are learning early to ignore hunger and fullness cues," she said. "They don't know when to eat and when not. And a lot of the parents don't either." When children move on to day care, they enter a world where snacks and meals are provided every few hours. Toddlers may need more frequent snacks because they eat so little at a time. But the institutionalized snacking continues through kindergarten, even though many children just don't need to eat between meals. "But if every other kid is eating a snack and they don't get it, they feel like it's punishment," said Vaughn. "And, as an adult, it's really hard to break that habit." As children get older, food remains the center of any gathering. "I'm amazed with kids at how many eating opportunities there are," said Parrott, the mother of three young boys. "At soccer games, for example, it's de rigueur to end the game with a bag of cookies and sweet drinks, even though the game is just after breakfast and these kids are about to have lunch. They really don't need that," said Parrott. "But are you going to be the parent who shows up with carrot sticks and flavored seltzer water?" Many children come home to empty houses where they have full access to the refrigerator. Dinner is often the only meal parents have any control over. But often both parents are too tired to cook a healthful meal. Fast food and convenience products reign. Forcing children to eat their vegetables and drink skim milk is not necessarily the answer, said Vaughn. Parents need to learn that it's their job to offer healthful options. It's the child's job to decide whether to eat it. "Parents are afraid their children will starve if they don't give them what they want," said Vaughn. But if they don't eat what's served at one meal, they'll be hungry for their next (hopefully healthful) meal -- so long as parents hold the line on snacks and empty-calorie alternatives. Parents need to model the concept of moderation, said Parrott. Instead of bringing the whole bag of chocolate chip cookies to the table, for example, put a few cookies on a plate, she said. "We don't have to eat the whole bag." And limits can be set on more than just food. Dr. Jay Cohen, an adult and pediatric endocrinologist with The Endocrine Clinic PC in Memphis, said he encourages parents to allow TV or computer game use only after a child exercises for at least 30 minutes on weekdays, and an hour on weekends. Gym class at school doesn't count, he said. "Half the time gym period is spent watching someone else hit a ball." Exercise is another lifestyle habit parents need to model, said Cohen. "Learn to make it a family habit, so the whole family gets outside together." (Lisa Jennings writes for The Commercial Appeal in Memphis, Tenn.) (Distributed by Scripps Howard News Service, www.shns.com)
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