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06.29.2015
AAP: Docs Have Role in Preventing Childhood Obesity
by Jeff Minerd
Contributing Writer, MedPage Today
Pediatricians should advise families to replace the cookie jar with a fruit bowl and trade in soda for tap water or low-fat milk, according to new recommendations from the American Academy of Pediatrics (AAP) for preventing childhood obesity.
The recommendations, published in the journal Pediatrics, lay out how pediatricians can be more proactive in helping families nip excess weight gain in the bud.
“Because of the numerous medical and psychosocial complications of childhood obesity and the burden of pediatric obesity on current and future health care costs, this condition is now recognized as a public health priority by many groups and experts,” wrote the authors, led by Stephen Daniels, MD, of the University of Colorado and chair of the AAP Committee on Nutrition.
“Even when families have knowledge of healthy behaviors, they may need help from pediatricians to motivate them to implement behavior changes,” Daniels said in a press release.
“Pediatricians can and should play an important role in obesity prevention because they are in a unique position to partner with families and patients and to influence key components of the broader strategy of developing community support,” Daniels and co-authors wrote.
Following are some highlights of the updated recommendations.
Beverages
Sugar-sweetened beverages such as soda and iced teas should be completely removed from children’s diets. The ideal beverages for children at all meals and during the day are tap water and low-fat milk.
Sparkling water, unsweetened flavored waters, and artificially sweetened drinks can be used to transition from sodas to plain water, but should have a limited place in children’s diets.
Families should limit the intake of 100% fruit juices because these are high in calories.
Foods
Children’s diets should be rich in low-calorie foods such as vegetables, fruits, whole grains, low-fat dairy products, lean meat, lean fish, and legumes and limited in high-calorie foods such as fat-rich meats, fried foods, baked goods, sweets, cheese, and oil-based sauces.
If high-calorie foods are purchased for special occasions, any leftovers should be removed immediately afterward. Any high-calorie foods in the home should be wrapped in foil to make them less visible and placed in the back of the refrigerator or high up in the pantry. Healthy foods should be readily available at all times and placed in plain sight.
“Practically, the cookie jar should be replaced by a fruit bowl,” the authors wrote.
Eating Habits
Family meals should be eaten at a table without distractions such as television.
Children should be encouraged not to skip meals, especially breakfast.
Families should be encouraged to review school menus and provide alternatives if healthy choices are not available.
Screen Time and Physical Activity
Screen time should be limited to 2 hours or less per day, both because it’s sedentary and it exposes kids to food advertising. Mindless snacking in front of the TV should be avoided.
At least 60 minutes of moderate physical activity is recommended per day. This can include walks and hikes, bicycle trips, bowling, roller skating, and dog walking. Families should consider taking stairs when possible and walking or biking rather than driving to nearby destinations.
Sleep
Pediatricians should take a sleep history and recommend children get their age-appropriate amounts of sleep per day, as lack of sleep has been associated with obesity in children.
“Parents and other family members are strongly encouraged to adopt the same fitness and lifestyle changes as the child. Pediatricians can educate families, provide support, and help them stay on track,” Daniels said in a press release.
“It is never too early for a family to make changes that will help a child keep or achieve a healthy weight,” said Sandra Hassink, MD, co-author and president of the AAP, via press release. “Families can improve their eating habits in a variety of ways, but it is important for healthy eating and physical activity to be tailored to the child’s developmental stage and family characteristics.”
The current report updates and replaces the 2003 AAP policy statement Prevention of Pediatric Overweight and Obesity and complements the AAP-endorsed 2007 expert committee Recommendations for Prevention of Childhood Obesity.
None of the authors reported financial relationships with industry.
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