Smart Food Choices, Limited Screen Time, and Family Meals Add Up to Healthier Kids

Use positive language, start with the basics, and keep it fun. These are the fundamentals in designing a family-based program to combat childhood obesity, said Melinda Sothern, PhD, Professor and Director of Behavioral Health, Louisiana State University Health Sciences Center. Outlining her group’s approach to encouraging healthier eating and increased physical activity for families of children with obesity, Sothern gave a lively and practical talk on November 7, 2014, during Obesity Week in Boston, MA.

Citing objectives of addressing poor parental role modeling in households whose children have obesity, Sothern emphasized the importance of reestablishing family routines centered around healthy eating and increased activity.

Implementing these changes, however, should be done in a stepwise and positive fashion in family-based interventions. “Tackle one thing at a time,” advised Sothern. Among her methods of accomplishing healthy eating goals for families:

• Shop with children, when possible.
• Select one new aisle of the grocery store per week, and read food labels in that aisle.
• Select one new fruit or vegetable per week to prepare together.
• Decrease consumption of fast food to once a week or less.
• Eat a sit-down dinner together, at the table. Begin on a weekend day, then expand slowly so the family eats together most nights of the week.
• Provide water for thirst, and low-fat milk during meals, with no sugary drinks.

All of these recommendations are evidence-based, Sothern noted. For example, children raised eating regular family meals during adolescence are more likely to have healthy eating habits five years later.

Similarly, limiting television and electronic device use can both help reduce mindless consumption of food and improve sleep quality and duration. Sleep deprivation in childhood and adolescence is associated with poor eating choices, as well as increased risk for obesity both in childhood and later in life. Some of the practical interventions Sothern recommends include:

• No electronic devices in the bedroom at night.
• No televisions in children’s rooms.
• Stop all screen time an hour or more before bedtime.
• No snacks after about 8:00pm.

The latter recommendation, Sothern notes, can also improve appetite in the morning — important because skipping breakfast is also associated with an increased risk of obesity. She recommends a balanced breakfast with protein, some fruit, and low-fat dairy item.

Addressing some frequent pitfalls that can contribute to obesity, Sothern again added practical solutions. To combat large portion sizes, teach parents age-appropriate portion sizes, encourage them to prepare their children’s plate and determine portions (rather than serving family-style), and allow children to stop when full rather than encouraging a “clean plate.”

To ward against mindless snacking, parents can institute a rule that food and drink should be consumed only in the kitchen and dining room. Unhealthy impulse snacking can be redirected if the refrigerator and shelves have ready-to-eat options including healthy fruits, vegetables, low-fat protein, and whole grain snacks.

Parents, Sothern advised, should not use food as a reward, but neither should they label a particular food as “good” or “bad.” Younger children can learn that healthier foods are “grow tall” foods, and are always good choices.

The pervasive problem of excess media time needs a variety of approaches. One of these is the “Play now, homework later” rule. When children return home from school, they drop their media devices in a dedicated box, and then are encouraged to play outside rather than beginning homework immediately. In neighborhoods or during times of year when outdoor play is difficult, parents can keep an “imagination station” with toys for age-appropriate large motor play, such as hopscotch, foam basketballs and hoops, hula hoops, and jump ropes.

Parents should also play outside with their children and choose developmentally appropriate and enjoyable activities. By practicing such fundamentals as kicking, throwing, and catching, parents can give children skills to maintain and increase physical activity through outdoor play.