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Daily Dose

Don't Let Your Child Become an Obesity Statistic

Healthy eating begins with the first foods that you feed your infant.An alarming statistic was released today which shows that one in five 4-year-old children are obese and these numbers are even higher in minority children. This study was just published in The Archives of Pediatric and Adolescent Medicine, and followed over 8,000 children looking at height and weight. The findings were quite concerning, showing a trend toward obesity at an age younger than predicted, and numerous long term health problems associated with obesity, such as heart disease, diabetes, high blood pressure and bone and joint problems.

This is a national health issue and a call to action for all families to teach and model healthy eating. One of the problems is that many of the government sponsored food programs provide foods high in carbohydrates, and low in fresh fruits and vegetables, and this promotes obesity. School lunches have also been found to be high in fat and carbohydrate and continue to promote poor food choices. With the bad economy and recession, families have cut back on groceries and may be eating more fast foods, breads and pastas, again providing more carbohydrate than protein. Healthy eating begins with the first foods that you feed your infant. A well balanced diet with grains, fruits, vegetables and meats begins in the high chair and should continue at the family dinner table. The meals may be simple and healthy. Being a short order cook, or providing your child's favorite pizza and fried food on a daily basis, even in a young toddler will have deleterious effects for the rest of their life. Don't let your child become a statistic heading toward lifelong health issues secondary to childhood obesity. Change your own eating habits, improve your children's and remain committed to family meals. We, as parents, cannot afford to raise a generation where obesity is the norm: the change must begin now. That's your daily dose, we'll chat again tomorrow. More Information: 1 in 5 Preschoolers Obese

Daily Dose

Sugary Drinks & Kids

1.15 to read

Do you buy soft drinks?  Several recent studies have been in the news and seem to confirm what I have thought for a while - sugary soft drinks really have no place in a child’s diet.  I must admit I was a mom who purchased different soft drinks of every color of the rainbow.  But about 15 years ago, I just stopped buying them altogether as I was convinced that not only did they all have enormous amounts of sugar, they were expensive, and if I bought them they somehow “disappeared” quickly from the refrigerator. They were like many other foods: “can’t just eat one”. 

Over time my kids stopped complaining that we didn’t have any “Cokes” and my husband decided that he would drink sugar free drinks if he was going to have a soft drink at all.  I would occasionally buy soft drinks for a party or something, but other than that our children resorted to drinking milk, water and Gatorade after sporting events. And guess what, they didn’t run away from home, even after threatening that it was “not fair”. 

I have routinely asked parents and children if they drink soft drinks.  I am continually amazed at how many families have soft drinks as their beverage of choice for dinner.  Calories, calories, calories, and all unnecessary, yet alone the cavities that might be forming. 

New research now confirms that drinking sugary beverages interacts with genes that affect weight, and in certain individuals will cause even greater weight gain and eventually may pack on pounds leading to obesity. With 1/3 of U.S. children being overweight or obese, this research would confirm that children (and I would ditto this for adults) DO NOT NEED to drink sugary soft drinks at all. Several other studies have shown that by giving overweight or obese children alternatives to sugary drinks, such as water of sugar free alternative beverages,  you can reduce a child’s weight gain.  Those children who continued to drink sugar sweetened beverages during different studies gained anywhere from 2-4 lbs more per year than those who cut out the sugary drinks.  If this is per year, then think of the cumulative effect. 

Lastly, many tweens and teens not only drink sugar sweetened drinks but they “super size” them or get free refills. Just recently NYC made headlines when a law was passed restricting the sale of drinks larger than 16 ounces, all in hopes of helping combat obesity. 

So parents take a stand and stop buying the drinks. If they are not in the house or available, most kids would not have access. Limit them for a special occasion.  That is a good place to start.

Daily Dose

The Importance of Vitamin D

As I start a new week and head to the office on a Monday morning there is some new news that will affect my daily practice. I have always been a big proponent in the need for children of all ages to drink milk to ensure healthy bones. We have talked about the concept of "banking your calcium" so that your calcium stores are growing while you are young and are "fully funded" by your 20s to ensure enough calcium for withdrawal later in life. The worry about this calcium issue is that many children do not drink milk or get enough dairy and that they may end up being adults with osteopenia and osteoporosis. Milk is also vitamin D fortified.

Now there is new data to show that children also need more vitamin D than previously thought as vitamin D may not only be involved in keeping bones healthy, but may also be beneficial in reducing risks of cancer, diabetes, and heart disease. It was previously recommended that children and adults to age 50 years needed 200 units of vitamin D daily. The new recommendations will be 400 units per day. So, exclusively breast fed babies will begin taking a vitamin supplement, and all of those children who are not drinking milk will also need calcium plus vitamin D supplement. The problem with this is getting mothers and children to remember to take a vitamin supplement. I have always recommended calcium for my patients who are not milk drinkers, but I have found that they rarely continue to take them more than several weeks to months and then they sit on the counter. This is especially true for tweens and teens who have rapidly growing bones too. Here is more information to support the need for vitamin D, so drink that milk, get some sunshine everyday and make sure you get 400 units of vitamin D a day. That's your daily dose, we'll chat tomorrow!

Your Baby

Can More Fruit Consumed During Pregnancy Raise Baby’s IQ?

1:30

The USDA recommends that women consume 2 cups of fruit daily. This can include fruits that are fresh, canned, dried or frozen, as well as 100-percent fruit juice.

Fruit not only contains important vitamins, minerals and fiber but may also provide benefits for the children of moms-to-be who consume more fruit during pregnancy.

According to a new study from Alberta, Canada, the children of mothers that consumed higher levels of fruit during pregnancy, had better cognitive development by the time they were one-year-old.

Researchers said the effects of eating more fruit on test scores were significant.

"It's quite a substantial difference," Dr. Piush Mandhane, an associate professor of pediatrics at the University of Alberta, said in a press release.  "We know that the longer a child is in the womb, the further they develop -- and having one more serving of fruit per day in a mother's diet provides her baby with the same benefit as being born a whole week later."

For the study, researchers analyzed data on 688 one-year-old children collected as part of the Canadian Healthy Infant Longitudinal Development study, and considered the amount of fruit their mothers consumed during pregnancy, gestational age at birth, parental lifestyle factors, including income and education, and cognitive tests given to the children.

Two-thirds of the population falls between 85 and 115 on the traditional IQ scale, with the average at about 100. The researchers found if pregnant mothers ate six or seven servings of fruit or fruit juice per day, their children scored six or seven points higher on IQ tests at one year old. There was no improvement in learning when only the babies were fed fruit.

The researchers noted that future studies will explore longer-term benefits of increased fruit consumption during pregnancy beyond one year of life, as well as whether higher intake of fruit affects development of other parts of the brain.

"We found that one of the biggest predictors of cognitive development was how much fruit moms consumed during pregnancy. The more fruit moms had, the higher their child's cognitive development," Mandhane said.

Experts recommend that pregnant women eat a variety of foods throughout the day to make sure they and their baby get the nutrients they need. A balanced diet contains fruits and vegetables, breads and grains, protein and dairy. Doctors often prescribe prenatal vitamins just in case a mom-to-be isn’t able to get all the nutrients she needs by diet alone.

While fruit is important to one’s overall diet, pregnant women should consult with their OB/GYN about their intake if they are diabetic or susceptible to gestational diabetes.

The study was published in the online edition of EBioMedicine,

Story source: Stephen Feller, http://www.upi.com/Health_News/2016/05/26/Eating-fruit-while-pregnant-helps-babys-cognitive-development-study-says/3311464273928/?spt=sec&or=hn

Daily Dose

The Obesity Epidemic Continues

The obesity epidemic continues with no end in sight. It is one of our major public health problems and the ongoing health care concerns of patients with obesity are well known. There have been many different studies looking for a biologic basis for obesity. There is a new study just released from the International Journal of Obesity that suggests that there is behavioral link for obesity.

In the study 226 families, both children and their parents were followed over three years with serial height and weight measurements. The results showed that obese mothers were 10 times more likely to have obese daughters, while obese fathers had a six-fold chance of having an obese son. In both cases, children of the opposite sex were not affected. Researchers therefore believe that the link for obesity may be behavioral rather than genetic. It would be very unusual to have genetics influence children only along gender lines. Rather, it seems that there may some form of “behavioral sympathy” related to becoming overweight. It seems that daughters copy lifestyles of their mothers, and sons their fathers. Looking further, researchers noted that eight in 10 obese adults were not severely overweight or obese when they themselves were children. In other words, the parents are passing their eating habits and behaviors on to their children, which brings us back to “modeling behavior”. I bring up the discussion of eating habits and nutrition when children are beginning their first table foods. Parents want to feed their children healthy foods, but they also worry if their child will not eat what the parent has prepared. Starting from the first foods the “notion” of eating healthy needs to be positively re-enforced. One way to do this is by preparing meals together which can teach cooking skills along with making healthy food choices. The idea that our children are going to like everything that we make, or clean their plates is obsolete. I think that our job as parents is to provide good food choices, a happy family mealtime and to be models of healthy eating. With this should come daily exercise. This study seems to confirm that it may be nurture, not nature that is contributing to the worldwide obesity problem. That’s your daily dose, we’ll chat again tomorrow.

Your Baby

Starting Baby on Solid Foods

Your goal over the next few months is to introduce a wide variety of foods. If your baby doesn't seem to like a particular food, reintroduce it at later meals. It can take quite a few tries before kids warm up to certain foods.Starting baby on solid foods can be an exciting and perplexing time for parents. What foods should I start with? How much? How often?

The American Academy of Pediatrics currently recommends gradually introducing solid foods when a baby is about 6 months old. Your pediatrician, however, may recommend starting as early as 4 months depending on your baby's readiness and nutritional needs. Be sure to check with your pediatrician before starting any solid foods. Is your baby ready? Breast milk or formula is the only food your newborn needs. Within four to six months, however, your baby will begin to develop the coordination to move solid food from the front of the mouth to the back for swallowing. At the same time, your baby's head control will improve and he or she will learn to sit with support — essential skills for eating solid foods. If you're not sure whether your baby is ready, ask yourself these questions: •       Can your baby hold his or her head in a steady, upright position? •       Can your baby sit with support? •       Is your baby interested in what you're eating? If you answer yes to these questions and you have the OK from your baby's doctor or dietitian, you can begin supplementing your baby's liquid diet. What Foods to Start With. Continue feeding your baby breast milk or formula as usual. Then: •       Start with baby cereal. Mix 1 tablespoon (15 milliliters) of a single-grain, iron-fortified baby cereal with 4 to 5 tablespoons (60 to 75 milliliters) of breast milk or formula. Many parents start with rice cereal. Even if the cereal barely thickens the liquid, resist the temptation to serve it from a bottle. Instead, help your baby sit upright and offer the cereal with a small spoon once or twice a day. Once your baby gets the hang of swallowing runny cereal, mix it with less liquid. For variety, you might offer single-grain oatmeal or barley cereals. Your baby may take a little while to "learn" how to eat solids. During these months you'll still be providing the usual feedings of breast milk or formula, so don't be concerned if your baby refuses certain foods at first or doesn't seem interested. It may just take some time. Do not add cereal to your baby's bottle unless your doctor instructs you to do so, as this can cause babies to become overweight and doesn't help the baby learn how to eat solid foods •       Add pureed meat, vegetables and fruits. Once your baby masters cereal, gradually introduce pureed meat, vegetables and fruits. Offer single-ingredient foods at first, and wait three to five days between each new food. If your baby has a reaction to a particular food — such as diarrhea, a rash or vomiting — you'll know the culprit. •       Offer finely chopped finger foods. By ages 8 months to 10 months, most babies can handle small portions of finely chopped finger foods, such as soft fruits, well-cooked pasta, cheese, graham crackers and ground meat. As your baby approaches his or her first birthday, mashed or chopped versions of whatever the rest of the family is eating will become your baby's main fare. Continue to offer breast milk or formula with and between meals. Foods to Avoid for Now. Some foods are generally withheld until later. Do not give eggs, cow's milk, citrus fruits and juices, and honey until after a baby's first birthday. Eggs (especially the whites) may cause an allergic reaction, especially if given too early. Citrus is highly acidic and can cause painful diaper rashes for a baby. Honey may contain certain spores that, while harmless to adults, can cause botulism in babies. Regular cow's milk does not have the nutrition that infants need. Fish and seafood, peanuts and peanut butter, and tree nuts are also considered allergenic for infants, and shouldn't be given until after the child is 2 or 3 years old, depending on whether the child is at higher risk for developing food allergies. A child is at higher risk for food allergies if one or more close family members have allergies or allergy-related conditions, like food allergies, eczema, or asthma. Introducing Juice. Juice can be given after 6 months of age, which is also a good age to introduce your baby to a cup. Buy one with large handles and a lid (a "sippy cup"), and teach your baby how to maneuver and drink from it. You might need to try a few different cups to find one that works for your child. Use water at first to avoid messy clean-ups. Serve only 100% fruit juice, not juice drinks or powdered drink mixes. Do not give juice in a bottle and remember to limit the amount of juice your baby drinks to less than 4 total ounces (120 ml) a day. Too much juice adds extra calories without the nutrition of breast milk or formula. Drinking too much juice can contribute to obesity can cause diarrhea. Infants usually like fruits and sweeter vegetables, such as carrots and sweet potatoes, but don't neglect other vegetables. Your goal over the next few months is to introduce a wide variety of foods. If your baby doesn't seem to like a particular food, reintroduce it at later meals. It can take quite a few tries before kids warm up to certain foods.

Daily Dose

Cut Soda to Fight Childhood Obesity

Getting rid of sugar-laden drinks and replacing them with water has a dramatic impact on the amount of calories children consume and could help in the fight against childhood obesity. Researchers from Columbia Mailman School of Public Health in New York found that children get 10 to 15 percent of the daily caloric intake from empty calories.

"The key observation is that when kids substitute sugar-sweetened beverages with water, there is a significant decline in total energy intake without any compensatory increase in the consumption of other beverages or food," said Dr. Y. Claire Wang. Dr. Wang also noted that substituting calorie-free beverages "is a simple and effective way of eliminating the excess calories while improving the diet quality." Sugar-sweetened beverages "should be viewed as treats, not necessities, and water is a perfect substitute for the purpose of thirst-quenching," Wang said. Wang and her colleagues looked at diet data from the 2003-2004 National Health and Nutrition Survey of over 4,000 children aged two to 19 years. They found that substituting sugar-sweetened beverages with water was associated with significant reductions in total calories consumed. Wang and colleagues estimate that replacing all sugary drinks with water could cut out an average of 235 calories out of kids' diets each day. Since the late 1970s, consumption of sugary drinks by children and adolescents has increased "substantially," and is thought to be "an important contributing factor to obesity," the researchers point out in the Archives of Pediatrics and Adolescent Medicine. "Replacing these liquid calories with calorie-free beverage alternatives therefore represents a key strategy to eliminate excess calories and to prevent obesity in childhood," they conclude.

Your Child

Importance of Breakfast

When your child was an infant, you were diligent about feeding them on schedule. So, why do so many parents let their children skip breakfast before heading out to school? A new study shows that 12 to 35 percent of adolescents skip breakfast and that number increases with age.

“Breakfast is another time to spend with your child,” says pediatrician Dr. Sue Hubbard. She says a healthy breakfast should have protein, fiber and calcium. “Try and stay away from sugar coated cereals” she advises. Dr. Hubbard also emphasizes that parents need to read cereal box labels and stay from breakfast bars because many of them contain large amounts of sugar. “A good thing as you’re running to the door and getting in carpool is a piece of peanut butter toast on whole wheat grain bread with some milk on the side,” she says. “Breakfast gives your child fuel for the day.”

Your Teen

Early Puberty and Bone Health

1.50 to read

The normal rate of bone mass decline in adulthood is about 1 to 2 percent each year. This means that a 10 to 20 percent increase in bone density resulting from a naturally early puberty could provide an additional 10 to 20 years of protection against normal age-related decline in bone strength, according to the researchers.A new study suggest the earlier your child starts puberty, the lower the risk he or she will have osteoporosis later in life.

The research was based on 78 girls and 84 boys, who were studied from the time they began puberty until they reached sexual maturity. The investigators found that adult bone mineral density was influenced by age at puberty onset, with greater bone mass linked to early puberty and less bone mass associated with later puberty. However, bone strength did not seem to be affected by how long puberty lasted. "Puberty has a significant role in bone development," study leader Dr. Vicente Gilsanz, director of clinical imaging at the Saban Research Institute of Children's Hospital Los Angeles, said in a hospital news release. "During this time, bones lengthen and increase in density. At the end of puberty the epiphyseal plates close, terminating the ability of the bones to lengthen. When this occurs, the teenager has reached their maximum adult height and peak bone mass," Gilsanz explained. Reduced bone mineral density leads to osteoporosis, which affects 55 percent of Americans aged 50 and older. The normal rate of bone mass decline in adulthood is about 1 to 2 percent each year. This means that a 10 to 20 percent increase in bone density resulting from a naturally early puberty could provide an additional 10 to 20 years of protection against normal age-related decline in bone strength, according to the researchers. The study was published in the January issue of the Journal of Pediatrics. Pediatricians have long understood the role of pediatric bone development in osteoporosis prevention. The tween and teen years are critical for bone development because most bone mass accumulates during this time. In the years of peak skeletal growth, teenagers accumulate more than 25 percent of adult bone. By the time teens finish their growth spurts around age 17, 90 percent of their adult bone mass is established. Following the teen years, bones continue to increase in density until a person is about age 30. The need for calcium in the diet. Calcium is critical to building bone mass to support physical activity throughout life and to reduce the risk of bone fractures, especially those due to osteoporosis. The onset of osteoporosis later in life is influenced by two important factors: •   Peak bone mass attained in the first two to three decades of life •   The rate at which bone is lost in the later years Although the effects of low calcium consumption may not be visible in childhood, lack of adequate calcium intake puts young people at increased risk for osteoporosis later in life. Other foods, including dark green, leafy vegetables such as kale, are also healthy dietary sources of calcium. But, it takes 11 to 14 servings of kale to get the same amount of calcium in 3 or 4 8-ounce glasses of milk. In addition to calcium, milk provides other essential nutrients that are important for optimal bone health and development, including: •       Vitamins D, A, and B12 •       Potassium •       Magnesium •       Phosphorous •       Riboflavin •       Protein The role of physical activity in bone development. Weight-bearing physical activity helps to determine the strength, shape, and mass of bone. Activities such as running, dancing, and climbing stairs, as well as those that increase strength, such as weight lifting, can help bone development. For children and teenagers, some of the best weight-bearing activities include team sports, such as basketball, volleyball, soccer, and softball. Studies show that absence of physical activity results in a loss of bone mass, especially during long periods of immobilization or inactivity.

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