Real Issues or Red Herrings?

Why does this paper, written by Baylor College of Medicine scholars Tom Baranowski, Kathleen J. Motil, and Jennette P. Moreno, exist?

Serious limitations have been found in the simple energy balance model (energy in — energy out) as the single or primary biological strategy for virtually all child obesity prevention interventions. Experts have criticized it for not reflecting the likely multifactorial nature of obesity. A substantial number of other possible, even likely, causes of obesity have been identified.

This is not just an ideological disagreement. Many health professionals believe that multietiological approaches are shunned, when they should be embraced.

The authors hold that concentrating on the energy balance model has not been the best course, because interventions based on manipulating the “energy in” and the “energy out,” are not very successful and have not made a demonstrable dent in the worldwide epidemic. Their claim is that currently, the biological sciences, the behavioral sciences, and the prevention sciences do not cooperate harmoniously, and even work at cross-purposes, in active opposition to each other.

The researchers’ attention was captured by three issues in particular — virus-related infection, imbalance in the microbiome, and messed-up biorhythms.

In the authors’ view, a sturdy research agenda that is truly oriented toward prevention would involve a whole series of steps, which they lay out. But what is more, “to exemplify how behavioral or prevention researchers may begin to address such problems from a biobehavioral perspective,” they identify research issues peculiar to each potential etiology.

Infectobesity

The shady reputation accorded to adenovirus 36 refuses to go away. Investigators want more complete data on the incidence of this infection among children, and how many of them develop obesity, to figure out once and for all whether there is a cause-and-effect relationship. They want to know how the virus spreads, and what behaviors and exposures are responsible for either enhancing or minimizing the chance of infection. They want to know if a vaccine can be developed, and if so, how to ensure that people will be vaccinated.

Microbiome

There is a lot going on in the human gut. Like the ocean, the microbiome has always been with us, and also like the ocean, we know next to nothing about it. There is pretty good evidence that the birth process and the feeding of the infant both play important roles in the establishment and population of the child’s bacterial, viral, fungal, and eukaryotic inheritance. All these creatures live inside us like tenants who can either provide the landlord with a comfortable passive income, or take a notion to wreck the place.

When our interior fauna don’t get what they need, and lapse into dysbiosis, they have their cunning little methods of registering complaints. Apparently, one of the ways they protest is by making us fat, especially if we are under two years old and have antibiotics prescribed to us. In addition to many other things, the authors say,

The internal and external validity of microbiome research in humans has been challenged. These are issues that prevention and behavioral scientists have usefully addressed.

Circadian and Circannual Rhythms

The field of chronobiology is why anyone interested in childhood obesity has heard so much about the importance of limiting electronic screen time and promoting sufficient sleep. The timing of meals may also be a significant contributing factor to obesity. Chronological issues are especially elusive because most of the information comes from self-reporting. Regarding such events as meals and sleep, timing is an intimate family issue and not particularly amenable to intervention.

Even if biological rhythms are proven to be of crucial importance in preventing obesity, what can be done about it, short of seizing all children and raising them in strictly regimented environments? The amount of eduction and public persuasion required to significantly change these areas of life would be staggering. Americans do not want to be told how to raise their kids, not even when their children’s lifelong health is at stake.

In short, there is plenty here to think about.

Your responses and feedback are welcome!

Source: “Behavioral Research Agenda in a Multietiological Approach to Child Obesity Prevention,” LiebertPub.com, 04/22/19
Photo credit: Catalina Rusu on Visualhunt/CC BY

BMI Takes Another Hit

As has been mentioned before in these pages, the venerable Body Mass Index system for keeping track of people’s degree of obesity is not popular in every corner of the obesity field. It takes the patient’s weight and height, and tabulates a result with a mathematical formula.

Childhood Obesity News quoted one expert objecting to the lack of consensus about the BMI, and complaining that studies of obesity-related illnesses…

[…] vary in terms of the BMI cut-off points used to define obesity, as well as the perspective employed from which to measure costs.

Some point to waist measurement as the statistic most pertinent to diabetes and heart disease. Others favor the Edmonton Obesity Staging System, or EOSS. The main objection to BMI testing seems to be that it is unable to distinguish between fat and lean tissue, causing researchers to estimate that as many as a quarter of obese children could be misdiagnosed by BMI. Some experts believe that BMI testing is used inappropriately, and blame it for the under-treatment or over-treatment of many individuals.

Once more, with feeling

Now, the pseudonymous “Your Fat Friend” has published “The Bizarre and Racist History of the BMI,” replete with a ton of reference links. The inventor of the two-centuries-old measurement system, Adolphe Quetelet, was not a doctor, but a sociologist obsessed with l’homme moyen, or the “average man.” He promoted the idea that average is best, a notion that has taken hold in some times and places, but been indignantly rejected in others.

If the term “phrenology” sounds familiar, it is because Quetelet promoted it too, as part of the field of anthropometry, of which he was a founder. Phrenology involves the art of correlating bumps on the skull with traits of character and personality. It was always controversial, and is now regarded as nonsense.

When Quetelet gathered data to develop his index, the “average men” he chose as subjects were French and Scottish. This is what sets off the fireworks where “Your Fat Friend” is concerned. She writes,

That is, the Index was devised exclusively by and for white Western Europeans. By the turn of the next century, l’homme moyen would be used as a measurement of fitness to parent, and as a scientific justification for eugenics — the systemic sterilization of disabled people, autistic people, immigrants, poor people, and people of color.

This alleged science, in other words, was misused to justify a brand of scientific racism. But here comes the disclaimer, from the fair-minded author who specifies that system…

[…] was never intended as a measure of individual body fat, build, or health. For its inventor, the BMI was a way of measuring populations, not individuals — and it was designed for the purposes of statistics, not individual health.

The insurance industry was responsible for turning BMI into an indication of overall health and longevity. The author reports that this is not optimal because the actuarial tables that the bean-counters came up with were…

[…] deeply flawed, representing only those with the resources and legal ability to purchase life insurance. Weight and height were largely self-reported, and often inaccurately. And what constituted an insurable weight varied from one company to the next, as did their methods of determining weight.

The various corporations added or ignored such variables as age and frame size, and discontent with the system grew. Researcher Ancel Keys tried for improvement, but not everyone vouches for his infallibility, either, and “Your Fat Friend” explains in detail what the problems were. The whole subject is worth sober consideration from any health professional. According to its critics, the science of fat measurement just might wind up on the shelf with the science of phrenology.

Your responses and feedback are welcome!

Source: “The Bizarre and Racist History of the BMI,” Medium.com, 10/15/19
Photo credit: National Library of Medicine — History of Medicine on Visualhunt/No known copyright restrictions

What Is a Teachable Moment?

Let’s begin with what a teachable moment is not. It is not what a lot of people think it is. This is one of those phrases (like the widely abused “passive-aggressive”) that has been co-opted by folks who say things they think make them sound smart, when actually the opposite is the case.

Here is a bad example, from a recent news story. A popular hoax perpetrated on elderly people, and also upon busy and distracted adults of all ages, is the phone call that claims to be from some governmental entity like the IRS, Social Security, or the local police department. The criminal on the other end of the line wants sensitive information, and if it is not forthcoming, will resort to threatening the call recipient with immediate arrest, for anything from drug trafficking to money laundering.

Taking advantage

When a police captain in North Carolina received one of these calls — at work, no less! — she strung the caller along, pretending genuine concern about the multiple charges the scammer claimed could be filed against her. Meanwhile, she recorded the call to post on social media. The video clip was also picked up by various TV shows and used as an educational demonstration, with the hope of warning vulnerable seniors against providing any personal information over the phone.

It was a good idea that captured wide attention, and maybe even prevented some crime. The only problem is, the police captain is widely quoted as having decided to use this opportunity as a “teachable moment,” amounting to a total misuse of the term. It was a fortuitous incident that a quick-thinking officer took advantage of to issue a useful caveat that probably saved some good people from anxiety and fear. But to call it a “teachable moment” is a grotesque misnomer.

More Halloween aftermath

News archives contain an article titled “Parents can use Halloween as a teachable moment,” which implies a certain degree of, if not coercion, at least an incorrect interpretation of the concept. Writer Lizzie Hedrick quotes psychology professor Donna Spruijt-Metz, whose mother would sit with her to sort the trick-or-treat bounty:

We had a joke about how she loved the mini-Hershey bars, so she would negotiate with me for them. She would bargain with me and always say that she wanted to keep those chocolates for herself… [I]t turned into a conversation in which she made me think about what I really liked and what I liked less — and then convinced me to give up the ones I didn’t truly enjoy.

Maybe it was a valuable lesson about weighing priorities. Maybe it was just that the little girl felt queasy from eating too much candy, so her emotions were easy to manipulate — which is not quite the same thing. Hyperactive children tend to have “teachable moments” when they are sick, simply because feeling ill drains off some of their bouncing-off-the-walls energy and they sit still for once.

Closer to the true meaning of the phrase is the title of a piece by Deb Porcarelli of the AIMS Center for Math and Science Education. In “You Never Know When,” she wrote:

A teachable moment can be thought of as a quick moment in time when a student’s interest in a specific subject is at its highest, usually because of a conversation or immersion in a situation that brings on curiosity.

Many adults want “teachable moment” to mean, “There is an idea I want to put across, and I’ve decided that now is the time to do it.” But that is not what it means. A teachable moment spontaneously arises from within the child, manifesting as a mood that is open, receptive, approachable, malleable, curious, ready.

A sensitive teacher or parent will be alert for such unexpected intervals, and make judicious use of them. A teachable moment cannot be decreed or created, it has to be caught in the wild by a grownup who is attentive and prepared, and (this is crucial) who also is willing to recognize when the moment is over.

Your responses and feedback are welcome!

Source: “Police captain turns the tables on a scammer claiming to be a cop,” ConsumerAffairs.com, 08/30/19
Source: “Parents can use Halloween as a teachable moment,” USC.edu, 10/30/15
Source: “You Never Know When,” AIMSEdu.org, 09/14/17
Photo credit: Giuseppe Milo (www.pixael.com) on Visualhunt/CC BY

Halloween Hangover

Leading up to Halloween, Childhood Obesity News devoted some energy to reviewing better ways to “do” the holiday. The desired condition is to have more fun than could ever previously have been imagined, with the minimum amount of candy.

Why are so many people against Halloween candy? Because childhood obesity is an epidemic with a huge financial cost and, more importantly, one that takes a huge toll in human misery.

For responsible adults, part of the misery is the dilemma of figuring out what to do about the trick-or-treat loot, both before the holiday and once it’s over. Aside from keeping and devouring it all, the various aftermath scenarios can chiefly be summed up as confiscate, donate, and eliminate.

Journalist Stephen Matthews noted that from the Halloween collection haul, a typical child consumes more than 3,000 extra calories, none of them nutritious. The average parent, to his or her secret shame, absorbs nearly 2,000 extra calories in a courageous gesture ostensibly intended to save the children from the dangerous substances.

Other writers find other comparisons. For instance, a trick-or-treater winds up with around three cups of sugar, the equivalent of about 200 of those little restaurant-size packets. Not counting costumes, decorations, etc., this year American consumers spent about 2.6 billion on candy alone. That’s up from an estimated $2.1 billion only four short years ago.

Confiscate

We have extensively discussed the various tactics and justifications that parents employ at Halloween in aid of outright seizure of the trick-or-treat proceeds. Some methods are sneaky while others involve open and often extensive and complicated negotiations.

One mother describes her solution:

So it’s free candy at work for anybody who wants it. We’ll pick out what we want and then I’ll give the rest away at work.

Donate

Other donation recipients may include homeless shelters, food pantries, senior centers, nursing homes, hospices, veterans’ organizations, and the overseas troops. Parents, doctors, and dentists may offer to swap other prizes for candy, which is then given away. Writer Julie Gunlock remarks, with tongue in cheek,

[M]aybe I should participate in my local dentist’s candy confiscation program: “C’mon kids; you get this snazzy toothbrush when you bring in your evil, cavity-causing candy!”

If giving it away is too big a sacrifice, Marilisa Sachteleben suggests freezing leftover Halloween candy for later use, like baking cupcakes with interior surprises. She also suggests using it to decorate birthday cakes, put in Christmas stockings, and include in Easter baskets — ideas which may or may not be considered acceptable by family members.

Eliminate

Dr. David Ludwig pronounces on the morality of simply disposing of the Halloween haul:

Yes, it’s important to respect food, and not be wasteful, especially when some people don’t have enough to eat. But typical Halloween candy isn’t food, it’s junk.

After your child has had one or two candies from their Trick-or-Treat booty, throw out the rest (don’t give it away and foist the problem on other kids). Use the occasion as an opportunity to teach your kids a critical message: health comes first.

Remember, the purchase price of those candies pales in comparison to the economic and human toll of diet-related disease!

Your responses and feedback are welcome!

Source: “Trick or treat? Children will consume more than 3000 calories just from Halloween sweets this year,” Daily Mail.co.uk, 10/29/16
Source: “How much candy are you buying for Halloween?,” USAToday.com, 10/05/19
Source: “Dietitians provides tips to parents to help control Halloween candy craze,” Fox59.com, 10/31/16
Source: “Don’t be afraid to let your kids gorge on Halloween sweets,” NYPost.com, 10/30/15
Source: “Halloween candy leftovers use-up recipes, ways to reuse stale candy from Trick-or-Treat,” BlastingNews.com, 11/01/16
Source: “Counterpoint: It’s Not Just OK To Throw Out Halloween Candy, It’s Smart,” WBUR.org, 11/02/16
Photo credit (left to right): abbamouse, Han Zuyderwijk, on Visualhunt/CC BY-SA

Parents and Liberation From Old Attitudes

Some things are simple, although maybe not easy. Childhood Obesity News has been talking about the magical and 100% free commodity known as attitude adjustment. Nothing could be simpler — you just flick a switch inside your head, and view a thing from a different perspective. Simple as it may be, of course attitude adjustment is not always easy. But it is guaranteed easier than dealing with the problems that can arise from old useless attitudes.

Plenty of parents have degrees in all kinds of impressive subjects — but it doesn’t mean there’s no room for improvement. All grownups have their own stories, of parenting that was good, bad, or indifferent; and from our own experience we have learned some truths, or at least formed some impressions. One thing we might do well to adjust is our belief that we know everything. Or even anything.

Lips can remain zipped

It isn’t even always necessary to make a self-judgment on whether one’s opinion is right or wrong. We don’t have to figure it out right now. All we have to do, really, is avoid saying it out loud. That’s right — there is no universal, immutable rule stating that we must say everything we think. Here is a hypothetical example, encompassing one of the most important pieces of advice a parent can ever hear: shut up.

Imagine you’ve tried for two years to convince the kid to eat leafy green vegetables, to the point where you’ve exhausted all strategies and all patience. Then one day, she or he comes home from somewhere and says, “How come we never have leafy green vegetables? That’s supposed to be the most important thing to eat.”

Please, please restrain yourself from saying one single word. Just be happy that the words of some teacher, or friend, or online video, have penetrated the earholes of your child in a way you never were able to. Also, when confronted by the sight of your kid self-righteously eating something you’ve TOLD them and TOLD them about, you must not waver. No scolding, no mockery, no gloating, no “I told you so.” Just clam up and take one for the team.

Negotiate policy

Even parents who like to think of themselves as free spirits can benefit from drawing up some policies. First, the disclaimer. It would be much, much better for everyone if nobody ever ate fast food. Dr. Pretlow will tell you that in a minute, and so will anyone else with a head on their shoulders. But if things are really a mess, accepting fast food might be a step worth making, toward a better future. Boundaries can be temporary answers.

Like, limit fast food to once a week. Avoid, for the present, the draconian decrees that start with “Never.” Reach agreement on the definition of terms. For instance, the week starts at 5 a.m. on Sunday morning. The lone fast food break can be any time within the week. Once is better than three or four times. If there is more than one child, they take turns choosing which den of iniquity will be visited.

The point of setting up rules and conditions beforehand is to limit the amount of pointless discussion about it. Less discussion equals less friction, and less friction equals less stress, and the reduction of stress means there is less inducement for anyone to emotionally overeat.

Again, once-a-week fast food is not recommended, and certainly not ideal. But it may be preferable to the current situation. We live in a world where all elements will not always cooperate to achieve our wishes. But we can do something, which is better than nothing.

The other point is to gain practice in negotiating conditions with all family members having a voice. It is a demonstration that everything does not have to be based on top-down decrees. The experience of realizing there is a problem, and figuring it out together, is worth gold.

Your responses and feedback are welcome!

Photo credit: Jeramey Jannene on Visualhunt/CC BY

More Effective Parenting — Awareness Is All It Costs

Attitude adjustment comes with no price tag attached. It does not cost a cent. It will not deplete the vacation piggy bank or impoverish the college fund. Childhood Obesity News has been discussing something that is both free and freeing: the decision to abandon, or at least modify, some ingrained mindsets that have proven to be counterproductive.

One of those negative and unhelpful attitudes is the punitive one. Why would we want to get rid of it? For the answer, consult the title of an article written by Dr. Stephen R. Daniels of the University of Colorado School of Medicine: “Kids of authoritarian parents ‘more likely to be obese’.” If that doesn’t do the job, consider the title of Wendy Wisner’s article: “‘Harsh Parenting’ Is Linked to Childhood Obesity.”

Dr. Daniels wrote about a study whose aim was to help clinicians aid parents in implementing a more effective parenting style. The researchers understood the importance of catching parents early, before they have a chance to fall into bad habits. He wrote,

Ignoring bad behavior but rewarding good behavior is the best way to think about this. Punishing bad behavior and ignoring good behavior doesn’t work from a psychological standpoint.

Wisner recommends mindfulness, which basically is paying attention to what is going on right now, without referencing past experiences or future expectations, both of which can muddle emotions, skew perceptions, and cloud judgment. She suggests that the parent give herself or himself a timeout, and just sit down for a few minutes, or even briefly leave the room, if that is feasible. The part that sounds a little dicey is,

I tell them, “Mommy’s feeling frustrated with your behavior right now. Mommy is really upset.”

It may seem unconnected with obesity, but some early childhood experts reject illeism, the technical term for referring to oneself in the third person. When an adult does it, children tend to copy the behavior and say such things as “Wendy want popcorn.” We certainly don’t encourage them to reach driving age saying things like, “No, Officer, Mark doesn’t know why the policeman pulled him over.”

Why begin by teaching kids incorrect English, when they will soon have to unlearn it, and figure out what pronouns are all about? It is a minor version of the Santa Claus debate, which goes like, “Why tell your children something that isn’t true, only to admit, after a few short years, that you not only lied, but perpetrated a whole elaborate structure of interrelated lies to prop up the Santa myth?” Some people feel very strongly, one way or the other, about that cultural artifact.

Motherhood blogger Rebecca Lang has some thoughts, of which these are only a sampling:

Perhaps we just know that we should simplify our speech around children who are learning our language. On the other hand, we don’t start speaking in the third person when we meet a person who isn’t fluent in English…

I have a theory on when we’re more likely to do it. Parents call themselves “Mommy” or “Daddy” when we’re stressed by something our kids are doing…

That observation opens up another whole field of inquiry. What good purpose is served by dropping into the conversation a verbal cue that Mommy is reaching the end of her patience — as if facial expression, body language, and tone of voice were not sufficient indications of that unfortunate state?

Maybe the pediatrician has suggested that little Wendy is carrying a few more pounds than would be ideal. It does not take long for the child’s subconscious to pick up on the fact that Mommy brings out the third-person terminology only when talking about meals or snacks.

What message does that convey? Is it a useful message? The problem is, we rarely know, in real time, what bounces off a kid and what sinks in. Details of that kind are generally unearthed years later, by therapists.

Your responses and feedback are welcome!

Source: “Kids of authoritarian parents ‘more likely to be obese’,” MedicalNewsToday.com, 03/20/14
Source: “‘Harsh Parenting’ Is Linked to Childhood Obesity,” Babble.com, 2016
Source: “Why Do We Refer to Ourselves in the Third Person When We Talk to Our Kids?,” Her.ly, undated
Photo credit: Shane Adams on Visualhunt/CC BY

What to Build, and Why

Let’s continue exploring a life-improving strategy that is absolutely free — attitude change. For starters, it is simple, although it may not be easy. The good news is, adopting a new mindset can be as easy as a person decides to let it be. What are some things that we can resolve to change our attitudes about?

There are parents who for some reason (usually, the actions of their own parents) find it very difficult to let their kids feel too good about themselves. Some parents are, in other words, active aggressors against their children’s self-esteem. But it doesn’t have to be this way.

First, a basic question needs to be answered. Why would any parent want to build a child’s self-esteem? There are a thousand reasons, and here at Childhood Obesity News, we focus on one of them. Simply put, when children feel bad, and in need of emotional consolation and compensation, they look for a solution. Eating is the answer many of them find. Food is their drug of choice for multiple societal and cultural reasons which our posts have examined.

But today’s point is, emotional eating is probably the biggest cause of childhood obesity. Emotional eating can be minimized or eliminated by granting a child the ability to develop self-esteem. A very generous and thoughtful article from HoustonNanny.com offers a 10-point inspiration list that makes a lot of sense. Here is a favorite:

Pay Attention — It seems simple, but taking the time to listen to your child when she speaks and to absorb the details of her day lets her know that you’re truly invested in her life and that you care what she’s up to. Knowing that you value her opinion and are there to support her makes it easier for your child to approach new situations with confidence.

Why does this sound so familiar? Because Dr. Pretlow talks about it all the time. The very title of his book, Overweight: What Kids Say, affirms the importance of listening to the young people who struggle with these problems. The important concept here is that by listening now, and providing fertile ground for the growth of self-esteem, a parent might be able to avoid the necessity for listening later, when the only thing that has grown is the child’s waistline.

We’re talking preventative medicine here, the kind that doesn’t even need a prescription, and doesn’t cost a cent. Another excellent suggestion is to avoid comparisons. No good can be served by comparing one child to another, either positively or negatively. It is not a child’s job to provide trophies for a parent to display. A child’s only responsibility is to become the best self that she or he is able to be.

The L word

Writer Jacqueline Burt Cote echoes the same sentiments:

[P]arents would do better to emphasize healthy eating and exercise, and to focus on making a kid feel safe and unconditionally loved. Because feeling good about yourself is an automatic safeguard against behaviors like overeating anyway!

She speaks from her own experience:

I was 8 years old when my well-meaning mother told me I was getting a little “chubby” and maybe it would be “fun” if we went on a diet together. Yes, fun! If by “fun” she meant that I’d be saddled with an at times severe case of anorexia for the next couple of decades, then sure!

Cote is specifically talking about the foolishness of hanging any label on a child, especially a food-related one like “picky.” The resentment that a child can feel about being labeled in any way can run very, very deep. She cites a study suggesting that the description “picky” can cause a child to shun fruits and vegetables.

We fear that in the case of an emotionally needy and unstable child, it can do much worse. Contemplate living with a child who is determined to prove a parent wrong, and to demonstrate how very un-picky he is by eating everything in sight.

Remember, labeling is just another word for name-calling, and name-calling never ends well.

Your responses and feedback are welcome!

Source: “10 Secrets to Building Your Child’s Self-Esteem,” HoustonNanny.com, undated
Source: “Telling Your Daughter She’s ‘Fat’ Is Not Your Job,” CafeMom.com, 02/10/15
Photo credit: Got Credit on Visualhunt/CC BY

A Question for Parents

This is the question: What if we told you that life with kids could be incredibly improved at no cost? What if we told you that to gain this priceless advantage, you would not need to move to a different climate, undergo elective surgery, or even invest in any equipment?

At this point, any sane person should be clamoring for the solution — and here it is: attitude revision. A change of attitude is life’s best bargain. Anybody can make the decision to look at a problem or a situation from a different perspective, especially from a perspective that reduces stress and conflict.

How does this happen?

Sometimes, people come to understand that they have let themselves slide, by imperceptible degrees, into attitudes that are not tenable, in the sense of not being reality-based. For instance, many adults suffer from the omniscience fallacy, taking it for granted that they know everything and there is nothing left to learn.

One of the things they think they know is that problems are unavoidable. (Not always true.) Another false belief is that, once problems get established, they can’t be fixed. Now, normally we think of conviction as a positive quality, connected with values and loyalty and all kinds of other admirable traits. But some convictions are toxic. If a person is convinced that it’s too late to fix a bad situation, that is no longer a legit conviction. It has morphed into the psychological disability known as a bad attitude.

Like what, for instance?

Longtime readers may say, “Childhood Obesity News has mentioned this before. Why does it need to be brought up again?” Because it keeps happening. Many parents labor under the mistaken belief that their job is to know everything, and to know everything all day long, without a single break, and to know everything so indubitably that there is never a need to listen to any other input.

And yet, some parents free themselves from the delusion of all-knowingness. Maybe they read Dr. Pretlow’s book, Overweight: What Kids Say, in which he talks about young people like the 186-pound 12-year-old who wrote to him, “If parents would just take the time to listen to their kids, less kids would go to the fridge when depressed.” Making the decision to listen and respond appropriately to what kids say is definitely a change of attitude worth striving for.

Help is good

One thing parents should know is that changes of attitude cannot always be made simply by snapping one’s fingers. The vast majority of adults were raised by parents who didn’t know what they were doing, either. There is no shame is being messed up. If we know we’re messed up and neglect to do anything about it — now, that’s blameworthy.

If parents are unable to change their attitudes on their own, which admittedly can be a pretty hard job sometimes, then as Dr. Pretlow says, “they perhaps would benefit from counseling.” Or even from reading another book. Parent Effectiveness Training by Dr. Thomas Gordon would be a great place to start. P.E.T. classes have helped thousands of parents to get a handle on things. For those who live in remote areas or can’t get out to classes, there is even a dedicated YouTube channel.

“Learn how to work with each other instead of against each other.” Does that sound attractive? Another of the P.E.T. selling points is, “How to listen to your children so they feel genuinely understood.” Bingo! Right on the nose!

Your responses and feedback are welcome!

Source: “Parent Effectiveness Training (P.E.T.),” GordonTraining.com, undated
Photo credit: Alan Levine (cogdogblog) on Visualhunt/CC BY

Let’s Keep Moving

A while back, researchers from the University of Maryland School of Medicine studied both Old Order Amish children and non-Amish white children from nearby areas, learning that:

Amish children were twice as physically active, spending 34 more minutes a day in light physical activity, plus 53 more minutes a day in moderate to vigorous physical activity. Higher activity levels were also correlated to lower body mass indexes, a commonly used obesity measure.

This particular faith community is well-known for shunning electronic accessories such as TV, electronic games, and computers. The kids do farm chores, play outdoors, and walk to and from school. Motorized vehicles are shunned.

The bad news is that by the time they grow up, Amish people are generally about as obese as their non-Amish counterparts — but — the good news is, they only develop half as much type 2 diabetes. The risk factor there is not in the obesity itself, but in the number of years the patient has spent being an obese adult.

Everything in moderation — including control

Authoritarian parenting has been a recent topic, and usually it has unhappy results. Yet it cannot be said that all control is bad. Some is necessary. Here is a very literal example of how it might be the lesser of two evils.

When a child is able to walk, it is time to retire the stroller. A child needs the practice in walking, and it burns calories, obviating the accumulation of fat. But some parents think only of their own convenience. “I just don’t want to walk that slow. The stroller has places to stash a diaper bag and bottles and all the other paraphernalia. With the kid strapped in and on wheels, I can talk on the phone. He’s safe in there, I know where he is.”

In other words, it’s a control issue. The parent wants to be in charge of the speed of travel, and of the capacity to bring along a bunch of stuff that may not even be necessary. The parent wants to control the child’s range without needing to actively monitor the situation. The arrangement is not really healthy for anyone.

Here is the plan

Make a change, but ease into it. Take the stroller along, but let the little child walk, as slowly as she wants. Using one hand to manage the stroller and the other to hold the child’s hand. Forget about the phone, and pay attention to what is going on. As Ram Dass famously said, “Be Here Now.” Do that until one of you can no longer tolerate it, and then put the kid in the stroller. Extend the walking portion of the trip a little farther each day.

Eventually, leave the stroller at home and carry the gear in a backpack or tote bag. The child could even carry some of her own essential belongings, in a cute little backpack with a leash attached. For the sake of physical activity and obesity prevention, consider this form of benevolent control, even though it might attract criticism. For the less bold, there is a compromise measure — a pair of soft wrist cuffs, one for the parent and one for the the child, joined by a curly cord.

If a sanctimonious stranger says, “You’re treating your child like an animal,” you can come back with, “No, what you mean is that most dogs are treated like children should be — permitted to move under their own steam, but not allowed to get in dangerous trouble. Why do you have a problem with that?”

Your responses and feedback are welcome!

Source: “Amish Avoid Obesity, Diabetes Through Activity,” EverydayHealth.com, 10/23/12
Source: “The Parenting of Fat: 10 Ways You are Making Your Kids Overweight,” Mamiverse.com, 10/09/14
Photo credit (left to right): Alex Thomson,Uma Ceawlin on Visualhunt/CC BY-SA

Some Parenting Angles

Academicians love to classify all worldly phenomena, and those in the “soft” sciences are no exception. They quite understandably like to define and categorize things like parenting styles into theoretical frameworks.

The Six-Cs ecological model originated with the STRONG Kids program. The survey this information came from was the self-reported kind, and as Childhood Obesity News has mentioned before, that can be problematic. The subjects were “329 parent-child dyads recruited from childcare programs in east-central Illinois.” Here is the breakdown:

The Six-Cs model identifies five spheres of environmental influence (child, clan, community, country, and culture) and one of genetic influence (cell) as being important determinants of childhood weight status. The Six-Cs model illustrates that a child’s weight status is influenced by the intake and expenditure patterns of the child, but these patterns are embedded within the larger ecology of the child’s family, community, and demographic characteristics.

Yes, it’s our old friend, multifactorialism, again. People are different, and react differently to stimuli and new ideas. Some welcome helpful suggestions; others resent intrusion; and some are all over the map, attitudinally. If the well-intentioned members of society expect to be given any regard, they need to adapt their approaches to the occasions.

The firmest hand

A very noticeable and widespread parenting style is the controlling one. When authority figures lean to extremes, either pressuring kids to eat or restricting them from eating, trouble is probably not far behind in the overweight risk sweepstakes:

Research indicates, for example, that when parents exert excessive control over what, when, and how much their children eat, the kids may be at higher risk of becoming overweight.

A normally healthy child is born with an internal signaling system in regard to hunger and fullness, and this needs to be allowed its natural development — in the same way that small children learn to observe and heed the signals of their eliminatory functions. These processes take time and practice, and when overlaid with emotional trauma, they can’t function correctly.

Parent behaviors that should be avoided include, not surprisingly, using food as a reward — and conversely, the fanatical restriction of “palatable” aka junk, foods.

A better approach […] involves leading by example and providing an environment where healthy eating is prevalent amongst all family members.

Sure, parents need to set some limits and draw a line in the sand now and then. But the problem, again, is human nature. Children are born with a natural instinct to conform, and to please the big people — and also with an equal and opposite instinct to rebel. By picking the battles judiciously, a conscious parent tries to walk the fine line between too much yes and too much no.

Your responses and feedback are welcome!

Source: “Risk Factors for Overweight/Obesity in Preschool Children: An Ecological Approach,” UNL.edu, October 2013
Source: “The Parenting of Fat: 10 Ways You are Making Your Kids Overweight,”
Mamiverse.com, 10/09/14
Source: “8 Things About You That Increase Your Child’s Risk for Obesity and Unhealthy Eating Habits,” HuffingtonPost.com, 02/23/14
Photo credit: CDA Appliances on Visualhunt/CC BY

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Profiles: Kids Struggling with Weight

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The Book

OVERWEIGHT: What Kids Say explores the obesity problem from the often-overlooked perspective of children struggling with being overweight.

About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:

Presentations

Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

Food & Health Resources