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For many years doctors told pregnant women, "Infant feeding is your choice; your baby will be fine with either breast milk or formula." This advice was still given long after research showed the value of breast milk to infants and the health benefits of breastfeeding to the mother.
It's the fast food, not the portion size
Eating studies have suggested a number of factors that might be affecting the amount people eat when they eat fast food. First and most obviously, the portion sizes have increased. Second, people tend to eat fast food meals more quickly, which can override the body's natural signals of fullness. Further, fast food is what we call "energy dense": it's high in calories for its physical size.
Added sugars may affect heart health risk factors in children
Last week I shared a meta-analysis that concluded that higher levels of sugar intake in an adult's diet were "strongly associated with higher triglycerides, total as well as LDL cholesterol (the bad cholesterol), and blood pressure." While that study was interested intotal sugars and not strictly added sugars, this week's study suggests that those effects are not limited to adults.
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Kids' weight control a family affair
We know that overweight and obese children are much more likely than normal-weight children to grow up to be overweight and obese adults. Studies have found that when parents take sole responsibility for managing their children's weight, as opposed to expecting the child to make their own behavioral or lifestyle changes, it is half as likely that the child will continue to be overweight eight years later. Yet conventional wisdom says that parents already possess the nutritional and dietary information they need to appropriately feed their children and blame instead poor parenting skills for a child's overweight status.
Dr. Rebecca Golley, in South Australia, devised a study to test that conventional wisdom (Pediatrics 2007;119(3):517-525). She and her colleagues recruited 111 overweight and obese children between the ages of 6 and 9, and their families, to participate in a weight-management program. One-third of the families received training for the parent in positive parenting skills and was aimed solely at improving the parents' ability to manage their child's behavior (the P group). In addition to the positive parenting training, they were provided with a pamphlet on healthy eating, but no formal training.
Another third of the families attended a second program, which included the same positive parenting skills training as the first as well as an additional lifestyle education component aimed at teaching the parent about healthy eating, including specific healthy food recommendations, snacks, and recipe modification (the P+DA group). Both the P and the P+DA group's training lasted six months.
The last group was put on a wait list for the weight-management program and acted as a control group (the WLC group). This last group received the same pamphlet on healthy eating as the P group.
The children's height, weight, blood pressure and cholesterol levels were tested at the beginning of the study, at the end of the six months of training (for those children not in the WLC group), and at 12 months (for all children, including those wait-listed).
At the end of the study, the researchers found that the growth rate for the children in the first two groups of the study was similar to that of the control group. However, the children whose parents received training in healthy eating as well as positive parenting reduced their relative BMI by 9%, compared to 6% in the positive-parenting-only group and 5% in the control group. Of all children, twice as many children in the control group actually increased their relative BMI score, as opposed to those in the weight-management training.
What this means for you
Weight control in children can be tricky because of the nutritional needs of their growing bodies and should be approached cautiously. If you are concerned about your child's weight, speak to your pediatrician about a referral to a dietitian and make healthy eating a family affair.
First posted: April 24, 2007