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Overweight children often remain overweight
Childhood obesity has nearly tripled since the 1970's, yet there are no clear guidelines to help pediatricians identify which children are at risk of obesity and when. Using growth data from the National Institute of Child Health and Human Development, researchers from six locations around the United States tried to identify one of the early signs of adolescent obesity (J Pediatrics 2006;118(2):594-601).

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.

Kids Enjoy the Low-Fat Version, Too
Helping overweight children lose weight is tricky. Not only do they need a certain amount of excess calories to foster healthy growth, but as any parent will tell you, small children like to eat things that taste good to them, and they won't eat things that don't taste good.


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Manage your child's expectations

a family of two adults and two children play in a wooded park area

You're probably well aware of the high levels of childhood overweight and obesity in the United States (and many other countries). You probably also know how difficult it can be to lose excess weight once you have it. With that in mind, some researchers are focusing their efforts on understanding why children become overweight in the first place.

We do know that children today eat far more frequently than they did even 30 years ago - and that their overall snack consumption is easily equivalent to the number of calories they consume at breakfast or lunch. One area that is drawing attention of scientists is what are known as "cognitive scripts." These are best described as "expectations about the order as well as the occurrence of events." For example: part of a cognitive script involving shopping for shoes at a store might go like this: Enter the store and find the shoe department. Choose a shoe. Ask a sales person to bring you the shoes to try on. Try on the shoes. Make a decision about purchasing the shoes.

These scripts are created by repetition of certain events in a particular situation, so the more common the events, the more likely they are to appear in an individual's cognitive script. As you might imagine, a person's cognitive script for a certain situation is influenced by past experience (visiting the shoe department every time one enters a department store) and can also predict future behavior (if one enters a department store, it's very likely that you'll visit the shoe department).

Researchers at Bowling Green State University in Ohio recruited 44 children between the ages of 4-6 (via their parents) from daycares and preschools in the area to participate in their study (Appetite 2015;85:66-69). The children's height, weight, and age were recorded by interviewing the parent of each child, and the Body Mass Index was calculated before the study. The study authors theorized that those children whose cognitive scripts included food more frequently would have a higher Body Mass Index.

Each child was shown a simple line drawing illustrating the location of certain events that were familiar to the child and were asked "to tell a story about four activities that occur during that event." These events were a play date, a movie theater, and a sporting event. These events were chosen because food was likely to be available during these events but was not necessarily integral to the event, as would be the case with such events as a birthday party or Thanksgiving. The researcher asked the child about food only if the child did not spontaneously mention food-related activities in their event scripts.

The researchers found that 54% of children mentioned food during the play date event or the sporting event, but 74% of all children mentioned food when discussing a trip to a movie theater. Further, those children who mentioned food more frequently in their event scripts had a higher Body Mass Index than those who mentioned food less frequently.

What this means for you

The take-home message here is twofold: first, more frequent mentions of food in a child's cognitive script that it not directly related to food suggests that they are likely to be eating (snacking!) more frequently - and that easily leads to excess body weight. Be aware of your child's cognitive scripts: are you setting them up to expect frequent, excessive snacks? Second, children's cognitive scripts are carried into adulthood: if you go to a movie, do you feel you have to get a tub of popcorn? Is it just not a baseball game without a hot dog? Try to be mindful of your cognitive scripts that include food, and make a conscious choice whether to eat or not.

First posted: January 7, 2015