Healthy eating options are plentiful, and fun, when giving children food for life

07/25/2014 2:14 PM

09/17/2014 3:06 PM

When Sheah Rarback, the director of nutrition at the University of Miami’s Mailman Center for Child Development, joined the department 30 years ago there was no Type 2 diabetes designation for children.

Sure, there were some overweight children, but, as Rarback said, “I rarely saw kids who were diabetic. The nomenclature had to be changed to Type 1 and Type 2 because kids were becoming diabetic.”

Indeed, they were.

Last year, the Centers for Disease Control and Prevention predicted that one in three babies born today will develop diabetes in their lifetime. The prevalence of Type 2 diabetes, a chronic disease once diagnosed for adults over 40, rose more than 30 percent for children ages 10 to 19 during the last decade.

According to a 2011 report by the American Diabetes Association, some 26 million children and adults in the U.S. are living with diabetes and 7 million of these individuals are unaware, yet to be diagnosed.

More than two thirds of obese children face the risk of cardiovascular disease and are more likely to develop diabetes and other ailments, like bone and joint pain and sleep apnea, as compared to their healthier counterparts.

According to recently released figures from the Centers for Disease Control and Prevention’s 2011-2012 survey, childhood obesity rates remain high, at about 17 percent, or 12.5 million children ages 2 to 19. Not a significant change from the previous 2003-2004 study.

The prevalence of obesity among children ages 2 to 5 decreased from 13.9 percent in 2003-04 to 8.4 percent in 2011-12. Among low-income, preschool-aged children, obesity went down, slightly, for the first time in recent years, from 15.2 percent to 14.9 percent. The greatest decrease was among 2-year-old Asian children.

That’s good news, if you ignore the fact that the 17 percent figure is still three times that of the previous generation. And obesity rates are still higher among Hispanic youth (22.4 percent) and black youth (20.2 percent) compared with non-Hispanic white youth (14.1 percent).

“The first five to 10 years I never saw a kid who was Type 2 diabetic and now I see it regularly,” said Rarback, who writes a nutrition column for the Miami Herald.

Sonia Angel, the coordinator for the Diabetes and Nutrition Center at Memorial Regional Hospital in Hollywood, has also seen a bump in obesity rates, especially among Hispanic youth.

“Researchers believed it could not be just diet-related but genetically, the way we’re built, that we have more susceptibility to insulin resistance,” Angel said. “But, as a clinician, I truly believe that it’s the lifestyle that a lot of Hispanics have who live here in the U.S.”

Angel cites examples of patients she has seen from Mexico and Cuba who have told her they used to walk everywhere when they lived in their homelands and lacked cars for transportation. In the States, they drive more. “Lack of activity is a factor,” she said.

“A third of children are overweight and it’s a growing problem because that can carry on in life,” said Erin Corrigan, nutrition manager at Miami Children’s Hospital. “It’s a continuing problem because there are so many processed foods and convenience foods available. A lot of marketing is directed to children and the products are eye-level at the grocery store with colorful cartoon characters. The manufacturers are savvy about making something kid-friendly.”

Corrigan cites products like Go-Gurt yogurt, made by Yoplait and packaged in a kid-friendly tube. “It’s yogurt so they think they are giving kids something healthy but Go-Gurt is very high in sugar. Another is fruit snacks that are mostly corn syrup, gelatin and artificial colors. Nothing can replace real fruit. Fruit is simple and you don’t have to do much to prepare it or make it portable or fun.”

Obesity, defined by the CDC as a body mass index (BMI) at, or above, the 95th percentile of the sex-specific CDC BMI-for-age growth charts, makes one more prone to Type 2 diabetes, a disease that can be controlled by either drugs or a change in lifestyle, such as regular exercise and proper diet.

Even a 10-pound weight loss is significant in a child who is overweight or obese, experts suggest.

“The interesting part is that studies show who is at risk but they also show that losing 5 to 10 percent of your body weight reduces the risk of developing Type 2 diabetes by more than half, 50 percent. You don’t have to lose a lot of weight to see how your body reacts to insulin,” Angel said.

Daily exercise is a key component, for all age groups. “Somebody who does exercise is burning glucose, which is sugar, and your body therefore needs less insulin, so you’re kind of reversing or preventing that insulin resistance you see in people who are pre-diabetic,” Angel said.

So what to do?

“Really, it’s all about keeping the foods balanced,” said pediatric dietician Myerly Kertis from Holtz Children’s Hospital. “Make sure you are including all the food groups in the right amounts. For her patients and their families, Kertis suggests the popular plate method: Half of a child’s plate should be fruits and vegetables. Split the second half between grains and proteins, like meats or fish or beans and legumes.

Convert young, finicky eaters by having them pitch in at the grocery store and in the kitchen.

“Get the kids involved and let them help with shopping and pick out new vegetables to try,” Kertis said. “It takes a few times before a child accepts new foods.”

Keep things fun. “Make it colorful. On cereal, make a happy face with a banana and raisins. If they help make it, they might eat it,” Kertis said.

Ditch the juices.

“Some kids are drinking upward of 1,000 calories a day just from juices. Take that out of the diet and that will make a big difference,” Kertis said.

Get the family involved. Eat healthy, too, and this goes for grandparents and caregivers, too.

“Often I see parents are very disciplined themselves, but they work and leave the child after school with a caregiver, usually an aunt or a grandma. What happens at grandma’s house? Anything goes. A lot of parents eat healthy but it’s grandma who says, ‘OK,’ to have cookies. No rules at grandma’s. That’s what grandmas are for. And this is not about me being mean, this is about preventing this child from getting a chronic disease at an early age,” Angel said.

Parents are the role models and everyone needs to try and eat together.

“Healthy eating is healthy eating,” Rarback said. “It’s not for weight loss. It’s for health. It’s for everybody.”

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