Question 3
posted by annie_weyhrauch @ 8:23 PM
33 comments
ISU Dietetic Internship Journal Club
Objective: To become familiar with current scientific literature on a variety of nutrition topics and to gain experience in gathering, organizing, critically evaluating, presenting and facilitating group discussion of the literature and the implications to practice.
33 Comments:
I think that it would be important to bring up this topic to all adolescents and not target a certain group. I think that everyone could use information on healthier eating. I think it would be important to test all adolescents and list the risk factors. By giving them their own info and having them hear the risk factors they would hopefully then realize what category they are in. It is important to be sensitive about what you would teach and how the families would implement it to prevent eating disorders. I think that it would take a whole family trying to eat healthier and be more active to make a change, rather than just that adolescent changing their ways. Keeping that in mind you would want to family to focus on healthier food options and keep in mind portion sizes. Parents should not limit what their children can eat but rather provide healthy options and let the kids choose.
I would tell the parents that this is not a "phase", and that it is a great time to model healthy eating and lifestyle choices to their child beginning RIGHT NOW. It's important that they know the statistics and the potentially deadly effects, as well as the decreased quality of life associated with metabolic syndrome/obesity. I would really promote weight management tactics for the family as a whole...this would eliminate any negative consequences of parent's restrictive actions. I would offer them the typical advice and suggest removing many of the offending foods from the household and replacing them with better alternatives.
Steph,
cool idea to lab-test adolescents and actually SHOW them what their blood values, BP, etc. are compared to what they SHOULD be, and explain it from there. It brings relavence to the issue by making it personal and specific. Also, I completely agree about encouraging parents to be healthy role models.
I would inform the parents and adolescents of the risks of obesity at such a young age. Then I would give some simple ways to reduce calorie intake such as portion control and healthier food choices. Give them attainable goals such as eating 5 fruits and vegetables per day or for those who prefer a tangible number giving them a calorie range to stay within could help motivate them. In addition to nutrition advice I would suggest aiming for about 60 minutes of moderate to vigorous intensity physical activity on most days. The parents should be leading by example and display healthy lifestyle choices for their children to follow.
When discussing these issues with parents, it is important for them not to limit foods or become negative with their children. Explaining cooking and shopping techniques, healthier snack options to have around the house and incorporating exercise in their child’s life are critical. The parents could play a very key role in their children’s health. Setting a good example and staying positive about being healthy could help their child. Targeting children at an early age could in fact lead them to a healthier state as an adult. Letting parents know that it is crucial to help their children, but to be sensitive to their feelings. Weight loss and healthy changes takes time, but through gradual changes, can be done!
I think that you have to bring this topic up very sensitively, I also think there are a thousand ways that you can put a healthy spin on thing and not focus specifically on “weight”. This is obviously a major problem and we as health professionals can’t just ignore it, so while it’s difficult to bring up, it’s absolutely necessary to discuss with all adolescents and their parents so that they know what the risks of developing overweight and metabolic syndrome are. Especially at such a young age because they are most likely going to be riddled with health problems associated with overweight for the rest of their lives. When discussing things with parents and teens, I would definitely be focusing on positive things and making sure not to focus on weight or weight loss. Focusing on eating more fruits, veggies, whole grains and lean proteins often yields weight loss naturally. Encouraging gentle exercise and more moving in general would likely have the same results; so I definitely think there are positive ways you can look at becoming healthier without focusing on weight loss.
Steph- I think that you have very good points about making sure that parents aren’t limiting overall calories. These kids are still growing, and that food deprivation can really affect their eating habits later in life. So, I agree that instead of limiting amounts, just try to offer more nutritious foods and let the teens decide how much they need to have. I also like the idea of testing everybody so they can see where they are at, I just think you would have to be very careful about people who were eating poorly with particularly good levels at this point- it could be un-motivating for improving health habits, and I also think you need to be careful with kids who do have high levels, sometimes that could cause a “panic” factor within the kids, as well as their parents, maybe causing them to make some really drastic changes quickly.
Emily- I really liked your ideas about explaining childhood obesity and how harmful it really is to an adolescent and changes need to be made immediately. I think encouraging the whole family to work on weight management is a great idea. I know if my whole family wanted to eat better and watch their weight it would be very motivating and helpful to my own health.
Weight is a sensitive topic for adolescents. In order to address it I would make sure I'm not singling out any one person. If a mother comes to me for advice on her overweight child, I would address the parents and the other siblings about overall health. If I was addressing a group at school, I would be talking to everyone not just the overweight or obese kids. I really think involving parents is a key in making changes in the adolescents life. The parents may also have a weight problem and by helping the parents, the children can learn from their parents good example. I would also make sure the parents had knowledge about not depriving their children of things they love but trying to teach their children importance of portion control and overall better food choices.
Karlie- I liked your point on not focusing on weight loss with adolescents. Our society is already so obsessed with it. I also think the weight will come off naturally if they start increasing their physical activity and eating more whole grains, fruits, vegetables, and lean proteins.
Weight management can be a touchy subject for adolescents, and bringing it up to them would definitely be a challenge. I think that not singling any one student out would be key to keep in mind when counseling groups of this age bracket. I would stress general overall health but focus on ways of living a healthy life as part of one's everyday routine and as a family. It would also be important for the parents to know just how important their own eating and activity behaviors are as a model for their children. The statistics ARE alarming regarding childhood obesity and metabolic syndrome, but it is really just a matter of calories in being greater than calories out. This is true not just for children today, but obviously adults as well, which is why it is so imperative that whole-family education will be becoming more and more important.
Emily--
I liked your suggestion that it may not be a bad idea to throw some important statistics regarding deadly effects of obesity and metabolic syndrome at the parents as well as the children. I do not think individuals really have a grasp on how negatively poor eating habits and lack of physical activity can impact lives.
I think a situation like this is best explained to parents/children in an approach taken by Ellyn Satter for "normal eating". Explaining that normal eating is "being able to eat when you are hungry and continue eating until you are satisfied" and that it is the parent's responsibility to OFFER a variety of foods and it is the responsibility of the child to determine the AMOUNT eaten. If a child normally has large portions or several servings, suggest eating one portion initially THEN decide whether or not to eat more if they are still hungry. Teaching them the importance of hunger cues and eating only when they are truly hungry will hopefully not only aid in weight loss but a healthy relationship with food as well.
Meredith-
I agree that weight can definitely be a touchy subject--for anyone--but for adolescents in particular. I feel that eating habits or "relationships" with food are often learned from parents and that addressing the parents and their eating habits would be equally important. Stressing never to deprive oneself would definitely be very important!
I would address the issue with adolescents and their parents from the standpoint on how they could add (rather than restrict) things to their lifestyle to lower the risk.
For example, how to add variety to family meals and easily prepared healthy snacks. How to not just rely on apples, corn, and frozen vegetables. And have the parents encourage their kids in hobbies that require physical activity.
If it's too complicated or they feel deprived then they probably won't stick to it.
I wholeheartedly agree with Sam that this is not about limiting the options for parents and adolescents, but adding to those options healthy ones.
At my current rotation site I have had a chance to sit in on an pediatric outpatient session regarding weight loss. In this session, it was obvious how sensitive you, as a counselor, must be to both the child and the parents feelings. Many times throughout the session the dietitian focused on becoming healthy, not losing weight, which seemed to bring a lighter tone to the session. Providing tips such as healthier snack and beverage options, healthier preparation methods, and reviewing portion sizes can make big differences in a child's life. It is also a good idea to make sure the parent understands that they are role models and what they do can really affect the behaviors of their children. By the parents chosing (and buying) healthier options as well as getting active along with their children will send a good message and help the child follow through with the plan to get healthy.
Stephanie & Emily,
I agree that showing data by drawing labs from the child may help the family and child to realize the importance of the situation. It may even be a good learning lesson for both the child and parents as well.
Lauren
I agree that parents can often be the enablers when it comes to their overweight children. Parents are stuck in a hard position; they want their children to be healthy eaters but do not know how to set a good example with our time restrained society. Sometimes when the parents restrict their child eating, this creates in the child an insatiable urge to over indulge in whatever particular food was forbidden. It is trusting the child to allow internal cues to guide feeding, rather then external cues. Relatives of mine that genetically carry more weight; they have large frames; stuggled with this feeding issue. The two younger girls (out of four) were >95th%tile for age and weight. The parents would not allow second helpings, not allowed to eat “junk” food,gave a very negative spin towards food and their larger bodies. One of the younger girls grew into her weight; where as the other sister became obsessed with food (she continues to be >95th%tile for age and weight.) Educating families is very important for lifestyle changes. In one aspect the restricting of food helped one sister, where as in the other sister it did not. It is interesting to also see the two older sisters are not overweight and very athletic.
When approaching this topic you need to be careful. These kids that are overweight/obese are aware that they look different than the other kids and might already be self concious. I think that taking a healthy eating approach would be one positive way. Also, remembering that weight loss isn't necessarily the goal with kids, but maintance and eating pattern changes. Also, talking with the parents seperately first to address question they might have but are don't want to ask around their children might be helpful. Then doing education for the whole family.
Tori McRoberts
Emily,
I like your idea about removing certain foods, but still reminding parents that it is okay for kids to have these foods on a very limited basis. Telling kids that they can never have certain foods might make them crave them even more and develop worse disordered eating patterns.
Tori McRoberts
Karlie, you make a good point about carefully bring the topic of overweight/obese children to parents. Many parents may already be on the defensive about their child being heavy and may take it as an insult to them and their child if phrased harshly. I agree that approaching with sensitivity is important when addressing this topic.
This topic is definitely sensitive for all parents. To have someone tell you that your child is overweight is often very devastating to some parents. I would approach the situation by discussing the child and parents eating habits. By discussing both, I would then tell them that all children model their eating habits by their parents eating habits. Essentially, what the parents eat is what the child will learn is 'right' to eat. So by addressing both the household's eating habits as well as the child's, we can prevent increasing formed poor eating habits by the child and hopefully increase formed good eating habits. I would also encourage the parents to become more physically active with their child, such as going on a bike ride or a walk. By increasing family togetherness and creating a group effort, the child will not be singled-out.
Steph,
Lab testing is a great idea! By having physical evidence showing the parents the consequences of their child's weight will be enough to make them want to take your advice seriously and begin changing their diet.
The parents should be made aware of the severity of their childrens overweight/obese status without their children being present. Make sure the parents also understand the possible repercussions of their negative comments or attitudes toward their childrens weight. To improve eating behaviors, first find out what foods the children prefer, then talk with the parents (possibly including the children as well) about healthy alternatives. These could include the use of olive oil, whole wheat flour in recipes, etc.
Katherine McCullah
Steph & Emily,
I think its a great idea (and essentail) to encourage the parents to get the whole family involved in becoming healthier. Involving other siblings encourages habits that will be carried on into later life. Whether or not any other family members have metabolic syndrome or are overweight/obese it is improtant to posess healthy lifestyle behaviors.
Katherine McCullah
I would want to emphasize that it is a healthy lifestyle not a diet. I think looking at the entire picture--the parents and the children would give you a good idea of what needs to be done in the home. Parents are supposed to be the first teachers for their children, and in turn the children will model what they see. In community education programs I think you have to focus on the fact that the children are still growing and need a balanced diet to be healthy. Limiting what they eat can hurt them just as much as allowing them to eat high fat foods. It would be important to encourage the whole family to be a part of a healthier lifestyle and to be more active. Susan
Colin
I agree goals should be set, something attainable the family can work toward. Including a variety of foods and exercise would be a great family activiey. Positive motivation!!! It has to be done as something fun not forced! Susan
Early adolescence is an important time to instill in individuals an importance of living an overall healthy lifestyle. If the focus is on eating healthy foods in correct proportions and exercising a little bit everyday in an effort to make the individual feel better, results may be longer-term. Taking this approach decreases the amount of stress placed on the individual to "watch the numbers" and to be overly strict, which can lead to problems with weight management into adulthood. Teaching a healthy lifestyle may also inspire parents, thus setting a positive example for their children now and for the future.
Like I stated in my first response, I would never restrict anything from a child's or parent's diet. I would promote increasing physical activity by getting involved in extracurricular activities. If you target all children through a class at school, you are not specifically picking out children who need the classes. It is good for all children to learn at a young age that staying at a healthy weight and eating a healthy diet will promote a healthier lifestyle with less risks of diseases. Many children are afraid of diseases/conditions that may hurt them, so stating the consequences of being overweight throughout life may movitate the children to achieve a healthy body weight.
Most people have said that parents need to be positive role models. I think also the entire family should be on-board with a "healthy lifestyle change." The child will most likely fail in their attempt at change if they are not supported by those around them, and if they are living in temptation (ie from another sibling eating hohos for dessert every night). We know that nagging and nagging on someone does not necessarily produce positive results. In this case, harping on a child to "not eat this and not eat that," could produce counteractive behaviors and habits.
Sam you had a good point when dealing with the parent issue. Children can be very influenced when discussing eating certain food will cause obesity. Studies have shown that when 6 year old children were asked if they would rather lose a limb or be fat. The children had picked to lose a limb. Obviously, these children are being influenced by their parents and other children (who are being influenced by their authority figures). It is sad to live in a society where as young chiidren would prefer to have a handicap rather than overweight.
Lauren,
You bring up an excellent point that if we refer to it to the parents and children as becoming healthy, I definitely agree that it is not as offensive and does not give the child a complex about their size! I also agree with everyone that parents need to be the role model. They are more than likely the ones out doing the grocery shopping and buying the food products, so it is important to make sure that you are providing healthy options for the kids.
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