By Laura Casey
Contra Costa Times
WALNUT CREEK, Calif. — When Oakland, Calif., mom Patricia Miranda's oldest son, Eduardo, was declared overweight and diagnosed with high cholesterol at age 5, she knew something about the family's eating habits had to change. But she didn't know where to start.
"I never got education or nutrition classes for eating healthier," she says, adding that her own cash-strapped mother would feed her family the food that she could afford, healthful or not. "Nobody taught me how to feed my children."
Miranda talked with little Eduardo about the problem, although not in great detail. She told him something needed to change. The family had to start eating better or else Eduardo might get sick.
Miranda started cooking more low-fat meals, but it wasn't until a little more than five years ago that she got involved with the California Department of Public Health's Network for a Healthy California program and learned about the importance of feeding her three kids nutritious meals with vegetables. Now, she says, 13-year-old Eduardo no longer has high cholesterol and all three of her kids are healthy and active.
"I add more vegetables to their meals, and I cook more at home than (I) buy fast food," Miranda says. "I cook with less oil and less salt. I put the chicken in the oven instead of frying it. They love that. And I make salad, too."
Experts say Miranda did exactly what most parents should do when faced with children who are overweight or obese — she changed the family's eating habits. Instead of addressing the issue as a child's problem alone, it became a starting point for the whole family to improve their health.
"Parents don't need to approach their kids and say 'Hey, you're fat,'" says Dr. Lisa Thornton, a pediatrician specializing in disability medicine at the LaRabida Children's Hospital in Chicago. "It's not really about being negative about weight and body image. It's about being a positive role model about it."
Thornton, who oversaw the development of the new Weight Watchers book "Eat! Move! Play! — A Parent's Guide for Raising Healthy, Happy Kids" (John Wiley & Sons, Inc., $19.95), says talking to kids about their weight starts first with going to the doctor and getting their body mass index (BMI) for their age measured.
"Your pediatrician really can tell you if your children's weight is an issue," Thornton says. "We can't trust our eyes in this case. We really need to know the number. In fact, many people who have really obese children don't view their children as obese. The BMI is the wake-up call."
According to statistics from the 2008 Centers for Disease Control and Prevention Pediatric Nutrition Surveillance System, nearly 20 percent of children are either obese or at risk of becoming obese. It's a problem that experts say is reaching epidemic proportions.
"We have children in this country who will need liver transplants by the time they're 20 years old," says Carol Danaher, a public health nutritionist for the Santa Clara County Department of Public Health who works in chronic disease and injury prevention. "Their obesity is killing them."
Danaher says that when a child becomes overweight, many parents lovingly try to fix the child with food restrictions and even diets. Danaher says these options usually don't work.
"Instead, the focus needs to be on the parenting. The research shows that parenting structure prevents children from being overweight," she says. Structure includes making sure kids get enough rest, eat meals at specific times rather than graze all day, play and exercise, and limit the time they are exposed to electronic distractions.
In fact, a 2010 study in "Pediatrics: Official Journal of the American Academy of Pediatrics" concludes that young children are healthiest when they regularly have an evening meal with their family, get enough sleep and have limited "screen time" or time with the TV, computer and cell phones. Usually, that screen time is about an hour.
Children also appear to model their own eating habits after their parents' or caregivers' habits as well, Danaher says.
"Through cross-section research, it appears that the parents who force or bribe or cajole their children to eat vegetables, those children are less likely to eat fruits and vegetables than parents who role model at the table and give their children what they are eating," Danaher says.
Jamilia Ashworth, a mother of four from Oakland who is also involved with Network for a Healthy California, has seen members of her family suffer from chronic illnesses because of their weight. Her mother, sister and aunt all have diabetes.
She says she knows her kids like junk food — fast food, candy, chips and soda — but for their health and her own, she shows by example the right way to eat. She makes spinach pizzas and turkey meat spaghetti sauce. She puts broccoli in the kids' favorite macaroni and cheese, and she avoids fast food restaurants, which are ubiquitous in her West Oakland neighborhood.
"I know they're kids, and they don't know what to eat," Ashworth says. "So I eat with them. I practice what I preach."
Portion sizes are also an issue, says Tuline Baykal, the Bay Area Children's Power Play Coordinator for the Network for Healthy California.
"We try to educate parents that children's portion sizes are significantly smaller than our own," Baykal says. "At this young age, it's really the role of the parents to glean that information and practice healthful behavior with their children."
Baykal says kids also need to get exercise, to play. This is another way parents can role model for their kids. Everyone in the family should be getting about an hour of exercise a day, whether it be walking around the neighborhood or playing at the park.
Miranda, whose son Eduardo lowered his blood pressure, makes sure she puts on some good music while she cooks and dances with her kids in the kitchen.
"I love to move, to be active," she says. "We exercise together."
STEPS TO A HEALTHFUL WEIGHT
Here are suggestions for helping your kids maintain habits for good health:
—Focus on wholesome, nutritious foods including whole grains and make water, low-fat milk and other noncaloric beverages the household drinks of choice.
—Always eat breakfast. Studies show that children who eat breakfast tend to be less overweight than children who don't.
—Include treats in reasonable portions.
—Limit "screen time," including access to television, computer and texting to less than two hours a day, outside of homework.
—Be active for one hour or more per day.
—Apply healthful eating rules to the whole family.