Ever look for a simple, straight-forward nutrition tool to help you figure out how much of which nutrient you should have per day?  How much fat or protein or carbohydrate should you have per day?

Well, here are two great resources:

• The University of Maryland Medical System provides a short process of a series of quickly-answered questions as part of the Health Calculators tools.  They provide information varying from calculating your own Body Mass Index to determining how much carbohydrate and fat you should aim at eating every day to determining at-risk teens issues such as marijuana and alcohol use.
• The United States Department of Agriculture (USDA) National Agricultural Library has a very informative website and Dietary Guidance (DRI) references.  The Interactive DRI for Healthcare Professionals is actually very user friendly and provides much insight into the world of nutrition on a more individualized basis.  

Remember with these and other health tools, the information provided is for generalized health and well-being; it may not be completely tailored to your individual situation and is certainly not meant to diagnose or treat a particular health problem.  But they certainly provide great insight and ballpark figures to aim for.

Picture by Aloysius Patrimonio, PhotoXpress

For more info: child and adolescent weight management

Childhood obesity and children running marathons

 

With the 2009 ING New York City Marathonapproaching, there is much excitement in the air!  Especially for those who have been feverishly training for running quite a long distance!

We see adults, both women and men, completing marathons, but did you know that children have been able to defeat all odds, compete and set world records as well?  It is not a well-known fact that children have participated in and completed marathons ... and quite an amazing feat it is!  It is challenging enough for adult bodies to push themselves to make it through the 26.2 miles of constant exercise, whether running or walking or any combination of those two known (for some others of us it may also involve crawling towards the end!)... can children do that?  Should children do that?

Since 1988 there have been teenage runners that are officially allowed to compete in marathon running (minimum 18 years of age) but the New York Times recently featured 3 preteens, 2 years before this minimum age regulation came to place.  The article entitled 'Children of the Marathon Recall a Forgotten Time' shares with its readers the fascinating story of these boys who did accomplish a grand goal and now as young men, their opinion about this experience.

Interestingly enough, the three took on running and training as a chance to spend more time with their fathers.  And running also proved to be a smart way to channel pent-up, active-boy energy.  They received much support from their parents; not pushed or forced but a stated desire to reach a particular goal was not shunned by the parents but encouraged and supported.  Once they said they were done with running, so were the parents. To this day, these three boys, now men and fathers, have accomplished many great things in life.

The verdict is still out and there is still much debate among physicians and trainers as to whether or not such an activity is recommended for children 'in the short and long run' (literally).  Perhaps there may be injuries such as overuse or repetitive use injuries that may be aggravated over time since these young athletes appear to start earlier in life to be active and to choose their sport?  

What does running marathons have to do with childhood obesity?  Much.  Actually, exercise, running or any other sport is  related to the obesity epidemic. -- the more active, the less likely children and teens are to be overweight or obese. 

Encourage your child to be active.  Be alert to activities and exercise that they are especially interested in.  Support them to be the best they can be.  Help to facilitate the discipline required through proper coaching -- not only to lead them to a healthy lifestyle but to help them excel in their chosen activity or sport.  The satisfaction and boost in self esteem that come with a child being proud of oneself in the athletic realm are both fulfilling psychologically, emotionally, and educationally thereby becoming tremendous deterrents of obesity both in childhood as much as adult life.

Picture by Byron Moore, PhotoXpress

Teen obesity, exercise, and breast cancer

This month, October 2009, is Breast Cancer Awareness Month.  What does breast cancer have to do with teenage girls? A lot.  Is there a connection between obesity and breast cancer?  Yes.  And now, just as important to know,... a way to help protect teenage girls from developing breast cancer in middle age.

It has been shown already that there seems to be a link between the amount of time a female body is exposed to estrogen, the female hormone, and the probability of being diagnosed with breast cancer -- a direct correlation.  The more time of exposure to estrogens (i.e. early menstruation),  the higher the probability of breast cancer.  To further complicate things, you should also know that fat produces estrogen, especially relevant after menopause.  So, the more overweight that women are, the more fat is present on their bodies, and the more likely they are to produce larger quantities of estrogen that could more likely predispose them to the development of breast cancer.

So, what can we do to decrease this amount of estrogen exposure and to decrease fatty tissue?  One simple answer -- EXERCISE!  

Very interesting research results from study were featured on the CBS The Early Show last year and reported in the Journal of the National Cancer Institute -- the greatest benefit to averting breast cancer in middle age was doing regular exercise  between the ages of 12-22 years!  And we are not talking major extreme sports; the exercise reported was well within the range of what is currently recommended for prime health benefits.  

The women at lowest risk reported doing vigorous exercise about 3 hours, 15 minutes per week or about 13 hours per week of walking, for the not so athletic!  Translate that to about 1 hour 45 minutes of walking per day per week -- we need to be aiming at getting 5,000 steps per day (approximately 5 miles)  and tack on another 30-45 minutes of say, fast walking, and you have just decreased your risk of breast cancer significantly!  That's great news!

Picture of Breast Cancer Awareness ribbon by Robert Mobley, PhotoXpress

For more info: Susan G. Komen 5K Race for the Cure, Teen Growth - an online health resource for teens

Bariatric surgery for obesity: what is it and is it for my teen?

We hear a lot these days about options for weight management -- nutrition, diets, exercise and activity, magical pills, and surgery.  Many times parents feel that they have tried 'everything' and are at their wits' end, concerned for their child's health and wellbeing.  They head for the internet, desperate to find a solution for their child and fast.... surgery, bariatric surgery seems like the next and final answer to it all.  Or is it?

Before heading down this route so quickly, even in this article, let's talk about some basics... 

• What is Bariatric Medicine?  As defined on the American Society of Bariatric Physicians (ASBP) it is very simply stated as " the art and science of medical weight management and associated co-morbidities."   In other words, bariatric physicians are specially trained in dealing with those who are overweight and obese, the medical and health issues associated with being overweight or obese, and and such, they are trained to help lose weight safely, effectively, and efficiently.

• What is Bariatric Surgery?  Simply stated, weight loss surgery.  Trained surgeons perform specific surgeries for those dangerously and life-threateningly obese for the purpose of losing weight and other added health benefits (many co-morbidities or associated health issues are resolved once weight is lost).  For more information visit the American Society for Metabolic and Bariatric Surgery (ASMBS).

• Who qualifies for Bariatric Surgery?  The basic criteria involves at minimum a vigorous 6-month trial of a non-surgical weight loss program; typically under the supervision of a bariatric medicine physician specialist or a primary care physician.  If no significant weight loss has occurred after this time period with a Body Mass Index of > 40 or >35 with associated health issues such as diabetes, high blood pressure, etc., there is then consideration for referral to a Bariatric Surgery Center of Excellence for determination of possible candidacy and further evaluation by their specialized team of multidisciplinary specialists.  Some Bariatric Surgery Centers may have different eligibility criteria, but this gives you a starting point.

• Is the criteria for eligibility for bariatric surgery the same for adults or teens?  Bariatric surgery is reported to have been performed on teenagers as young as 14 years of age.  There are more stringent criteria for teens.  Careful consideration of many factors must be taken seriously and the decision to proceed with the surgery should not be taken lightly.  Often times teenagers have not fully matured physically or psychologically and they may not fully comprehend the lifelong consequences of such a surgery.  A recent study done at Cincinatti Children's Hospital is the first of its kind to report that teens should not be referred until they are morbidly obese, but before then; it appears that a narrow window of opportunity exists to perform bariatric surgery in teens to achieve maximum benefits.

• What types of surgeries are available?  At this time, there are 2 major types of bariatric surgery -- Gastric ByPass and Gastric LapBand.  Gastric byPass involves major surgery and a part of your intestine is removed; lifelong nutrient replacement supplements must be taken. The LapBand technique is less invasive and involves placing a special band over the middle-upper part of your stomach creating a small pouch; it significantly  limits the amount of food that one is able to consume at one meal or any one point in time.  Determination of which one may qualify for is determined by an experienced team of specialists at a Center of Excellence usually comprised of bariatric physician surgeon, psychologist, dietician, and coordinator.

• Are the weight loss and health benefits after surgery permanent?  In many cases they absolutely are and the results are an amazingly increased quality of life and lengthening of longevity.  However, it is highly dependent on each person -- the medical and psychological issues leading to the obesity before surgery must be dealt with openly and honestly by both surgical team and patient and resolved -- if not, you can count on the weight returning and going back to square one.  In addition, the patient must be fully aware that the decision to have bariatric surgery is life-altering forever and must be willing to adhere to the recommendations provided by  the surgical medical teams.  Click here to view the potential health benefits of bariatric surgery.
  

For more information regarding Teen Bariatric Surgery, click here to view a superb article regarding a teenager in Pittsburgh and her story. 

Picture by Stephan Morrosch, PhotoXpress

For more info: my training zone - bariatric medical weight management for children and adolescents

Do parents accurately perceive their child's weight status?

It has been reported in the past that up to 90% of parents do not correctly identify the level of their child's overweightness, risk for obesity, and thus, associated health risks.  The latest research seems to back this up...  

A study just recently came out regarding parent's perception of their child's weight status.  It is eye-opening!  Over 550 parent-child pairs of children ages 5-12 were involved -- it was reported that  "86% of parents of obese and overweight  children misclassified them as overweight or normal weight, respectively" (Medscape,  Edmunds and Scudder,  My Child Is Not Fat, October 2009).

In other words ...  wake up, parents and primary caregivers!  A significant majority of us underestimate our child's weight -- possibly due to denial or unrealistic optimism or we ourselves being overweight or being too busy to really take notice the expanding waistlines of our children or feel helpless despite seeing warning signs.  Whatever the cause, the family, as a whole, needs to be aware of the situation in their household and take charge!  

Here are a few tips and suggestions:

• Make healthy living a priority in all of your family members and hold each other accountable -- not only for their own life and health but that of their brother, sister, parent, child, or spouse.
• Talk to your child's physician regarding your concerns.  It can be determined whether of not your child is, in fact, overweight or obese and at risk for present an future health problems by simply having their BMI (Body Mass index)  and other key factors evaluated.  It's a great start.
• If you yourself are also overweight or obese, talk to your own physician.  
• See or talk to a weight management specialist.  There are physicians who specialize in both adult and pediatric weight issues that can help - this is what they are trained to do and many have a passion for doing just this -- helping you though the tough phases of weight management (my training zone - child and adolescent weight management or American Society of Bariatric Physicians).
• Enroll the entire family (yes, including yourself) in exercise and active programs whether before-, after- school or weekend programs. It could be as simple as exercising close to home or going to the local park or signing up for a gym membership.
• Read, read, read!  Inform yourself from reliable sources regarding healthy living -- the more education and information you have, the more easily you will integrate these changes that work for your family and children.  No family is alike and no two children are alike. It is very important to tailor what you read to what will work for you and your family.  Good places to start are the my pyramid and kidshealth websites for parents, teen, and children.
• Be aware of what your children are eating -- nagging is never very effective but facilitating proper eating like helping them pack their lunches, letting them provide input on meals, and having healthy snacks at home ready when they arrive sure help!
• Always start your kids' day (and your own) with a good breakfast.  It has been proven that when you do not eat breakfast, the rest of the day you will be famished and are way more likely to overeat by dinner time, leading to unwanted retention of excess calories.
• Take a little extra time at the grocery store and become an informed, smart consumer!
• Be an example to your kids -- actions speak louder than words (and those of you with teenagers sure know that!).  

Embark on this journey with them, share your thoughts and challenges with each other, use this time as quality time, not fighting about food or exercise.  Make it fun... your kids will thank you for it!

America's economic cost of obesity

OK, so we have been hearing for awhile now that the obesity epidemic has many negative health ramifications both for adults, teens and children; it has also been reported that there are some pretty heavy financial concerns for this country associated with so many Americans being overweight, obese, and/or with the associated medical issues ... so what is it really that we are talking about financially?  What are there economic costs?

According to the CDC, Centers for Disease Control (one of our country's most reliable institutions for medical information and research), the national economic cost of obesity involves a few factors: 

• direct medical costs - preventive, diagnostic, and treatment services related to obesity
• indirect medical costs - morbidity and mortality costs.  In other words, how obesity negatively impacts someone's life defined as value of income lost (present and future) from decreased productivity on the job, restricted activity, absenteeism, bed days, and premature death. 

Click here to view your state compared to others.

Studies done have shown that medical expenses associated with being overweight and obese  are estimated to have reached as high as $92 billion in 2002 (Finkelstein, Fiebelkorn, and Wang 2003).  Other studies estimate that our nation's obesity epidemic is costing the country more than $117 billion (Office of the Surgeon General) every year.

 And a more recent study by Thomson Medstat in 2005 has estimated that the America's national cost of childhood obesity alone stands at about $14 million per year. 

Children diagnosed with obesity are two to three times more likely to be hospitalized, adding to the medical costs.   Studies have shown that there is a difference in whether a child has health insurance by private, Medicaid or not insured at all; Medicaid appears to carry a substantial burden of these costs.  Rising childhood obesity rates suggest that these costs will continue to increase if nothing is done to reverse the trend.

We must not lose sight of the task at hand. This is a significant health problem and financial issue in what is now rapidly becoming a danger to ALL children, in ALL social classes, of ALL races, in ALL of the United States. 

Picture by Madriger, PhotoXpress

For more info: my training zone - weight management specialists

2009 National School Lunch Week

This week, October 12-16, 2009 has been declared the National School Lunch Week.  It is a time dedicated to increase public awareness -- parents, schools, and to the public at large -- of the importance of providing healthy meals to the children under their care.  

What is the importance of providing healthy meals at school to children?  To keep it simple, there are two major reasons (although there are plenty more):

• Childhood obesity and its medical complications such as diabetes and heart disease (high cholesterol and elevated blood pressure) which were once thought to be only adult diseases, are on the rise in this country and have been so for the past 20-ish years or so.   
• It has been shown that children and teens (and adults, for that matter) do WAY better in school when they are provided with healthy food choices throughout the day -- better concentration, better behavior, better grades, and consequently, better opportunities and futures.  

What can I do as a concerned parent?

• Try to make the time to pack your child's lunch with healthy, delicious options.  Enlist the help of the little yet opinionated person who will be eating their lunch later on -- they are more likely to eat it if they have more say in the lunch-preparing process.   Click here for more suggestions from local Miami chefs and nutritionists.
• Eating away from home does not automatically mean that your child will not have good eating habits.  That is is more difficult to do so, yes, absolutely,  Impossible?  No.  Click here for some tips and suggestions on eating out and away from home.  
• Join your School Board and attend Parent-Teacher Associations to provide your much-needed input and be an informed parent.

Every opportunity should be taken to provide growing minds and bodies with healthy fresh fruits, vegetables, grains, and dairy products.  This will make a big difference in both the short AND long run of their lives.  

Picture by Renata Osinska, PhotoXpress

For more info: my training zone - weight management specialists for children and adolescents

Back to basics: A review in the criteria defining obesity in children and adults

OK, so we hear a lot about being, heavy, chubby, baby fat, overweight, obese... What exactly are the criteria for overweight or obesity, anyway?  Let's go back to basics for a bit...

Although not infallible, the best way that we have to determine medically, uniformly and objectively, whether or not a child or adult is overweight, obese, or at risk of becoming so, is the Body Mass Index (BMI).  It is a calculation measured by the weight, height, and a invariable factor.  

For CHILD and TEEN BMI ages 2-20 years:

In children and teens, determining whether they are overweight or obese is determined first by obtaining their BMI calculation and then comparing it to their age and sex. Age- and sex- specific growth charts let us know in which percentile they rank compared to other children -- whether they are :

• Underweight: less then 5% percentile
• Healthy for age: 5-84% percentile
• Overweight: 85-94% percentile
• Obese: >95% percentile

For some children, it is important to maintain a certain weight as they grow.  For others, it will be important to lose a certain amount of weight.  Treatment depends, as well, if they have medical complications such as diabetes and high cholesterol or elevated blood pressure.

It is possible to see where your child ranks on the CDC website Child and Teen BMI Calculator.

For ADULT BMI, following is the criteria: 

• Overweight: 25 - 29.9
• Obese: >30

For adults, to find out how your weight measures up and your BMI, click on the myfooddiary.com banners on this website to the right or at the bottom and sign up!

Picture by mashe, PhotoXpress

For more info: Tips for Parents to Maintain Healthy Weight for Kids - CDC,  my training zone - weight management for children and adolescents

2009 Fattest versus fittest cities in America: how does yours rank?

Think about your own city that you either currently live in, your hometown, or where you would want to move to... would you say it is a fit-conscious or not-so-fit-conscious sate?  Last week at the annual Miami-Dade Start! Heart Walk, Laura Denoux from NBCs The Biggest Loser hosted the event and stated that ... Miami is the fattest city!  Wow!  Ouch!  Really?  No way!

Yes, way.  Research regarding this subject yielded the following results... Well, apparently there is an annual report of a survey published by Men's Fitness magazine -- the 11th one this year.  It is called the " 2009 Fattest Cities in America"?  (In all fairness, there is also the Fittest City survey also mentioned later).  The survey bases its criteria on, for example,  numbers of certain fast food joints per capita, percentage of people that either have gym memberships or home gyms, presence of ball parks per capita, etc.   It is definitely worth taking a look!

Here's a brief list of the Top 10 fattest cities in America:

10. Louisville-Jefferson, KY

9. Charlotte, NC

8. Jacksonville, FL

7. El Paso, TX

6. Houston, TX

5. New York, NY

4. Las Vegas, NV

3. San Antonio, TX

2. Oklahoma City, OK

and #1...  MIAMI, Florida!

And for curiosity's sake, here are America's Fittest states:

10. Virginia Beach, VA

9. Omaha, NE

8. Seattle, WA

7. Honolulu, HI

6. Portland, OR

5. Albuquerque, NM

4. Denver, CO

3. Minneapolis, MN

2. Colorado Springs, CO

And congratulations goes to the fittest city of... 1. Salt Lake City, UT

For more detailed look at our 11th annual Fittest/Fattest City survey conducted with the help of RFG Research, click here.

Miami skyline picture by Wimbledon, PhotoXpress