Dr. Helen Ostro Brown, M.D.

March 2, 2005

Outline-No Benchmark Needed

Health related diseases associated with exercise and nutrition

 Physical inactivity is the major risk factor for coronary artery disease and stroke.  The American Heart Association is recommending 60 minutes or more of moderate to vigorous activity every day. Atherosclerosis , the fatty deposits in arteries, leads to heart disease and stroke.  These diseases are the largest cause of death in the U.S.  This process of atherosclerosis begins in childhood.  High cholesterol is one of the causes for this process.  Eating patterns, lifestyle, and genetics affect cholesterol levels.  Normal cholesterol levels for children are:

Total cholesterol 170

LDL, bad cholesterol´ less than 110

HDL, good cholesterol´, greater than 35

Triglycerides, another fat in the blood, less than 150

NOTE: THESE NUMBERS ARE DIFFERENT THAN ADULTS

High cholesterol, as mentioned, can cause heart disease and stroke, but is also associated with peripheral vascular disease, affecting the circulation in your legs and feet, and with kidney disease.

  High blood pressure is also increasingly found in children.  It is caused by genetics,  being overweight.  The treatment is diet, and exercise and blood pressure medications.  But it is more important to prevent the high blood pressure in the first place by healthy diets and exercise.

  Overweight children lead to overweight adults.  Definition- greater than the 75%ile. The percentage of children overweight in the U.S. has increased significantly:  From 4% in 1963 to 12-26% in the year 2000.

BMI-or Body Mass Index is the simplest way to measure body weight. (See chart). Normal is 18.5-24.9, overweight is 25-29.9,obese is BMI greater than 30.

No smoking (includes 2^nd hand smoke), exercise, healthy diets.

Benefits of physical activity:

 -increased life expectancy

-decreased heart disease

-psychological benefits

-social benefits

-weight loss

-decreases blood pressure

-increases HDL, good´, cholesterol; decreases LDL bad´ cholesterol

-decreases Diabetes

-decreases cancer

Benefits of Healthy Diet:

-"feel better"-less headaches, less dizziness, weakness, better exercise tolerance

-more energy

-decrease in heart disease, stroke, diabetes

-decrease in cancer (certain cancers decreased risk with increased fibre)

-decrease ?other diseases

-decrease hypertension

How to promote physical activity:

-decrease sedentary time

-make it fun

-parents to be role models for active lifestyle

How to improve nutrition:

-focus on small but permanent changes in eating ,e.g. easiest start is to lower fat intake

-prevention of weight gain as they grow instead of focusing on weight loss

-parental involvement by ROLE MODELING  

4 Roles:

1.Provider- provides fruits and veggies in abundance in preschool years.  This leads to increased intake of these foods in school years.

2. Enforcer- Don´t be the enforcer´. When a parent controls, the child cannot self-regulate their food intake later. This also leads to a dieting mentality.

3. Role Models- Parents who are always dieting result in children who diet. "Walking the

  Talk" positive food behaviours lead to positive self image.

4. Protectors- Parents trying to protect their children from the harm of obesity, so they become the "food police" enforcers. Don´t do this- be a "provider" of healthy foods and also a GOOD "enforcer". Example- discouraging soda pop but not counting every gram of food is an example of a good enforcer.

Division of Responsibility:

Parent responsibility- what, where and when the child eats. Mealtimes should be pleasant, choose and prepare food with regularly scheduled meals and snacks.

Child responsibility- How much and WHETHER they eat.

Child naturally knows how much to eat and will naturally eat a variety of foods, and will grow, and will mature with respect to eating. However, their ability to regulate food intake and preference can be impaired by the way they´re treated with respect to eating.

Experiment- Kids who ate a high calorie snack- some kids did adjust their food intake during the next meal and some kids did not adjust.  The kids who did not adjust came from homes where parents were over controlling. External pressure can cause children to eat more or less then they really want; fighting against the pressure can also cause over eating or under eating.

Children and Food Acceptance:

Children naturally don´t like new food.  However they will taste itthe more often they tasteincreased chance of liking it.  Parents let kids take the easy way out by offering only familiar foods or having sweets easily available or being a short order cook´. WHAT WORKS? 

-being there

-have new foods available

-positive meal environment

-don´t be too demanding or too protective- the 2 extremes