StayCurrentMD · Taking the Battle Out of Getting Kids to Eat Healthier and Move More: Child &...
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Video69 min·Published Jul 2017Older

Taking the Battle Out of Getting Kids to Eat Healthier and Move More: Child &...

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What the experts said24 expert statements · 4 host summaries
Weight is not a behavior; weight loss is not something a child can go home and do. Providers should focus on healthy habits applicable to all children regardless of size.
Guideline
Authoritarian (controlling, strict) parenting may involve hand-feeding long after developmentally appropriate or restricting intake, overriding the child's internal cues.
Clinical
Indulgent (permissive) parenting uses food as comfort or reward to control behavior, with the child in control much of the time.
Clinical
Uninvolved (neglectful) parenting leaves young children responsible for choosing their own food and deciding how much to eat, with no structure or expectations.
Clinical
Authoritative (responsive) parenting sets structure and limits with clear roles, communicates warmly, respects the child's opinions but does not give in to all demands, allowing the child to learn self-regulation.
Guideline
When parents take too much control (forcing, pressuring, restricting), they override the child's internal hunger and fullness cues or desire to be active.
Clinical
When parents give the child too much control (indulging, bribing), it teaches the child they can get their favorite food by whining or crying.
Clinical
Breastfeeding is the first introduction to the family table; breastfed babies get used to different flavor profiles from the mother's diet, which may prevent picky eating tendencies later.
Clinical
A baby's crying can mean many things (wet diaper, discomfort), not just hunger. Parents should learn to read cues rather than automatically feeding in response to crying.
Clinical
When a toddler throws food off the highchair tray, that is a cue that mealtime is over. If they continue eating food on the tray, the parent should let them continue.
Clinical
It is acceptable for a preschooler to skip a meal. The parent should let them know the next eating opportunity will be the next scheduled meal or snack, with only water available in between.
Guideline
The 60 minutes of daily physical activity can be broken up throughout the day (e.g., 20 minutes before school, 20 minutes after school, 20 minutes after dinner).
Guideline
Moderate to vigorous activity means the body is working: increased heart rate, sweating, muscle fatigue, and shortness of breath are normal cues that should be taught to children as positive signs.
Clinical
When parents praise a child for finishing all their food, it sets the child up to want to finish all meals to get praise again, overriding their hunger and fullness cues.
Clinical
Using food as a reward for good behavior teaches the child that food is contingent on behavior rather than an expectation. Good behavior should be an expectation with or without rewards.
Guideline
When a parent makes vegetable intake contingent on getting dessert (e.g., 'eat your broccoli to get a brownie'), it teaches the child that vegetables are yucky and dessert is the reward.
Clinical
If dessert is on the menu, everyone in the family should get one serving regardless of what else they ate. The parent decides which days dessert is offered, not whether the child 'earned' it.
Guideline
Productive screen time (homework, school work) does not count toward the 2-hour daily screen time limit. The limit applies to unproductive screen time (TV, video games).
Guideline
Taking away physical activity as punishment is counterproductive. A misbehaving child may need physical activity to release pent-up energy and refocus their behavior.
Clinical
Using physical activity as punishment (e.g., 'run 3 laps around the house') teaches the child to associate physical activity with something to avoid, undermining lifelong motivation.
Clinical
A 'brain break' before homework—getting the child up and moving for a few minutes to raise heart rate—helps refocus the brain and makes homework more efficient.
Clinical
There are not enough chips to fill a child up. Snacks lacking protein will not satisfy hunger, leading to grazing and overeating at dinner.
Clinical
Protein is a crucial component in snacks to help keep a child feeling full until the next meal.
Clinical
Children should not go more than 4 hours without eating. Skipping meals or going too long without eating impairs the child's ability to gauge hunger and fullness cues at the next meal.
Guideline
Research shows it can take 10, 15, or more exposures for a child to accept a previously refused food.
Host summary
The American Academy of Pediatrics recommends no screen time for infants, and for children 2 years and older, no more than 2 hours of screen time daily.
Host summary
Toddlers need at least 30 minutes of structured physical activity daily and at least 60 minutes (up to several hours) of unstructured physical activity. They should not be sedentary for more than 60 minutes at a time except when sleeping.
Host summary
School-age children need to be active 60 minutes a day, with most activity being aerobic at moderate to vigorous intensity, plus muscle and bone strengthening activities.
Host summary