Commentary

Encourage good nutrition and exercise


 

References

With lots of opportunity to run and play, and an abundance of fresh, seasonal fruits and vegetables, summer is the perfect time to talk with families about developing healthy habits for a lifetime. Add to that the large volume of children seen in the summer for school physicals, and the string of recent reports about the importance of fostering good habits, and this is a timely topic to bring up in your practice.

In July, the American Academy of Pediatrics released a clinical report, “The Role of the Pediatrician in Primary Prevention of Obesity,” encouraging the support of healthy eating, exercise, and good screen time habits from an early age, with practical tips for the pediatrician (Pediatrics 2015 [doi:10.1542/peds.2015-1558]).

As an illustration of why these things are important, just 1 month earlier an article in Pediatrics, “Active Play Opportunities in Child Care,” demonstrated decreased opportunities for preschoolers in child care to engage in active play (Pediatrics 2015 [doi:10.1542/peds.2014-2750]). Earlier this winter, another paper described how televisions and “small screens” (for example, smartphones and tablets) in the room at night can decrease sleep duration and restfulness (Pediatrics 2015 [doi:10.1542/peds.2014-2306]).

Dr. Lee Savio Beers

Dr. Lee Savio Beers

Understandably, many parents – myself included – have a lot to worry about every day and cringe at the thought of just one more thing to do or think about. I think it is helpful to have a few key tips you can share with parents to help them make small but meaningful changes, or – even better – set up good habits from the start. I share a few of my own below, and I am sure all of you have many more great ideas!

• No (or, realistically, very little) juice. This is a hard one, and often an uphill battle, as juice is available at child care centers, through the WIC program, and at every birthday party or class celebration you go to. This is advice I give parents very early on, given that if their child develops the habit from the beginning of drinking water and milk only, and doesn’t have regular access to juice, it is much easier to make it just an occasional, special thing. I tell parents that juice is high in sugar and calories, but because it tastes good, kids (and adults) are prone to drink way too much of it. I also share tips for making water taste a little more appealing – add a lemon slice, a squirt of lemon juice, or a sprig of mint, or offer sparkling water (without added sugar – all drinks except milk should be 10 calories or less per serving) as a treat.

• Limit screen time. Really. I know as much as anyone how hard that is to do, and sometimes there are times when your kids watch way more TV than you know they should, but that should be the exception rather than the rule. Make sure there are lots of books available, all the time. Books can be expensive, so regular library trips are a great way to keep a wide variety of interesting books around the house. Stash little buckets or baskets of small toys and puzzles throughout the house so that no matter where you are, when your kids say “I’m bored,” you can say, “Why don’t you pull out that basket over there and find something to play with?” (And be willing to listen to a little whining while your kids do find something else to do). Get out of the house – if you are not in the room with the TV, it is easier to say no – even if it is just to take the kids grocery shopping, get the car washed, or run a few errands (but don’t let them play with your phone while you are out…). Think long and hard about when your children need their own phones, and if it has to be a smartphone or can just be an old-fashioned flip phone. You will find it is probably not as soon as you think. Keep “small screens” and TVs out of your kid’s room. And – this one is hard for me too – put your own devices down anytime you can while your kids are awake.

• Stay active. Find time every day to move a little. Think about how you can alter your schedule to walk places instead of drive, stop by the playground after school, or find after-school activities that keep kids moving (many of these activities, especially if they are sponsored by the school, are free, so definitely take advantage of them). My daughter and I have started running together every Sunday morning; it is wonderful exercise for both of us and has been a really nice opportunity to have some quiet time together, talking about her week and the things going on in her life.

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