Childhood, obesity and diabetes -- reversing the trend
12:00 PM EDT, July 20, 2011
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Being overweight as a kid not only creates social problems, but also sets the stage for medical problems that can last a lifetime. The concern is a growing one given that more than one third of U.S. children ages 10 to 17 are overweight or obese.
Learn what you can do to help America's youth trim down and gain healthy habits for life.
Dr. Angela Fals, a pediatrician and medical director of Florida Hospital for Children and the Healthy 100 Kids program; and Lauren Adams, a pediatric diabetes educator and endocrine dietitian at Florida Hospital, will address your questions and share their insights.
Dr. Angela Fals is the medical director at Florida Hospital for Children and the Healthy 100 Kids program. A pediatrician who specializes in weight management for children and adolescents, Dr. Fals graduated from Loma Linda University Medical School, inCalifornia. Among her specialties is creating weight management programs for families, schools, fitness centers, medical practices and other community organizations.
Lauren Adams is a pediatric diabetes educator and endocrine dietitian at Florida Center for Pediatric Endocrinology, Diabetes and Metabolism. She works with children to help them control blood sugar and make healthy choices. Diagnosed with type 1 diabetes in 1992, Adams runs marathons and is the mother of a healthy baby boy.
Children, Obesity & Diabetes ¿ Reversing the Trend
Being overweight as a kid not only creates social problems, but also sets the stage for medical problems that can last a lifetime. The concern is a growing one given that more than one third of U.S. children ages 10 to 17 are overweight or obese.
Wednesday July 20, 2011 12:00 Orlando Sentinel Health
12:00
Orlando Sentinel Health:
Today we'll talk with two experts in pediatric obesity and diabetes about what you can do to help America's youth trim down and gain healthy habits for life.
Wednesday July 20, 2011 12:00 Orlando Sentinel Health
12:00
Orlando Sentinel Health:
Dr. Angela Fals is a pediatrician and medical director of Florida Hospital for Children and the Healthy 100 Kids program; and Lauren Adams is a pediatric diabetes educator and endocrine dietitian at Florida Hospital.
Wednesday July 20, 2011 12:00 Orlando Sentinel Health
12:01
Orlando Sentinel Health:
Welcome!
Wednesday July 20, 2011 12:01 Orlando Sentinel Health
12:01
Dr. Angela Fals:
Welcome to all and thank you for participating in our webchat today!
Wednesday July 20, 2011 12:01 Dr. Angela Fals
12:01
Orlando Sentinel Health:
Here's our first question:
Wednesday July 20, 2011 12:01 Orlando Sentinel Health
12:01
Orlando Sentinel Health:
More than a third of U.S. children ages 10 to 17 are overweight or obese (and two-thirds of adults), and we keep getting fatter. How can we put on the brakes and turn this around?
Wednesday July 20, 2011 12:01 Orlando Sentinel Health
12:04
Dr. Angela Fals:
This is not an easy answer -- childhood obesity is a complex issue with roots deeply set within our society as well as in changes in our own personal lives. These include -- financial strains causing an increase in stress for parents, decrease time spent with their children, a decrease in activity or in the amount of fruits and vegetables offered, and an increase in sugar-sweetended beverages, just to name a few. So being able to address any and all of these topics will certainly help the situation in the short and long term.
Wednesday July 20, 2011 12:04 Dr. Angela Fals
12:06
Orlando Sentinel Health:
Are fat kids destined to become fat adults?
Wednesday July 20, 2011 12:06 Orlando Sentinel Health
12:09
Dr. Angela Fals:
Overweight or obese children are more likely to become overweight or obese themselves. That has been shown to be true -- also, if parents are overweight or obese themselves, the children are 40-80% more likely than others who are not. This is not, however, their assured destiny. Only less than 1% of obesity is caused by medically related issues so that means that 99% of culprits, we do have some control over!
Wednesday July 20, 2011 12:09 Dr. Angela Fals
12:09
Lauren Adams:
This is the genetics vs environment issue.
Wednesday July 20, 2011 12:09 Lauren Adams
12:09
Lauren Adams:
And our family is our environment, so the two are intertwined.
Wednesday July 20, 2011 12:09 Lauren Adams
12:13
Lauren Adams:
Emma, I do agree that organics are a healthy choice, but eating organics has nothing to do with weight loss. As Americans we tend to gravitate toward the foods we crave vs the foods we need.
Wednesday July 20, 2011 12:13 Lauren Adams
12:13
Orlando Sentinel Health:
Emma says obesity is not the fault of the overweight person In fact, it is almost impossible to lose weight in the USA due to Food Chemicals. Do you agree?
Wednesday July 20, 2011 12:13 Orlando Sentinel Health
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Lauren Adams:
We don't always train our metabolism (how we burn calories) to be efficient. So we eat 1-2x/day and don't exercise and then wonder why we don't lose weight.
Wednesday July 20, 2011 12:14 Lauren Adams
12:16
Lauren Adams:
We need to eat light and eat often, then we must move our bodies. The equation of calories in vs calories out seems like a simple equation, but its very complex in that it involves our mind, body and spirit. Food chemicals are not the main culprit, though I will say high fructose corn syrup and hydrogenated oils aren't doing anyone any favors.
Wednesday July 20, 2011 12:16 Lauren Adams
12:16
Dr. Angela Fals:
Emma, the truth is that the freshest, most natural foods with the least amount of additives and preservatives is always the better option no matter where you live. It is certainly not impossible to lose weight in the US as we have seen many, many children and parents arrive at a healthy weight here in Orlando -- not easy, but certainly has been accomplished.
Wednesday July 20, 2011 12:16 Dr. Angela Fals
12:16
Orlando Sentinel Health:
In your experience of counseling hundreds of children and families, what are the three most common problems you see? In other words, if all families could do three things to help reduce their children's waistlines, what would you recommend?
Wednesday July 20, 2011 12:16 Orlando Sentinel Health
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Dr. Angela Fals:
Great, great question - tough to narrow it down to three, but here it goes: 1. Sleep well at night -- children need between 8-10 hours per night uninterrupted sleep in order to maximize their health efforts. It is nearly impossible to be at a healthy weight without this sleep.
Wednesday July 20, 2011 12:18 Dr. Angela Fals
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Dr. Angela Fals:
2. Decrease the amount of sugar-sweetenend beverages drastically - the recommendation now is a maximum of 4-6 oz per day of juice max -- the rest is water, water water, which is the liquid that the body best uses most efficiently. No room for sodas in the diet except on very rare occasions.
Wednesday July 20, 2011 12:19 Dr. Angela Fals
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Dr. Angela Fals:
Increase the physical activity DAILY -- the official recommendation is a minimum of 40-60 minutes of 4 days per week of exercise of moderate-vigorous intensity. We have seen that, actually, this is not sufficient for many children these days and we recommend DAILY activity of at least 1 hour of duration.
Wednesday July 20, 2011 12:21 Dr. Angela Fals
12:22
Orlando Sentinel Health:
Motivating kids -¿ who often think they'll live forever -- toward healthy behaviors is tough. They don't listen. Telling them about heart disease and diabetes often doesn't scare them. How can you get them to want to help themselves?
Wednesday July 20, 2011 12:22 Orlando Sentinel Health
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Dr. Angela Fals:
Yes, the million dollar question ... a lot depends on TRUST. It takes a bit of time to develop rapport with a child or family but once that trust is there we make headway. One of the advantages to our program is that we communicate very frequently with our families, quickly building this relationship and trust. The other key is to provide fun, age-appropriate educational scenarios for the children/teens to learn -- good luck getting anyone to focus on anything if they are bored. The final, very important point with kids is to be transparent -- if you don't walk the talk, you will get no where with them. We exercise together with the famailes often, I ride my bike to work or walk as often as I can, and although many times it may bring a smile to a child, they know that we are not kidding about living a healthy lifestyle and that it is doable.
Wednesday July 20, 2011 12:27 Dr. Angela Fals
12:28
Lauren Adams:
Well said Dr. Fals!
Wednesday July 20, 2011 12:28 Lauren Adams
12:28
Orlando Sentinel Health:
Because of the rise in childhood obesity, type 2 diabetes, which used to be called "adult onset," is also on the rise among kids. Is it true these kids will have this disease the rest of their lives?
Wednesday July 20, 2011 12:28 Orlando Sentinel Health
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Lauren Adams:
It's possible. I used to hear from adult patients that they were "cured" and didn't have diabetes anymore. This isn't actually true, but may mean that their diabetes (their blood glucose) is under control. Once someone is diagnosed as having type 2 diabetes, they may not be destined to a life on pills or on insulin, but a doctor will need to continue to monitor.
Wednesday July 20, 2011 12:31 Lauren Adams
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Lauren Adams:
So final answer is yes they will have diabetes, but may not need to continue or even start on medication with the proper intervention of diet and exercise.
Wednesday July 20, 2011 12:33 Lauren Adams
12:33
[Comment From Guest Guest : ]
What about appealing to a kid's vanity or sports prowess to motivate them to eat better and exercise? Is telling him or her that losing weight will make them more attractive or more athletic a cheap shot? Or a good means to a healthier end?
Wednesday July 20, 2011 12:33 Guest
12:35
Dr. Angela Fals:
It is a fine line, very tricky, as in kids you want to avoid fostering any eating disorders or potentially harmful habits. I would say to encourage your child to always strive to be the best at what they do -- although not stress the fact that it is for weight -- but more for personal accomplishment and fulfillment. Your child should know that they are beautiful no matter at what weight they are and that you are proud of them for reaching important health-related goals one at a time. No pressure as they will likely rebel.
Wednesday July 20, 2011 12:35 Dr. Angela Fals
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Dr. Angela Fals:
You always want to keep anything that has to do with food, weight, exercise, etc. very positive in a child's mind.
Wednesday July 20, 2011 12:36 Dr. Angela Fals
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Lauren Adams:
Exactly, focus on the fun they'll have playing the sport or the new foods they could try.
Wednesday July 20, 2011 12:37 Lauren Adams
12:37
Orlando Sentinel Health:
How important is it to take action when your doctor tells you your child has prediabetes?
Wednesday July 20, 2011 12:37 Orlando Sentinel Health
12:40
Dr. Angela Fals:
Prediabetes is a red flag -- pay attention to it! Do not think it will go away by itself as it will most likely just worsen with time -- it is an indication of a body making dangerous changes and the time to act is NOW.
Wednesday July 20, 2011 12:40 Dr. Angela Fals
12:41
Lauren Adams:
This is so very important, because this is the opportunity to make changes that may prevent becoming diagnosed with type 2 diabetes. This is the time to make changes as a whole family.
Wednesday July 20, 2011 12:41 Lauren Adams
12:41
Orlando Sentinel Health:
Focusing now on the success stories you've witnessed, tell us what works? And what can parents and kids hope to achieve if they work together?
Wednesday July 20, 2011 12:41 Orlando Sentinel Health
12:44
Dr. Angela Fals:
The only way to do this is working TOGETHER as a family unit -- whatever that means for a particular family. It will not work otherwise -- if you are just battling each other instead of the obesity epidemic, you will only get to frustration and increased health problems. Everyone must be "on board" with making healthy changes.
Wednesday July 20, 2011 12:44 Dr. Angela Fals
12:45
Lauren Adams:
Yes this must be done together as a family. Try making goals that are within reach and measurable. So you might start with a goal of I will walk for 20min every day. Then once you have achieved and it has become a habit, make a new goal.
Wednesday July 20, 2011 12:45 Lauren Adams
12:46
Lauren Adams:
Often I hear what people call excuses as to why they have a hard time reaching their goals. I like to call these speed bumps, because we can usually find a way over them if we truly want to achieve our goal.
Wednesday July 20, 2011 12:46 Lauren Adams
12:47
Lauren Adams:
And again the goal should be within our reach. Or attainable.
Wednesday July 20, 2011 12:47 Lauren Adams
12:47
[Comment From Jenny Jenny : ]
When do you need to start wondering if your child has baby fat or if it is something I should be concerned about?
Wednesday July 20, 2011 12:47 Jenny
12:49
Dr. Angela Fals:
Jenny, yes, great question ... never assume that a baby's fat is just that ... baby fat. We all need to have some level of fat in our bodies for healthy bodies. This is where it is very important for your baby or child to have the regularly scheduled well child checks where weight and height (and now BMI) are regularly monitored. The primary care physician can spot early warning signs and can give great recommendations for healthy food choices at any age and levels of recommended activity.
Wednesday July 20, 2011 12:49 Dr. Angela Fals
12:50
Orlando Sentinel Health:
Most people understand that sugary soft drinks are a huge source of empty calories, but can you set the record straight on sports drinks, like Gatorade, and juice?
Wednesday July 20, 2011 12:50 Orlando Sentinel Health
12:54
Lauren Adams:
12 oz soda = 140 calories, 12 oz juice = 180 cal, 12 oz Gatorade = 100-120 calories. Again, water is the best option.
Wednesday July 20, 2011 12:54 Lauren Adams
12:54
Lauren Adams:
Gatorade makes a product called Propel that is 20 calories/serving and tastes like Gatorade.
Wednesday July 20, 2011 12:54 Lauren Adams
12:55
Lauren Adams:
Gatorade is only really needed for endurance athletes.
Wednesday July 20, 2011 12:55 Lauren Adams
12:56
Orlando Sentinel Health:
Food can be such a power struggle, especially between kids and moms. If a child is overweight, how can parents help them lose weight without causing them to rebel?
Wednesday July 20, 2011 12:56 Orlando Sentinel Health
1:00
Dr. Angela Fals:
One way to avoid power struggles as much as possible over food is to start when they are babies and very young to provide a varied diet of colorful fruits, veggies, grains, and low-fat protein and low-fat options. This is what their taste buds will get used to and makes this transition into childhood and teenage-hood less difficult (at least in terms of food and activity). Now for teens...
Wednesday July 20, 2011 1:00 Dr. Angela Fals
1:00
Lauren Adams:
We have to give some of the power to the kids. For example don't just say you have to eat vegetables. Make it fun, have them come to the grocery store or even start a little garden at home. If they can be involved in the process of growing, selecting and cooking their own food, they'll be more likely to eat it.
Wednesday July 20, 2011 1:00 Lauren Adams
1:03
Dr. Angela Fals:
Absolutely -- great suggestion, Lauren. Now for teens or older kids who may already be "set in their ways," respecting the teen's desire for independence is key. Offer healthy options and let them choose their food or activity. Compromising creatively is key as well.
Wednesday July 20, 2011 1:03 Orlando Sentinel Health
1:04
Orlando Sentinel Health:
If you missed any part of this event, you can replay it! Just go to http://orlandosentinel.com/healthchat to see all of our recent and upcoming events.
Wednesday July 20, 2011 1:04 Orlando Sentinel Health
1:04
Dr. Angela Fals:
Thank you for spending some time with us today -- we look forward to chatting with you again in the future!
