Obesity is killing our country, and it is no longer just an "adult disease." Unfortunately, the associated co-morbidities are not either. The statistics are startling: The number of overweight children and adolescents has nearly tripled in the last 20 years, and at least 17% of children and adolescents ages two to 19 years are overweight.


    The Doom and Gloom

    Overweightness and obesity is scary when it affects adults, but it is even worse when it impacts children. The dangers that go along with being overweight and obese include: type 2 diabetes, at least six different types of cancer, insulin resistance, heart disease, hypertension, osteoarthritis, psychological issues and so on; they become even more dangerous when they develop at young ages. And there are, of course, consequences to being overweight as a child that carry over to adulthood. In fact, there is a higher likelihood of persistence of obesity into adulthood, a higher rate of psychological and socioeconomic issues, and the side effects of diseases like type 2 diabetes and hypertension are even greater the earlier these occur. In fact, 50% of people diagnosed with type 2 diabetes already have heart disease.


    Making Change

    Fitness professionals are perfectly poised to intervene and make change. There is no one single answer to the growing epidemic of obesity in our entire population; there are a number of factors that all play a role, such as physical inactivity, overeating, too many calorie-dense, low nutrient foods in the diet (chips, cookies, soft drinks, sweets, etc.) and so on. Let's dissect these one step at a time.


    Fitness First

    As fitness experts, how can you personally get involved in making change? A recent study derived from the journal Pediatrics suggested that those six to 13 years of age spend an average of four to six hours in front of some screen each day, two out of three have a television in their bedroom, and the average household has at least four televisions! Add those numbers to the time for sleep and school, which are both sedentary activities themselves, and there is little left for actual movement.

    Unfortunately, many schools are actually eliminating physical education from the curriculum as well; the one chance each day for planned activity is being taken away. But we can't be too quick to point the finger, as recent data suggests the actual time spent during physical education classes where heart rate is elevated is only eight minutes. Again, there are many pieces to the puzzle  — and this is just one of many.
    Organized sports are fantastic for physical and mental health, but they are not the only avenue for kids to be active. How can you make change? Consider starting a group fitness class or boot camp for children at your facility. The key is to get away from the competitive nature that may turn some kids off and allow kids to simply "play" and include planned exercise as part of the day. Reach out to schools, your current clients (as they may have kids themselves) or other organizations. Try sending a letter to schools in your area discussing some innovative programs you have that would help children in that school system improve their physical and mental performance.
    To make exercise fun and safe, it's important to take the current activity levels of children into account. Keep in mind, too, that many kids may be afraid of the competitive nature in sports. Always keep it fun, and remember that there may be a strong psychological barrier to participation in many children. And it's important to use positive language at all times — for the child who seems to be struggling the most, hearing how amazing they are for participating and the fact that they are such a champion for participating will go a long way.
    Nutrition Can't Be Forgotten
    Unfortunately, even the most active people can quickly "eat back" their calories quickly, and nutrition is truly the bigger piece to the weight loss puzzle. Let's take a look at some simple changes that can be made to truly have an impact on the health of our youth. Consider starting an "Obesity Task Force," where you partner with other health care practitioners to truly make the biggest impact. Let's delve a bit into some specific nutrition tips for young children:
    v      Carbohydrate Quality — Carbohydrates should absolutely be the cornerstone of anyone's diet. The key is to focus heavily on quality — "think fiber, not carbs!" There is a huge difference between white bread and whole grain, high-fiber bread, sugar-coated cereal and oatmeal as well as French fries and sweet potatoes. Focus on the quality of the carbohydrates. And, no, children do not "need" sweet foods, just like we don't "need" them as adults.
    For example, definitely eat breakfast, but try a whole grain cereal with some fresh fruit for the nutrients and fiber. Sandwiches should be made with whole grain bread rather than their white counterpart. Snacks can be whole grain crackers with peanut butter, fruit or veggie sticks with peanut butter, etc. The list can go on. The focus of carbohydrates should always be on foods that provide a few grams of fiber per serving (the exception is milk and yogurt, which are very healthy and carbohydrate-based but provide little, if any, fiber).
    v      Fruits and Vegetables Are Crucial — An integral element to a healthy diet, kids often shy away from fruits and vegetables, and parents don't always push them. However, research has suggested it can take at least one dozen times to determine if a child likes a particular food. The key is to introduce kids to as many of these nutrient-dense, colorful foods as possible! Make it fun. Here are a few ideas:
    o        Ants on a log: celery with natural peanut butter and raisins
    o        Sailboats: apple slices with toothpicks holding a cheddar cheese "sail" — of course, watch your child to ensure they don't eat the toothpick
    o        Homemade trail mix: mixed nuts, dried fruit and some whole grain cereal
    Keep in mind that dried fruit counts towards the total fruit intake for the day, as does 100% juice (this shouldn't be the mainstay, though, as whole fruit provides more fiber) and fruit puree. Whole fruits are always the best, though.
    v      Protein Needs of Young Children — In the world of athletics, no other macronutrient has received the same level of attention as protein. Everywhere you look, everything you see tells us we need more and more protein, whether you're trying to lose weight or gain muscle. Of course, protein plays a role, and a very important one at that! One vital message is to make sure young children always focus on food first. High quality protein sources include: fish and other seafood; low- or non-fat milk or yogurt; chicken and turkey breasts; lean red meat; tofu; mixed nuts; eggs; beans; natural peanut butter; and more. The greater the variety in the diet, the better off they will be at getting the most "bang for their buck," in terms of various amino acids and other nutrients.
    v      Chewing the Fat — Fat is another crucial nutrient for children; there have even been a handful of scientific studies to show that one component of fats, the omega-3 fat DHA, is crucial in terms of brain development. Overall, though, healthy fats are essential for providing DHA and the other important components in fat. Nordic Naturals Children's DHA, in chewable or liquid form, is a great option to boost intake of this important nutrient, in addition to including food sources of healthy fat, like fish.
    Remember that fat provides a lot of calories, over double that of protein or carbohydrates, which can be important for very active, young athletes who need more calories than most to develop healthy, strong bodies — but be cautious for overweight or obese children. Again, it's important to focus on quality here and not just quantity. Fish once again pops up as a great, healthy source of fat, along with egg yolks, olive oil, mixed nuts, flax oil and others.
    The fats we want to avoid or at least limit are those which are solid at room temperature (with few exceptions): butter, shortening, animal fat, etc. Remember, unhealthy snacks and foods are not "necessary" for children. Moral of the story: don't overdo the fats, but definitely don't skimp on them either — moderation is king!
    v      Fluids — These are actually the most important nutrient anyone can consume. Unfortunately, the types of fluids consumed aren't the best. Over the past few decades, milk consumption has decreased dramatically and is being replaced with soft drinks. This is unfortunate because of the nutrients being lost without the milk and the empty calories they're being replaced with. I mentioned earlier that 100% juice does count as fruit; however, we also don't want kids to live off this, as it doesn't provide all the same fiber and nutrients whole fruit does, and it's way too easy to over-consume. Keep in mind that four ounces of juice counts as one fruit; this is one-half of a cup of juice. It would be very easy to drink two whole cups of juice, but you are less likely to eat the equivalent four whole oranges, meaning it is easy to pack in a lot of excess calories. And sports drinks are too easily consumed as well; these shouldn't be in the hands of children unless they are truly active consistently throughout the day.
    Water is always the best option — considering kids drink an average of 90 pounds of sugar each year! The 2005 Dietary Guidelines make a recommendation to consume at least three servings of low-fat milk or other dairy products, and the majority of other fluids should be water. If you need to make water more exciting for kids, add a squeeze of orange, lemon, lime or cucumber. And always keep a pitcher in the refrigerator so there is cold water at their fingertips.
    v      Making Nutrition Fun — Now that we have the basics, let's take a look at how to incorporate healthier foods into the diets of children and adolescents. Let's face it, not everyone is going to be exciting about loading up their plates with broccoli, spinach and carrots. Try these five tips to make "regular" foods even healthier:
    1.       Add a handful of mixed veggies to scrambled eggs.
    2.       Make homemade smoothies with yogurt, fresh fruit and milk (loads of nutrients, yet no added sugar).
    3.       Pureed fruit popsicles — to make these, puree fresh fruit in a blender, add the fruit to ice cube trays, and when nearly frozen, stick a popsicle stick in there. Serve when solid.
    4.       Add broccoli or spinach to "regular" macaroni and cheese.
    5.       Add handfuls of fresh vegetables (mushrooms, peppers, squash, etc.) to spaghetti sauce before mixing with pasta.
    That's a Wrap!
    In summary, here are a few tips to keep in mind when fueling young athletes:
    ·         Get kids to move — whether organized in a fitness class, sport, boot camp or simply turning off the screens and encouraging real play time
    ·         Encourage family activity
    ·         The more fruits and vegetables each day, the better
    ·         Think fiber, not carbs
    ·         Protein is absolutely important, just as it is with adults
    ·         Fat quality is crucial
    ·         Be creative to get kids to eat a variety of foods
    ·         Hydrate, hydrate, hydrate!
    Most importantly, make sure children have a chance to try a variety of activities in order to have fun and enjoy themselves. Feed them well, and teach them positive nutrition habits that will stay with them for life.
    Christopher R. Mohr, PhD, RD, is the co-creator of www.FuelLikeaChampion.com. Visit the website for exact nutrition strategies for permanent success, starting at a young age!