TEEN HEALTH:

New Year's Diet Commandments

by Dr. Ann L. Engelland

(January 3, 2008) January. Is it my imagination or are my jeans a bit too tight? I’m sure I’m not alone since I recently read that the average American adult supposedly gains 10 pounds over the holiday season.

New Year’s resolutions may involve how we eat, snack and exercise but also how we shop, cook and serve our families. We are often bombarded with conflicting information on the latest take on dieting, healthy eating, benefits of different fats, carbs and proteins. It is confusing, to say the least.

What to do? Just in time, there comes a comprehensive “expert committee” report entitled “Assessment of Child and Adolescent Overweight and Obesity.” This report was made public electronically and is published in the journal Pediatrics, December 2007.

So you may be better informed to make your resolutions, let me share the highlights of the report with you. The committee was convened by the American Medical Association, the Department of Health and Human Services, the Centers for Disease Control and Prevention and is endorsed by a host of august professional organizations including the American Academy of Pediatrics and the American Heart Association.

What makes this report different from earlier ones is that it is “evidence-based.” This means that all of the recommendations have evolved from published research and studies and are therefore more powerful than mere suggestions or informal ideas. Think of them as “commandments” for a healthier life.

According to the report, evidence supports the following:

1. Limit consumption of sugar-sweetened beverages. This includes “vitamin water,” sports drinks, sweetened teas, as well as sodas.

2. Encourage consumption of 9 servings per day of fruits and vegetables. Serving sizes may be found at www.mypyramid.gov. They are not as intimidating as one might think; two cups of lettuce greens meets almost half the daily vegetable requirement.

3. Limit television and screen time to a maximum of 2 hours per day for children over 2 and remove TV’s and other screens from children’s primary sleeping areas. Let’s face it: these particular recommendations were based on a 2001 study before iPods, portable DVD’s, laptops and other easily transportable “screens” became ubiquitous. So beware.

4. Eat breakfast daily. (See: “Breakfast of Champions”)

5. Limit eating out at restaurants, particularly fast food restaurants. Watch portion control; ask for a doggie bag before you start to eat that double serving.

6. Encourage family meals (shown to be associated with higher quality food and lower obesity prevalence). Even breakfast counts.

7. Limit portion size. Beware of tricky packaging. There are 4 portions in a pint of most ice creams!

8. Eat a diet rich in calcium.

9. Eat a diet high in fiber.

10. Eat a diet with balanced macronutrients (fats, carbs and protein).

11. Promote moderate to vigorous physical exercise for at least 60 minutes each day.

12. Limit consumption of energy-dense foods (high fat, high carb).

This report comes with limitations. Remarkably, there is very little that is new here. In many ways it seems so simple. For children who are obese, overweight, or who live in homes and cultures where these “commandments” are more the exception than the rule, changing habits is anything but simple. Practical guidelines for clinicians are given. Alas, the “Fifteen Minute Obesity Prevention Protocol” will be hard to do for many pediatricians whose time slots are down to seven minutes per patient. It will be up to the community of parents, coaches, teachers, friends, and kids to be responsible for our own wellbeing.

So, I think I will go home and throw out the eggnog ice cream I received in a gift package and stick to the flavors I really love. (Commandments 8 and 12)

I will also hold to a quarter of a pint (7),

and jump on the treadmill (11),

snack on celery sticks (2 and 9),

have oatmeal for breakfast with my kids (1, 6, 9, and 10),

eat an orange instead of a coke for a snack (1 and 2),

and I will have fulfilled at least 10 of the above 12 commandments!

Happy, Healthy New Year!

Dr. Engelland has a practice in Mamaroneck devoted to Adolescent Primary Care. She now accepts Aetna and Hudson Health Plan. Dr. Engelland can be reached at 698-5544. Have a teen health question? Use the form below to send it to Dr. Engelland. Please note: Dr Engelland cannot respond privately to individual queries online. Comments are welcome and anonymous questions may be answered in future columns. Serious medical problems should be referred to your own physician.

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