By Julie Engebretson, Associate Editor

In the past decade, Americans have become increasingly aware of a rampant epidemic. Televised public service announcements encourage parents, teachers and doctors to watch for the danger signs as childhood obesity continues to rise.

“Many of our lifestyle habits are truly increasing our risk factors, from an early age, for a number of health problems in adulthood,” says Kathy Shadle James, DNSc, CNP, an associate professor of nursing in the Hahn School of Nursing and Health Sciences at the University of San Diego, who also provides weight counseling for obese adolescents and their parents. “These [risk factors] include diabetes, high blood pressure, polycystic ovarian disease in women and heart disease; not to mention unseen factors such as low self-esteem, diminished body image and even depression.”

Parents are urged to be part of a solution to this growing concern, meeting the problem of childhood obesity head-on and taking measures to avoid the potentially lifelong consequences surrounding this condition. Here are six suggestions for how your patients can become forces of change and lasting examples of health for their children. Share this information with parents and refer them to the same article in the January issue of To Your Health (www.toyourhealth.com).

1 Establish motivation for your children to eat well.
Each family member, depending on their age, interests and physical condition, has a different understanding about why proper nutrition is so important. It’s helpful to identify everyone’s “good food motivators,” says Debra A. Boutin, MS, RD, clinic nutrition coordinator at the Bastyr Center for Natural Health in Seattle. “For a 3-year-old, it may be to grow tall. For a 13-year-old, it may be to be the best soccer player. Help identify motivators with your family that are personal and individualized, and use these to encourage healthful food choices.”

2 Make good foods easily accessible to children.
When children head to the pantry or refrigerator for a little something to eat, more often than not, they will reach for the first thing visible. So try slicing up carrot sticks and storing them in clear containers on eye-level shelves in the refrigerator. Place baskets of fruit on the kitchen table. Store dried fruits and nuts in glass jars. No matter your strategy for making good foods first, healthy snacking starts with the parent. “Making good choices begins at the grocery store, with parents selecting which foods to bring h ome,” says Boutin. “If healthy foods are the choices, the right choices are easy.”

3 Establish a regular schedule for meals and snacks.
Let’s face it: It takes time to eat right and regularly. But the benefits, of establishing why and where we eat, are worth the effort. It’s really a question of priority. “Families have to decide together to make nutrition a priority. Parents are responsible for providing regular times to eat,” says Dr. James. Sticking to scheduled meal and snack times also encourages a healthy attitude toward food and an understanding of its purpose.

“Help your family recognize physical hunger as separate from emotional needs,” advises Boutin. One easy way to thwart your good efforts is allowing your child to eat regular meals in front of the television! Studies show that, while watching television, children exhibit very little brain activity, allowing for mindless eating – literally. In order to recognize fullness, the brain must be engaged, telling the stomach, in a sense, that it’s time to stop eating. According to Boutin, establishing regular meal times and locations will ensure that “food will be used at the right times, in the right ways.”

4 Get children involved in grocery shopping.
This proposition might sound frightful, especially for parents whose children show a proclivity toward tantrums. So, although it might not be the best idea to take Junior with you on a two-hour supermarket excursion, try a quick trip to the farmers market or specifically to the produce section of the grocery store, and “involve the child in selecting two new fruits or vegetables to try that week,” suggests Dr. James. Chances are, they’ll go for what’s colorful, and coincidentally, the more color, the more likely the food contains higher concentrations of vitamins, minerals and other micronutrients the body needs.

5 Get children involved in cooking.
This can result in a bit of extra cleanup, but when children become more familiar with simple meal preparation, they learn that “healthful cooking need not be complex,” according to Boutin. For breakfast, ask your child which fresh veggies he or she would like folded into an omelet, or have them select a handful of berries from the refrigerator to top a bowl of cereal. For dinner, make a pizza or a calzone together using a whole-wheat crust and low-fat mozzarella. Ask your child to choose three veggie toppings, such as sliced mushrooms, zucchini and chopped bell peppers, and let them load on the veggies.

6 Limit your child’s beverage menu.
What your child drinks is just as important as what he or she eats. Many beverages commonly served in the home can do great harm to a child’s health. Soft drinks are the worst offenders. It’s a hard-line stance, but soda should be eliminated from the home if at all possible. At 100 to 150 calories and nearly 30 grams of sugar per can, these heavily marketed beverages boast no nutritional value whatsoever and can contribute to cavities, childhood obesity and diabetes. Not to mention the caffeine, a drug that children certainly do not need. But, you don’t have to worry about your child drinking too much soda if it isn’t available at all.

Even juice should be limited. Each 8-ounce glass of 100 percent orange juice, a commonly cited source of vitamins and often fortified with calcium, packs 110 calories. If unlimited, multiple glasses of orange juice each day can result in the consumption of several hundred excess calories daily. The Nemours Foundation, www.kidshealth.org, offers these “juicy” guidelines for parents:

• Up to 6 months old: no juice.
• 6-12 months old: no more than 4 ounces (120 milliliters) of 100 percent juice per day, always served in a cup.
• 1-6 years old: 4-6 ounces (120-180 milliliters) of 100 percent juice per day.
• 7-18 years old: 8-12 ounces (240-360 milliliters) of 100 percent juice per day.

Make a habit of offering milk and water to drink. Soymilk also is a good choice. An 8-ounce glass of low-fat milk offers 300 milligrams of calcium. Good ol’ H₂O is always your best bet. Children, as well as adults, often mistake dehydration for hunger. Serving more water gets children used to recognizing the signs of dehydration and desiring a calorie-free and virtually taste-free beverage to quench their thirst.

So, there you have it: Six simple ways to help patients lay a solid nutritional foundation for their children. Remind parents that teaching children the fundamentals of proper nutrition is just like teaching them how to ride a bike – once they learn, they never forget.