My mom, who is a nurse, decided to put the whole family on the South Beach Diet. My parents both needed to lose some weight, and my mom was convinced that this diet was the healthiest way to eat. I tried to go along with it. I went through the motions, but I cheated a lot. Then my dad told me to read the book, like he had, so I would be more motivated to stick to the diet. After I read The South Beach Diet, everything fell into place for me. It was no longer about not eating certain foods; it was about relearning how to eat. I learned how to choose the right foods and live a healthier lifestyle in general.
Now one of my favorite activities is preparing a meal with my family. The South Beach Diet has given us the tools to be healthy, happy, and well fed. Nearly all the recipes in the South Beach Diet books have been tested and approved by my family.
It’s now 5 years since I started living the South Beach lifestyle. I’ve lost well over 100 pounds and wear a size 6. My parents have done well, too—they’ve lost 50 pounds each. The South Beach Diet has given me my life back and my family a new outlook on life. And we continue to have many fun nights in the kitchen.
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And There’s More Bad News
Poor nutrition is having other unfortunate health ramifications for our children as well. In June 2007, James Perrin, MD, of Harvard Medical School, and others from the Harvard School of Public Health published an editorial in the Journal of the American Medical Association (JAMA) showing that the incidence of chronic health conditions in American children had increased dramatically over recent decades. Overall, the percent of US children with chronic conditions that interfere with their daily lives is more than 7 percent, compared with less than 2 percent in the 1960s, when I was a teenager. Asthma, obesity, and attention deficit hyperactivity disorder (ADHD) top the list. In fact, asthma affects about 9 percent of children and teens today, double what it was in just the 1980s. And when I was growing up, you rarely heard the term ADHD. The study authors emphasize that beyond the individual tragedies represented by these problems, the cost to our health-care system, both in the near and not so distant future, will be increasing dramatically.
Not long ago, I heard a politician remark on the increased incidence of asthma in Harlem, which he then equated to the air quality there. I immediately thought to myself that Harlem’s air quality must have improved over recent decades due to stricter emission standards. What has gotten worse, however, is the greater dependence on convenience, processed, and fast foods, not only in our inner cities, but throughout America. And with this has come widespread obesity.
In fact, there is a direct association between obesity and the incidence of asthma. Obesity promotes inflammation, which is widely believed to aggravate, if not cause, this disease. Studies show that an improved diet can help. The results of the Childhood Asthma Prevention Study (CAPS) were reported in 2004. The study found that in young children at high risk for asthma, getting supplementation in the form of omega-3 fish oils significantly decreased the incidence of cough over the next 3 years. In general, I don’t recommend supplements over whole foods (you can get omega—3s from fatty cold-water fish such as salmon, herring, and sardines), but when it comes to omega-3 fish oil supplements, I make an exception.
As for ADHD, it is thought that poor nutrition, particularly in young mothers and young children, contributes to this problem. But I believe that ADHD is only the tip of the iceberg when we consider nutrition-related academic and behavioral problems in schoolchildren. It was my cousin, a recently retired math teacher, who first alerted me to a very common observation among teachers. She told me to ask any teacher about the sugar high kids experience after a fast-food-type lunch. “They appear to be hyperactive, jumping off the walls,” she said, “and then, an hour later, they fall asleep.”
I see many current and retired teachers in my practice, and they all confirm that the attention of schoolchildren today has deteriorated, whether due to ADHD or not. An example came from one of my patients who had worked as a park ranger in the Everglades for 25 years. As part of her job, she had lectured about the national park to groups of Florida students. She told me that over the years, she had to shorten her lectures from 45 to 15 minutes because of the decreasing attention span of her young listeners.
Another cause of academic and behavioral problems in kids—one that’s also associated with poor nutrition and weight gain—is sleep apnea, a problem characterized by pauses in breathing during sleep and that you probably thought occurred only in adults. This fatiguing ailment is actually quite common in children, and it can occur in those who are only mildly overweight. Not surprisingly, sleep apnea has been associated with hyperactivity, inattention, and aggression in children. And, as in adults, weight loss is the best treatment for this problem if the child is overweight.
In addition, sleep apnea has been associated with insulin resistance—the problem that leads to prediabetes and type 2 diabetes. Type 2 diabetes is another disturbing nutrition-related health phenomenon in children that was previously associated only with adults. You may remember that type 2 diabetes used to be called adult-onset diabetes because it occurred after many years of stress on the pancreas from eating the wrong foods. Ultimately, the pancreas couldn’t produce sufficient insulin, and blood sugars became elevated. Today, because of the sugary, starchy, bad-fat-laden diet of many of our children, coupled with the fact that they’re getting minimal exercise, we’re seeing type 2 diabetes in more and more teens and even preteens.
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AVOIDING THE FRESHMAN 15
Some of my patients have told me that their struggle with controlling their weight began when they were in college. They’re very concerned that the same thing will happen to their college-bound children.
Their fears are not unfounded. Studies show that college students gain anywhere from 8 to 20 pounds their first few years away at school. This weight gain is so common, in fact, it’s been dubbed the freshman 15.
You don’t need a degree in nutrition to figure out why kids gain so much excess weight at college. For the first time in their lives, they are away from parents in an unstructured environment, completely free to make all their own meal decisions. Too few have even a basic understanding of the principles of healthy eating. Tired, hungry kids grab food on the run, load up on junk food, and indulge in lots of high-fat snacks and sugary drinks. Furthermore, many first-year students are so overwhelmed by the pressures of school and a new social life that they don’t make time for regular exercise. Add to this the fact that many college kids consume large quantities of alcoholic beverages, and the problem only gets worse. I’m not going to discuss the legal or moral implications of underage drinking, but I’ve seen many a beer belly on a middle-aged man or woman that got its start in college.
Weight gain is not a mandatory part of the college curriculum. Here are some simple steps that students can take to avoid packing on those extra pounds.
Don’t skip meals. Eat when you’re hungry—don’t wait until you’re starving. Eating three meals daily and some healthy snacks in between will keep your blood sugar stable and help prevent the cravings that drive you to eat highly processed refined carbs.
Eat good foods when you can. Maximize your choices of lean protein, good high-fiber carbs, good fats, and low-fat dairy. You don’t have to eat food you don’t like, but you can make compromises. If you usually start your day with a white bagel and cream cheese, try ordering an egg and whole-grain toast instead. Or have some whole-grain unsweetened cereal with fruit and fat-free milk. For lunch, choose a whole-wheat wrap with lean beef or turkey over a high-fat hamburger or sub. For dinner, fill up on lean protein (have some roast chicken breast) and plenty of vegetables instead of pasta, pasta, pasta. And when it comes to dessert, choose high-fiber whole fruits over pie or cake. When you’re thirsty, drink water, seltzer, or a glass of fat-free or low-fat milk instead of sugary soda or a beer. By eating more fruits, vegetables, beans, and other high-fiber foods, you’ll feel—and stay—more satisfie
d.
Keep healthy snacks on hand. Fill that dorm-room or apartment fridge with plenty of fresh vegetables and fruits, low-fat dips, and reduced-fat cheeses, and reach for them when you have a yen for chips and pastries. Keep boxes of high-fiber cereal and whole-grain crackers around as well. Sure, you can still enjoy junk food on occasion, but the more often you make good choices, the better you will feel and the better you will study.
Get regular exercise. The Interval Walking program in Part II of this book is perfect for you because it takes 20 minutes max. Instead of hopping the campus bus, hoof it, and you’ll automatically burn more fat and calories. Try to make time to get to the school gym. You might meet some nice people you wouldn’t have otherwise encountered.
If you drink, do so in moderation. Excess drinking is often a sign of being stressed-out or trying too hard to be the life of the party. In the end, it won’t make you feel better. Try to find healthier social outlets, like clubs or intramural sports. If you must drink, learn the adult art of nursing one drink for the entire night or alternating alcoholic drinks with seltzer or water. It’s also a good idea to eat something healthy, like fruit or veggies, before you drink. Cutting back on beer and cocktails is not only a lot better for your health and waistline but also for your grades and general well-being.
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In Chapter 6, I discussed the relation of belly fat to prediabetes and diabetes in adults. But what about in children and adolescents? As noted earlier, there’s no question that both abdominal fat and body mass index (BMI) have been on the rise in our kids. And studies show that while both are predictors of high blood pressure in childhood, abdominal fat may be a stronger predictor than general obesity. Both belly fat and high blood pressure are criteria for the diagnosis of prediabetes. And just as prediabetes is an important predictor of heart disease in adults, so it is becoming a predictor of heart disease in children. In fact, the Princeton Lipid Research Clinics Follow-Up Study, published in August 2007, has demonstrated this relationship. In the study, researchers showed that metabolic syndrome diagnosed in children ages 6 to 19 predicted heart disease 25 years later.
The Exercise Connection
While a poor diet has clearly caused big trouble for our children, the problems have only been compounded by their lack of exercise. When I was growing up, the after-school period was almost exclusively for sports and other physical exercise. We came home and played pickup baseball, basketball, or football. We rode our bikes around the neighborhood. Later we played intramural sports and then freshman, junior varsity, and varsity sports. And the pickup games never stopped. Nearly everyone participated.
Today, it seems that when kids go home after school to play a sport, it’s only their fingers that are getting exercised—the athletes are the players in a video game! Worse yet, kids are sitting on the couch eating potato chips and watching TV or slouched in front of a computer surfing the net. A 2006 study published in Pediatrics reported that from the age of 2, on average, a child spends up to 3 hours a day watching television. Combined with the additional time spent playing video games or working on home computers, the average child could spend up to 8 hours a day sitting in front of a screen!
The decrease in exercise is so obvious that I don’t think I need to cite many more statistics, but let me just mention one: The Centers for Disease Control and Prevention (CDC) reported in 2002 that 61 percent of children ages 9 to 13 did not participate in any organized physical activity during nonschool hours. Does this lack of exercise contribute to overweight school children? Clearly, yes. But luckily, studies also show that kids who do more physical activity gain less weight from childhood into adolescence.
It’s important to understand that exercise is an antidote not just to obesity but to nearly all the health problems we’ve discussed. Exercise improves insulin resistance, lowers blood pressure, and decreases belly fat. It helped cure Theodore Roosevelt’s asthma (he lifted weights; did gymnastics daily; and studied wrestling, boxing, and judo), and it helps kids with asthma today. It also seems to improve behavior and academic performance. In fact, new studies show that exercise actually increases the growth of brain cells and perhaps gives new meaning to the concept of the scholar athlete. And while I am not sure that it can accurately be measured, I am convinced that sports participation, both formal and informal, builds character by teaching invaluable lessons such as teamwork and how to win and lose.
Turning Things Around
Many of you might be thinking, of course we know that exercise is good for kids. I certainly thought so and was surprised to learn that in Florida and across the United States, less time than ever is devoted to physical education in schools. This trend may be partially due to schools devoting more time to preparation for standardized statewide tests. I have found all this very discouraging because I am convinced children will do better on tests if they exercise during the day. Fortunately, in Florida, Governor Charlie Crist recently led the charge to pass legislation requiring at least 30 minutes of school exercise daily.
Frankly, I could go on for hundreds of pages documenting the benefits of healthy nutrition and exercise for children, not to mention the present and future costs to America if we don’t begin effective programs soon. But I trust you’ve gotten the message and I’ll spare you all that extra reading.
If You Teach Them, They Will Eat…the Right Way
The challenge now is how to stem the tide of childhood obesity and do it in an affordable manner. One approach that I have long felt would impact the majority of American children is to change the food service and nutritional education offered in public schools. Many studies have suggested that if you feed children high-fiber, low-glycemic foods, they will be less hungry and consume less. One such study performed in Oxford, England, was reported in the journal Pediatrics in 2003. Children were given a test breakfast for 3 consecutive days, consisting essentially of a high-fiber bran-type cereal with milk or a low-fiber flake-type cereal with milk. Juice was also served. The children were allowed to eat as much as they wanted from a buffet for lunch, and the amount they consumed was recorded by observers who didn’t know what the children had eaten for breakfast. The children who got the high-fiber breakfast ate less at lunchtime and felt more satisfied.
Based on these types of studies, the Agatston Research Foundation began implementing a holistic nutrition and lifestyle intervention program in Florida public elementary schools more than 3 years ago. It’s known as the Healthier Options for Public Schoolchildren (HOPS) study. As of this writing, this program has included more than 15,000 children. Led by research director Danielle Hollar, PhD, with nutritional assistance from our registered dietitian, Marie Almon, MS, RD, the study began by creating breakfast, lunch, and extended-day snack menus in the intervention schools. Each menu included more nutrient-dense, higher-fiber options, while reducing saturated fats and sugars.
Let me tell you, this was not easy. School food-service staffs had to learn new processes for ordering, acquiring, and preparing these foods, and without their willing participation, our program would never have gotten off the ground.
But as every parent knows, simply offering healthier foods isn’t enough to get a child to eat them. Also needed is an education and lifestyle curriculum that teaches why the foods are healthy, as well as hands-on programs like tastings and school gardens. Not only did we add these elements, we also arranged for assemblies and stimulating classroom materials to teach children about the impact of nutrition on their health. In addition, we encouraged physical activity, as much as the daily schedule allowed.
From our HOPS experience, we have learned that elementary-age children will absolutely embrace healthy foods. Two years into the program, we can declare HOPS a success story. During the 2005 school year, the children in HOPS intervention schools showed an improvement in BMI, compared with kids at schools with the standard cafeteria program. Remember, our goal was not weight loss—children who are growing should be gaining weight—but, rather, develop
ment at a healthy, normal level of growth.
We’ve also had some very positive feedback from teachers who’ve told us that they’ve noticed an improvement in students’ behavior and concentration. And we’re hearing from parents that the kids are now asking for raw vegetables, fruits, and whole-grain breads at home!
There is good reason to expect that when children consume higher-fiber, lower-glycemic-index foods, they will be less hungry and less obese.
Today many schools of public health, pediatricians, nutrition organizations, the USDA, and food celebrities are getting involved in the fight against childhood obesity. And we applaud this. It is through broad communication and by creating evidence-based solutions that we will begin to turn the tide against this dangerous epidemic.
The Take-Home Message
It is clearly time for parents to take a good look at what their kids have on their plates. Regardless of a person’s age, the optimal diet is one that contains whole grains, fresh fruits and vegetables, lean protein, good fats, and plenty of fiber. These are the basic eating principles of the South Beach Diet, and they are family friendly. The problem is, kids are not getting the foods they need to thrive. Like their parents, most children are eating a steady diet of nutrient-deficient, highly processed foods that are high in sugar and saturated and trans fats—and very low in fiber. And they’re washing it all down with a glass or two of sugary soda. If I were to set out to design a diet to promote heart disease and diabetes, I couldn’t do a better job.
The South Beach Diet Super Charged Page 11