But first, it’s important to remind yourself why you’re making these healthy choices.
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SMALL CHANGES, BIG IMPACT
Studies have shown that as little as 3 grams per day of two particular omega-3 acids, EPA and DHA, found mostly in fish, can lower your systolic blood pressure by five points and your diastolic pressure by three points. This decrease in blood pressure would reduce the number of Americans with hypertension by 40 percent—a big difference from a little change! Another omega-3 acid, ALA—found in flaxseeds and flax oil, walnuts, canola oil and soy oil—can also lower blood pressure. In fact, a 1 percent increase in blood levels of ALA is linked with a five-point reduction in blood pressure.
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PICTURE PERFECT CHILI
1 cup coarsely chopped bell peppers, any color
1 cup chopped onion
3-4 garlic cloves, minced
1 tablespoon olive or canola oil
1 12-ounce package veggie crumbles*
1 15-ounce can black or red beans, drained
1 15-ounce can chili beans in sauce
1 15-ounce jar tomato-based pasta sauce
1 14-ounce can diced tomatoes
1 4- or 5-ounce can chopped green chiles
1 tablespoon chili powder
1 tablespoon oregano
½ teaspoon cumin
1. Sauté peppers, onions and garlic in oil in a large skillet or saucepan over medium-high heat for 2 minutes.
2. Stir in veggie crumbles and cook for another 2 minutes.
3. Add all remaining ingredients and stir well. Bring to a boil, reduce heat to medium-low, cover pan and simmer for 20 minutes, stirring occasionally.
Yield: about ten 1-cup servings;
approximately 150 calories per serving.
CHAPTER 2
For Parents: A Warning and a Call to Action
There’s a good one-word reason for making the kind of healthy choices embodied in the Beat Diabetes Pyramid: kids.
Your kids, if you’re a parent. Kids in general, if you’re a concerned citizen and taxpayer worried about the rising tide of ill health in this country and the scarily rising cost of health care.
Check out the nearest playground. Those adorable little tykes on the swings and jungle gym are part of the first generation of Americans expected to have a shorter life span than that of their parents. Shorter and sicker.
Look closer. Some of those adorable little tykes are overweight. We used to think of it as charmingly pudgy baby fat. But today we know better. Childhood obesity has become an epidemic in this country, and it is an epidemic with alarming consequences. The extra pounds on little children put them at risk for:
Heart disease
Gallstones
Liver disease
Joint problems
Asthma
Digestive disorders
Headaches
Vision problems
That extra weight also increases their risk of diabetes. In fact, carrying even eleven extra pounds can double an individual’s risk of type 2 diabetes.
What is particularly frightening is that these health problems are showing up earlier and earlier in younger and younger children. The correlation—obesity and poor health—is now inescapable. Today, almost one in five American four-year-olds is obese. And type 2 diabetes is today being found frequently in children ages eleven and twelve and has been diagnosed in children as young as four.* The link could not be clearer.
Contracting diabetes before the age of forty shortens life span by some eleven to fourteen years, so when we hear that one-third of everyone born in the year 2005 will get diabetes at some point, it becomes clear why this generation has a shorter life expectancy than the previous generation. Moreover, in fifteen or twenty years, these kids will be having their own children, to whom they will pass on their unhealthy eating habits. How early will those kids get sick? And what will their life expectancy be?
Excess weight in young children is therefore not cute. With 90 percent of overweight kids having at least one avoidable risk factor for heart disease, an overweight or obese child is a time bomb waiting to go off. Young children who develop type 2 diabetes have more time to accumulate vascular and nerve damage; they are thus more likely to suffer severe and costly complications as they grow to maturity. They will pay a terrible toll in suffering and in limitations to their lives.
And the rest of us will pay a terrible toll in health care costs and in the cost of lost productivity of these individuals.
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SODA AND THE METABOLIC SYNDROME
Researchers who tracked some nine thousand men and women over four years concluded that drinking at least one soda per day raised the likelihood of a diagnosis of metabolic syndrome by 44 percent.
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THE PSYCHOLOGICAL TOLL
There’s another terrible price that children pay for being overweight: it is psychologically painful in a way that can scar an individual for life. Overweight kids often seem “different” or “other” to small children, and they may be made to feel that way: the last kid picked for the team, or the only one not invited to the sleepover. What’s more, children—even very young children—can be cruel, and a teasing nickname can slice a child like a knife through the heart.
Ostracized by contemporaries or self-isolated as a defense mechanism, overweight children early on develop a sense of inferiority and feelings of insecurity and low self-esteem, which can affect their adulthood in unhappy ways. In an era when body image seems shaped by impossible magazine fantasies and starved-looking Hollywood starlets on the red carpet, it’s little wonder that anorexia, bulimia and other eating disorders are on the rise among children as young as elementary school age, while there is also an increasing and intensifying surge in depression showing up in overweight and obese children. It is a heavy price for a little child to pay during the all-important developmental years.
How did it happen? How did our kids get to be this way—overweight, unhealthy and unhappy about it?
PARENTS ARE RESPONSIBLE
Again, there’s a simple one-word answer: us.
Sure, there are lots of outside influences on children—even on very young children—urging them to eat “fun” foods that are bad for them. But the dominant influence on kids, especially very young ones, remains their parents.
Children are not born with poor eating habits or the desire to eat unhealthy foods. They learn the eating habits that form their eating tastes from us, their parents. We’re the ones who buy the foods our kids eat. The meals we put on the table, the foods we order in or the restaurants we take our kids to establish patterns our kids learn to mimic. It’s how they acquire taste—which is a learned experience. That’s how and why we are ultimately the teachers of our children’s eating habits, and that makes us responsible for their eating future—and the diseases that come from it.
But lately, many parents seem to have begun to abdicate that responsibility. To be fair, the abdication hasn’t been by choice. When both husband and wife are working and the kids are busy with all sorts of after-school activities, it’s virtually impossible to plan family meals, much less to sit down together as a family to eat one. Result? Kids—and parents—rely more and more on fast food, which is high in carbohydrates, calories and fats. Americans eat 40 percent of their calories outside the home, and consumer spending on fast food has increased eighteen-fold since 1970. Waistlines have grown with the rise in fast food, and 70 percent of kids ages six to eight think fast food is healthier than homemade food. Sure they do: they have the former almost more frequently than the latter.
And the portions tend to be outsized—having nothing to do with what’s sufficient for normal growth, fitness and well-being. A recommended serving of meat, fish or poultry is 3 ounces; that is what is recommended for good health and nutrition by the U.S. Department of Agriculture, the Food and Drug Administration and the National Institutes of Health. The typical portion of meat, fish or
poultry that Americans eat is about 8 ounces—nearly three times what is needed and recommended. Today’s typical pasta portion is 480 percent bigger than the government recommendation.
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LARGE PACKAGE, SMALL SNACK
Studies show that small packages lead to bigger consumption of high-calorie snacks by the weight-conscious. One look at a large bag of, say, potato chips, and folks conscious of weight and body size may grab one or two, then quit—if they even open the package. But the 100-calorie snack packs are so readily seen as “diet aids” that the weight-conscious chow them down with impunity.
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When you ordered a hamburger in 1957, you got a 1-ounce patty on a bun, and the whole thing contained 210 calories. When you order a hamburger today, you’re eating 6 ounces of food and taking in 618 calories. A side of fries was once 2.4 ounces, totaling 210 calories; today, you get 6.9 ounces and 610 calories.
School lunches aren’t much better; like most assembly-line eateries, they tend to offer lots of fried food, thus doubling down on the carbs, calories and fat content kids get in the fast-food places. And the beverage of choice at school as well as at home or in the restaurant tends to be soda—which is nutrition-free and typically loaded with calories. In 1950, American children drank three cups of milk to one soda; in the twenty-first century, that ratio is precisely reversed, with three sodas to a single cup of milk. Each of those sodas contains 150 calories, and all you need to gain 15 pounds a year is 150 calories—that is, a single soda—per day.
True, we can’t be responsible for what our children eat when they are not home. And let’s face it, we are up against a formidable opponent in the food industry, which spends tens of billions of dollars on advertising to young children, not to mention the indirect “advertising” on Web sites featuring licensed characters, games and the like. In fact, the average American child sees several thousand food advertisements on television each year. And despite the industry’s promises to the contrary, most of the advertising focuses on the least nutritious foods. As we learn from an October 2009 study by Yale University’s Rudd Center for Food Policy and Obesity, “the least healthy breakfast cereals are those most frequently and aggressively marketed directly to children as young as age two… The researchers’ evaluation of cereal marketing, the first such study of its kind, shows pervasive targeting of children across all media platforms and in stores.”* The reason is simple: get kids to like this stuff early, and they’ll be customers for life. So today’s kids are indeed growing up making unhealthy food choices. Did you know that 25 percent of the vegetables eaten in the United States today are french fries?
In addition, as every parent knows, kids are exercising less. By the age of seventeen, today’s child has spent 38 percent more time in front of the TV than in school. According to Time magazine, every hour of TV a kid averages per day raises his risk of obesity by some 6 percent. We can’t totally blame the kids: if they live in big cities, their parents tell them not to play outside because it’s too dangerous. If they live in the suburbs, there may not even be a sidewalk inviting them to walk to school. City or suburb, kids’ rooms are equipped with a computer, television, Xbox—you name it. Who wants the fresh air of the outdoors, who needs a leg-stretching run across a field, when you can do it all virtually or watch it from the comfort of your bed? No one, which is why most kids today spend from two to four hours in front of some sort of screen every day—and almost no time outside at all.
With too much fast food that is nutrition-free and a minefield for metabolic syndrome and not enough exercise, no wonder there is an epidemic of childhood obesity and a surge of such killer diseases as diabetes.
So yes, you’re up against a formidable obstacle in trying to get your kids to make healthy eating choices—a relentless barrage of images, endless chatter, peer pressure and the ever-present convenience factor.
But you’re not without resources. As parents, you are the first habit setters, and you can demonstrate the example both at home and in restaurants. You are also the first authority figures, with immense power to teach your children to make the right choices.
Bottom line? Just as we teach our children how not to behave—not to lie or cheat, not to be rude or unfriendly—so also can we teach them what not to eat. And just as we teach them to be honest, polite, considerate of others and responsible, so also can we give them the foundation of healthy eating that will enable them to grow up strong, fit and as protected against disease as possible.
GIVING YOUR KIDS A HEAD START ON HEALTHY EATING
The Beat Diabetes Pyramid is your family’s map to healthy eating. And the sooner you start the better. With type 2 diabetes showing up in eleven-year-olds, and with obesity plaguing four-year-olds, you cannot afford to wait.
If you are expecting a child or are the parents of a newborn, you can start providing your child the benefits—and pleasures—of varied, nutritious food as soon as the child is weaned and you have begun to introduce solid foods. If your child is beginning to show evidence of excess weight, you need to intervene now to retrain his or her way of eating.
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ENVIRONMENT AFFECTS OBESITY
Who is most likely to be obese? Lower-income minorities and people in rural areas of the country. The Centers for Disease Control and Prevention track obesity by race, income and geography and find that African American and Hispanic children are more likely to be overweight than white American kids. More than twice as many kids living below the poverty line are overweight or obese than kids with family incomes above the line. And 16.5 percent of rural kids versus 14.4 percent of urban kids are obese.
Conclusion? Environment defines the choices available—including the eating choices. And adults create the environment for kids.
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Whenever you begin, be sure to think of the changes you are making as being about health. If you talk to your child about the change, frame the discussion in just those terms—that the changes are about getting healthy. Talk about foods not as good or bad but as healthy or unhealthy. Don’t prohibit or restrict any foods; it will backfire. Instead of eliminating the food from your child’s eating pattern, you will imbue that food with special importance.
Perhaps the most important first step is for you yourself to model the eating behavior you want your child to assume. There is no more powerful lesson for your child than seeing you enjoy healthful foods and physical activity.
In fact, it is a good idea to make any change in eating habits a family affair. Involve everyone in creating a weekly healthy eating plan, and make meals regular collective events—no different meals or special foods for different family members. Make the outing to a fast-food restaurant a less and less frequent event—maybe cut back to once a week, then once a month and so on.
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MODEL BEHAVIOR
As the song says, children are watching—and researchers at Dartmouth College agree. They took 120 kids ages two to six on a simulated shopping trip. When asked to “buy” foods at the make-believe grocery store stocked with toy foods, children whose parents customarily made healthier food purchases bought healthier foods.
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Interview with Jonathan, 13 years old
When Jonathan came to me, he was 12 years old, 5’6” and weighed 228 pounds. Now Jonathan is 13, and after following a new diet for just 21 weeks he has brought his weight down to 186 pounds and significantly improved his health.
Dr. S: What is the main trigger that got you to start a diet?
Jonathan: I would get tired fast. I wanted to do all the things the boys in my class could do. I couldn’t exercise the same way as all of them. Now that I’ve lost weight I am starting on the basketball team. Probably the track team, too. And I’ll be able to run more.
Dr. S: What was the most difficult thing about starting a diet?
Jonathan: Not giving up. I didn’t give up. I used to eat a lot of fast food and starch, high-calorie foods. I don’t eat those foo
ds that often anymore.
Dr. S: Do you miss them?
Jonathan: Sometimes. I have some replacements.
Dr. S: What are the replacements?
Jonathan: I used to have regular sausages—now I have Morningstar sausages. I found healthier snacks—like soy chips and low-calorie popsicles.
Dr. S: Did you ever feel uncomfortable about the fact that you were dieting while the other kids were eating high-calorie foods?
Jonathan: The other kids were eating pizza and other things in school, but it didn’t bother me that much because I knew one of these days I would have more energy and I’d be able to keep up with them.
Dr. S: Was it worth it?
Jonathan: Yes, I have more energy now and I can keep up with my friends.
Dr. S: What was the most difficult part of the diet?
Jonathan: Sticking to it in the “middle,” when I was partway through.
Dr. S: What advice might you give to a child who needs to go on a diet?
Jonathan: It might be difficult but it’s all worth it in the end. (Jonathan’s mother—Stephanie)
Dr. S: When Jonathan decided to start a diet, was it a conversation you had with him or did he come home and say something?
Stephanie: Jonathan asked me for help. He began to develop a complex, and when he asked me for help that’s when I began to do the research for a diet. At his school they had an obstacle course for exercising. He couldn’t do it. And he was embarrassed—when he did track he was the slowest. There were a couple of other kids on the team who tried to motivate him, but he knew he wasn’t part of it. He was discouraged. So when he came to me and asked me for help, it broke my heart.
Eat & Beat Diabetes with Picture Perfect Weight Loss Page 4