Keeping Your Kids Slim

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You're concerned about your weight, and you're pretty careful about what you eat, avoiding high-fat fare as much as you can. You even try to work in an hour or so of walking every other day. But you may be forgetting something.

Your kids.

You know, those small creatures with insatiable appetites for sugar, salt and Nintendo. Right now they're just tater tots, but they might slowly be turning into couch potatoes, not only getting chubby but also piling up all the heart disease risk factors associated with the sedentary lifestyle you're trying so hard to avoid. Of course, it's not all their fault--or yours. Plenty of factors are contributing to the fattening of America's youth.

* Physical education has all but disappeared in high schools.

* Kids are less inclined to walk or ride bikes to school, even if they live just blocks away.

* Television has become the electronic opiate of the teenage masses, with kids infusing 15 to 25 hours of TV and video games into their heads each week.

* The family dinner table has been replaced by the drive-through window, with "You want fries with that?" becoming the toughest culinary decision.

So it's no surprise that kids are fatter than ever. In fact, a study found that children weighed an average of 11.4 pounds more in 1988 than in 1973, even though they were eating the same number of calories and less fat. Ten-year-olds jumped from 75 pounds to 86 pounds, without getting any taller! And, sadly, it doesn't look as though the situation's likely to improve any time soon.

"We're churning out unhealthy kids, who may tragically become unhealthy adults," agrees fitness guru Kenneth Cooper, M.D., president of the Cooper Aerobics Center in Dallas and author of Kid Fitness. "We're already finding higher blood pressures and evidence of premature coronary heart disease among the young right now."

That news may sound alarming, especially if your kids are already overweight and underactive. But you can fight the trend. You can help get your kids--whether they're tots, teens or somewhere in between--on the road to a slim body and a healthy lifestyle they can follow for life.

Eating Slim, Kid-Style

While you can't control what your kids eat when they're at the mall, away on trips or at a movie with their friends, you can--and should--take command at home. You can turn your house into a healthy sanctuary from all the greasy fast-food and sugar-packed snacks that assault your child away from home. Here's how to offer kids maximum nutrition to help them grow up but not out while they're under your roof.

Shop smart. Improving your child's eating patterns means getting the upper hand at the supermarket. Studies show that more and more children are responsible for making food purchases and preparations, with less parental supervision. And that presents problems. The key: selecting, and helping them select, the right foods to fill the fridge and the cupboards.

Give kids choices . . . within reason. "Parents should be in charge of what children are offered, and then children should be in charge of what they choose to eat from what's being offered," says William E. Dietz, M.D., Ph.D., pediatrician at the New England Medical Center in Boston. Then you don't have to infringe on your children's sense of independence, which will only cause them to rebel when they're away from you.

Secure the snacks. Make sure there are plenty of healthy no- and low-fat snacks on hand. Sliced fruits, vegetables, unsalted air-popped popcorn and nonfat fruited yogurt can be given easy access. The sports bars athletes use as low-fat, high-carbohydrate boosters can be cut up into smaller portions and used as snacks as well. They come in chocolate and other tasty flavors.

Be a role model. If you want children to eat healthy and slim down, you'd better be prepared to toe the line yourself. "A parent who sits on the couch and asks her child to get her a bowl of cheese dip and then expects him to eat fruit had better think twice," says Ronald Kleinman, M.D., chairman of the American Academy of Pediatrics Committee on Nutrition and chief of pediatric gastroenterology and nutrition at Massachusetts General Hospital. "But if you stock your house with healthy foods and your child sees you eating them, there's a good chance he'll eat them, too."

Learn from the enemy. "Look at commercials to see what kids are being told to eat or what's fun to eat, and interlace those items with foods they should be eating for better health," suggests Liz Applegate, Ph.D., a nutritionist from the University of California, Davis, author of Power Foods and mother of two growing kids. If you completely cut your kids off from the popular stuff, they'll go wild on junk food the minute they're old enough and have a little change in their pockets.

But be careful: Don't confuse your children by using sugar and fatty items as treats and then turn around and tell them how bad those foods are. "Integrating these foods into a healthy diet shows kids that they can have a little of them, but in a controlled, responsible manner," says Dr. Applegate.

Pay attention to breakfast. One way to keep a kid from snacking too much on the wrong things is by serving him a good breakfast. Filling him up with wholesome cereals and breads that have little fat and are no sweat to prepare can make your child less likely to pig out the rest of the day. What's more, getting him into the breakfast-eating habit early in life means he won't have to learn it when he's 40--after the cardiologist orders him to.

And you needn't serve your children the usual bowl of boring old bran flakes. Says Dr. Applegate, "I let my kids have both kinds of cereals--the sugary kind and the high-fiber kind. We pull out five boxes and mix them up." That interesting blend may keep 'em coming to the breakfast table instead of gobbling down a candy bar on the bus.

Dress up a waffle. "I put light whipped cream on low-fat frozen waffles, and my children think it's a sundae," says Dr. Applegate. "I'll toss strawberries on it so it fools them into eating their fruit. If you separate the foods out, they're less likely to eat them. I make a face on the waffle, using whipped cream as hair and strawberries as eyeballs. It's an exciting way to provide variety using things they will eat."

Slim by skimming. Start reducing the fat in your child's diet by weaning her off whole milk after age two. You can start by dropping down a notch--to 2 percent, then 1 percent, then onto skim.

"By substituting skim milk for whole, you're cutting out eight grams of fat per glass," says Dr. Cooper. "And you're actually giving your kids more calcium, too--302 milligrams per eight-ounce glass, compared with 291 milligrams from whole milk." And don't worry if your child craves chocolate milk, it doesn't add to her fat intake, though it does add sugar. "If your child isn't eating a high-sugar diet, chocolate milk is fine," says Dr. Applegate. "It may get a child who hates milk to drink it."

Freeze to please. Sure, fruits are cool and colorful, but to most children they're borrr-ing. So turn them into kid-pleasing desserts by chucking them into the freezer. Grapes, when frozen, are transformed into fun-to-eat mini ice pops, loaded with juice. Frozen bananas, strawberries, watermelon and cantaloupe are other great choices. Just cut the fruit into pieces, spread them on a flat pan and put them in the freezer for an hour. When frozen, pop the pieces into plastic bags, where they'll be ready when the snackers ambush the fridge.

The Pudgy Problem There's nothing worse for an overweight child than hearing the coach or gym teacher yell, "Scrimmage! Shirts on one side, skins on the other!" If it's tough to get kids involved in exercise, it's even tougher for those with a weight problem. "Overweight children are often not accepted by their peers and become wallflowers, participating in even less activity," says Kenneth Cooper, M.D., president of the Cooper Aerobics Center in Dallas and author of Kid Fitness. "Some just get embarrassed to death." Luckily, there are many neighborhood fitness programs geared specifically for overweight boys and girls. Some, like those found at local YMCAs, are free, and others may cost you, but even so, insists Dr. Cooper, "It's worth it." For instance, Shapedown helps overweight young people ages 6 to 20. It promotes safe short- and long-term weight loss, improving self-esteem and increasing knowledge of nutrition, exercise physiology and weight-management principles. It's offered by hundreds of hospitals, HMOs, medical centers, private practitioners, clinics and health departments across the country. Another program, the Body Shop, is distributed by the American Institute for Preventive Medicine and is available at approximately 100 hospitals throughout the United States. A ten-week program for kids that focuses on diet, exercise, weight loss and self-esteem, the Body Shop also offers a support group for their parents.

How to Make a Brown Bag Appealing

Pity the typical brown-bag lunch. Most kids empty the contents, trade what they don't want and toss the rest. You can help prevent this pattern by making healthy, low-cal lunches with plenty of kid appeal. Here's how.

Pick fruit first. Pack apples, bananas, peaches, melon chunks--whatever your children like best. Fruits that have excessive juice can be packed in a plastic container. Even kids who don't generally like fruit will probably eat boxed raisins and dried fruits.

Skip the sandwiches. Baked or broiled chicken pieces, low-fat soup in a Thermos bottle, turkey slices or cubes of low-fat cheese are other appetizing alternatives.

Counter that snack attack. Include a container of low- or nonfat yogurt or fat-free pudding, a homemade low-fat muffin or some fat-free potato chips to help kids steer clear of fattening, commercial snack items.

Block that punch. Avoid packing punch or fruit beverages, which are little more than colored water and sugar. Instead, serve natural, 100 percent fruit juices.

"I'm not a firm believer in the typical lunch consisting of a sandwich, a piece of fruit and a drink," says Dr. Applegate. "Kids like to nibble. They eat one thing, put it down, blab to a friend and pick up something else." The more items the better, she says, but with much smaller serving sizes. "I give my daughter fresh-cut vegetables, caramel-flavored rice cakes, dried fruit, a sports drink (milk in a Thermos is usually not touched--it's boring), maybe a quarter of a sandwich and a slice of nonfat process cheese. She eats everything instead of trading away the big three lunch items and scarfing dessert."

Dancing the Fast-Food Shuffle

You don't have to blow the diet--yours or the kids'--just because you're at a fast-food restaurant. "They may be tugging at you, telling you what they want, but they aren't ordering. You still have control," says Dr. Applegate. Here are a few things you can do to keep down the fat and calories when the kids insist on a fast-food meal.

Try a little take-in. "We go with a bag of crunchy vegetables like cucumber slices," says Dr. Applegate. "While we wait in line for our burgers we munch on the veggies. I also bring sports bars--they're lifesavers. Kids treat them like candy bars, and they're a great way to avoid the fatty stuff that's out there."

Look for lower-fat items. If the kids are craving a cool, sweet dessert, fear not: The low-fat frozen yogurt cones are often the lowest-fat items on the fast-food menu. Low-fat milk is also available. And order the basic burger--"The cheapest one almost always ends up being lower in fat," says Dr. Applegate.

Share and share alike. "It's very difficult to go into a place with all the smells and see everyone else eat and say, 'We're here but we can't have that.' It doesn't make sense to kids," says Dr. Applegate. "So we'll divvy up our food, such as french fries, to reduce the amount of fat we're all getting. And we'll pass around the low-fat shake, taking turns sipping."

Overcoming the Yuck Factor You know eating more veggies is a key to losing weight and keeping it off. But try telling that to a kid who thinks the four food groups are burgers, fries, soda and desserts. Leave it to a pro football athletic trainer to figure out how to do it. Dean Kleinschmidt, president of the Professional Athletic Trainers Society and head athletic trainer for the New Orleans Saints professional football team, has found the trick to getting his kids to not just eat their vegetables but actually love them. He brings on the veggies as soon as possible, while the children are still open to new tastes. He also sets a good example. "For the past ten years, the focus at home has been on having more vegetables," he says. "I have a ten-year-old son, and from the time he was three his favorite meal has been fettuccine and broccoli. Our two-year-old daughter is also into vegetables." Is Kleinschmidt trying to raise a generation of vegetarians? No way, he insists. "We serve grilled chicken and veal and even pork sometimes," he says. "But these kids eat vegetables and grains and like them, and it's because we started them early."

Don't Forget the Physical Fix

The scientific evidence is in: Kids don't need strenuous exercise to be thin and gain important health benefits. They do need to exercise, however.

The basic prescription is simple. To maintain fitness, children and teens should set aside three 30-minute periods per week for some kind of sustained aerobic activity--walking, jogging, dancing, cycling or any continuous activity they find fun. "If they're already involved in a vigorous school sport like basketball, gymnastics or soccer, you can drop that down to 20-minute periods," says Dr. Cooper. The key is to have your children identify an activity they enjoy and encourage them to do it as often as they can.

Whether your kid is now fairly active or whether he's already showing signs of turning into a BarcaLounger-and-beer aficionado, you can help him get fit and stay slim at every stage of his development. Here, according to Dr. Cooper, is what kind of exercise your child may need at each age.

Birth to 2 years: This isn't a critical time for maintaining or improving fitness. Kids are highly active on their own (just ask any new mom!) and don't need any extra exercise. For now, stacking toys or blocks, rolling and retrieving objects, playing games and crowd-pleasing attempts at walking are all these energetic tots normally need to do.

2 to 5 years: Here's a time when you can join in and help develop certain skills involving hand-and-eye coordination. Teach your child to kick, throw, catch or bat a ball. These skills do more than provide the groundwork for other abilities they'll develop later--they're also fun.

5 to 8 years: Start encouraging your child to exercise aerobically with walking, playing soccer and basketball with friends, or other playground sports. Group play and even some milder team sports are possible options. "Getting your children involved with other kids helps keep exercise fun and can prevent them from losing interest later in life," says Dr. Cooper.

8 to 10 years: Now kids can get more actively involved in more vigorous activities. Let them investigate all sorts of sports and games to find out which one suits them. Tennis, bowling, volleyball and soccer are all popular, fun, low-risk activities available at most neighborhood youth centers. "At this time some children may find team sports attractive, while others may not," says Dr. Cooper. "All kids are different. But if they do get involved, allow them to choose what they want to do and play down the competitiveness, which can turn them off."

10 to 14 years: Here's where the adolescent slump can rear its lazy head, with the tendency to turn slothful reaching its peak. It's especially important now to provide the support and enthusiasm needed to help your child stay interested in exercise.

14 to 17 years: "If you haven't gotten your kids used to a regular pattern of exercise by this time, it'll be a real uphill struggle," warns Dr. Cooper. Since most older teens have already reached their growth potential, you can help encourage a strength-training program--for both boys and girls--by purchasing a basic weight set. Weight training may appeal to older teens by creating tangible physical rewards (muscles get bigger) that offer psychological benefits. Weight training also helps avoid the competitive pressures of team sports that alienate those who aren't as skilled as others. If your child does take a shine to strength training, make sure there's always strict supervision by a knowledgeable adult.

Building a Better Body Image Can a teenager feel better about her body and maybe even avoid developing an eating disorder via regular exercise? Medical research suggests the answer is a definite yes. In a report presented at the American College of Sports Medicine, researchers looked at girls ages 13 to 17 who participated in a school athletic program. They were found to be more satisfied with their bodies, their overall appearance and their level of fitness when compared with a similar group of girls who didn't participate at all. More important, these active girls were less preoccupied with their weight compared with the other girls. Although the researchers didn't look specifically at the incidence of eating disorders such as anorexia or bulimia among the study subjects, the results strongly suggest that regular exercise may be one active, powerful way to offset negative feelings, the kinds of feelings that may lead girls to dangerous eating habits.

Keeping Motivation Going

Tell a kid, "Get plenty of exercise," and chances are the response you'll hear will fall somewhere between a groan and mocking laughter. Forget lip service--the key is motivation. Here are a few strategies to keep exercise fun and continually interesting for your child--and you.

Let the kid take charge. Exercise imposed from above will be deep-sixed in no time. Let your child freely choose her activities. Encourage her to select the kind she likes, not necessarily the activity you excelled in when you were her age.

Make it an event. Have at least one fun fitness outing--a hike or bike ride, for example--scheduled for the weekend. That way exercise becomes less of a chore and instead becomes something fun the kids can look forward to.

Get peers involved. Organize weekend or after-school events that get your child's friends and classmates into the act with ice-skating outings, touch football or Frisbee.

Set a good example. Research has established that a parent's actual involvement in his own sport or exercise has a positive effect on the kids. (Call it the trickle-down theory of fitness.) Think about it: How can you ask your kids to keep in shape and cut down on TV watching while you're notching a permanent imprint on the den couch? If you don't want to actually play, you can get involved as a sponsor or coach for your child if he's on a team or just show up and become an interested spectator.

Select a substitute. If your child is involved in an organized activity and you can't be there to offer support, find someone else who can go to the games. A relative, older sibling or close neighbor can substitute and cheer your kid on.

Lend support. If she's beginning an organized activity, monitor her physical and emotional well-being. Be alert to physical complaints or any major emotional change. Is she sullen or depressed since tennis or basketball started? Is she feeling sick right around practice and suddenly feels better when she knows she doesn't have to go?

Have your child teach other children. As your child forges ahead in an activity, whether it's golf, bowling or softball, encourage him to teach others how to play. "You'd be surprised how that child takes pride helping other kids," says Dr. Cooper. In a way, you may help create a chain of healthy instruction in your neighborhood, where each child teaches a friend, who teaches another and so on.

Boning Up For young girls, the looming threat of osteoporosis later in life makes it imperative that they get regular doses of weight-bearing exercise, such as walking, running, dancing and most competitive sports, to supplement their dietary intake of calcium. Resistance exercises, such as light weight lifting and calisthenics, are also good. The "fracture threshold" is the level below which a bone might be likely to break spontaneously, and the goal is to get as far above that threshold as possible. That way, when bone declines later in life, as it inevitably will, there's a sizable deposit of bone to draw from. "Most young girls have less than optimum bone strength, and by the time they're 25 to 35 years old they have reached their maximum bone density," warns Kenneth Cooper, M.D., president of the Cooper Aerobics Center in Dallas. But by getting enough exercise and calcium during the early years, young women can rise way above the threshold that makes bone vulnerable. "Exercise doesn't have to be intense--just fun, all-around weight-bearing activity may do the trick," says Dr. Cooper. "That way women may not have to start worrying about that threshold until they're 90 years old."