Some solutions for "lifestyle change"

So, we bogged you down with the dilemma of the pediatric obesity epidemic yesterday. Then we told you that you shouldn't have your child diet if he or she is obese. And, to top it all off, we gave you the vague solution of "lifestyle change" as an alternative to dieting.

We're aware of how ineffective that advice would be without more details. So, we went back to our clinical dietiatian and pediatric obesity expert, Deborah Stern, to get some specific ways to encourage your child to adopt a healthy lifestyle instead of a one- or two-month dieting fad.

1)It all starts with you - Stern sees patients who struggle with obesity every day. The ones who succeed, she says, are the ones who have parents not only encouraging, but participating in the weight-loss process. "It's the parents who have instilled these behaviors in the kids. So, the parents need to decide to change as a family. It's nice when the parents switch their eating and exercise habits, too. That shows the kids that getting healthy isn't a punishment for something they've done wrong and that they aren't in it alone."

2)Make activity changes before diet changes - Increasing activity can be a fun way of easing children into a healthy lifestyle, Stern says. "That way, you're making it more about what you can do instead of what you can't do. You can go to the park and play ball as a family, or you can go to the mall and walk if it's cold outside. You can also set up the Nintendo Wii or Xbox Kinect and do a dance video together."

3)Make fruits and veggies plentiful and available - Repeatedly offer fruits and veggies to your children throughout the day. Leave some (ones that don't go bad in room temperature) out on display. Basically, inundate your kids with the idea of eating fruits and veggies. "If children aren't offered fruits and vegetables multiple times, then they aren't going to choose fruits and vegetables," Stern said.

4)Pack their lunches - Although it's getting better in some places, our children are still basically offered what we were offered in school cafeterias - soggy, greasy pizza; french fries; sodas; corn nuggets; taquitos; and other various non-green things. They aren't exposed to a whole lot of variety there. And since they spend more waking hours at school than at home, guess where they're forming their eating habits? "I know that packing a lunch is a time and money challenge for families, but if you can do it, I think it's very helpful," Stern said.

One basic packed-lunch menu she suggested: a wholegrain or wheat sandwich/wrap with lean protein like ham or chicken; chopped up cucumbers or carrot sticks; granola bar; light yogurt; and a bottle of water.

5) Do it all gradually - "I would advise against bombarding them with lifestyle changes," Stern said. "Maybe there are three things they can work on one month. When the month is over and those are accomplished, we can give them three new goals. But when they have 10 things to change at once, they generally get more discouraged - especially if it's 10 things thrown at them at the beginning of the weight-loss process."

Dieting isn't the way to lose weight for kids

As we've addressed many times and as you've literally seen hundreds of times on the news, childhood obesity is a problem in America. Many well-informed, concerned people would even take it a step further and say that it's an epidemic. That group includes many experts on our team at Children's.

So, it seems like we should be doing whatever possible to get kids to lose weight, right? (For examples of "whatever possible," see this story on tracking devices in a New York school district and a recent ad campaign by the Georgia Children's Health Alliance.)

Maybe not, revealed a recent University of Minnesota study . The results of that study indicate that teens shouldn't even be dieting.

Why? Children's clinical dietitian Deborah Stern said dieting "implies the starting and stopping of something. And eating healthy shouldn't be a temporary thing. It should be a lifestyle change."

The teens who participated in the Minnesota study proved Stern's point. The ones who regularly dieted, skipped meals and took weight-loss pills actually gained more weight in young adulthood than the ones who didn't take any of those measures.

The problem with diets, medicines, fasts and cleanses is that they're usually unsustainable over the long haul. "They set you up to fail," Stern said. Teens (and some adults like the one writing this blog) get pulled into them because they often do provide significant short-term results, and they see the dramatic transformations people undergo from drastic diet and fitness adjustments on shows like NBC's "The Biggest Loser."

"I have to admit that it's one of my favorite shows; I watch every episode," Stern said. "But kids have to understand that all the contestants do 24 hours a day, every day is workout and diet. They don't see family. They don't go to work. It's unrealistic."

Stern said that it's vital that weight loss goals be realistic for kids. Instead of focusing on losing 20 pounds in one month by eating only lettuce, they need to look at getting healthy as a process, adjusting their lifestyle a couple of steps at a time. That may result in less drastic weight loss in the short term, but it will equip them to be healthier in the long term.

"If kids don't look at being healthy as a lifestyle, they're never going to develop healthy habits," Stern said. "Instead, they'll develop habits of trying new diets and then dropping them entirely, which isn't healthy at all."

So, how do you help your child make being healthy a lifestyle instead of just a one-month goal? We'll talk about that in tomorrow's blog.

Celebrating Dr. King

If you will be at the hospital this week, be sure to stop by these events in honor of Dr. Martin Luther King, Jr.

Monday, Jan. 16Noon to 1 p.m.
Character Chorus, Bray Elementary School, Cedar Hill
Butterfly Atrium, Dallas campus

2 p.m.
Service honoring The Rev. Dr. Martin Luther King, Jr.
Abbott Chapel, Legacy Campus

Tuesday, Jan. 172 to 3 a.m.
Chapel Service for night staff
Haggerty Chapel, Dallas campus

Thursday, Jan. 192 to 3 p.m.
“A Slice of the Rainbow” – Storyteller/Musician Doralynn Breedlove,
Butterfly Atrium, Dallas campus

Friday, Jan. 2011:45 a.m. to 12:30 p.m.
“Remembering The Rev. Dr. Martin Luther King, Jr.”
Haggerty Chapel, Dallas campus

Week-long Events

Daily devotionals in Haggerty Chapel from 11:45 a.m. to noon featuring tributes to world leaders who stand for peace; musicians and vocalists invited to perform

Poster display featuring winners of Nobel Peace Prize

Table tents and quiz cards in The Dining Car

The flu frenzy

My first child, the darling Emerson Lee Foster, was born at the end of November. The first six weeks of her life have been full of love, joy, celebration and... a lot, lot of paranoia.

Seems like all I can think about sometimes are bad drivers, BPA, blocked airways, falling picture frames and contagious diseases. Yes, I drive myself crazy. And it's been especially difficult to keep my sanity as I've started hearing an excessive amount of sniffling and coughing the past few weeks. In the office. At the store. All over the mall.

I can't escape it. The flu season is revving up. But, luckily, I have the experts at Children's to help me make it through - as you do, too.

So, I asked the director of the infectious disease department at Children's, Dr. Jeffrey Kahn, if he could give us some advice on keeping our children healthy the next couple of months.

Me: When is it safe for parents of babies to take their children out in public places? 8 weeks, 12 weeks, 6 months? Or should they just refrain from taking babies out into crowds during flu season?

Dr. Kahn: There are no official recommendations from the Centers for Disease Control that specify the age that young children can be safely taken to public places during influenza season. The best advice for parents and other caretakers would be to be cautious when influenza is circulating in the community. That information can be found at the CDC website (or follow the CDC's Twitter account that focuses entirely on flu news, @CDCFlu). Good hand washing for anyone who will hold/touch the child will also decrease the risk of influenza transmission. The best way to protect young children from the flu is vaccination (when they reach the appropriate age of older than 6 months). Also, vaccination of all those who come in regular contact with the baby (since a large proportion of influenza infections are acquired from infected individuals within the home) is the best way to protect children who are too young or not eligible to receive the vaccine.

Me: Is it a good idea for children to receive a flu vaccination now if they haven’t already received one? Is it too late?

Dr. Kahn: There is still time for children to get the influenza vaccination. At this time, there is still little influenza activity in north Texas suggesting that the “flu” season is yet to come. Vaccination is the BEST way to protect children from the flu. There are no school requirements for flu vaccination BUT All children who are eligible should be vaccinated.

Me: Is there a difference in the effectiveness of the flu shot and the flu mist?

Dr. Kahn: For the most part, these vaccines are of equal efficacy. For children who are eligible for either vaccine, the decision can be made by the parent, clinician and/or the child!

A visit with a "notorious" patient

A few weeks ago, I had the opportunity to meet a special patient, Zach Guillot. The 7-year-old is notorious, as his mom says, around the hospital because of the “antics” he’s involved in on the floor where he is undergoing chemotherapy and waiting to receive a second bone marrow transplant.

Zach was readmitted to Children’s Dec. 16 after relapsing from his battle with acute myeloid leukemia.

One of his antics includes riding his Big Wheel around his impatient floor at night. And he's recently found fame among Children’s employees for the videos he and his Child Life specialist have recorded.

Among the 14 videos on his YouTube channel, there’s a legendary lightsaber duel between Zach and his “Sith Nurse” caught on camera, animated shorts and adventures as Indiana Jones and Ironman.

When I walked into his room, he introduced himself with some playful meowing. Being a bit of a kid myself, I thought it was hilarious. But I really had to hold back from laughing when he welcomed his doctors to his room by hissing.

Zach’s mom Julie said she and her husband Jeff have appreciated how the staff at Children’s has allowed Zach to be himself during his stay in the hospital.

“There’s more to recovery than medicine,” Julie said. “The staff keeps it lighthearted and play with him. It really helps with the whole experience. It’s the little things that can make a kid feel better.”

I certainly saw that's the case with Zach. It’s so encouraging to see a young child being himself, in high spirits, playing Wii and meowing at guests, while going through something as challenging as chemotherapy.

If you’re interested in helping kids like Zach, join the bone marrow registry or participate in the Be a Match Bone Marrow Drive held at Children’s annually on Valentine’s Day. For more information on times and locations for the drive visit marrow.org.