Treatment Of Childhood Obesity: The Diet Component

Wednesday, January 17, 2007 - 12:07pm

By Erica Lesperance, RD, LD

According to the U.S. Department of Agriculture (USDA), there is a steady decline in the diet quality of children and adolescents as they get older.   This is one of several factors contributing to the increase in childhood obesity in the United States.  Just as the cause of obesity in children has many factors, so should the treatment.  Obesity cannot be adequately treated without addressing physical activity, psychology/behavior, diet, genetic factors, and how they are all intertwined.  However, here we will explore just one very important aspect of treatment: Diet. 

Treating overweight children with diet is complex. Children should not be placed on severe calorie-restricted diets.  Unlike adults, children are still growing; significant calorie restriction can affect their ability to grow and develop properly.  However, that doesn’t mean that parents of overweight children can’t positively impact their children’s weight by improving the overall healthfulness of the foods that they and their children are eating.  Making the following healthy choices will make everyone feel better, physically and mentally, and is likely to safely reduce the calorie content of the diet.

Provide a healthy diet for your children

For the most part, parents are the ones who provide, prepare or purchase the food that their children eat.  Therefore, it is imperative that parents make changes in their own food habits to help their children. Even small changes can make a big difference. Consider the following changes: 

Changes in food preparation

1.    Low-fat substitutes in your child's diet

Try some low-fat substitutes such as low-fat cheese, salad dressing and evaporated skim milk. Try low cholesterol egg products. Use two egg whites instead of one whole egg to significantly reduce the fat and cholesterol content of some baked goods.

2.   Use healthy oil/fats and remove any excess fat

When you use oil, select olive or canola oil. Drain off visible fat while cooking, and blot pan-fried foods on paper towels to absorb extra grease.  Allow soups to chill before reheating and serving so that the fat can be skimmed off the top.

3.   Avoid frying food as this adds calories

Choose roasting, poaching or stir-frying as frequent cooking methods, and limit frying.  Microwave cooking is a healthful way to cook vegetables because the short cooking time reduces nutrient loss and usually no added water or fat is needed.

4.   Use fat substitutes when baking

Reduce the fat in home baked goods by substituting applesauce, pureed prunes, mashed bananas or yogurt for up to half of the butter, oil or shortening.

5.   Try fruit desserts for less calories and fat

Try more fruit desserts (fresh, stewed and cobblers) instead of cakes and cookies. Choose frozen yogurt, sherbet and sorbet instead of ice cream. Or skip dessert altogether and save it for special occasions.

6.   Include more vegetables in your child's diet

Add vegetables to meals and snacks whenever possible.  Add shredded vegetables in casseroles, and add additional vegetables to soups and stews. Try vegetable salsas and fruit chutneys as accompaniments to meat or poultry in place of heavy gravies or sauces.

7.   Use "non-stick" to reduce the fat eaten

Use non-stick cooking spray or non-stick pans for grilling or stir-frying.

Changes in food selection

  • When buying groceries, choose fruits and vegetables over convenience foods high in sugar and fat.
  • Limit drinks to water or milk.  Sweetened beverages, even fruit juice, are high in calories and don’t necessarily provide nutritional value.
  • Select colorful foods such as green and yellow vegetables, fruits of various colors, and brown (whole grain) breads.  Limit white carbohydrates (e.g. rice, pasta, white bread and sugar).
  • Limit the number of times you eat out, especially at fast food restaurants. Many of the menu options are high in fat and calories.

Involving children in change

Children are more likely to be motivated to change their diets if they are involved in the decision to do so. With the goal of improving health rather than losing weight, children should be encouraged to take charge of their diets by reading nutrition labels and learning about the My Pyramid Food Guidance System (formerly known as the food guide pyramid).  It is likely they have learned these things in school, but you should also bring them into the home and put them to practical use. 

Need help to make the changes?

Making the changes mentioned above is healthy for everyone, not just your overweight child.  However, seek professional advice before making any drastic changes, and keep your doctor informed of any changes you make.  Nutrition counseling with a registered dietitian that specializes in children’s needs is often a valuable part of dietary treatment for obesity.  Nutrition consultants can outline specific and appropriate nutritional needs for healthy growth and find an approach that is right for your child.