Category Archives: Nutrition

How can I help my child lose weight?

Posted on by
Suzanne Berman, M.D.

Obesity and being overweight have been epidemic among American adults for years. Unfortunately, Americans are getting heavier at a younger age now. Many children as young as 4 years old are obese. It’s never too late to lose weight, though. Here are some tips for both parents and children that will help your child lose weight:

Shopping tips for parents. This is the first step towards healthy eating at home. Remember, if you don’t buy it, it can’t be eaten.

  1. Don’t take the child with you on food shopping trips. Not only will this cut down on junk food purchases, you’ll save money too.
  2. If you do take kids grocery shopping, make the most of it by discussing healthy food choices as you shop. Teach kids how to read nutrition labels and how to comparison shop for prices. If you do buy candy, NEVER buy any at the checkout lane, so your child will get into the habit of passing up these impulse items without a tantrum.
  3. Do your grocery shopping after a meal when you’re not hungry.
  4. Shop from a list — no impulse buying.
  5. Buy more low calorie foods.
  6. Buy fewer high calorie foods in smaller quantities.

Pantry tips for parents:

  1. Keep high calorie foods out of sight. Better yet, don’t buy them at all.
  2. Low calorie foods are kept in plain sight and are easily accessible.

Meal serving tips for parents:

  1. Don’t offer second helpings.
  2. Don’t even make second helpings. make just one portion per person of high calorie foods.
  3. Put food on the plate in the kitchen, rather than serving the food “family style” at the table. This controls your child’s portion sizes.
  4. Don’t say anything about “cleaning your plate.”
  5. Encourage conversation at meal times. This will slow down the rate of eating.
  6. Put food on smaller dishes and glasses so they don’t seem so small.

Miscellaneous tips for parents:

  1. Don’t use food as a reward or punishment.
  2. Maintain a list of activities, privileges, and small rewards to reinforce your child and praise his/her efforts to change eating and exercise behaviors regularly.
  3. Take lunch to school whenever possible. Discourage buying snacks at school — these tend to be sodas, chips, and candy bars.

Meal time tips for children:

  1. When you eat, eat only at the kitchen table.
  2. Never eat while doing anything else, such as computer games, TV watching, etc.
  3. Schedule meals and snacks ahead of time. No impulse eating!
  4. When wanting to snack, have sugarless gum, a glass of water, or diet soda instead.
  5. Don’t take second helpings.
  6. Put down the utensils and food between bites. This slows down how fast you eat.
  7. Stop eating BEFORE you feel full.
  8. Write down foods eaten every day in a diet diary. A week’s worth of information can be valuable in assessing — and changing — eating patterns.

Exercise tips for children:

  1. Exercise to burn 50 extra calories per day 3-4 times a week.
  2. Consider buying a pedometer (about $15) and setting goals to exceed a certain hundred number of steps per day.
  3. Write down exercise every day in an exercise diary.
  4. Limit TV, video, and computer games to a maximum of one hour per day.
  5. If you’re having trouble limiting TV time, consider making the TV room a little less comfortable. Some families move the TV to a small, stuffy room to prevent overwatching. Other families have moved the TV couch out of the room so the only place to watch TV is sitting on the floor.

For further reading:

Child of Mine: Feeding with Love and Good Sense by Ellyn Satter. A nutritionist describes a structured eating program to help your child lose weight. Price: about $12.

Healthy diet questionnaire

Posted on by
Suzanne Berman, M.D.

Completing this diet questionnaire and reviewing it with your physician or dietician will help us make suggestions to improve your child’s diet. After completing this questionnaire, we recommend you keep a one-week diet diary for a “reality check” to see what your child is really eating.

How often does your child eat:
  • Fried foods such as hamburgers, french fries, or fried chicken? __ times a week
  • Snack foods such as potato chips, tortilla chips, pretzels, Cheetos, etc? __ times a week
  • Sweet treats like candy and chocolate? __ times a week
  • Fruits and vegetables? ______ times a day
  • What kinds of fruits does he/she like?
  • What kinds of vegetables does he/she like?
How much does your child drink in a day?
  • Soda pop: __ cans a day of regular soda
    __ cans a day of diet soda
  • Milk: ______ ounces a day
  • Juice: ______ ounces a day
  • Water: _______ ounces a day
  • Other: _______ ounces a day

If you are having trouble answering these questions, you may not really know what your child is eating, and how much.

Do herbal remedies for kids work?

Posted on by
Suzanne Berman, M.D.

Herbal and “natural” remedies have been available for thousands of years. Recently, there has been an increase in their popularity, availability, and use. Some doctors have embraced them and use them readily; other doctors are hesitant to recommend them. We are often asked where we stand on this important health issue. Here are three principles we look at when evaluating the use of any medication (not just herbals, homeopathics, or other remedies.)

Principle No. 1: First, do no harm.

In other words, medicines should be safe before anything else. This is especially important in children, whose bodies respond to medications of all kinds differently. Some remedies have been tested for safety in adults, but there have been very few studies documenting safety of herbals in infants and children. Even with “natural” remedies, it is still important to prove they’re safe. Remember that an adult dose can be 5 to 10 times a child’s dose. Also, while the herb itself may have been proven safe, other contaminants or materials in the herbal preparation may not be.

Principle No. 2: Good remedies can be proved effective in studies.

The best kind of study to test a medicine is called a “blinded placebo” study. Volunteers are randomly divided into two groups. One group takes the medicine to be tested; the other group takes a “placebo” (sugar pill). To avoid bias, neither group knows which medicine they’re taking. Both groups record changes in their symptoms. Finally, the outcomes of both groups are compared. If the medicine is truly effective, a significant difference should be seen between the medicine group and the placebo group.These studies can be hard to do. Enough people have to volunteer to make it worthwhile. (For example, it is better to compare two groups of 1000 people each then two groups of 10 people each.) The researchers doing the study shouldn’t have any financial interest in the results. False assumptions, or attempting to “compare apples and oranges,” can also produce flawed results. For the best proof, several studies over a period of years should all produce the same results.

Some herbal remedies have already been tested in this way, and more are being tested all the time. Some remedies look very promising, such as camomile tea for colic in babies. Other remedies haven’t stood up to the test, such as melatonin as a cure for ADHD. Still others have conflicting results, such as echinacea for colds.

You may be interested to know that many traditional medications commonly recommended for cold symptoms (Robitussin, etc.) haven’t stood up to this test either! (We are hesitant to recommend them for this reason.)

Principle No. 3: “Natural” isn’t necessarily the same thing as “safe”.

A good example is an herbal remedy that was touted for many years to produce relaxation and calming effects. Harvested from a plant, it was inexpensive and readily available. It was proved efficacious for relaxation and many people took it several times a day without any apparent side effects. By the 1940s, many doctors were even recommending this herb for their patients. It wasn’t until the herb had been in use for 400 years in this country before doctors finally realized its devastating side effects. The herb in question, of course, is tobacco, and even today we continue to discover its implications in ill health.

More recently, in June 2009, the FDA advised consumers to stop using Zicam, a homeopathic cold remedy, because it can cause permanent loss of smell. Its manufacturers never sought FDA testing or approval before it was marketed.

In summary, some herbal remedies may indeed be effective for some of common problems of children. A few herbals (like camomile) have been shown safe and helpful, and we can recommend those enthusiastically. However, studies for most herbals in kids just haven’t been done yet. Until then, we won’t feel comfortable recommending them. If you do choose to treat your child with herbal remedies, please let us know when we ask, “Is your child taking any medications right now?”

If you have questions about a specific herbal remedy, let us know. We can look up the most up-to-date research on that herbal together.