The South Beach Diet Supercharged: Faster Weight Loss and Better Health for Life (12 page)

In
Chapter 6
, I discussed the relation of belly fat to prediabetes and diabetes in adults. But what about in children and adolescents? As noted earlier, there’s no question that both abdominal fat and body mass index (BMI) have been on the rise in our kids. And studies show that while both are predictors of high blood pressure in childhood, abdominal fat may be a stronger predictor than general obesity. Both belly fat and high blood pressure are criteria for the diagnosis of prediabetes. And just as prediabetes is an important predictor of heart disease in adults, so it is becoming a predictor of heart disease in children. In fact, the Princeton Lipid Research Clinics Follow-Up Study, published in August 2007, has demonstrated this relationship. In the study, researchers showed that metabolic syndrome diagnosed in children ages 6 to 19 predicted heart disease 25 years later.

The Exercise Connection

While a poor diet has clearly caused big trouble for our children, the problems have only been compounded by their lack of exercise. When I was growing up, the after-school period was almost exclusively for sports and other physical exercise. We came home and played pickup baseball, basketball, or football. We rode our bikes around the neighborhood. Later we played intramural sports and then freshman, junior varsity, and varsity sports. And the pickup games never stopped. Nearly everyone participated.

Today, it seems that when kids go home after school to play a sport, it’s only their fingers that are getting exercised—the athletes are the players in a video game! Worse yet, kids are sitting on the couch eating potato chips and watching TV or slouched in front of a computer surfing the net. A 2006 study published in
Pediatrics
reported that from the age of 2, on average, a child spends up to 3 hours a day watching television. Combined with the additional time spent playing video games or working on home computers,
the average child could spend up to 8 hours a day sitting in front of a screen!

The decrease in exercise is so obvious that I don’t think I need to cite many more statistics, but let me just mention one: The Centers for Disease Control and Prevention (CDC) reported in 2002 that 61 percent of children ages 9 to 13 did not participate in any organized physical activity during nonschool hours. Does this lack of exercise contribute to overweight school children? Clearly, yes. But luckily, studies also show that kids who do more physical activity gain less weight from childhood into adolescence.

It’s important to understand that exercise is an antidote not just to obesity but to nearly all the health problems we’ve discussed. Exercise improves insulin resistance, lowers blood pressure, and decreases belly fat. It helped cure Theodore Roosevelt’s asthma (he lifted weights; did gymnastics daily; and studied wrestling, boxing, and judo), and it helps kids with asthma today. It also seems to improve behavior and academic performance. In fact, new studies show that exercise actually increases the growth of brain cells and perhaps gives new meaning to the concept of the scholar athlete. And while I am not sure that it can accurately be measured, I am convinced that sports participation, both formal and informal, builds character by teaching invaluable lessons such as teamwork and how to win and lose.

Turning Things Around

Many of you might be thinking,
of course we know that exercise is good for kids
. I certainly thought so and was surprised to learn that in Florida and across the United States, less time than ever is devoted to physical education in schools. This trend may be partially due to schools devoting more time to preparation for standardized statewide tests. I have found all this very discouraging because I am convinced children will do better on tests if they exercise during the day. Fortunately, in Florida, Governor Charlie Crist recently led the charge to pass legislation requiring at least 30 minutes of school exercise daily.

Frankly, I could go on for hundreds of pages documenting the benefits of healthy nutrition and exercise for children, not to mention the present and future costs to America if we don’t begin effective programs soon. But I trust you’ve gotten the message and I’ll spare you all that extra reading.

If You Teach Them, They Will Eat…the Right Way

The challenge now is how to stem the tide of childhood obesity and do it in an affordable manner. One approach that I have long felt would impact the majority of American children is to change the food service and nutritional education offered in public schools. Many studies have suggested that if you feed children high-fiber, low-glycemic foods, they will be less hungry and consume less. One such study performed in Oxford, England, was reported in the journal
Pediatrics
in 2003. Children were given a test breakfast for 3 consecutive days, consisting essentially of a high-fiber bran-type cereal with milk or a low-fiber flake-type cereal with milk. Juice was also served. The children were allowed to eat as much as they wanted from a buffet for lunch, and the amount they consumed was recorded by observers who didn’t know what the children had eaten for breakfast. The children who got the high-fiber breakfast ate less at lunchtime and felt more satisfied.

Based on these types of studies, the Agatston Research Foundation began implementing a holistic nutrition and lifestyle intervention program in Florida public elementary schools more than 3 years ago. It’s known as the Healthier Options for Public Schoolchildren (HOPS) study. As of this writing, this program has included more than 15,000 children. Led by research director Danielle Hollar, PhD, with nutritional assistance from our registered dietitian, Marie Almon, MS, RD, the study began by creating breakfast, lunch, and extended-day snack menus in the intervention schools. Each menu included more nutrient-dense, higher-fiber options, while reducing saturated fats and sugars.

Let me tell you, this was not easy. School food-service staffs had to learn new processes for ordering, acquiring, and preparing these foods, and without their willing participation, our program would never have gotten off the ground.

But as every parent knows, simply offering healthier foods isn’t enough to get a child to eat them. Also needed is an education and lifestyle curriculum that teaches why the foods are healthy, as well as hands-on programs like tastings and school gardens. Not only did we add these elements, we also arranged for assemblies and stimulating classroom materials to teach children about the impact of nutrition on their health. In addition, we encouraged physical activity, as much as the daily schedule allowed.

From our HOPS experience, we have learned that elementary-age children will absolutely embrace healthy foods. Two years into the program, we can declare HOPS a success story. During the 2005 school year, the children in HOPS intervention schools showed an improvement in BMI, compared with kids at schools with the standard cafeteria program. Remember, our goal was not weight loss—children who are growing should be gaining weight—but, rather, development at a healthy, normal level of growth.

We’ve also had some very positive feedback from teachers who’ve told us that they’ve noticed an improvement in students’ behavior and concentration. And we’re hearing from parents that the kids are now asking for raw vegetables, fruits, and whole-grain breads at home!

There is good reason to expect that when children consume higher-fiber, lower-glycemic-index foods, they will be less hungry and less obese.

Today many schools of public health, pediatricians, nutrition organizations, the USDA, and food celebrities are getting involved in the fight against childhood obesity. And we applaud this. It is through broad communication and by creating evidence-based solutions that we will begin to turn the tide against this dangerous epidemic.

The Take-Home Message

It is clearly time for parents to take a good look at what their kids have on their plates. Regardless of a person’s age, the optimal diet is one that contains whole grains, fresh fruits and vegetables, lean protein, good fats, and plenty of fiber. These are the basic eating principles of the South Beach Diet, and they are family friendly. The problem is, kids are not getting the foods they need to thrive. Like their parents, most children are eating a steady diet of nutrient-deficient, highly processed foods that are high in sugar and saturated and trans fats—and very low in fiber. And they’re washing it all down with a glass or two of sugary soda. If I were to set out to design a diet to promote heart disease and diabetes, I couldn’t do a better job.

I’m not advocating that an already overworked parent needs to prepare a special meal for every member of the household, but no extra work is required to make a sandwich with whole-wheat bread instead of refined white bread, or to make spaghetti using whole-wheat pasta instead of white, or to offer a piece of fresh fruit instead of chocolate cake for dessert. It’s just as easy to buy a prepared salad at a salad bar as it is to pick up a far less healthy meal at a fast-food restaurant.

Fortunately, many food manufacturers have caught on to the problem of childhood obesity and are now offering healthier versions of prepared foods that kids actually like. For example, several brands of breakfast cereal are lightly sweetened and high in fiber. These are much better choices than highly sweetened cereals that quickly raise blood sugar. In the frozen-food case, you can buy pizza with a high-fiber crust topped with nutrient-rich vegetables. This is a much better choice than a conventional frozen pizza topped with full-fat cheese and fatty pepperoni. For dessert, there are now plenty of low-sugar and trans fat-free options.

Recent studies show that kids—just like their parents—eat lots of meals outside of the home. When they go to friends’ houses or hang out at fast-food restaurants after school, they will be exposed to junk food. This is unavoidable, but it’s not cause for alarm. If your child is eating nutritiously most days of the week, an occasional order of fries and a soda isn’t harmful. Just like adults, kids need to learn how to make good lifestyle choices most of the time. But it’s up to parents (and teachers) to give them the right guidance.