1. Diet and Lifestyle Changes Begin at Home Family based change Cara Karner MS, RD, LD, CDE Catherine Robinson MS, RD, LD, CDE

2. Table of Contents Statistics on Weight Increases in Children Key Components for Weight Loss Family based changes Behavior Modification Healthy Eating Increased Activity Summary

4. Prevalence of Obesity in U.S. Children 2-19 Years of age

7. Family Based Change

9. Stages of Change Pre-contemplation Contemplation Preparation Action Maintenance

10. Lack of Role Models- Parents & Professionals “Do as I say, not as I do. The new epidemic of Childhood obesity.” “Children need models rather than critics.” –Joseph Joubert, French essayist (1752- 1824) McCrindle BW. Can Fam Physician. 2006 Mar;52:284-5, 292-3.

11. Role Modeling Families that play together stay together. –Reserve at least ½ day of each weekend for family physical fitness Parents don’t have to be thin, but they must set a good example: –Participating in family activities –Reducing TV viewing Create an environment for active play both inside and outside the home. Southern et al, Trim Kids, Harper Collins, 2001

13. Obesogenic Families A study examined the self-reported physical activity and dietary intake patterns of parents and changes in weight status (BMI and skin folds) over 2 years in offspring. Girls (ages 5-7)with parents of high caloric intake and low activity levels (obesogenic) had significantly greater increases in weight status. Family environment may explain increased weight status in children over and above genetic susceptibility. Davison and Birch, Int’l J Ob 2002

14. Obesogenic Families Cntd A 4 year follow up study of the previous slide found: –The girls (now ages 9-11)of the obesogenic families had higher BMI’s, percent body fat diets higher in fat higher TV viewing levels Than daughter’s of non-obesogenic families Note: results were independent of parent’s BMI Krahnstoever, Francis, et el Obes Res. 2005 Nov;13(11):1980-90

16. Parenting Influences Parental restriction of highly palatable food Using food as a reward Parental concern/ criticism of child’s weight Parental control of child intake Parental pressure/ encouragement to eat University of California, Berkeley Center for Weight and Health

18. To bring up a child in the way he should go, travel that way yourself once in a while. ~Josh Billings

19. Behavior Modification

20. For all Children: Early interventions are critical Physical activity is important, but is not enough Environmental changes are needed to foster healthy choices University of California, BerkeleyCenter for Weight and Health

21. What is Behavior Modification? Using proven techniques to improve behavior (positive/negative reinforcement) Changing diet for the whole family Changing exercise for the whole family Decrease screen time –The recommendation is less than 2 hours of screen time per day

26. Healthy Eating A Brief Summary

29. Research confirms that there is an optimal diet for prevention of pediatric overweight Moderate calorie intake by watching portion sizes and selecting foods low in energy density Limit fat intake, especially saturated fat Choose foods high in fiber Eat lots of fruits and vegetables Limit and choose carefully: fast/restaurant food Drink low fat milk and water; avoid sweetened beverages Eat breakfast University of California, Berkeley Center for Weight and Health

31. Increased Activity Have Fun!

36. What Ever Happened To? Riding your bike to school Recess at School Meals with your family around the table Raking Leaves Using the Stairs Playing outside until dinner Getting up to change the channel Getting out to raise the garage door

40. Summary Recording Behaviors Activity Healthy Eating Behavior Modification Family Based Change The above are proven ways to help fight against obesity

41. For More Information Contact our Member education department for a one on one appointment with a Dietitian (386) 676-7133 Other Resources –http://www.mayoclinic.com/print/childhood- obesity/FL00058/METHOD=print

42. “Just because you can’t do everything, it’s no excuse to do nothing.” ~Jacqueline Domac, Health teacher, Los Angeles