The UK Gets Tough on Parents

The UK is going to try a new tactic in the war against child obesity. The Guardian is reporting that the British government is starting a public campaign to educate parents as to the consequences of indulging their children with cookies, candies and soft drinks.

Most parents don't realize that the treat they are using as a reward for good behavior may be setting their child up for lifelong health problems, including high blood pressure, diabetes, and cancer.

The government will use graphic pictures of children suffering the effects that obesity has on a child's health, and directly links this with parental behavior.

This is a bold maneuver, one which I hope has the desired effect of creating an environment of social unacceptability of overindulgence in junk food.

Michael P. Scaccia, M.D., F.A.A.P.

The Obesity Tax

David Patterson, the Governor of New York, wrote a commentary on CNN.com justifying his recent proposal for an "obesity tax" on sugared drinks. He is proposing taxing all sugared drinks (not just sodas) in an attempt to dissuade consumption by children.

After reading his commentary, I kept thinking "This guy gets it." Until society starts to address the factors that lead to childhood obesity, we as health care providers are doomed to fail.

Our government needs to reflect an understanding of the negative impact of obesity, and make it a national priority to address the problem through legislation and fund appropriation. Banning soft drinks from the schools was a start. Taxing sugared drinks will also help. More work will need to be done, however, to stem the tide of rampant obesity, and it won't be easy.

A government can tax soft drinks and place a barrier to their consumption, but it is much more difficult to limit TV time for children, or mandate an hour of physical exercise per day. We must use other means to address these factors for a more comprehensive solution to the problem.

Until ignoring childhood obesity becomes socially unacceptable, we will continue to fight an uphill battle. We have only to look at societal progress in reducing tobacco consumption to see what is possible when we as a society put our minds to something.

Michael P. Scaccia, M.D., F.A.A.P.

Too Much TV is Bad for Children's Health

OK, so this isn't necessarily news, but a recent scientific study highlighted in this TIME magazine article is disturbing nonetheless.

A comprehensive look at the many different effects media has on our youth revealed that the more exposure there was, the greater the risk of childhood obesity, tobacco use, sexual behavior, drug use, alcohol use, low academic achievement and ADHD.

This study actually looked at hundreds of other studies and chose the most scientifically sound and put together their findings.

Let this be a reminder to continue to rein in countless hours in front of the TV. Get your kids up and moving - your family will be happier and healthier for it.

Michael P. Scaccia, M.D., F.A.A.P.

Diets and Kids: Does My Child Need to Lose Weight?

The roles of diet and nutrition in kids have become increasingly popular subjects in the last few years, with good reason. Child obesity is running rampant throughout the Western World and shows no signs of letting up.

Still, how does a parent know when it’s time to “put their child on a diet”?

The first thing a concerned parent should do is talk to their child’s doctor. What your physician will do is measure your child’s height and weight and compare them to other children their age.

Next, they’ll use those numbers to come up with a body mass index, or BMI, which they will again compare with other children their age. If a child’s BMI is higher than 85% of the other boys or girls their age, then that child is considered to be at risk for being overweight. A BMI over the 95th percentile means that the child is overweight.

Losing weight is not always the answer, believe it or not. As pediatricians, we will often tell parents that we don’t want kids to lose weight, but that we would rather see them not gain any more weight for a while, so their height can catch up to their weight.

Using diets are also something not typically recommended by most pediatricians. A diet usually has a beginning and an end. Instead of the latest fad, we would rather see children make adjustments to their lifestyle that will last a long, long time.

Your doctor should be able to provide you with some information, but you will probably have to learn more than what they will be able to explain to you in a short office visit.

Start educating yourself about healthy eating habits, and how to teach them to your children.

Learn how to read labels and make better choices when you go shopping.

Make sure that your doctor clears your child to start an exercise program, and integrate that with your nutrition plans.

Study the reasons why kids overeat and take steps to prevent that from happening.

Put everything that you learn into a comprehensive plan and check back with your physician from time to time to make sure you’re on the right track.


Michael P. Scaccia, M.D., F.A.A.P.

Trans Fats: What are they, and why you should avoid them

As of January 2006, the United States government has made it mandatory for all manufacturers to show trans fat content on the Nutrition Facts food label.

What are trans fats, and what role do they play in child nutrition?

Trans fats are made by manufacturing during a process called hydrogenation. Food manufacturers will add hydrogen to oils in order to increase shelf life and improve flavor stability.

You can find trans fats in foods such as vegetable shortenings, some margarines, crackers, cookies, snack foods, and other foods made with or fried in partially hydrogenated oil. You can also sometimes find trans fats occurring naturally in some meats.

It’s been well established that trans fat can increase LDL (bad cholesterol) and increases the risk for heart disease.

There is no daily recommended value for trans fats. Instead, the USDA recommends limiting trans fat intake to as little as possible.

You should always look at the Nutrition Facts food labels when shopping. Make sure that you try to keep foods with trans fats out of your grocery cart when possible, keeping an eye out for alternatives.

Don’t fry your foods. If you have to cook with oil, use canola or safflower oil which will be lower in saturated and trans fats.

Also, choose lean meats and fish to limit the amount of trans fats and saturated fats your family consumes.

Michael P. Scaccia, M.D., F.A.A.P.

Getting the Nutrition Facts at Restaurants

The nutrition facts at restaurants can be hard to come by if you don’t know where to look.

Most restaurants, especially fast food places, won’t just hand you a nutrition guide as you decide to order. You almost always have to request it specifically, and it will often take them a few minutes to track one down.

You can do a little research before heading out to some restaurants by visiting their website and looking over the nutritional information for their foods. Some even have information laid out in the same format as a nutrition facts label. There are also other websites dedicated to providing the nutrition information of choices at popular restaurants.

If you can’t find nutrition information, or you’re visiting a local restaurant that may not have that information readily available, you can keep the following points in mind:

Choose grilled or baked foods instead of fried

Instead of chicken nuggets, get a grilled chicken sandwich and cut it up. Choose a baked potato instead of french fries.

Go with fresh fruits or vegetables if possible

More and more restaurants are offering fresh fruit cups in place of fries. Take advantage of this!

Choose non-caffeinated, sugar-free drinks

Sugared drinks are one of the biggest sources of unnecessary calories. Restaurants are getting better at offering healthier choices of drinks, but sometimes you have to ask.

Michael P. Scaccia, M.D., F.A.A.P.

Decreasing Portion Size

The fewer calories and fat your child takes in, the more likely he will be able to achieve and maintain a healthy weight. This is a simple concept, but difficult to put into practice. There are several pitfalls that you want to avoid in cutting back on how much your child is eating.

It's important that you don’t promote a sense of deprivation. If your child feels like you are depriving him of something that he should have, he will only want it more. Eventually he will focus on attaining the “forbidden fruit” and all other principles will go out the window.

You want to try to adjust portion size in a slow and subtle manner. The more rapid and drastic a change you try to make to their dietary habits, the more likely you are to foster a sense of deprivation.

Don’t encourage skipping meals.

This is so important. It’s natural to think that an easy way to cut back on how much your child eats would be to skip breakfast or lunch. When you miss a meal, your sugar drops and your body sends you signals to correct the situation.

Hunger pains, headaches, and nausea are your body’s way of telling you to get something to eat. This will cause binging on snacks in between meals, and in the end wind up increasing the amount of calories and fat your child consumes.

Here are a few tips on decreasing portion size:


Don’t keep serving dishes on the table.

Put the food on their plate away from the table, preferably before your child sits down for their meal. Having the serving dishes in front of him sends a subconscious message that he should finish what he has because there’s more to eat.

Use smaller dishes and bowls.

This is a nice psychological tool that really works. Your child is more likely to overeat or feel unsatisfied when he sees a half-filled large plate than if he was given a completely filled small plate. Try this one on yourself!

Measure serving sizes once or twice a week.

It’s hard to measure serving sizes at every meal. This quickly becomes a chore and there is little chance you would do this long term. Measuring serving sizes occasionally is valuable so that you begin to get a sense as to how many calories and fat your child is consuming. It also gives you an idea as to what reasonable portions are in general.

Cut back slowly.

If your child is accustomed to having three servings of pasta, don’t take him right down to one. Take a little bit away at a time, and don’t do it right in front of him. Have his plate ready to go when he sits down at the table. Cut back too quickly, and he’ll feel deprived.

Michael P. Scaccia, M.D., F.A.A.P.

My Pyramid for Preschoolers

The U.S. Department of Agriculture recently added to its MyPyramid.gov site. The site, which has promoted healthy lifestyles for children for several years, has recently added content for children ages 2-5.

The site helps parents with everything from developing healthy eating habits to encouraging play and physical activity from a young age. There are sample meals and kitchen activities to make learning fun for parents and children alike.

For more information, click here to visit the MyPyramid.gov website for Preschoolers.

Michael P. Scaccia, M.D., F.A.A.P.

Halloween: Healthy and Safe

Halloween is this Friday, and the American Academy of Pediatrics has put together a tip sheet for parents to keep their little ghosts and goblins safe, happy, and healthy.

Click here to read the AAP Halloween Safety Tips.

Have fun!

Michael P. Scaccia, M.D., F.A.A.P.

New Vitamin D Recommendations

When I attended the American Academy of Pediatrics National Conference and Exhibition in Boston last week, the big news was about Vitamin D.

Vitamin D is essential in ensuring good bone development and a healthy immune system in both children and adults.

The American Academy of Pediatrics now recommends that all infants, children, and adolescents get 400 IU of Vitamin D per day, double what was previously recommended.

Breastfed infants should start receiving Vitamin D in the first few days of life. Children and teenagers should try to drink 2-3 glasses of milk per day, or use supplemental vitamins to achieve the 400 IU daily requirement.

For more information, click here for the parent FAQ from the AAP, and click here for the AAP press release.

Michael P. Scaccia, M.D., F.A.A.P.