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.