Positive approaches to healthy eating and kids

If you had a choice, which conversation would you rather have with your children? The one about the birds and the bees? The one about saying no to drugs? Or the one about them needing to lose weight?

According to a new study by WebMD and Sanford Health called "Raising Fit Kids," parents find the idea of the weight talk the most daunting. "Most parents are aware that it's just a very sensitive subject and they're just afraid to," says Maureen Shannon, a school psychologist with Nassau County BOCES who also runs the group discussion for Healthier Tomorrows, a Huntington-based, multidisciplinary weight-management program for children 9 to 16.

But even kids who aren't yet overweight can benefit from discussions about healthy eating habits. Area experts suggest the following ways parents can bring up the topic in a positive way and encourage their children on the road to better health:

DENIAL AND FEAR

The biggest reason some parents don't talk to their kids about being overweight is because they are in denial, according to the study. "When we're looking at someone we love, we often don't see them as they really are," says Dr. Joanna Dolgoff, pediatrician and a child obesity specialist who runs the Red Light, Green Light, Eat Right program with nine locations on Long Island.

You can determine with black-and-white numbers whether your child is at a healthy weight, says Susan Bartell, a Port Washington psychologist specializing in fitness, body image and weight loss for kids and teens and a WebMD contributor. Plug your child's height, weight and age into BMI calculator -- you can find one at apps.nccd.cdc.gov/dnpabmi. If your child is in the 85th to 95th percentile, he's overweight; 95 to 99 is obese; above 99 is morbidly obese, Dolgoff says.

Some parents also worry that bringing the topic up with a child might trigger an eating disorder, Bartell says. "Eating disorders are very, very complicated," Bartell says. "They don't come from you having positive conversations with your child about eating better."

Overweight children already know they are overweight, Dolgoff says. "Even if you're not talking to them, the kids on the playground are, and chances are they're not being very nice," Dolgoff says.

STARTING THE CONVERSATION

"How should parents talk to children about weight? In a nutshell, very delicately," Shannon says. Though it may seem counterintuitive, don't focus on the scale. "When you weigh kids, they get fixated on the number," Bartell says. Instead, talk to all your children about a family effort to be more healthy, all the experts interviewed say.

"You want to make sure you use the word 'we,' " Dolgoff says. "Even if you are a thin parent, you might not have the best eating habits in the world. Even thin children shouldn't be eating cupcakes every day. Even thin people get heart attacks and strokes. I would not give one kid a cupcake and one kid a carrot stick."

Don't make it a sit-down talk, but rather incorporate an ongoing discussion into different moments of your life, the experts advise. You do need to give the kids a heads up that things will be changing, Dolgoff says. "Don't all of a sudden say, 'We're having vegetables instead of French fries today,' without telling them why. They get angry," Dolgoff says. You'll need to be a role model and adopt healthier habits as well.

TURNING TALK TO ACTION

Take advantage of moments. When the kids ask yet again to go through the drive-thru, don't be angry or yell. Be firm and consistent. "Say, 'We've been eating a little too much fast food lately.' Suggest going home to whip up something from the fridge," Bartell says.

Go slowly. "If you make fast changes, your kids will rebel," Bartell says. Try substituting a bowl of fruit instead of a calorie-laden dessert, for instance. Bring the kids to the grocery store to show them labels and explain why one food choice is healthier than another. Prepare a meal together at home, Shannon suggests.

Praise results. "I like to praise habits, not weight loss," Dolgoff says. "Say, 'How great that you chose low-fat cheese over the brownie for a snack,' versus 'Wow, you lost five pounds.' "

ADD IN EXERCISE

While the federal Centers for Disease Control recommends at least 60 minutes of physical activity each day, Dolgoff says she's more realistic about what kids can fit in, opting to encourage at least 45 minutes four times a week. Some kids are exercising only in gym class. "That's just not enough," Shannon says.

Exercising is more than just getting on the treadmill. Choose a family activity such as biking or hiking, which can also encourage family bonding, Shannon suggests. And cut down screen time to carve out time to play.

Make sure your child is getting at least nine hours of sleep a night, Bartell says. When they're tired, they won't exercise and they're more likely to turn to comfort food, she says.

SOME "DON'TS"

Don't have children formally "diet." Kids need a range of foods and nutrients, and they don't need drastic calorie reduction to start losing, Bartell says. If you make them diet, they'll sneak food when you aren't around and they'll binge at friends' houses, she says.

Never reward their progress with food, Bartell says. "The reward is you start to feel good, you feel more energetic."

For more advice for your kids, have them visit fit.webmd.com, a new online resource for kids ages 2-18, part of WebMD and Sanford's new Fit initiative. They've also got a site to help parents: webmd.com/raisingfitkids.

Weight management programs for kids

Healthier Tomorrows is a three-month nutrition and exercise program for children 9 to 16 run by Huntington Hospital, Dolan Family Health Center and Huntington YMCA. $150. 855-855-4448

Red Light, Green Light, Eat Right is a 12-week program dividing foods into groups so children learn to eat well. Run by pediatrician Joanna Dolgoff at nine locations; covered by many health plans with regular co-pays per weekly visit. 516-801-0022.

Healthy Kids is a 10-week program operated by Winthrop University Hospital, 516-663-3919.

Fit Kids For Life is a 10-week program for children 8 to 18 run by pediatric cardiologist Peter Morelli at Stony Brook University Hospital. (631) 444-KIDS.