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Expert Q&A

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How can we tackle my 10-year-old's weight problem?

Asked by Julie, Texas

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My 10-year-old daughter struggles with her weight. We have been told by our family doctor that she is "off the charts" on weight. She is currently 4 feet 6 and weighs 105 pounds. We walk 2-3 miles several times per week; I also try and provide healthy meals, etc. We have had her thyroid checked; her blood-work all came back normal. I am curious on how many calories she should have daily to try and guide us on how much she should be eating. Any useful tips would be greatly appreciated.

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Diet and Fitness Expert Dr. Melina Jampolis Physician Nutrition Specialist

Expert answer:

Hi Julie -- With almost one in three children today overweight or obese, you are not alone in your struggle and in your concern for your daughter. Childhood obesity is an important predictor of adult obesity and has been associated with an increased risk of type 2 diabetes, high cholesterol, and psychosocial issues. While I strongly believe that public policy changes are critical to combat this growing epidemic, the American Academy of Pediatrics has released an extensive set of guidelines that may help you.

Your goal for your daughter at this age should be geared more towards weight maintenance rather than weight loss, allowing her to grow into her weight as she ages and her height increases. If she does lose weight, the AAP suggests that weight loss for children aged 2-11 be no more than 1 pound per month and older children should lose no more than 2 pounds per week. It is critical that adopting a healthy lifestyle become a family affair, as it appears you are doing by promoting regular walking and healthy meals. Avoid overly restrictive behavior or making your daughter feel punished or deprived from the things that the rest of the family enjoys. Here are a few more tips from the AAP guidelines along with a few of my suggestions for implementation.

1. Aim for at least 60 minutes of supervised active play per day. Ideally, 30 minutes of this would be done at school. Try to make home activity fun -- whether it involves dancing around the living room to her favorite music, ping pong or playing with a Hula Hoop or jump rope. Whenever possible, plan active family outings like mini-golf or bowling instead of movies and dinners out. Team sports may be intimidating for an overweight child, so try to find an activity or sport in which your daughter might feel more comfortable like tennis or even just riding her bike around the neighborhood.

2. Limit TV time to less than 2 hours per day and make sure there is no TV in her bedroom. There is a significant association between television viewing and childhood obesity, especially when TV viewing displaces physical activity.

3. Make sure she consumes at least five servings of fruits and vegetables per day. Include fruits and veggies in snacks and meals whenever possible but limit high fat-toppings and sauces such as cheese and butter. One easy way to increase vegetable consumption, particularly in children who don't love vegetables, is by incorporating them into dishes that include lasagna, pasta salads, soups, omelet, and stir fry. There are a several good books out that feature creative ways of sneaking in fruits and veggies into kids meals including "The Sneaky Chef" and "Deceptively Delicious."

4. Limit sugar sweetened beverage and fruit juice consumption, as much as possible. If you do allow fruit drinks, make sure that they are 100 percent fruit juice and limit her consumption to no more than 8-12 ounces per day. If you want to get creative, try making fruit "spritzers" with 2 ounces of juice and 6 ounces of sparkling water. To make them even more fun, you could even include fruit juice-flavored ice cubes (make sure cubes are diluted with regular water so you don't add too much more juice).

Hope some of these suggestions help and best of luck. Just being aware of the problem and the need for intervention sooner rather than later is a step in the right direction.

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