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February 2005
 
 
Shape Up America! Newsletter

Greetings!
FEBRUARY -- NOT TOO LATE TO PUT YOUR HOUSE IN ORDER

START WITH A CLEAN SWEEP
We know that January is the month of New Year's resolutions, but February is not too late for starting over. Now is as good a time as any to clean out your refrigerator, freezer, pantry and kitchen cabinets. As you consider the "temptation rating" of each food, ask yourself the following question and give yourself an honest answer. Is this a food I overeat once I taste it? If the answer is yes, then that food is a "red light" food.

If you live alone, now is the time to get rid of all red light foods in your home. If you live with others, this is an opportune time to sit down and explain why you need to eliminate red light foods from your home. Maybe the people you live with will have red light foods of their own. Be prepared to compromise. Your goal is to devise a strategy that will work for everyone. One idea is for everyone to agree they will purchase red light foods outside the home and not bring them home. Another idea is to mutually agree on special occasions (such as holidays or birthdays) to purchase red light foods in small quantities and bring them home for the purpose of eating them on that special day only.

No matter where you encounter red light foods, the idea is to consume them rarely. How often is "rarely"? Start out by considering "rarely" as no more than once a month. Rather than cutting them out altogether, the goal is to eat red light foods occasionally so that you don't feel deprived. Remember when you do purchase red light foods, purchase just enough so that everyone at the table can enjoy one small serving with no leftovers.

FOR WEIGHT MANAGEMENT -- THE KEY IS PORTION CONTROL FIRST AND BECOMING MORE ACTIVE (BUT LATER)
We suggest you take it in order. Focus first on regulating your food intake, choosing smaller portions and making wiser food choices. After you feel you have mastered the portion control issues (this can take several months for most people), you can begin to focus on physical activity. Why? Because if you are significantly overweight and out of shape, physical activity can be hard on your joints - especially your knees, hips, ankles and feet. It will be easier on your body if you take a few pounds off first. That is why we recommend you learn the principles of portion control first. If you are confused about what a serving is, now is the time to check out two tutorials on the Shape Up America! website [www.shapeup.org]. One tutorial focuses on portion control and the other teaches you about how to read a food label. You will find those tutorials in the "Members Only" section of the Shape Up America! website. We encourage you to check them out as soon as possible.

If you are ready for more physical activity, a small investment (less than $30) will buy you a pedometer that will count steps for you. You should start out by conducting your own personal survey of your activity levels. To do this, you should wear your pedometer for several weeks. In a journal or personal diary, make a note at the end of each day of how many steps you took that day. Your pedometer must be securely attached to a belt or firm waistband in order to work properly. Take two or three weeks of baseline information so that you have a good picture of how many steps you customarily take each day before you start "stepping out." Take an average of the steps you take each day. That number will be your own personal baseline. Then you should set a daily step goal for yourself that is 500 steps above your baseline - and keep that goal for several weeks until you are confident that it feels comfortable for you and you are ready for more. Keep in mind that you should increase your steps by a small increment - adding 500 steps is a good number - approximately every two weeks. Don't go overboard because you will get discouraged if you pull a muscle or injure yourself. For more information, check out the Shape Up America! website and read the step by step procedure to reach the goal of 10,000 steps a day.

ARE YOU WATCHING TOO MUCH TV?
Look for alternatives to TV viewing and other forms of sedentary entertainment. The goal is to get you out of your chair and moving. Go for a 10 minute brisk walk for each 20 minutes of TV viewing. Limit your TV viewing to no more than two hours a day.

Preventing Childhood Obesity
What's a parent to do ???
MONITORING HEALTHY GROWTH BY TRACKING BMI PERCENTILE

Starting at birth, parents should insure their baby's health care provider uses the pediatric growth charts to monitor the growth and development of their baby. Starting at the age of two, parents should ask that a historical record of their child's BMI Percentile be started and regularly updated throughout childhood. Visit the Shape Up America! pediatric BMI Percentile calculator at http://www.shapeup.org/oap/entry.php to learn about an automated system that makes it all easy.

What is BMI Percentile? A child's BMI Percentile offers a way to compare the growth of your child to the growth pattern of a large population of healthy children of the same age and sex. The pediatric growth charts were derived from and apply to children of all ethnicities. All children should be measured (both height and weight) and BMI evaluated at least yearly.

The BMI is then plotted on the growth chart to determine the BMI percentile for that child. For example, a child may be fairly steadily tracking at the 50th percentile for several years in a row. Then he or she may jump up to the 75th percentile, which may indicate a problem. A significant change in a child's BMI percentile may signal a need for intervention. This should be verified by a properly trained and qualified health care professional.

If intervention is determined to be appropriate, the intervention that is recommended should involve the entire family and all caregivers (grandmothers, sisters, fathers, etc.) who play a role in shaping the feeding habits and activity levels of the child. There is no need to target the overweight child directly for the purpose of weight management. Targeting the entire family is less stigmatizing and traumatic for the child, as well as more effective in the long run.

1. Institute of Medicine. 2005. Preventing Childhood Obesity: Health in the Balance. Washington, DC: The National Academies Press, See pages 360 and 361.

ACTIONS SPEAK LOUDER THAN WORDS
Parents/Caretakers are the role models for the eating behavior of their children. That means that the food and beverage choices of parents/caretakers represent the single most important influence on young children's food preferences and choices. To help children learn to regulate their own intake in a healthy manner, parents/caretakers should:
  • Allow children to determine their own portions at meals.
  • Encourage children to pay attention to their own internal signals of fullness
  • Permit children to decide when they have finished eating a meal. Do not insist on "cleaning the plate"
  • Avoid using food to manipulate the mood or behavior of children. For example, avoid using food (such as candy or ice cream) as a reward. This practice dissociates eating from hunger and clearly establishes preferences for those foods used as rewards.
  • Make fruits and vegetables readily available in the home to encourage selection of these foods as snacks and desserts.
  • Limit calorie dense snacks and sodas of low nutritional quality
  • Offer smaller portions of foods and encourage going back for seconds if still hungry. 4

LIMIT RECREATIONAL "SCREEN" TIME (TV, ETC.)
Recreational screen time includes more than just TV viewing. It includes the viewing of movies, DVDs, video games, gameboys, and other forms of "screen time." TV viewing by infants and toddlers should not be permitted. Removing the television from bedrooms and reducing all forms of recreational screen time to less than two hours a day can help prevent obesity. If parents/caregivers have a TV in the bedroom or watch more than two hours of TV each day, this is sending the wrong message to children. Remember that your actions speak louder than words.

2. See Golan et al. American Journal of Clinical Nutrition 1998; 67(6):1130-1135 3. See pages 358-359 in Preventing Childhood Obesity: Health in the Balance (Ref. 1) 4. This list is taken from page 347 in Preventing Childhood Obesity: Health in the Balance 5. See page 353-357 in Preventing Childhood Obesity: Health in the Balance

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