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Catch ’em young

Even though Callinicos is working with students as young as kindergarten, Elizabeth Reifsnider, APRN, PhD, believes the obesity problem can be traced back to habits set as babies and toddlers. An associate professor at the University of Texas Health Science Center at San Antonio, Reifsnider decided to research obesity among children aged 2 to 4.

“I’d like to prevent children from becoming obese because once they are overweight, it’s harder to lose weight than if they don’t start off heavy,” she said. “The older someone is, the harder it is to lose weight.”

With grant money from the National Institutes of Health and the Texas Department of Health, she started studying toddlers who had a BMI in the 95th percentile or higher. She discovered that many of the children had cavities along with being obese. Based on surveys from the mothers, she believes many of these children had sweetened beverages in their bottles, such as soda. These toddlers would carry their bottles throughout the day and sip on high-calorie drinks.

Reifsnider also discovered that the more hours the toddlers watched television, the heavier they were.

“I also found that the longer mothers breastfed, the less likely their children were to be obese,” she said. She attributes this to the fact that a nursing baby fills up and then doesn’t eat again until the next meal, while a baby who has a bottle can snack throughout the day.

Mothers who were strongly directive about feeding also tended to have heavier children. Rules like “You must clean your plate” or “You can’t eat dessert until you eat your vegetables” taught the children to ignore their own sensations of fullness, Reifsnider said.

Although all of these parenting behaviors influenced the likelihood of childhood obesity, the heaviest association was when parents were obese. “Some of it may be genetics, but it could also be the way a family cooks,” Reifsnider said. “I’m seeing it as a family issue, and the whole family has to change their activity level and cooking habits.”

She encourages families to try simple changes first, such as switching to low-fat milk and diet drinks, and consuming more water instead of sweetened beverages. She also advises families to limit fast-food trips to perhaps once a week.

For some families, changes like this may seem monumental when juggling the stresses of working and parenting, but Luna has seen the payoffs of making these adjustments.

During the Stanford program, she lost more than 10 pounds and her stepson, who was 12 at the time, also lost weight. Now, he’s a 19-year-old college student who exercises regularly and makes informed choices about what he puts into his mouth, Luna said. She also shares his joy when he expresses the high he feels when finishing first during a running exercise in his health-conditioning class.

Five years after her stepson finished the class, Luna volunteered to be a facilitator for the program. She understands what many parents may feel, and how important it is for them to guard their alliance with their children, even when the barriers seem insurmountable.

“Our society is so thin-conscious that you can almost be prejudiced against overweight children,” she said. “It’s important to realize where you are starting from, and all of the emotional issues that affect how we eat. I tell them to take it step by step, and sometimes it will be a faster journey, sometimes slower.”

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