CEDE Healthy Lifestyle

Our approach to care
In children who need lifestyle modification (reduce BMI, reduce weight, improve diabetes or prediabetes) we have the following approach
1. Initial appointment - Evaluation and Labs based on the child's need.
2. 2nd appointment - Medical Management followed by 6 Modules of lifestyle changes in families who are motivated and who need the care.
3. We do believe good change will come with the whole family making changes and following through on it with proper guidance and lab test done periodically, to have a lasting effect.

Nuestro enfoque de cuidado

En los niños que necesitan modificación del estilo de vida (reducir el IMC, reducir el peso, mejorar la diabetes o prediabetes), tenemos el siguiente enfoque

1. Cita inicial: evaluación y laboratorios según las necesidades del niño.

2. Segunda cita: Administración médica seguida de 6 módulos de cambios en el estilo de vida en familias motivadas y que necesitan atención.

3. Creemos que un buen cambio vendrá con toda la familia haciendo cambios y siguiendo con la orientación adecuada y pruebas de laboratorio realizadas periódicamente, para tener un efecto duradero.

About Child & Teen BMI

Acerca del índice de masa corporal para niños y adolescentes

BMI calculator


Current Dietary Guidelines

CHOOSE MY PLATE for children:


https://www.choosemyplate.gov/MyPlatePlan The MyPlate Plan shows your food group targets – what and how much to eat within your calorie allowance. Your food plan is personalized, based on your age, sex, height, weight, and physical activity level. 
https://www.choosemyplate.gov/plan-miplato El Plan de MiPlato muestra sus metas de grupos de comidas—qué y cuánto deber comer dentro de la cantidad de calorías recomendadas. Su plan alimenticio está personalizado, basado en su edad, sexo, estatura, peso, y nivel de actividad física. 

http://es.nourishinteractive.com/  SPANISH RESOURCE

Weight Control Information Network

http://www.nourishinteractive.com/ Nourish Interactive is your free one stop resource for fun nutrition games for kids, interactive nutrition tools and tips for parents and health educators to use to promote healthy living for the whole family. Created by nutrition and health care professionals, Nourish Interactive's nutrition education website gives children and families the knowledge and skills they need to make healthy choices.

USEFUL INFORMATION from Stanford - Lucile Salter Packard Children's Hospital,

Weight management for children and adolescents:

The basis of treatment for obesity in children and adolescents involves diet changes and exercise. It is important for parents and the adolescent to be ready and willing to make the change. Generally, weight loss is not recommended for babies and young children who are still growing and developing. The goal of treatment for these children is to maintain their weight while they continue to grow taller. Weight reduction may be recommended for obese adolescents who have completed their growth. The following are some of the general guidelines that may be followed in treating your child and adolescent:

For children under 2 years of age:
  • The goal is to slow down the rate of weight gain, not to lose weight.
  • Decrease the amount of juice to 4 ounces a day.
  • Limit the amounts of high-calorie foods, such as desserts, puddings, and ice cream.
  • Use a pacifier in-between feedings to help satisfy the child's need to suck on something.
  • See a nutritionist.
  • Monitor weight gain regularly.
For children between 2 and 7 years of age:
  • The goal for this age group is to maintain a baseline weight, not to lose weight. As the child grows taller, a slow decrease in weight may be noticed.
  • After the age of 2, it is permissible to reduce the amount of fat in the child's diet.
  • Increase the child's intake of grains, fruits, and vegetables.
  • Decrease the intake of high-calorie foods and desserts.
  • Use low-fat dairy products.
For children older than 7 years of age:
  • The goal is to maintain baseline weight initially, and then add slow changes in eating and exercise to achieve slow weight loss as recommended by your child's physician.
  • At this age, a child or adolescent should follow adult guidelines, and limit fat intake.
  • Eat a variety of foods that are low in calories. Consider the following:
    • Your child needs enough calories to maintain his/her energy level, but no more than he/she can burn off. This is called an energy balance.
      • If he/she takes in more calories than he/she burns, he/she gains weight.
      • If he/she takes in fewer calories than he/she burns, he/she loses weight.
      • If he/she balances the two, he/she maintains his/her weight.
    • Even when dieting, however, calories should not be cut back so much that your child's energy needs are not met. The number of calories your child needs depends primarily on age, gender, and activity level.
  • Decrease consumption of high-fat foods.
  • Eat more vegetables and fruits.
  • Eat less sweets, candy, cookies, chips, and sodas.
  • Change to skim milk.
  • Refer to support groups.

As a parent, what can I do to help manage obesity?

  • Do not use food as a reward. Use other activities as a reward for good behavior.
  • Have family meal time and snack times.
  • Provide only healthy options for your child to choose from. For example, stock in the refrigerator apples or yogurt, rather than cookies and pies.
  • Have the entire family become involved on a healthy eating plan, not just the child or adolescent who is overweight.
  • Encourage activities that promote exercise, such as riding a bike, walking, or skating.

Healthy Diets Overview

Eating healthy is an important part of a healthy lifestyle and is something that should be taught to children at a young age. The following are some general guidelines for helping your child eat healthy. It is important to discuss your child's diet with your child's physician prior to making any dietary changes or placing your child on a diet.
  • Eat three meals a day, with healthy snacks.
  • Increase fiber in the diet and decrease the use of salt.
  • Drink a lot of water.
  • Children under the age of 2 need fats in their diet to help with the growth of their nervous system. Do not place these children on a low fat diet without talking with your child's physician.
  • Eat balanced meals.
  • When cooking for your child, try to bake or broil instead of frying.
  • Decrease your child's sugar intake.
  • Eat fruit or vegetables for a snack.
  • For children over 5, use low-fat dairy products.
  • Decrease the use of butter and heavy gravies.
  • Eat more lean chicken, fish, and beans for protein.

Making healthy food choices:

The food guide pyramid is a guideline to help you and your child eat a healthy diet. The food guide pyramid can help you and your child eat a variety of foods while encouraging the right amount of calories and fat.

The United States Department of Agriculture (USDA) and the US Department of Health and Human Services have prepared the following food pyramid to guide parents in selecting foods for children 2 years and older.

The Food Pyramid is divided into 6 colored bands representing the 5 food groups plus oils:
  • Orange represents grains: Make half the grains consumed each day whole grains. Whole-grain foods include oatmeal, whole-wheat flour, whole cornmeal, brown rice, and whole-wheat bread. Check the food label on processed foods - the words "whole" or "whole grain" should be listed before the specific grain in the product.
  • Green represents vegetables: Vary your vegetables. Choose a variety of vegetables, including dark green- and orange-colored kinds, legumes (peas and beans), starchy vegetables, and other vegetables.
  • Red represents fruits: Focus on fruits. Any fruit or 100 percent fruit juice counts as part of the fruit group. Fruits may be fresh, canned, frozen, or dried, and may be whole, cut-up, or pureed.
  • Yellow represents oils: Know the limits on fats, sugars, and salt (sodium). Make most of your fat sources from fish, nuts, and vegetable oils. Limit solid fats like butter, stick margarine, shortening, and lard, as well as foods that contain these.
  • Blue represents milk: Get your calcium-rich foods. Milk and milk products contain calcium and vitamin D, both important ingredients in building and maintaining bone tissue. Use lowfat or fat-free milk after the age of two years. However, during the first year of life, infants should be fed breast milk or iron-fortified formula. Whole cow’s milk may be introduced after an infant’s first birthday, but lower-fat or skim milk should not be used until the child is at least two years old.
  • Purple represents meat and beans: Go lean on protein. Choose low fat or lean meats and poultry. Vary your protein routine - choose more fish, nuts, seeds, peas, and beans.
Activity is also represented on the pyramid by the steps and the person climbing them, as a reminder of the importance of daily physical activity.

According to the Dietary Guidelines for Americans 2005, a decrease in energy intake of 50 to 100 calories per day for children who are gaining excess fat can reduce the rate at which they gain weight. With this reduction in energy intake, they will grow into a healthy weight as they age. Help your child to find higher-calorie foods that can be cut from his/her daily intake.

Nutrition and activity tips

  • Try to control when and where food is eaten by your children by providing regular daily meal times with social interaction and demonstration of healthy eating behaviors.
  • Involve children in the selection and preparation of foods and teach them to make healthy choices by providing opportunities to select foods based on their nutritional value.
  • For children in general, reported dietary intakes of the following are low enough to be of concern by the USDA: vitamin E, calcium, magnesium, potassium, and fiber. Select foods with these nutrients when possible.
  • Most Americans need to reduce the amount of calories they consume. When it comes to weight control, calories do count. Controlling portion sizes and eating non-processed foods helps limit calorie intake and increase nutrients.
  • Parents are encouraged to provide recommended serving sizes for children.
  • Parents are encouraged to limit children’s video, television watching, and computer use to less than two hours daily and replace the sedentary activities with activities that require more movement.
  • Children and adolescents need at least 60 minutes of moderate to vigorous physical activity on most days for maintenance of good health and fitness and for healthy weight during growth.
  • To prevent dehydration, encourage children to drink fluid regularly during physical activity and drink several glasses of water or other fluid after the physical activity is completed.
To find more information about the Dietary Guidelines for Americans 2005 and to determine the appropriate dietary recommendations for your child’s age, sex, and physical activity level, visit the Online Resources page for the links to the Food Pyramid and 2005 Dietary Guidelines sites. Please note that the Food Pyramid is designed for persons over the age of two who do not have chronic health conditions.

Always consult your child’s physician regarding his/her healthy diet and exercise requirements.

Food Guide Pyramid for Young Children, USDA


Facts about children and exercise:

Exercise is an important part of keeping children healthy. Encouraging healthy lifestyles in children and adolescents is important for when they grow older. Lifestyles that are learned in childhood are more likely to stay with the child into adulthood. Changes in lifestyle are harder to make the older the person becomes. The best way to promote healthy lifestyles is for the whole family to become involved.

Establishing an exercise plan:

A daily exercise program can provide a way to share an activity with family and friends, while helping establish good heart-healthy habits. The following exercise guidelines for adolescents can help you and your child plan activities:
  • Children and adolescents need at least 60 minutes of moderate to vigorous physical activity on most days for maintenance of good health and fitness and for healthy weight during growth.
  • Parents are encouraged to limit children’s screen time (TV, video, and computers) to less than two hours daily and replace the sedentary activities with activities that require more movement.
Even low-to-moderate intensity activities for as little as 30 minutes a day can be beneficial. These activities may include the following:
  • pleasure walking
  • climbing stairs
  • dancing
  • home exercise
Regular, aerobic physical activity increases a child's capacity for exercise and plays a role in prevention of heart diseases. Aerobic activities are continuous activities that cause the heart rate to increase and cause the breathing rate to increase. Aerobic exercise may also help to lower blood pressure. To prevent dehydration, encourage children to drink fluid regularly during physical activity and drink several glasses of water or other fluid after the physical activity is completed. Examples of vigorous activities may include the following:
  • brisk walking
  • running
  • swimming
  • cycling
  • roller skating
  • jumping rope
  • playing on the playground
  • dancing
  • gymnastics
  • hiking
  • soccer
  • tag games
Exercise on a regular basis is part of a healthy lifestyle. However, some children can exercise too much. If your child begins losing weight and falls below his/her normal growth patterns, or if exercise interferes with other normal activities and school, consult your child's physician.

For children and adolescents, daily exercise may help prevent conditions such as obesity, high blood pressure, poor cholesterol levels, and poor lifestyle habits that may lead to heart conditions later in life.

Benefits from regular exercise or physical activity:

The following are just some of the benefits that regular exercise or physical activity provides:
  • improves blood circulation throughout the body
  • keeps weight under control
  • improves blood cholesterol levels
  • prevents and manages high blood pressure
  • prevents bone loss
  • boosts energy level
  • releases tension
  • improves the ability to fall asleep quickly and sleep well
  • improves self-image
  • helps manage stress
  • counters anxiety and depression
  • increases enthusiasm and optimism
  • increases muscle strength

The information on this Web page is provided for educational purposes. You understand and agree that this information is not intended to be, and should not be used as, a substitute for medical treatment by a health care professional. You agree that Lucile Salter Packard Children's Hospital is not making a diagnosis of your condition or a recommendation about the course of treatment for your particular circumstances through the use of this Web page. You agree to be solely responsible for your use of this Web page and the information contained on this page. Lucile Salter Packard Children's Hospital, its officers, directors, employees, agents, and information providers shall not be liable for any damages you may suffer or cause through your use of this page even if advised of the possibility of such damages.

http://www.healthykids.nsw.gov.au/ :
The new Healthy Kids website provides information, resources and ideas on physical activity and healthy eating for children and young people

See the following in : http://www.dukechildrens.org/services/nutritional_disorders_and_obesity

5-3-2-1 Almost None!!
5: Fruits and vegetablesEnglish [PDF, 302KB] Spanish [PDF, 44.7KB]
3: Structured mealsEnglish [PDF, 63.7KB] Spanish [PDF, 28.5KB]
2: Hours or FEWER of "screen time"English [PDF, 215KBSpanish [PDF,183KB]
1: Hour or MORE of being activeEnglish [PDF, 111KBSpanish [PDF,92.6KB]