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The following Healthy Kids column originally appeared in the November 24, 2003 edition of the St. Louis Post-Dispatch.

Next to visits from Santa and Thanksgiving parades, one of the most exciting aspects of the holidays for children is the easy availability of cookies, cakes and other sweets. For some children the holiday season means loading up on goodies that are high in fat and sugars, and many parents find it hard to say no.

Parents owe it to their children to help control cravings for foods that are full of sugar and empty calories, particularly at a time when childhood obesity is at an all-time high. The American Academy of Pediatrics reports that more than 30 percent of America ’s school-age children are overweight.

This epidemic of childhood obesity comes with a high price, in terms of health problems when children are young and as they grow older. Among the health problems faced by overweight children are high cholesterol, high blood pressure, early heart disease, diabetes and bone problems.

Part of the blame falls on diets high in fast food and “junk” foods such as sodas and chips. Also to blame is a sedentary lifestyle, which is encouraged by television and video games.

“It’s not unusual to see a young person order a Double Whopper with cheese, supersize fries and a soda, but that single meal contains a 10-year-old’s entire daily allowance for calories.   A steady diet of fast food can be very harmful to a child’s healthy development,” says Chris Ohlemeyer, M.D., a physician in the Weight Management Program at SSM Cardinal Glennon Children’s Hospital. “When you combine that kind of food intake with a sedentary lifestyle, it’s not difficult to imagine the child developing weight and other health problems.”

Knowledge is key to helping parents control their children’s cravings for unhealthy sweets, particularly with the holiday season upon us. There are several things parents can do to help prevent childhood obesity, including:

  • Most importantly, set a good example for your child. It is difficult for a young person to understand the concepts of exercise and proper nutrition if he or she sees parents who eat poorly and wear out a spot on the couch.
  • Don’t insist that your child join the “Clean Plate Club” at every meal. Children will eat much more food during a growth spurt, and much less as growth slows. Rather than volume of food, concentrate on what kinds of foods your child is eating. Try to avoid having your child consume too many calories. Children need 90-120 calories per kilogram of body weight (1 kilo equals 2.2 pounds) during their toddler years, 60-75 calories per kilogram of body weight as grade-schoolers, and 30-60 calories per kilogram during the teen years.
  • Avoid pre-prepared foods and foods with extra sugar.
  • Replace whole milk with skim milk at about 2 years of age.
  • Encourage your child to engage in active play, and get involved as a family in activities such as walking, swimming or playing outdoor games.
  • Limit TV viewing and video game playing to 1-2 hours a day.
  • Try not to use sweet desserts as a reward for finishing a meal. When you do this, eating the meal becomes a “chore” that must be completed to receive the reward.
  • Encourage your child to eat slowly, so they can better judge when they are full. This helps to avoid overeating.
  • Remember is that each child is different. Even siblings may have very different metabolisms and needs for food.
  • Discourage eating in front of the TV. Having meals or snacks while distracted by television can lead to overeating.
  • Don’t have too many sweets or junk foods in the house. Many children’s bodies require snacks between meals, especially during periods of heavy growth. Encourage your child to have carrot sticks, a piece of fruit or a granola bar, all of which are much healthier than high- caloried treats.

There really is no simple test parents can do at home for determining whether their child is overweight. The American Academy of Pediatrics recommends that all children have a Body Mass Index (BMI) done at every “well-child” visit to the doctor’s office. The BMI is a useful tool that incorporates a child’s weight and height in determining whether obesity is an issue. Since growth is a dynamic process, it’s important for the doctor to follow these measurements over time.

With the holidays here, have fun and enjoy the sweets of the season. Just be sure that you and your children do so with moderation.

Dr. Bob Wilmott is Chief of Pediatrics at SSM Cardinal Glennon Children’s Hospital and is a Professor of Pediatric Medicine at St. Louis University School of Medicine. If you have a child health question for Dr. Wilmott, go to the “Ask Dr. Bob” section of the Cardinal Glennon Web site at

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