Child Weight Loss MD

WE'VE MOVED!!!

2009-04-04T06:21:00.001-04:00

JUST A QUICK POST TO LET YOU KNOW THAT MY BLOG HAS MOVED. TO CONTINUE READING AND LEARNING, GO TO:

http://www.DrWeigh.com/blog

Hope to see you there!

Joanna Dolgoff, M.D.

Why you must not allow your child to skip breakfast!

2009-03-24T07:56:00.001-04:00

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What is the worst diet mistake that many parents make for their kids? Skipping breakfast!

Eating breakfast refuels your body and replenishes your blood sugar levels. If you want your car to go, you have to put gas in it. Breakfast is the gas that gives children the energy they need to last all day long. Breakfasts that combine protein, calcium, and fiber rev the metabolism, which, for most kids, has been dormant for ten hours or more after a night of slumber. Kids who eat breakfast daily not only do better in school, but maintain—or even reduce—body weight and reap the benefits of overall good health.

According to the American Dietetic Association, children who eat breakfast are more likely to have better concentration, problem-solving skills and eye-hand coordination. They may also be more alert and creative, and less likely to miss days of school. Breakfast eaters also have better muscle strength during the morning. Kids who eat breakfast tend to have lower weights than kids who skip breakfast. These kids also tend to be less hungry throughout the day!

Many dieters skip breakfast in order to 'save' the calories. This thinking is flawed because studies show that those who skip breakfast wind up taking in MORE calories throughout the day than those dieters who start the day with a substantial meal. Skipping breakfast sets your body up to feel hungry throughout the day. And as we all know, hungry dieters often make poor choices!

Skipping breakfast also puts your child's body in a mini-starvation mode. When the body thinks it is starving, it will do anything it can to hold on to calories. First, the resting metabolic rate is lowered. This means that your child burns fewer calories all day long. Second, the body starts to break down muscle mass for energy. When your child does finally eat something, the food is immediately turned into fat to help last through the next 'famine'! This pattern sets your child up for weight gain and obesity.

On days when the family sleeps late, have to-go breakfasts planned. Busy schedules run on the energy and nutrients found in a healthy breakfast. Fiber One bars, cheese sticks, or yogurt can be packed in a backpack and eaten on the bus or before class.

Planning is the key to breakfast. When you know your morning will be hectic, plan breakfast the night before. Don't wait until the last minute.

Give your child the edge he/she needs to have the most productive and happy day possible. Start each day with a healthy breakfast!

Is 'added fiber' as beneficial as the fiber naturally found in foods?

2009-03-21T18:21:00.000-04:00

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Is 'added fiber' as beneficial as the fiber naturally found in foods? Marketing campaigns certainly seem to indicate so. Ever since fiber became the new nutritional savior, companies are adding it to just about everything, even water! Consumers are unaware that this added fiber does not have all the benefits of natural fiber.

The fiber that is added to foods is called 'functional fiber'. Functional fiber does not have the same properties as the fiber found in whole grains, fruits and vegetables. Companies have invested lots of money into producing these new fibers and many of them have not been well-studied.

Natural dietary fiber is divided into two categories: soluble and insoluble. The soluble dietary fibers becomes viscous in water and lowers cholesterol by escorting it out of the body. Lower cholesterol levels help reduce the risk of heart disease and stroke. Insoluble fibers add stool bulk and promote regularity. Insoluble fiber is not digested in the stomach or small intestine. They get transported to the large intestine where they have their main effects. Bacteria ferment the fiber causing an increase in the acidity of the large intestine. This increased acidity leads to many health benefits, including a decrease in inflammation, an increase in immune function and increased calcium and mineral uptake. Further, many illness-causing pathogens don't tolerate the acidic environment and die before causing disease. Fiber in the large intestine also helps to add bulk to stool, helping to decrease constipation.

Functional fiber is a nondigestible carbohydrate that has been shown to have some benefits yet studies are not clear. By definition, functional fiber is fiber that is extracted or isolated chemically or some other way. Like soluble fiber, functional fibers are often soluble in water but they are not always 'sticky' and therefore can't lower cholesterol levels the way that soluble fiber can. Functional fiber does seem to increase stool bulk and help prevent constipation. Functional fibers have names such as inulin (from chicory root), polydextrose, resistant maltodextrin, oligosaccharides, fructooligosaccharides and methylcellulose.

According the the American Dietetic Association, consumers should get fiber from a variety of sources. The ADA maintains that fiber found in natural foods is superior to 'added' or 'functional' fiber. More studies must be done to fully determine the difference.

Marketing campaigns are extremely misleading. They imply that these added fibers are equal to natural fiber. Even the nutrition label is no help; functional and natural fibers are lumped together under the dietary fiber category.

The basic idea is that while it is okay to get some of your fiber from these added sources, it is not okay to get all of your fiber from added sources. The key is variety. Try to get your fiber from a bunch of different sources.

Beware of Hidden Sugar!

2009-03-17T20:57:00.003-04:00

Dr. Dolgoff's Weigh: Learn how your child can lose weight... today!

Children in America eat way too much sugar each day! Much of the sugar is obvious. Cookies, candies and cakes clearly contain sugar. Sugar cereals and soda are other large sources of obvious sugar. But there is lots of sugar hiding in non-obvious food sources.

Even sugar-free pudding has sugar in it! The sugar is in the form of lactose, a natural sugar found in dairy products. So how can they advertise the product as sugar-free? Sugar-free simply means that there is no added sugar. It doesn't mean that the food item is entirely free of sugar.

Why do we care about foods containing extra sugar? Eating too much sugar leads to being overweight, obesity, metabolic disorder, diabetes, heart disease, and cancer.

Read on for some foods that contain hidden sugar; you will be surprised what you learn!

Foods That May Contain Hidden Sugar

Ketchup
Pasta sauce
Barbeque sauce
Peanut butter
Bread (White and Wheat)
Canned beans
Energy bars
Salad dressings
Granola
Bagels
Crackers
Vanilla soy milk
Canned sweet peas
Deli meats
Frozen pizza

When picking your food, be sure to look at the nutrition label. The grams of sugar on the label include both natural (healthy) sugars and the added (less-healthy) sugars. Obviously it is preferable to choose foods that contain natural sugars because they are usually found in foods that also contain vitamins and nutrients.

How do you know which type of sugar is in the food? Read the ingredient list. The trick is to look out for these sugar traps. If you see the following words on a nutrition label, the product contains sugar.

* Brown sugar
* Corn sweetener
* Corn syrup
* Dextrose
* Fructose
* Fruit juice concentrate
* Glucose
* High-fructose corn syrup
* Honey
* Invert sugar
* Lactose
* Maltose
* Malt syrup
* Molasses
* Raw sugar
* Sucrose
* Syrup
* Table sugar

How much sugar should a child eat each day? A good rule of thumb is to limit added sugar to less than 10 percent of total calories. Note that we said 'added sugar'; this does not include naturally occurring sugars found in dairy products (lactose) and fruits (fructose).

Maximum Sugar Intake

Daily Calorie Intake	Grams	Teaspoons
1200	30	7.5
1500	37	9
1800	45	11
2100	52	13
2400	60	15
2700	67	17

Probiotics for kids

2009-03-16T19:02:00.004-04:00

Dr. Dolgoff's Weigh: Learn how your child can lose weight... today!

Probiotics are getting more and more attention these days but it is hard to separate fact from fiction. Are probiotics necessary for healthy children? Will probiotics help to prevent illness? Is it safe for a child to take probiotics? According to the American Academy of Pediatrics, the answers are sometimes, possibly, and yes. Read on to learn more...

More and more studies are supporting the use of probiotics to treat and prevent GI (i.e. stomach) problems in kids.

What are probiotics?

Probiotics are harmless microbes that live in our body. These microbes are helpful because they take up space that could otherwise be used by harmful microbes. When we have plenty of 'good' microbes in our body, there is no room for the 'bad' microbes that could cause illness and disease.

How can we increase the number of probiotics in our bodies?

Probiotics are found in dietary supplements or in some of the foods we eat. Probiotics are naturally found in fermented foods, such as buttermilk, yogurt and sauerkraut. However, it is hard to get high enough doses just from eating these foods. Dietary supplements provide higher doses of probiotics and are usually more effective in treating/preventing illness.

Which are the best probiotics to take?

Lactobacillus GG, Bifidobacterium, and Saccharomyces sp.

What diseases/illnesses can probiotics help treat/prevent?

Studies show that probiotics may help to prevent and treat many different GI disorders such as irritable bowel syndrome, inflammatory bowel disease, acute gastroenteritis, and antibiotic-related diarrhea. They may also help with constipation, eczema and pancreatitis.

What are some common side effects of probiotics?

So far, studies have not revealed major adverse effects of probiotics in healthy individuals, and long-term consumption also appears to be safe and well tolerated. However, there are case reports of severe side effects in severely debilitated, immuno-compromised children and in neonates.

Is it safe for my child to take probiotics?

Studies show that L acidophilus, Lactobacillus GG and Saccharomyces sp are safe for use in children if administered in appropriate doses. Studies have been done on children as young as one month of age (although I would wait until your child is older than that before starting him/her on probiotic supplements!)

How much should I give my child?

Studies have looked at doses from 1 million to 300 billion CFU units per day. Unfortunately, there is significant discrepancy in the literature as to the appropriate doses for children and doses vary between the different probiotics. Further, variations within the same product are broad because production usually is not standardized.

When should I give my child a probiotic?

Some doctors recommend giving a child a probiotic supplement daily. Other doctors suggest starting a probiotic when a child begins taking an antibiotic.

Why should I consider giving my child a probiotic when my child begins an antibiotic?

Antibiotics are useful because they kill the bacteria that cause infections and make us sick. Unfortunately, they also kill the 'good' bacteria (probiotics) that live in our bodies. Without these 'good' bacteria, our body is susceptible to infection from yeast and other harmful microbes. Giving a probiotic supplement when starting an antibiotic helps to replenish the supply of 'good' microbes that are being killed off by the antibiotic. Probiotic treatment should be continued for one to four weeks after resolution of symptoms from the initial infection.

How should I store my probiotic?

Be careful because some probiotics must be refrigerated and others should not be. Read the label carefully.

Should I give the probiotic with food?

Again, this varies based on the type of probiotic and the brand. Some can be sprinkled on food or dissolved in drinks but others must be given on an empty stomach.

Crumbs Cupcakes

2009-03-15T07:47:00.003-04:00

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I am experiencing eater's remorse. I had a lovely meal last night at an Argentinian tapas restaurant and everything I ordered was extremely low-calorie and delicious. And then our friends suggested we head next door to Crumbs for a cupcake. There are few things I like more than Crumbs cupcakes. They are just heavenly. So I decided to indulge. The four of us shared four cupcakes. Yum.

This morning, I decided to investigated Crumbs cupcakes. I knew that they were high-calorie. In fact, I had estimated about 500 calories per cupcake. Well, I was wrong.

Each Crumbs cupcake has about 780 calories and 36 grams of fat!

That is about half the calories I eat in a day! I am shocked and horrified. Wow! Next time I indulge, it will be with HALF a Crumbs cupcake.

Eater beware!

Why some people are 'naturally thinner' than others...

2009-03-12T19:22:00.004-04:00

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Did you know that not all fat in the body is the same? And that some fat helps to burn more calories than other types? It is true.

Brown fat burns more calories than white fat. Babies are born with brown fat- in fact, brown fat is what helps babies regulate their body temperature during those early days. Unfortunately, as we age, our brown fat begins to disappear.

Scientists now believe that people who are 'naturally thin' retain more brown fat than those who are more prone to weight gain. The thought is that brown fat helps people stay thin because it burns more calories than white fat.

Another possible reason some lucky ducks stay thin despite their calorie intake? It has to do with how efficiently our bodies uses energy. In this case, it is better to be wasteful than to conserve! Bodies that waste a lot of energy need to burn more calories to perform the same tasks than bodies that are super-efficient. Studies show that energy efficiency can vary from person to person by two or more percentage points which can lead to a big difference in body weight! In fact, an efficient body can 'save' enough calories to store up to 6 additional pounds each year!

I will keep you updated as new studies are reported!

The truth about High Fructose Corn Syrup

2009-03-10T13:16:00.002-04:00

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High-fructose corn syrup is a common sweetener and preservative. High-fructose corn syrup is made by changing the sugar (glucose) in cornstarch to fructose — another form of sugar. The end product is a combination of fructose and glucose. Because it extends the shelf life of processed foods and is cheaper than sugar, high-fructose corn syrup has become a popular ingredient in many sodas, fruit-flavored drinks and other processed foods.

According to the AAP, high-fructosecorn syrup, the principle nutrient in sweetened drinks, is nota problem food when consumed in smaller amounts. The problem is that most sweetened drinks contain large amounts of the substance so it is not easy to consume it in small amounts!

According to the Mayo Clinic's website:

So far, research has yielded conflicting results about the effects of high-fructose corn syrup. For example, various early studies showed an association between increased consumption of sweetened beverages (many of which contained high-fructose corn syrup) and obesity. But recent research — some of which is supported by the beverage industry — suggests that high-fructose corn syrup isn't intrinsically less healthy than other sweeteners, nor is it the root cause of obesity.

While research continues, moderation remains important. Many beverages and other processed foods made with high-fructose corn syrup and other sweeteners are high in calories and low in nutritional value. Regularly including these products in your diet has the potential to promote obesity — which, in turn, promotes conditions such as type 2 diabetes, high blood pressure and coronary artery disease.

If you're concerned about the amount of high-fructose corn syrup or other sweeteners in your diet, consider these tips:

Limit processed foods.
Avoid foods that contain added sugar.
Choose fresh fruit rather than fruit juice or fruit-flavored drinks. Even 100 percent fruit juice has a high concentration of sugar.
Choose fruit canned in its own juices instead of heavy syrup.
Drink less soda.
Don't allow sweetened beverages to replace milk, especially for children.

Family Fun Sunday

2009-03-08T16:51:00.003-04:00

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The nice weather is finally here. I don't know how long it will last but I do know that I am taking advantage of every sunny second. The best part of Spring is the opportunity to (finally) get the kids out of the house. Every weekend, my family and I pick a different State Park, botanical garden, or college campus to explore. Today we brought the kids' bikes (a bike with training wheels for 6 year old Zachary and a tricycle for 3 year old Danielle). My mom even decided to join us, making the day that much more fun! Zachary and I have a tradition: we race at every opportunity. Of course, since he is on a bike and I am running, I don't stand a chance. His self-confidence SOARS every time he beats me- which is every time we race. And this year, for the first time, Danielle was able to participate. Last summer we strolled her in the stroller but this year we tried out the tricycle. We went on a three mile trail, thinking we would walk a little bit and then turn back. It didn't turn out that way! The kids were having so much fun that they wouldn't stop! Danielle tricycled the entire three mile trail. Desite a few falls along the way, she had a blast. We kept asking her if she wanted to walk a little but she was persistent. And God forbid we try to help her by giving her a little push. "Mommy, I can do it by myself!"

Of course, Zachary and I were faster since we were running/biking so we would go up a bit and then come back for the rest of the family. In all, we must have done 4 or 5 miles! And Zachary didn't want to stop either. I came to dread the phrase, "JET POWER" because I knew it meant that he was going to sprint forward and I had to use all my energy to try to catch him! It was a blast.

Even my husband was a total trooper! He woke up at 7:30 (which was like 6:30 due to daylight savings time) to play soccer with his buddies and he twisted his ankle in the game. He wouldn't let that stop him though! And my mom had already taken a sixty minute strenuous bike ride when we called to invite her to join us- but she was into it too.

The bottom line? We had a FABULOUS family day that included lots of 'exercise' that didn't feel like exercise. It felt like fun. And that is what Family Fun Sunday is all about.

Try it with your family. Go outside and explore some part of nature. You can walk, jog, run, bike, rollerblade, or even use a scooter (just be careful!) Just get outside and get moving!

The dangerous condition your pediatrician most likely is not screening for...

2009-03-06T09:17:00.003-05:00

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According to the CDC, there has been a 90% increase in new cases of diabetes over the past ten years.

Unbelievable. Even more disturbing is that most children and adults with 'prediabetes' don't even know it. I am constantly diagnosing patients with pre-diabetes and the first question they have is, "How come my pediatrician never mentioned it?" The answer is simple... I really don't know. I can often tell that a patient has pre-diabetes simply by looking at the back of their neck. Acanthosis nigricans, or a darkening of the skin behind the neck or in the armpits and other skin folds, is all you need to see to know that your child has pre-diabetes. Look at the examples below... These are fairly advanced stages of acanthosis nigricans. Your child's may be lighter than this so look carefully.

Acanthosis nigricans is usually seen with conditions that increase insulin levels, such as type 2 diabetes or being overweight. High insulin levels can trigger activity in skin cells, resulting in this dark, thick, velvety skin. Acanthosis nigricans can also be caused by medicines such as human growth hormone and oral contraceptives (aka "the pill"). There is no specific treatment for acanthosis nigricans, although weight loss may decrease its appearance.

I always check fasting glucose and insulin levels to make sure that my patient has not yet developed diabetes. Acanthosis nigricans is a sign that a patient's weight is starting to affect his/her health. It should be a wake-up call that weight loss is needed immediately to prevent the development of diabetes. If your child is overweight, be sure to check their neck and make sure that they do not have this sign of "hyperinsulinemia" (higher than normal insulin levels). The absence of acanthosis nigricans, however, does not mean that your child does not have pre-diabetes or diabetes.

Any overweight child should have their fasting glucose and insulin levels checked as a precaution.

Now overweight children all over the country can follow Dr. Dolgoff's Weigh online at www.DrWeigh.com. We have a 96% weight loss success rate!

Obese Teens Risk of Dying Young Same as Heavy Smoker's!

2009-03-04T11:03:00.003-05:00

Wow! A new study was reviewed in the NY Times that has some shocking results. They discuss a large European study published in this week's British Medical Journal that spanned decades. The study found that young men who were overweight at age 18 were as likely to die by age 60 as smokers who smoke up to10 cigarettes a day (aka 'light smokers'); these young adults were one-third more likely to die young! The study then went on to say that obese teens were as likely to die by age 60 as heavy smokers who smoke more than half a pack of cigarettes a day; their risk was DOUBLE the normal risk.

As with every study, there is some backlash that the risk is overstated. But either way, it does serve to remind us that being overweight or obese is not a cosmetic issue; it is a severe medical issue.

Smoking is the leading cause of preventable death in our country. According to the CDC, obesity will soon overpass smoking to take this dubious honor.

Parents: take action now! Do not wait. The time to help your overweight child is NOW!

Our site is live! Now your child can lose weight following Dr. Dolgoff'sWeigh online. Go to www.DrWeigh.com for more information. Your child's road to wellness starts here...

Lean Types of Protein

2009-03-02T18:13:00.002-05:00

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Not sure what to make for dinner? Many dinners revolve around the protein portion so I will review some lean proteins that are healthy and easy to incorporate into yummy meals.

Beef: Extra-lean beef can be surprising healthy. The leanest cuts are tenderloin and top sirloin. When opting for ground beef, choose extra-lean (not lean which can have up to 10 grams of fat per serving!) In terms of percentages, choose ground meats that are at least 93% fat-free.

Chicken: Chicken breasts are an extremely healthy source of protein. But the breast is not the only cut that you can eat. While dark meat does have more calories and fat than white meat, it is still okay to eat- as long as you remove ALL of the skin. Vary the type of chicken that you serve so your kids don't get bored.

Ground Turkey: It is a myth that ground turkey is healthier than ground meat. It all depends on the type of ground turkey and ground meat. Regular ground meat includes the light meat, the dark meat, and even the skin! It can have significantly more fat than 95% fat-free ground beef. And, in my opinion, ground turkey never tastes as good as ground beef. However, if you want to get really lean, opt for the 99% fat-free all white meat ground turkey. That is as lean as it gets!

Fish: It is not true that all kids hate fish. There are some types of fish that kids love (and no, I am not talking about the fried fish stick versions!) My daughter loves salmon and my son loves rare tuna. Other mild fish include cod and tilapia. Just remember, fresh fish should be used or frozen within two days. Once frozen, fish will stay good for about a month.

Tofu: Tofu is a source of protein that takes on the flavor of whatever you cook it with! For stir-fries and main dishes, use firm or extra-firm tofu. For baking or smoothies, try silken or soft tofu. For increased flavor, buy pre-packaged tofu that has already been marinated.

Enjoy!

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A trick to get your kids to exercise

2009-03-01T18:55:00.001-05:00

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Your dog can truly be your child's best friend. Give your child the chore of walking the dog and voila- instant movement! Dogs love to run around outside. Chances are your child will feed off of the dog's enthusiasm. Encourage your child to play outside with the dog as much as possible. Studies show that simply getting your kid outside of the house helps with weight loss. So don't even mention exercise! Just tell your kids that the dog is getting restless and suggest they take him for a walk, play chase, or even play fetch. Once they are in the routine of walking the dog, tell them that their beloved pet is getting too heavy and the vet wants the doggy to run around a bit. All vets encourage exercise so it is not really a lie ;) In any case, suggest that your child jog with the dog for one minute and then walk for five minutes. Each week, increase the jogging by thirty seconds and decrease the walking by thirty seconds. In time, your child and dog will be jogging straight through! Gradually increase the length of the walks.

Not only will your child benefit- but your dog will be in better shape as well!

EXCITING NEWS: OUR INTERACTIVE ONLINE WEBSITE IS SET TO LAUNCH TOMORROW! BE SURE TO CHECK IT OUT. YOUR CHILD CAN LOSE WEIGHT ONLINE WITH DR. DOLGOFF'S WEIGH. DON'T FORGET- WE HAVE A 96% SUCCESS RATE. SEE FOR YOURSELF!

Let's Celebrate... without food!

2009-02-27T12:34:00.002-05:00

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My son lost his first tooth yesterday. It was really exciting. The tooth had been dangling and we knew it would be falling out soon. But I didn't realize how truly happy I would be when it finally came out. It hit me that my little boy is growing up. Wasn't I nursing him yesterday, praying that his teeth wouldn't grow in and hurt my boob? Time really does fly.

As I came in the door, he ran over to me. "Mommy, mommy. My tooth fell out at school today!" He was bubbling over with excitement. He sat me down and told me all about how he was playing basketball and tripped and boom- the tooth flew out of his mouth. He was laughing as he explained how everybody got on their hands and knees to hunt for his missing tooth. By the end of the story, I was laughing too.

And what was my next reaction? "Let's celebrate!" I then (almost) added, "Who wants ice cream?" That is how we celebrated everything in my house growing up. Piano recital? Hot fudge sundaes. Graduation? Banana splits. Good grade on a test? Well, you get the drift. It wasn't until I was a teenager that I realized my father would use any excuse to go for ice cream. And I grew up, as did many others, associating celebrating with eating fattening foods.

I don't want that for my children. But how do we celebrate the tooth without eating lots of calories and fat? Hmmm... I thought about that long and hard. Let's reward him with something he would like, that doesn't cost too much, and isn't bad for his health. "Let's go ice skating this weekend to celebrate!" I suggested. He immediately broke into a huge grin. "That's a great idea!" So- this weekend, we will go to the ice skating rink and spend a family day celebrating by doing an (active) activity that the entire family loves. I think that was a great solution!

Anybody else have other suggestions?

New Study from Harvard and NIH determines most effective way to lose weight!

2009-02-26T07:59:00.002-05:00

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A landmark study just came out of the Harvard School of Public Health and the NIH.

Researchers recruited 811 overweight or obese older adults and put them on one of four diet plans. Two of the plans were low-fat plans with 20% of calories from fat. Two of the plans were high-fat plans with 40% of calories from fat. The calories from carbohydrates ranged from 35% to 65%. Protein was either 15% or 25% of calories.

All four plans adhered to heart-healthy guidelines, which emphasize eating less than 8% of calories from artery-clogging saturated (animal) fat, eating vegetables, fruits and whole-grain products, and consuming at least 20 grams of fiber a day.

The eating plans were based on the DASH (Dietary Approaches to Stop Hypertension) diet, not on popular plans such as the Atkins or South Beach diets.

Dieters were encouraged to attend regular individual and group weight-loss counseling sessions and keep an online food diary. Everyone was given a personalized calorie goal, and most aimed for 750 calories below their daily needs. No one was supposed to eat fewer than 1,200 calories a day.

Participants' exercise goals were modest: about 90 minutes of moderate physical activity a week. Researchers were focused on how the composition of the diets affected weight loss and did not want to distort the results.

Among the findings, presented in today's New England Journal of Medicine:

• In six months, the dieters lost an average of 13 pounds no matter which diet they were on.

• After two years, they had kept off an average of 9 pounds and lost 1 to 3 inches in the waist, regardless of which diet they were on.

• Dieters had improvements in heart-disease risk factors, including increases in the HDL (good) cholesterol, and decreases in LDL (bad) cholesterol and triglycerides (blood fats) at six months and two years.

• People reported similar levels of fullness, hunger and satisfaction on the different diets.

'Reasonable range' of fats, protein, carbs

The plans did not include a very low-carb Atkins-type diet, Sacks says, because most "people don't stick with that low-carbohydrate intake, and we didn't want to try anything unrealistic. We tried a big range but a reasonable range of fats, protein and carbohydrates."

Some research indicates that dieters may feel full longer on higher-protein diets, but these dieters did not report any differences in feelings of fullness, says Catherine Loria, a nutritional epidemiologist with the heart, lung and blood institute.

THE BOTTOM LINE:

They came up with "a very simple message that cuts through all the hype: To lose weight, it comes down to how much you put in your mouth — it's not a question of eating a particular type of diet," says Frank Sacks, a lead researcher and professor of cardiovascular disease prevention at Harvard.

* Information obtained from the New England Journal of Medicine and USA Today

Medical Problems of Obesity

2009-02-24T17:52:00.002-05:00

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Being overweight affects every body system.

BRAIN:
Overweight children are very often depressed and anxious.
Brains of overweight children don't respond well to leptin, a hormone that tells the brain your child is full. Therefore, overweight kids are even MORE likely to overeat and gain more weight.
Overweight children are more likely to have atherosclerosis (fatty deposits in the carotid arteries) that can lead to stroke.

LUNGS:
Overweight children are more likely to have asthma. Asthma makes obesity worse because asthmatic children tend to avoid exercise, thus leading to more weight gain.

HEART:
Overweight children are more likely to have atherosclerosis (fatty deposits in the arteries of the heart). Atherosclerosis can lead to heart attacks!
Overweight children are more likely to have high blood pressure, also leading to heart attacks.

STOMACH:
Overweight children are more likely to have GE reflux and constipation.

BONES:
Overweight children are more likely to have bone problems that can lead to hip pain, knee pain, and back pain. This also makes weight gain worse because children in pain do not exercise!
Pressure from excess weight increases the risk of bone fractures.

PANCREAS:
Overweight children are more likely to become resistant to the effects of insulin, causing diabetes (type 2).

GALLBLADDER:
Overweight children are more likely to have gallstones. Gallstones are also common in overweight kids who lose weight too quickly.

LIVER:
Overweight children are more likely to have fat accumulate in the liver, commonly known as 'fatty liver'. If severe, fatty liver can lead to cirrhosis and liver failure.

IS YOUR CHILD AT RISK FOR THESE HEALTH PROBLEMS? WE CAN HELP. STARTING THIS MONDAY, YOUR CHILD CAN FOLLOW DR. DOLGOFF'S WEIGH CHILD AND ADOLESCENT WEIGHT MANAGEMENT PROGRAM ONLINE. GO TO WWW.DRWEIGH.COM FOR MORE DETAILS.

Does skiing burn calories?

2009-02-23T17:18:00.002-05:00

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I just got back from a wonderful week in Vermont. We definitely had a blast- although I wouldn't call it a relaxing vacation. I could still use a week on an island somewhere to unwind! :)

It seems that most of my patients opted to go skiing this week. Before they left, we sat in my office and discussed what would be hard about eating healthy during a ski trip. Without exception, my patients all told me, "Don't worry. I will be burning so many calories skiing so it won't matter if I eat more."

I had my doubts and they were confirmed this week. First, the ski lift lines are endless. Then there is the time sitting in the ski lift. It seems that it takes at least a half hour of waiting before you get your five (maybe 10) minutes of exercise. And even the exercise is not too vigorous. I mean, you're going downhill! Gravity plays a large part! I am not denying that your muscles get sore from skiing. But I don't think your heart rate gets high enough to really count as vigorous exercise.

So, to all my skiing patients out there, you still need to stick to your healthy eating plans while on a ski trip! Skiing is certainly better (in terms of calorie burn) than lying on the beach but it does not give you carte blanche to eat whatever you want!

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I went to Burger King...

2009-02-14T10:29:00.002-05:00

www.DrWeigh.com

I know you have all been there. You are on a long car ride with the kids and suddenly, everybody is crying that they are hungry. You are in the middle of nowhere and suddenly a rest stop appears. You frantically search for something healthy only to be disappointed. Burger King and Dunkin' Donuts.

That is where I found myself last night. So I took the kids to Burger King. We each got a hamburger kids' meal. I was shocked at the price. TEN DOLLARS TOTAL! No wonder lower income families tend to be heavier. Where else can you eat for that price?

I do have to say that the kids' meal was plenty for me. I definitely wasn't hungry afterwards. How do people eat the supersize meals? All in all, I think we did pretty well in what could have been a calorie disaster.

I am taking the holiday week off so I will be back blogging next week. Enjoy your vacations!

5 Diet Tips For Kids That Don't Involve Food or Exercise

2009-02-12T10:43:00.003-05:00

www.DrWeigh.com

Obviously diet and exercise are the key to losing weight. However, there are many other little things we do every day that either help or sabotage our 'get healthy' efforts. Here are some tips on how you can make your child's weight loss easier without starving of spending hours at the gym.

1. Teach your children to like what theysee in the mirror. Focus on their great legs or strong arms. Remind them that their bodies have many wonderful attributes. Dieters with higher self-esteem lose more weight!

2. Help them lose their inner negative voice. We all have that little voice in our heads, telling us that everything we do is wrong. "You shouldn't have eaten that..." "Why didn't you go to the gym today?" This voice makes us feel worthless. When that voice arises, tell your kids to tell the voice to shut up! Or teach them to counter back with something positive. "Maybe I shouldn't have eaten that but I only had a half portion. To make up for it, I will cut back on my afternoon snack." "I really didn't feel like going to the gym today but I will go tomorrow, even though tomorrow is usually my off day. I don't want exercise to seem like a chore; I can reschedule my gym sessions as long as I get in my 4 or 5 days."

3. Celebrate small milestones. You don't have to wait until goal to congratulate your children. Set smaller mini-goals so they have that sense of accomplishment. And pick a (non-food) reward. Maybe let them buy that new shirt they've been wanting or let them go with their friends to the movies on a school night. Just find something that they want that doesn't involve food. It needn't be expensive!

4. Dieting can be stressful. Help your children find a non-food way to deal with stress. Some people like yoga. Others try deep breathing. I like taking a long, hot bath with a good book! Your child may want to spend a few minutes playing a video game. Exercise can also be a stress release. Plan in advance- make sure they know how to handle stressful situations so they don't instinctively turn to food.

5. Teach your children to enjoy food! It may seem counter-intuitive but if your children really enjoy a meal, they may eat less. First, teach them to eat slowly. Savor the flavors. Notice the feeling of the food on their tongues. They should not just throw the food down their throats. Have them pay attention to the food and allow their bodies the time it takes to realize that it is full.

Top Ten Healthy Foods To Add To Your Child's Diet

2009-02-11T07:57:00.003-05:00

www.DrWeigh.com

Here are some healthy foods to add to your child's diet.

1. Blueberries- full of antioxidants and delicious! Blueberries don't last long in my house- my kids usually eat them all in a day!

2. Salmon- Omega 3 fats lower cholesterol and protect your heart!

3. Edamame- Full of soy protein and fiber, edamame will keep your child full longer than most other snacks. My daughter calls them "the beans that pop".

4. Eggs- Surprised to see eggs on this list? Eggs have protein and contrary to popular belief, will not increase your child's cholesterol level.

5. Peanut butter- Once the salmonella scare is over, take another look at this kids' favorite! Peanut butter is protein... just watch the portion size. One tablespoon is plenty.

6. Nuts- Peanuts, pistachio nuts, almonds, and walnuts all taste delicious and have lots of protein and fiber to keep your child feeling full and the fat in nuts is the good kind. Nuts do have lots of calories, however, so watch your portion sizes.

7. Low-Fat cheese- Calcium is very important for growing kids. But regular cheese has saturated fat. Be sure to include dairy in your child's diet but make sure it is either low-fat or (even better) fat-free. 2% string cheese is a great choice to put into your child's lunch.

8. Low-Fat yogurt- Healthy for the same reasons as the low-fat cheese. But beware- some yogurts have lots of added sugars and calories. Pick a yogurt that has less than 100 calories.

9. Avocado- Avocado is full of good fat. Add some to your child's turkey sandwich or mash it up and serve it on whole-grain crackers. I started my kids on avocado at six months old and they have been enjoying it ever since!

10. Pomegranate- Pomegranates, while hard to find and messy to eat, are delicious and full of fiber and antioxidants.

Kids' Fave Meals Made Healthy

2009-02-10T10:08:00.003-05:00

www.DrWeigh.com

Let's make-over some of our kids' favorite meals. Delicious meals don't have to be unhealthy.

Hamburger: Instead of using regular beef, use 93% or 95% fat-free ground meat (also called extra-lean meat). You can also try all white meat ground turkey (although I don't find it as tasty). Put the burger on a light hamburger bun.

Hot Dog: My family loves the 97% fat-free Hebrew National hot dogs. Try two hot dogs on one light hot dog bun. Yummy!

Grilled Cheese: At home, use two slices of reduced-calorie whole wheat bread with two slices of fat-free cheese or one slice of 2% cheese. Then, put it in the toaster or put it in a panini maker or on the George Forman Grill. At a restaurant, order the grilled cheese on whole wheat bread with just one slice of cheese, no butter, no oil, no mayo.

French Fries: Two options here. The easy route is the frozen baked fries found in the freezer section of most supermarkets. Just put them on a cookie sheet and bake them without any butter or oil. Your other option is to take a potato or a sweet potato and slice it thinly. Then bake it on a cookie sheet that has been sprayed with Pam.

Pizza: Pizza is not as unhealthy as many people believe. If your child can stick to just one slice, pizza can be a great meal. The problem begins when kids start eating two or three slices in one sitting. To make pizza more filling, load on the veggie toppings. Some pizza places even offer whole wheat crust which adds needed fiber. You can also order the pizza with half the amount of cheese to save calories and grams of fat. At home, use a thin crust whole wheat Boboli pizza crust and top it with reduced-fat or fat-free cheese and tomato sauce.

Quesadilla: A staple in my home on nights when we just don't have time to cook. We take a flour tortilla and top it with pre-cooked Perdue chicken strips and shredded, fat-free cheddar/Mexican blend cheeses. Just microwave for 30 seconds and enjoy! Top with salsa, if desired.

Insufficient sleep may cause Diabetes!

2009-02-08T13:55:00.002-05:00

www.DrWeigh.com

New evidence suggests that not only can lack of sleep lead to obesity, it can also lead directly to Type II Diabetes!

It seems that when you don't get enough sleep, your body needs needs more insulin to keep sugar levels normal. Lack of sleep impacts your central nervous system and your hormones, both of which play a large role in sugar regulation. Remain too tired and your insulin-producing cells stop functioning normally, causing high sugar levels and then diabetes.

There are also other, less direct, ways that lack of sleep leads to diabetes. Everybody know that you eat more when you are tired. Eating more leads to obesity which leads to Type II Diabetes.

But there is now evidence that sleep deprivation can lead to diabetes even in somebody who is not overweight.

Just another reason why EVERYBODY, regardless of weight, should eat a healthy diet.

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Liquid Candy (aka soda)

2009-02-05T16:16:00.002-05:00

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Just how bad is soda? Well, let's look at the statistics.

A can (12 fl oz) of soda has 150 calories.
If you drink one can of soda a day, you will have consumed 54,750 extra calories in a year.
It takes 3,500 calories to form a pound of fat.
Therefore:

You will gain 15.6 pounds each year by drinking just one can of soda a day.

It gets worse...

Look at the vending machines around you. It is now rare to see soda cans in them. Instead, we have 'upgraded' to the 20 fl oz bottle. What happens if you drink a bottle of soda a day?

A bottle (20 fl oz) of soda has 250 calories.
If you drink one bottle of soda a day, you will have consumed 91,250 extra calories in a year.
It (still) takes 3,500 calories to form a pound of fat.
Therefore:

You will gain 26 pounds each year by drinking just one bottle of soda a day.

And let's not discuss kids who drink soda with lunch, snack, and dinner. They are at very high risk for obesity.

More on soda tomorrow...

Launching March 1, 2009: Dr. Dolgoff's Online Weigh! Your child can follow Dr. Dolgoff's Weigh online from anywhere in the country. 96% of children following Dr. Dolgoff's Weigh lose weight. Your child can be next! Go to http://www.DrWeigh.com for more details.

Being tired can make you heavy!

2009-02-03T19:18:00.002-05:00

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A recent study from the University of Chicago showed that people snack more when they are tired. I could have told them that from my own 'study' during my residency! Surprisingly, their study did not show that tired people eat more at mealtimes. Adults who got fewer than 5 hours of sleep consumed 221 more calories from snacks than adults who got more than 8 hours of sleep. The tired eaters also tended to choose a higher percentage of calories from refined carbohydrates.

So- if you can't get a full night sleep, watch your snacking! Make sure you have healthy snacks on hand for when hunger strikes. Your snacks should be a mixture of protein and fiber. Aim to have two snacks a day, each worth 100 - 150 calories.

Work out at home on a budget!

2009-02-02T19:12:00.005-05:00

www.DrWeigh.com

Ready to start your child on an exercise program but don't have the money to pay for a personal trainer or a gym membership? There are lots of inexpensive ways to get your child to exercise. Read on for some examples of equipment you can use at home that won't break the bank. I found these products on Amazon.com.

Jump Rope- It's fun and easy to do. $4.95

Speed Agility Ladder- Just lie it on the floor and run, hop, shuffle your way through the squares. You can find lots of exercises for the ladder with a quick search of the web. $24.95.

Step: Step aerobics are a fun way to get your child moving. Start with the step on the floor and (depending on your child's height) work your way up to using the blocks. You can find lots of step routines on demand or on the web. $29.99

Tubing: You don't need to buy an entire set of dumbbells to strength train. Just pick up some tubing with handles. They are cheap and effective. $9.99

Bosu: Use the bosu for cardio by using it as a step or for core conditioning by lying on it while doing crunches. The possibilities are endless. $59.75

Adjustable Dumbbells: Each weight can be adjusted to weigh from 2.5 pounds to 12.5 pounds. Be sure to consult a trainer before allowing your child to lift dumbbells. $77.40

Medicine Ball: You can work your entire core with a medicine ball. You can also look online for suggestions on how to incorporate the medicine ball into a cardiovascular workout. $9.75

Kid's Exercise Bike: A moderately priced exercise bike built for kids. $89.99

Kid's First Treadmill: Start them early! $129.99

New Product Recommendation

2009-02-01T20:29:00.002-05:00

www.DrWeigh.com

I came home early the other night and found my kids having dinner with our nanny. I looked at their plates and immediately got upset. The kids were eating potato pancakes which looked fried and greasy. I tasted them and got even more fired up. They were so delicious and clearly fattening. My nanny knows that I don't like my kids to eat fried food. "Katie," I said. "I would rather you didn't serve my kids such unhealthy foods." As I was about to start a lecture on the dangers of saturated fats, I noticed that Katie was smiling. "So you like the new vegetable pancakes I found?" "Vegetable pancakes?" "Yes, they are made with all natural ingredients, no trans fat, no preservatives. Only 70 calories each." "Wow!" I was shocked. They tasted way too good. But she showed me the package.

The brand is Golden and they are called Vegetable Pancakes. Ingredients: potatoes, water, meal, canola oil, string beans, dehydrated onions, corn, carrots, whole eggs, peas, egg whites, deydrated potatoes, red peppers, salt, green peppers, pepper, parsley.

All you do is put them in the oven and bake them for 10 minutes.

I served them for my husband at dinner tonight and he couldn't believe they were healthy, either. They got a strong approval rating from my husband and kids; we all fought over the last one!

Try them. My nanny found them at Pathmark.

Gym Tax???

2009-01-30T16:15:00.002-05:00

www.DrWeigh.com

I just heard some very disturbing news. Governor Paterson and the New York Legislature are considering imposing a sales tax on health club dues and services (including personal training) to make up for New York State's budget deficit. How shortsighted is that thinking? Are they not aware that we are in the midst of an obesity epidemic? One out of every three children in this country is either overweight or obese. Do they know how much money is spent on obesity-related health expenses in this country? More than 10 million American children are overweight, leading to an annual health-related cost of 117 billion dollars. Studies show that obesity-related health costs will total 860 billion dollars by 2030. Is this really the wisest way to save money?

Governor Paterson has talked extensively about the medical and economic importance of healthy lifestyles and is proposing an "obesity tax" on non-diet, sugary sodas and advocating a "Healthier New York". Therefore a tax on health clubs is directly in opposition to this goal. The State should be encouraging, not discouraging, memberships to health clubs to stem the obesity epidemic and promote good health.

Here's how you can help - visit HealthClubs.com today to quickly and easily tell your lawmakers to oppose this proposed tax.Thanks in advance for participating. I will update you as the details unfold.

* Special thanks to LIFT gym for providing the link to HealthClubs.com.

"Mom, am I fat?"

2009-01-29T18:07:00.002-05:00

www.DrWeigh.com

How do you respond when your overweight child asks if she is fat? Do you sugarcoat the truth and tell her she is perfect? Do you go for the hard love angle and tell her that yes, she is fat? I would advise for something in between.

It is not easy to talk about something as sensitive as weight, particular with a pre-teen or a teenager. Parents must walk a fine line between acknowledging the problem and promoting self-confidence.

Children know they are overweight. And if you don't mention it, their peers certainly will! If you pretend everything is fine, your child will learn that her weight is a shameful topic that can't be discussed. She will then try to lose weight with her own methods, usually by starving herself or binging. These are the children who are most at risk for disordered eating. Studies show that if you acknowledge and treat an overweight child in a sensitive manner, you actually decrease the risk of disordered eating!

Ideally, the conversation would go something like this...

"Mom, am I fat?"
"What makes you ask that, honey?"
"The kids on the playground called me names today."
"Well that is not nice. But maybe we would be healthier if we did learn to eat better. We could all use to revamp our diets." Notice how I have chosen to say 'we' could be healthier and 'we could all use to...' This sounds less accusatory and alerts your child that you are both in it together. I have also turned it around to be about health and eating better rather than about fat or thin. This way, even a thin parent can have this conversation. Most thin people I know could eat healthier if they tried. "Why don't we try to make some changes together. We can learn how to eat right and we can start getting more active. Would you like that?"

I have had many parents call me after this conversation, worried that they said the wrong thing. Often, the parents responded with, "Don't be silly. Of course you are not fat. You are beautiful." And then they want to know how they can help their children. It is better off not to lie. If your child demands an answer to the question, I would say...

"Fat is such a nasty word. You look good but you might be healthier if you weighed a little less. Let's work together to learn to eat better and exercise more." Notice again that I didn't say 'you would look better if you weighed less'. It is important to focus the discussion around health- not around looks. Again, bring it back to the 'we' as soon as possible. And always end the discussion with next steps... "Why don't we go online and look at some websites about healthy eating." "Let's call the pediatrician and see if she has any suggestions." "Let's go to the supermarket and pick up some healthy foods so we can get started right away."

Good luck. And if you are still nervous about broaching the subject with your child, feel free to call my office (516-801-0022) or e-mail me (jdmd@drweigh.com) for more advice.

The family that eats together...

2009-01-27T11:47:00.002-05:00

www.DrWeigh.com

New studies prove what we all believed to be true: children whose families eat together tend to be happier and healthier. The importance of the family meal has now been proven.

Science daily magazine revealed that teens who regularly eat meals with their families are less likely to drink and smoke. In fact, a study of middle school children followed over five years showed that girls who regularly ate meals with their families were half as likely to use alcohol/drugs than girls who did not regularly eat meals with their families. The research also shows that children who regularly eat with their families are closer to their parents than children who do not.

The beneficial effects of the family meal are vast. These children are also less likely to be overweight or obese. And family mealtime is a great opportunity to reconnect with your children. Discuss their day. Ask them about their friends. Find out what is happening in school. In other words, GET INVOLVED!

Notice that I have been referring to family mealtime and NOT family dinnertime. Contrary to popular belief, the family meal does not have to be dinner! I often work late nights but I try to eat breakfast with my children in the mornings. That is the time that I find out what is going on in their lives. And we always have Saturday lunch, Sunday brunch and Sunday dinner together. Even with my busy schedule, I carve out time to eat meals with my kids. It is important to have that uninterrupted time for conversation!

So sit down with your kids and enjoy a nice meal. The benefits are immeasurable.

Wrap vs. Pizza: Which is a better choice?

2009-01-25T14:16:00.003-05:00

www.DrWeigh.com

I went to a birthday party with my son this morning. While the kids were being entertained by a 'mad scientist magician', the moms sat around a table, eating and chatting. Finally, lunch was served. The options were wrap sandwiches (turkey and cheese or roast beef and cheese) or pizza. All the moms took wrap sandwiches. They looked at me with horror as I picked up a slice of pizza. I laughed... "You do know that this slice of pizza has fewer calories than those sanwiches you are eating, right?" Apparently, they did not.

Look at the nutritional information for the wrap. Note that this doesn't include the sandwich meat or the cheese. The information is for the wrap bread itself.

Wrap: 320 calories, 8 g fat, 53 g carbs

Now look at the nutritional information for a slice of pizza.

Pizza: 250 calories, 10.5g fat, 54.8 g carbs

Surprised? So were my friends. One slice of pizza has fewer calories than a wrap sandwich.

Bon Apetit!

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Tips for helping your child stick to an exercise program.

2009-01-23T08:39:00.003-05:00

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The only thing harder than getting your child to start an exercise regimen? Getting them to stick to it! Here are some tips to help.

1. Set up an exercise schedule.

These days, kids are used to being tightly scheduled. A typical child's schedule includes music lessons, religous lessons, tutors, and homework. Why not squeeze some exercise in there? For example:

Mon: school, piano lesson, 45 minutes exercise, dinner, homework

Tues: school, religous school, dinner, homework

Wed: school, free time for playdate, 45 minutes exercise, homework

Thurs: school, religous school, dinner, homework

Fri: school, tutor, 45 minutes exercise, dinner, homework

Sat: tennis lesson

Sun: day off from schedule!

Make sure the exercise is as an important part of the schedule as school and lessons.

2. Be flexible...

It's Friday afternoon and your daughter really wants to have a sleepover with her friend. You know that she won't exercise if you let her. What do you do? Let her have the sleepover and reschedule the exercise session. Tell her, "You can have the sleepover today but we will make up the exercise session on Sunday." That way you allow her to have her fun without getting her weekly exercise off track.

3. Make it fun!

Exercise does not have to be a chore. Pick activities that your child truly enjoys. Tennis, jumping rope and bouncing on a trampoline can all be great forms of exercise. Wii Fit is another great exercise option. Try to think outside the treadmill!

4. Exercise with friends.

Everything is more fun when done with a friend. Have your child pick an exercise buddy and let them get fit together. They can keep each other on track while making the experience more enjoyable.

5. Buy a few exercise accessories.

You don't need to break the bank to have some workout equipment at home. Consider a rope ladder that you lie on the floor and do running drills on. A small, individual-sized trampouline is also quite inexpensive. You may also invest in a step for step aerobics. Consider buying your child some new exercise clothes so they feel excited to put them on and get moving!

6. Don't start by running a marathon.

The easiest way to get a child to hate exercise is to push them too quickly. Take it slowly and build up. Remember, if your child doesn't enjoy the exercise they will soon give it up.

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Habits of Naturally Thin vs. Successful Dieters

2009-01-22T13:36:00.002-05:00

www.DrWeigh.com

I just read a very interesting article that I wanted to share with you. The study looked at the habits of the naturally thin, successful dieters, and failed dieters. The study was from Consumer Reports and looked at 21,632 people.

Group 1: 'always thin', never overweight.

Group 2: 'successful dieters', people who now weigh at least 10 percent less than they did at their heaviest and have been at that lower weight for at leat 2 years.

Group 3: 'failed dieters', people who would like to lose weight but still weigh at or neaer their lifetime high.

Only 3% of the 'always thin' group said that they never exercise and eat whatever they want.

The study shows that the eating and exercise habits of the 'always thin' group was the same as the eating and exercise habits of the 'successful dieters'. Both groups said that they regularly eat healthy foods, such as whole grains, fruits and vegetables, and routinely stay away from excessive dietary fat. Both groups also watch their portion sizes and follow a regular, vigorous exercise plan.

It seems that the only advantage the 'always thin' have over the 'successful dieters' is that those habits seem to come a bit more naturally to them, according to Consumer Reports.
"When we've compared people maintaining a weight loss with (those) who've always had a normal weight, we've found that both groups are working hard at it; the maintainers are just working a little harder," Dr. Suzanne Phelan of the California Polytechnic State University and co-investigator of the National Weight Control Registry, which tracks people who have successfully maintained a weight loss over time, noted in a Consumer Reports press statement.

Tips to cut costs at the supermarket

2009-01-20T21:07:00.002-05:00

www.DrWeigh.com

The recession is causing us all to watch our bottom lines. It is true that healthy foods often cost more than junk foods. Read on for some suggestions to help you keep your supermarket bills in check.

MAKE THREE SHOPPING LISTS!
Look around your house before you head to the market. Make three shopping lists: what you need immediately, what you will need soon, and what you definitely don't need. When you get to the supermarket, buy the items that you need right away. Then consider your list of items you will need soon. Any of them on sale? If so, buy them now. If not, wait until next week. You never know when a sale will pop up. Do not buy the items that you definitely do not need.

DON"T SHOP HUNGRY!
It is diet and wallet sabotage to shop hungry. Hungry shoppers fill their baskets with all kinds of non-essentials. Make sure to have a healthy snack before heading out the door.

BUY IN BULK!
Instead of pre-packaged foods, buy bigger containers and make your own single servings! For example, buy a large barrel of pretzel rods and portion them into small baggies at home. Consider going to a wholesale store for your non-perishables.

BUY IN SEASON!
Fruit can be reasonably priced when it is bought in season. Each season offers delicious produce options. Take advantage of nature's natural variety!

BUY FROZEN!
If fresh produce is too expensive, consider frozen. Frozen produce has almost all the same vitamins and nutrient as fresh.

USE THOSE COUPONS!
Many supermarkets offer coupons. Clip the coupons and save them until you need the item. Coupons can help you save lots of money.

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Obese in the US now outnumber the overweight

2009-01-19T16:06:00.002-05:00

www.DrWeigh.com

The obesity crisis is getting worse and worse! A new report states the the number of obese individuals in the US now outnumbers the number or 'merely overweight' individuals. Congratulations America. Something must be done before every American is considered overweight or obese.

Where can we start?

1. New York City now requires most restaurants to post calorie information for all food offerings. The calorie information must be at least as visible as the price information. This law should be generalized to the entire United States.

2. I love the idea of an obesity tax. Let's make unhealthy foods more expensive. And let's try to lower the cost of fresh fruits and vegetables. Maybe fruits and vegetables could be tax-free. The government could use the money from the obesity tax to offset any lost tax money from fruits and vegetables.

3. Serve ONLY healthy foods in schools. Get rid of all vending machines. Lose the cookies, cakes, and other junk food. Stick to lunches that are nutritious. Do you know that many schools serve mozzarella sticks and nachos for lunch? Let's get rid of all of that stuff and turn our schools into healthy havens.

4. Let's put more money into school physical education programs and after school athletic programs. Nowadays, the money for school athletics goes to the elite athletes who are good enough to play on the sports teams. None of that money is used for the chubby, non-athletic student who needs it the most! We should take the emphasis off of competitive sports and start building non-competitive sports leagues for those students who are not currently physically active.

5. Limit child-targeted advertising. The average child sees 40,000 commercials a year, mostly for high-fat, high-calorie foods. The reason companies spend so much money on child-targeted advertising? Because it works! These commercials prompt children to crave these unhealthy foods. Remember when commercials for alcohol weren't allowed on TV during certain hours? Let's do the same for child-targeted junk food commercials.

These steps may seem severe but they are necessary. Without intervention, our country is going to eat itself to death.

Eat a food you hate!

2009-01-16T14:43:00.002-05:00

www.DrWeigh.com

Eat a food you hate...

I recently read this advice on Twitter and I love it!

Eat a food you hate... Why? Because taste is a learned process. Many people believe that you either like the taste of a certain food or you do not. But actually, taste develops over time. In fact, it often takes ten to fifteen times of trying the same food before you actually learn to like it. So when you eat a food you hate, you are training your taste buds. Before long, you may actually enjoy it!

I found this with brussel sprouts. My mother loves brussel sprouts. Growing up, she made them often. And although to this day she insists it is not true, she always forced me to eat my brussel sprouts. I didn't have to eat all of them but I did have to try them. At that time, I resented it. Even now, my son and I joke about how much I hate brussel sprouts. But the other day, I was served brussel sprouts at a dinner. I took a bite and to my surprise, I loved them! I even ate the entire serving. My son, Zachary, couldn't believe it and he agreed to try them also. He didn't like them but we are not giving up hope!

I don't believe in forcing kids to eat foods they dislike but I do believe in the 'two bite rule'. Insist your child try two bites of each food you put in front of them. If he/she doesn't like it, he/she doesn't have to eat more than two bites. But the next time that food is served, the 'two bite rule' still applies.

Eat a food you hate and you just might wind up with a food you love!

Treadmill Routines for Kids Age 8+

2009-01-15T19:31:00.005-05:00

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Too cold to walk outside? That doesn't mean that your child's fitness regimen needs to chill until Spring. That treadmill gathering dust in your basement can be safely used by a child (age 8+). Just be sure to get your child's pediatrician's approval before starting any new exercise regimen.

To begin, make sure your child is wearing a supportive pair of sneakers. Start the treadmill at a very slow pace so your child is walking comfortably. Do not go too fast or your child may fall down. You can SLOWLY increase the pace until your child is at a brisk walk. Then, choose from the following three workouts.

Workout One: Steady does it...

Keep your child at one pace throughout this workout. Make sure your child is walking fast enough; if your child is not breathing heavily and sweating, increase the pace. Ideally, your child will be unable to speak fluidly in complete sentences. The goal is to walk at this pace for a total of 45 minutes. Work up to this slowly. Start with 5 or 10 minutes and increase the length of time by 5 minutes every day or so.

Workout Two: An uphill battle...

Begin your child on a flat incline and have him/her walk at a brisk pace (as above) for 5 minutes. Then slowly increase the incline on the treadmill. Do this slowly. Increase by 0.5 every 2 minutes until you reach a maximum incline of 4 percent. (If this level of incline is too difficult, back off by 0.5 until your child is able to keep up. As the incline gets higher, you may need to lower the speed slightly. Adjust the treadmill so that your child is working hard but is able to tolerate it.) End the routine with 5 minutes at incline 0.

Workout Three: What goes up must come down...

This workout is an interval workout. You will be frequently adjusting the speed of the treadmill. Begin the workout with your child walking at a brisk pace for 5 minutes. Then increase the speed so that your child is either walking very quickly or jogging for 1 minute. Then lower the speed so that your child is walking at a reasonable pace for 3 minutes. Alternate between 1 minute at a fast pace and 3 minutes at a reasonable pace until your child has been working out for 35 minutes total. End the workout with 5 minutes at a reasonable pace.

A reminder: check with your doctor before trying this workout! Do not attempt these exercises without your doctor's approval.

Not sure how to teach this to your children? Go to http://www.DrWeigh.com to learn more. Our interactive website launches next month!

10 quick tips to save calories...

2009-01-14T17:54:00.002-05:00

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1. Order grilled instead of fried. Avoid the word 'crispy'!
2. Ask for food cooked without butter, oil or mayo. If it can't be cooked without them, ask for as little as possible.
3. Avoid tuna salad. Order turkey instead or make your own tuna at home with low-fat or fat-free mayo.
4. Take your own snacks to the movies. You can pop your own 94% fat-free microwave popcorn at home and save over 500 calories from the movie theater oil-popped popcorn.
5. Avoid creamy or cheesy soups. Stick to red or chicken broth-based soups instead.
6. Be wary of salad dressing. Just because it has lettuce doesn't mean it is healthy. Instead of regular dressing, try fat-free dressing or some balsamic vinegar!
7. Always order the 'kiddie-size' version, when possible. Kiddie-size items usually contain at least one normal adult serving.
8. Serve dinner on smaller plates. You will trick your body into thinking you ate more than you did!
9. Skip regular cuts of meat. Go for extra-lean cuts whenever possible.
10. Limit yourself to one trip to the buffet table. Try to avoid seconds!

Mommy, how calories are in my sandwich?

2009-01-13T11:35:00.002-05:00

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The other night my three-year old daughter asked me how many calories were in her turkey sandwich. I was part horrified and part pleased. I couldn't help but wonder if maybe I had taken things too far. Sure, I want my kids to be aware that some foods are healthy and some are not. But calories? Hmmm...

I like my patients to think of food in terms of colors, not calories. Green light foods are the healthiest. Red light foods are the least healthy. And yellow light foods fall in between. There is certainly no harm in that.

But thinking in calories may be too much. Limiting total calorie intake is clearly necessary for weight loss. But not all calories are equally nutritious. For example, the calories in an apple are not the same as the calories in a few Hershey's Kisses even if they add up to the same total number. So it's not enough to just consider how many calories... you have to consider the type of the calories as well.

I would rather kids think about food quality and appropriate portion sizes. Of course, an overweight child should monitor how much they are eating to facilitate weight loss. In my program, I suggest how many green light foods should be eaten at each meal and snack. If they want a yellow light food, they must give up two green light foods. And red light foods are limited to twice a week.

So, in answer to Danielle's question about her sandwich, I replied, "Honey, a turkey sandwich on whole wheat bread is a very healthy food. Don't worry about calories. Just try to make healthy choices and eat green light foods." To which she responded, "okay!" Simple enough!

Nature Deficit Disorder

2009-01-11T13:59:00.003-05:00

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I recently read an article about a movement in New Hampshire called "No Child Left Inside". The movement is from the New Hampshire Children in Nature Coalition. They have coined the phrase "Nature Deficit Disorder". Basically, our children are not spending enough time outside (in nature) and are suffering. Children who spend time outside tend to be more active and much thinner. Most outside activities are fairly active: hiking, biking, playing on a swingset. Kids who spend a lot of time outdoors burn off excess energy and are more relaxed than those who shun the outdoors. They are calmer and do better in school. The benefits of taking your children outside are many. Don't let the cold weather scare you off. Bundle your kids up and send them hiking. Literally. Go to a botanical garden and admire the winter landscape. Teach them to enjoy nature's beauty. Start today.

Enough with the celebrity diets!

2009-01-11T12:27:00.002-05:00

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It seems everybody is talking about celebrity diets. Enough already. I don't think that information helps anybody. I bet it would be much easier to lose weight with a personal trainer, a private chef and a personal assistant. Plus, who has time to work out two hours a day? And most of these celebrities use very unhealthy methods. Detox cleanses? Please...

There is no secret to losing weight. Eat less. Exercise more.

My thoughts on the latest diets advertised by Us Weekly and their appropriateness for kids:

The Fresh Diet: High priced meal delivery system based on the Zone philosophy (40% carbs, 30% protein, 30% healthy fat).

Even if you have the cash for this, it doesn't teach you or your child anything about nutrition and making healthy choices. Once you go off the program, you will likely gain the weight back because you haven't learned anything. Plus, your child can't go to playdates and eat with friends. This may work for Paula Abdul, but it is definitely not a child-friendly option.

The Eat-Clean Diet: No sugar, white flour, alcohol and processed foods.

I don't know how long anybody could last on this one. Can you imagine sending your child to a birthday party on this plan? This could never work for a kid. And I don't really think this could work for an adult. It is too restrictive. How about going for moderation instead of total deprivation? Nicole Kidman and Halle Berry are on their own with this one!

Eating in the Raw and The Raw 50: No food cooked above 116 degrees.

Umm... I don't even know what to say about this one. The logic is supposed to be that the uncooked foods contain more enzymes, which may help you lose weight. There is absolutely no science backing this up. How could anybody eat this way for more than a day? I probably couldn't even do it for a day. Demi Moore, Carol Alt and Alicia Silverstone must have more (unnecessary) discipline than I do. No thanks! And I am not even going to address the suitability of this for kids. It's just too ridiculous.

The 5-Factor Diet: Low-glycemic index carbs, low-fat protein, healthy fats, and fiber. Follow it 6 days a week and splurge on day 7.

This is the most reasonable of the lot but is still too restrictive for kids. Children would definitely not be able to eat anything from the school cafeteria and would have a tough time on playdates. Plus kids (and adults) can do major damage on their binge, I mean splurge, day. I would rather teach consistent moderation than six days of deprivation with one day of binging. I guess that Kate Beckinsdale, Eva Mendes, and John Mayer are sure to keep their splurge days in check.

Skinny Bitch in the Kitch: Vegan diet (no animal products, including fish, chicken, and dairy), no caffeine, and no simple carbs. Also no calorie counting.

Well, even the name tells us that this is not appropriate for children. Kids, teens, (and adults) need protein and this diet limits most of the palatable protein choices. Not many kids are content eating beans, nuts, and tofu at each meal and snack. Plus, where is the calcium coming from? Natalie Portman and Pamela Anderson must be eating lots of green, leafy veggies or they will have issues with osteoporosis in the future!

Let's stop this trendy fad diets. Watch portion size, make healthy food choices, and exercise.

Not sure how to teach this to your children? Go to http://www.DrWeigh.com to learn more. Our interactive website launches next month!

You do not need to give up entire food groups to lose weight.

We have managed to make sushi fattening!

2009-01-09T13:22:00.004-05:00

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Americans have the ability to take any healthy food and bastardize it into something fattening. We have even managed to ruin sushi.

I had a patient in my office, discussing which types of foods she likes to eat. I was thrilled when she mentioned that she loves sushi. After telling her that sushi is a particularly healthy type of food, I asked her which types she enjoys most. "Oh, I eat everything," she began. "Shrimp tempura rolls, spicy tuna rolls, Philadelphia rolls and Spider rolls." Each of those types of rolls is unhealthy in its own way! Shrimp tempura rolls are fried. Spicy rolls of any kind are made with mayonnaise. Philadelphia rolls contain cream cheese. And Spider rolls are also fried. Hmmm... not one of these rolls is nutritious.

Why have we created these unhealthy options? Sushi should be fish on rice. It's even better when served on brown rice! Don't order your children sushi that contains these fattening ingredients. Instead, opt for rolls that include combinations of fish, cucumber, avocado, and other vegetables. Refuse to order anything tempura, spicy, or with cream cheese. And give brown rice sushi a chance. Brown rice contains fiber which helps to keep your children feeling full longer! They probably won't even notice the difference.

Top Ten Least Healthy 'Salads'

2009-01-07T22:35:00.002-05:00

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Top Ten Least Healthy 'Salads': in no particular order

1. Taco salad- The beef, cheese, and sour cream make this a calorie nightmare. And that is before you add on the shell!

2. Tuna salad- Tuna itself is great... but the mayonnaise ruins it!

3. Potato salad- Carbs and mayo- not a great combination.

4. Caesar salad- Caesar salad wins the marketing prize. For some reason, everybody thinks it is healthy. But it is horrendous. The dressing, the cheese, and the croutons all add up to a disaster.

5. Chicken salad- Again, the mayonnaise makes this a nutritional no-no.

6. Any type of Crispy salad- Crispy equals fried. Enough said.

7. Macaroni salad- A white starch and mayonnaise. Not a healthy ingredient to be found!

8. Shrimp salad- I suppose this is the best of the worst. Still, not a great choice.

9. Cobb salad- Blue cheese, eggs, and bacon. Can you feel a heart attack coming on?

10. Egg salad- One of the worst!

Now- let's try to make these into healthy meals.

1. Taco salad- Skip the beef and order chicken instead. Hold the cheese and sour cream. Instead, ask for a small amount of heart healthy guacamole and lots of salsa! And definitely don't eat that taco shell!

2. Tuna salad- Use tuna packed in water, not oil. Instead of regular mayonnaise, opt for fat-free or low-fat mayonnaise and use it sparingly!

3. Potato salad- There isn't much you can do with the potatoes, but you can use fat-free or low-fat mayonnaise.

4. Caesar salad- Pass on the cheese and croutons. If possible, use a fat-free Caesar dressing. If that is not an option, ask for the dressing on the side. Mix a small amount of the dressing with balsamic vinegar (not vinegarette) to dilute. Use this mixture sparingly!

5. Chicken salad- Fat-free or low-fat mayonnaise will drastically reduce fat and calories!

6. Any type of Crispy salad- Order your protein grilled instead of fried. Your heart will thank you later.

7. Macaroni salad- Use a whole grain pasta and fat-free or low-fat salad dressing.

8. Shrimp salad- I am sure you can guess this trick... fat-free or low-fat salad dressing.

9. Cobb salad- How about using egg whites and turkey bacon? Also, try a fat-free blue cheese dressing, if possible. If not, quickly dip your empty fork into the dressing before spearing the lettuce. This gives each bite a small burst of flavor without all the calories and fat.

10. Egg salad- Egg whites and fat-free or low-fat mayonnaise. Voila! Your meal is healthy.

** Note that low-fat mayonnaise is not the same as light mayonnaise. Light mayonnaise has many more calories and fat grams and is not anywhere near as healthy.

Exercise for children

2009-01-06T20:23:00.002-05:00

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I had a great visit with a patient today. She is twelve years old and has already lost about 15 pounds. She has more to lose but is getting closer to her goal every day. Today we discussed exercise. She loves to dance! In fact, she takes about six dance classes a week (2 classes a day, 3 days a week).

This patient has tried lots of different exercise regimens. She sometimes goes on the treadmill. Other times she goes on her trampouline. But she always comes back to dance. It is truly her passion!

So we decided to base her exercise routine on her dancing. We determined that tap dancing is the most vigorous type of dance. When she is tapping, her heart is racing and she is sweating. So we decided that, instead of suffering on the treadmill, she would tap to her heart's content.

The patient (who asked that I keep her name confidential) aims to exercise five days a week. She takes her dance classes three days a week and taps on her own twice a week. She is getting the exercise that her body needs- and enjoying every second of it.

Tip for parents: Find an active activity that your child loves and try to base their fitness regimen around that. If they love soccer, have them do soccer drills for exercise. If they love jumping rope, let them do that for exercise. A child (or an adult) will only stick to an exercise regimen if he/she enjoys the activity. The more they enjoy the activity, the more they will exercise.

LIFT Gym

2009-01-05T22:55:00.002-05:00

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I just started referring patients to a new gym in Roslyn, called LIFT. And I am very impressed with it. First, I just love their catchphrase.

Lift: It's a lifestyle, not a competition.

How great is that? So many gyms get that wrong. I hate it when people are at the gym to show off. When I go to the gym, I just want to work out and relax. I can't stand it when everybody around me has their hair done and their makeup perfect. It's a gym- not a meat market!

But this is even more important for children, particularly overweight children. Overweight children need a place to exercise where they do not have to worry about being judged. And LIFT is just that place! It has a great, laid-back vibe. And the owners are always around, monitoring the gym and making sure that everybody is exercising safely. In fact, if they see that someone is performing an exercise incorrectly, they will stop what they are doing to go help the person. It is such a friendly environment.

My advice to parents who don't live near LIFT... shop around until you find a gym with a casual atmosphere. Don't bring your overweight child or teen to the trendiest gym in town. It is much better to find a smaller gym with caring staff. You don't want to have your child intimidated by exercise. Spend some time looking for the perfect gym. It is so very important.

The vacation is over...

2009-01-04T19:56:00.002-05:00

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Well, the vacation is over and tomorrow we all go back to work, school, or our regular routines. It is likely that many of you did not eat as well during this vacation as you had planned. Most people enter December with additional pounds hanging on them.

So, now what?

There are two mistakes that you do not want to make.

Mistake 1) Giving up. Don't get so overwhelmed by the extra pounds that you do nothing. Regardless of how much weight you gained over the holidays, you can still take them off.

Mistake 2) The starvation diet. It is tempting to try to starve the weight right off. That is the worst thing that you can do. Nobody can stick to a starvation diet without, well, starving themselves to death. And since you are clearly not going to do that, at some point you will give in and regain the weight that you lost (and then some). Even though the weight came on over a few weeks, you will not be able to (safely) take them off in just a few weeks.

The best thing to do is go back to basics. Eat a reasonable number of calories. Cut back on sweets. Increase your exercise. Eat mostly fruits, vegetables, lean sources of protein, and whole grains.

Don't try to lose it all at once. Slow and steady always wins the race.

And if you need help, by all means, give us a call at 516-801-0022 for more information on our weight loss program.

Good luck. See you at the gym!

My son put it perfectly...

2009-01-02T16:57:00.002-05:00

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Happy New Year everybody! I hope you all enjoyed your holidays without indulging too much. I will admit that I wasn't as good as I could have been but I am looking forward to getting back on track now that things are back to normal.

I did make a New Year's Resolution... I will blog more often. I know you all are reading this and checking it often- so I will make sure I get here more frequently.

I finished filming a segment for the 10 pm news on Channel 11 that will air tonight (do you like how I threw that plug in there?) and decided to treat my kids with frozen yogurt. They were thrilled when I walked in the door! We all sat down and began to eat. About one quarter of the way through, Zachary (my 6 year old) looked at me with such a sad look on his face. "Mommy", he said. "My tummy is telling me that I am full but I really want to eat this! What should I do?"

Well- isn't that the question that we all struggle with? We know that we are full but the food looks so good. What do we do?

I said to Zachary, "What do you think you should do?" He looked at me and said, "I should probably put it in the freezer and eat the rest tomorrow." "That's a great idea!" I told him. And that is what he did.

This is an important lesson to teach to your children. The next time you think that your children are eating because the food tastes good (and not because they are full), talk about it. Explain that our bellies hurt when we eat after we are full- and that it is not healthy. Tell them that they can save the yummy food for later. Always give them the option of taking food home so they don't think it is a now or never situation!

Wouldn't it be great if they could learn that lesson when they are younger so it becomes an ingrained habit? Start teaching your children healthy habits from a young age so that healthy choices become second nature!

And just so you don't think that my kids are perfect- as soon as we put his yogurt in the freezer, he turned to me and asked, "Now that I didn't finish the frozen yogurt, can I have a few Hershey's Kisses?" WHAT? "No," I answered. "That defeats the whole purpose!!!" I guess we all have more work to do!

Nestle Tollhouse Cookies

2008-12-21T19:03:00.002-05:00

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Nestle Tollhouse chocolate chip cookies... Boy do I love them. In fact, I simply cannot control myself when they are around. For this reason, I have never baked them with my children. So you can imagine my horror when my husband decided that he just HAD to bake them with the kids today. At first I protested. But then I thought about it. It is okay to bake cookies every once in a while. But how could I do that without going crazy? And without my kids binging on cookies for the next few days.

Doug came home with the cookie dough. I have never seen such a big roll of cookie dough. He saw me look at it and said, "I had the choice of the one that made 17 cookies or this one that made 32 cookies. And this one was only a dollar or so more expensive!" Hmmm... my husband fell into the 'super size me' trap. Yes, it may make more sense from an economic standpoint. But we do not need to eat 32 cookies- regardless of the price.

But then Doug said something that made a lot of sense. "I just figured we would make a few cookies for today and freeze the rest of the cookie dough until we decide to bake them again."

What a great idea! We didn't have to make all the cookies at one time. Instead, we made a small tray of cookies with just enough for each of us to have three or four (not at one sitting but over the next day or so). And we just stuck the rest in the freezer. We were all happy, indulging in the most delicious cookies. But we were not overdoing it. And I know that if we had made all the cookies, they would be gone in a few days (or until I got sick of the kids eating them and just threw them out in the trash). And that really would not have made economic sense!

Ha! As I sit here typing this, I realize that I should divide the rest into three or four small bags before it freezes so I can just take out another small portion when we want to bake again- without having to defrost the whole thing. I think I will go do that right now!

Healthy Fettuccine Alfredo

2008-12-10T18:27:00.003-05:00

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My family has discovered a healthy way to eat Fettuccine Alfredo. We found a packet of Alfredo Sauce mix from Knorr's at our local supermarket. There are 180 calories and 4.5 grams of fat in the entire package (which served our entire family). The directions call for butter/margarine and milk but we didn't follow them. Instead, we mixed the packet with skim milk and omitted the buter/margarine completely. I will admit that the sauce was slightly thin- but it was delicious. We served the sauce over whole wheat fettuccine. My children went crazy for it. My daughter said, "Mommy, I love this!" My son proclaimed, "This is my new favorite dinner!" I was thrilled- although I did warn them that we would NEVER order the dish in a restaurant because the restaurant version is so unhealthy. Try it and let me know what you think!

Let's go nuts!

2008-12-03T17:55:00.002-05:00

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Nuts are an extremely healthy snack for kids because they contain the healthy type of fat: monounsaturated fat. Monounsaturated fats actually don't raise 'bad' cholesterol but do raise 'good' cholesterol. The fiber in nuts helps to keep you full and the high fat level helps to keep you satisfied. Nuts have been shown to be part of a healthy diet. They can even decrease your risk of heart disease! Of course, you want to watch your portion size because nuts do contain calories. But if you keep your intake at a moderate level, they are a great snack.

Great nuts to snack on include:

peanuts (which are actually legumes but have similar a nutrient profile to nuts)
walnuts
almonds
pistacio nuts
macadamia nuts
cashews
pecans

One other caution about nuts: they should not be given to children under the age of two years. If you have a strong family history of nut/peanut allergy, wait until your children are three years before you introduce them. You also want to watch your children as they eat nuts as they can be a choking hazard. Children should be sitting down while eating nuts.

Enjoy!

Thanksgiving Dinner

2008-11-30T20:23:00.002-05:00

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Well, the Thanksgiving weekend is finally over! How did you all do? Did you follow my 'Holiday Tips?' My family did- and we survived Thanksgiving without any extra pounds (or cholesterol).

I gave my kids a snack before heading out to my Aunt's house. When we got to the party, I let my kids eat a few appetizers and then encouraged them to leave the den with the food. Instead, I set up some activities in the next room. We started dinner with a salad. Then, when the main course was served, my husband and I made plates for both kids. I started their plates with a nice serving of white meat turkey and some broccoli. Then I added two tablespoons of mashed potatoes and a medium serving of candied yams. I avoided the stuffing because it is very caloric and while my kids like it, they don't love it.

After dinner, the kids ran to play while the adults helped clear the table. Then, dessert was served. Each child got to pick their dessert of choice. One serving and they were done.

We definitely had a happy Thanksgiving! Hope you did too.

Back from Disney World

2008-11-26T08:11:00.002-05:00

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Hi everybody! I am back from my vacation and my blogging hiatus. We took the kids to Disney World and we all had a blast. I was actually very impressed with Disney, in terms of nutrition. Of course, they had the junk food. But they also had healthy options. In fact, they had a fruit and vegetable cart in the middle of the Magic Kingdom! And to my delight, there was a line waiting for fruit. (This was actually one of the very few lines we saw at Disney! The place was empty.) Also, all of the restaurant/cafeterias had kids' meals which came with a main course and a choice of two of the following: grapes, apple slices, carrot sticks, or applesauce. None of the kids' meals included french fries. Fries were available for an additional charge. What a great idea! Why not make the fruit and veggies the standard- with an option of fries, rather than making fries the standard with the option of fruit/veggies. I think Disney has it right. Hopefully other companies will follow suit!

Subway

2008-11-10T18:04:00.002-05:00

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I had a great meeting with Subway today. The Subway people are intent on providing healthy choices for children. Lanette, the official Subway Registered Dietician, went over the menu, pointing out all the healthy options. They are offering kids' meals with a choice of mini-sandwich with baked potato chips, low-fat yogurt, or apple slices. They also offer bottled water, juice, or low-fat milk for a beverage. They are proud that they do NOT include a cookie with the meal (although they do include a toy). The Chief Marketing Officer told a story about going to McDonald's and ordering apple slices. The server placed the apple slices and a container of caramel on his tray. He said, "No thanks. I don't want the caramel," and the server said, "But it all comes together." "Why," he asked. "Aren't apples naturally sweet enough?" It seems that McDonalds insists on making everything more caloric than it needs to be. Subway does not. Subway is also spending money promoting children's health issues. Jared was also at this meeting. What a nice guy. He has started his own foundation to increase awareness about childhood obesity. He goes to schools all over the country, warning kids not to make the same mistakes that he made.

I can honestly say that I endorse Subway and its products. Parents can be sure that Subway will provide a fast, inexpensive, HEALTHY meal for their children.

How to teach your children to enjoy fresh herbs in their food.

2008-11-05T19:34:00.003-05:00

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Herbs add lots of taste to food without adding lots of calories. But most of my patients tell me that their children refuse to eat anything with 'clumps' of green in it. They are missing out on a very low-calorie way to make their food taste better. Read on to see how I handled introducing my children to herbs in their food.

The other night, I was eating a dinner of chicken and barley. The chef had used a bunch of different herbs in the seasoning. I didn't know which herbs they were- but they smelled and tasted great. My kids were examining my plate, as usual. "Mommy, I want some rice," my daughter told me. I let her try the barley and she liked it. "This type of rice is called barley," I explained. "What's this?" my son asked, pointing to a dark green leaf on my plate. "That's a seasoning, a type of herb," I informed him. He wrinkled up his nose. I told him, "It smells and tastes great. And it's healthy!" He looked at me skeptically. "I want to smell it," he said. So I held the leaf up to his nose and he inhaled the aroma. "It smells good," he said.

Now- you have to realize that my mother has an herb garden and has always let him smell and taste the different herbs. We had conditioned him to the idea of herbs.

"It tastes great, too," I said. He agreed to try it. "Wow, it does taste pretty good." I replied, "It makes my chicken taste extra fresh and extra delicious." "Cool," was his reply.

Let's analyze this a little more closely.

The first step is to introduce your kids to herbs from a young age. Plant a small pot of parsley and mint. Let your child watch it grow. Water it together. Pick leaves, smell them, and taste them. Teach your children that these herbs make food taste better and are very healthy. Then, when they encounter them in restaurants (or even at home), they are used to the idea of 'leaves' in food.

Secondly, let them see you enjoying foods with herbs. Zachary was skeptical until I told him that it makes food taste great. It was a stress-free environment. I don't think it would have been as successful if I have put a plate of chicken with herbs on his plate. But since it was on my plate, he knew that he didn't have to eat it if he didn't want to. Plus, everything tastes better from mommy's plate!

I also think it helps to let them smell the herbs. Our smell sense is closely related to our taste sense. He smelled it and recognized that it smelled just like the herbs he grows with Grandma.

Finally, ask them to taste it. Just be sure to act very positively about it. Don't say, "Taste it. You don't have to eat more if you hate it." That implies that you think there is a good chance he is going to hate it. Instead, say "Taste it. I just know you are going to love it as much as mommy does!" It puts a more positive spin on the food.

Good luck!

Why don't I exercise more often?

2008-11-04T16:44:00.005-05:00

My patients often tell me that they want to exercise. They have no problem starting an exercise regimen. Yet they are unable to continue with an exercise regimen. "I always have such good intentions," they tell me. "I even plan when I want to exercise. But then something always comes up and it just doesn't happen."

How can we handle this? The bottom line is that exercise is essential. Planning is definitely the first step but you have to follow through. Consider it an appointment. You wouldn't just bail on a doctor's appointment or a piano lesson. So don't bail on your exercise. If you have a calendar, write it down. Don't accept any excuse to cancel.

Another idea is to exercise with a friend. If you can't actually exercise with a friend, at least pick an 'exercise buddy' to keep you on track. Make a deal with a friend that you will report to each other with your exercise progress. It is psychologically more difficult to skip an exercise session if you know you have to report to somebody.

You can also come up with a reward for yourself for perfect exercise attendance. For example, treat yourself to a manicure if you work out four days this week. Or ask your parents if you can stay up a half hour later for each day that you exercise.

Don't let excuses derail your exercise plans. Stick to your program and you will see great results.

How was Halloween?

2008-11-02T19:21:00.002-05:00

Hopefully, we are all coming out of our Halloween chocolate-induced comas. Now it's time to reflect on the holiday. How did it go? Did your children eat every piece of candy in sight? Or were they able to moderate their intake?

I'll be honest... my plan backfired. Throughout the year, I monitor my kids' junk intake but I have a sweet spot (ha!) for Halloween. So, as in the past, I told my children they could eat as much candy as they wanted. In the past, they ate a decent amount and then decided they were finished. This method allowed my children some unrestricted candy intake- but I was there to make sure it didn't go overboard. And in the past, I didn't have to intervene.

This year was different.

My son didn't stop eating chocolate. I broke my first rule by not leaving enough time for my children to eat a healthy snack before leaving the house. So we went trick-or-treating on an empty stomach. And we went before dinner so they were hungry.

By the time we got back home, I was in a bind. Naively, I had told my son that he could eat as much candy as he wanted. But I realized that I didn't really mean it. I was getting nauseous as I watched him eating chocolate after chocolate. My husband and in-laws actually intervened. We were all aware of the irony of them telling me that I was giving the kids too much chocolate. Luckily, they played my usual role of the 'bad guy' and made him stop eating. But I learned my lesson. There will be different rules next Halloween.

Hmmm... maybe I need to read my own newsletters a little more closely!

Happy Halloween. And don't forget to vote on Tuesday.

Newsday's Article on School Lunches

2008-10-28T10:43:00.003-04:00

www.DrWeigh.com

The recent articles in Newsday about school lunches were interesting. Schools need to make money (or at least not lose money) on food sales. The sad truth is that the healthier the meal, the fewer kids want to buy it. One statistic showed that schools make up to half their profits on the sale of chips and cookies. At a recent PTA meeting in my district, the moms told me that their kids have been complaining about the pizza. They said that the children no longer wanted to buy lunch on 'pizza Fridays'. This change occurred at the same time the school began serving whole wheat pizza with low-fat cheese. I don't know how to solve this dilemma. Perhaps as parents we need to convince our children that healthier food is better for our bodies, even if it doesn't taste as good. My experience has shown me that school officials are more than happy to make these healthy changes. It is the parents (and the children) who are hampering the process. Parents want school lunches that their children will eat. And children don't want to eat the healthier options. At our PTA meeting, the parents will asking for the old (more fattening) pizza instead of the healthier pizza. Personally, I tell my kids that they need to eat the healthier food. I don't really give them a choice. If they don't like the school option, they can bring a healthy lunch from home. But then the school loses money. It is a hard situation.

Desperate Housewives

2008-10-26T18:58:00.002-04:00

www.DrWeigh.com

I recently read an US Weekly article about the overweight child actress, Madison de la Garza, on Desperate Housewives. Critics fear that the actress's self-esteem will suffer from being ridiculed on television. I certainly feel bad for that little girl. It's one thing for an adult to decide to be the butt of a joke on TV; it is something else for parents or an agent to decide that. At one point in the show, Gaby is driving the car and making her daughter, Juanita (played by de la Garza) run after her- for exercise. Every time Juanita gets close, Gaby drives a little further. It's so degrading. The producers claim that they arrange the shooting schedule so Madison doesn't see the jokes about her being filmed. But at the end of the article, they talk about the actress watching the episodes with her family. So obviously she realizes that she is being made fun of. Child obesity is serious. And the show is making it into a joke. A fat joke. I really don't approve.

Nutrient Rich Foods Index

2008-10-22T19:21:00.002-04:00

www.DrWeigh.com

Adam Drewnowski, PhD, has an interesting proposition. He wrote an article for the Nutrition Reviews magazine, in which he discusses his proposed Nutrient Rich Foods Index. He wants to rank foods based on their nutrient content. Foods with unhealthy nutrients would be lowly ranked. Foods with healthy nutrients would be highly ranked. Dr. Drewnowski would like all food packages to be labeled with the foods nutrient foods index so consumers would know which foods are healthiest.

In theory, it sounds like a good idea. I am assuming that higher calorie foods and higher fat foods will be given lower ratings. We definitely need something to help consumers make better choices. Perhaps this will be it!

I will keep you posted on any developments!

Trans-Fat Free

2008-10-16T18:12:00.002-04:00

www.DrWeigh.com

The FDA is allowing nutrition packaging to mislead us. A patient brought in some delicious Fiber One muffins the other day. She also brought the box so she could show me how healthy these muffins were. As we looked at the nutrition label, she said, "I used all the mix but made one quarter the number of muffins because otherwise the muffins wind up way too small." So to be accurate, we would have to multiply everything on the nutrition label by four to get an accurate assessment of what we had eaten. I looked at the front of the box. It said, "Trans-fat free" in big letters. I then looked at the nutrition label. Trans fat: 0 g. But then I looked at the ingredient list and there it was- PARTIALLY HYDROGENATED SOYBEAN AND/OR COTTONSEED OIL. Wait a minute... a partially hydrogenated oil is a trans fat. How can they advertise that it is trans fat-free when there is a trans fat in the ingredient list?

Let's look at this more closely:

Serving size: 1 muffin Serving we actually ate: equivalent to 4 muffins
Calories: 190 Calories we ate: 760
Total fat: 3 g Total fat we ate: 12 g
Trans fat: 0 g Trans fat we ate: WE DON'T KNOW!!!

How is it that we don't know how much trans fat we ate? Because a product can be advertised as 'trans fat-free' if it has less than half a gram of trans fat per serving. But we ate four servings! So we may have eaten up to 2 g of trans fat, which is a large amount.

Beware of hidden trans fats! Always look for hydrogenated or partially oils on the ingredient list. If they are on the list, the product contains trans fats so be aware of the serving size.

By the way- I wouldn't eat those muffins again!

When you slip up...

2008-10-15T02:45:00.002-04:00

www.DrWeigh.com

What should you do when you lose control? You have been eating healthy foods with proper portion sizes and then... boom... you go crazy. Maybe you drank a glass of wine or two. Maybe you hit the dessert platter with a vengeance. All you know is that you didn't do well. Now what?

The mistake that many people make is thinking, "Okay, I blew the day (or the week) and no matter what I do now, I can't recover from it. I may as well eat the rest of this cake. I will get back on track tomorrow (or next week).

No, no, no! That is the worst thing you can do. The moment you catch yourself, get right back to your good habits. Even if your 'slip' was 2000 calories worth, it is still better than a 3,000 calorie slip. Don't fall into that trap. Immediately get back to your good habits and a slip won't turn into a neverending slide.

What is an ideal weight?

2008-10-13T10:55:00.002-04:00

I think our society is very confused about ideal weight. Your ideal weight is NOT the weight at which you could model on the cover of Sport's Illustrated Swimsuit Issue. It is ironic that a society so obsessed with looking emaciated is also so overweight.

My program is targeted to overweight children and teens. A child whose belly does not look completely flat in a bikini is NOT an overweight child. I often have parents (almost exclusively size 0 parents) bringing in their gorgeous, curvy teens, complaining that they are 'fat'. Some will lament that their daughters gained twenty pounds in a year but are unfazed when I point out that they also grew five inches during that time. Children are supposed to gain weight and girls bodies change as they grow and mature. A woman's body is supposed to have curves and yes, some flesh. As mothers, we need to teach our children to love their bodies. Overweight children must lose weight to prevent serious health complications. Yet even those children can be taught to think positively about their bodies. I always frame these discussions by explaining that even though a child looks great, his/her weight can be harming his/her health. Weight loss should be for health, not for bikinis.

Moms, if your child is truly overweight, it is essential to get some help. But please don't chastize your daughters for turning into the women they are destined to become.

Indulging with thought

2008-10-06T13:01:00.002-04:00

www.DrWeigh.com

I am usually a very healthy eater. But every now and again, cravings strike. When I first sense a craving coming on, I sit with it. Very often, it passes. Last night, it did not pass. In fact, I felt it growing stronger and stronger. And since I usually am able to wait them out, when my cravings get that strong, I indulge. I know that if I do not indulge these cravings, they will overwhelm me. I would estimate that I give in like this every three or four months. Last night, I indulged.

Doug, my husband, is very familiar with these cycles. All I have to do is look at him and say, "It's time" and he says to the kids, "C'mon guys, we're going to Friendly's." My Friendly's decadence is always the same. I am actually embarrassed to write it... but I want to be honest with everybody. I order fried clams with well-done French fries and then a Reese's Peanut Butter Cup Sundae. DELICIOUS!!

But I did feast with thought. The clams were incredible but the French fries were just good. I was not going to waste calories on good so I pushed them to the side of my plate and decided not to eat them. Had the fries been amazing, I would have eaten them. I ate the clams slowly, really tasting each bite. I noticed the sensations on my tongue and paid attention to the crunch. I got most of the way through the clams and felt myself getting full. So I stopped eating. I did not want to get too full to enjoy the ice cream. I ordered my sundae with extra fudge and extra peanut butter sauce because if I was going to do it, I was going to do it right! It was incredible. But halfway through, I realized that I was getting too full. And I hate that stuffed feeling. I felt so conflicted. I so rarely eat like this and I didn't want to stop eating. But I knew that I would regret it if I overdid it. So I put my spoon down. And I stopped eating. And that was that. I really enjoyed myself. And I woke up this morning ready to enjoy the healthy fare I usually eat.

It was interesting to watch my children at Friendly's. I watch what they eat carefully but they do have junky food in moderation. They were thrilled to be at Friendly's. Zachary said, "Daddy, I can order anything I want... even chicken nuggets and French fries." But when our meals came, Zachary and Danielle each ate only half of their order. And they did the same with their sundaes. They ate half and then told me that they were full. I was very proud. They indulged the same way that I did. They ate what they wanted and stopped when they were full.

Like my mom always says, "Everything in moderation, including moderation!"

Watch Joanna Dolgoff, MD on WABC Eyewitness News

2008-10-04T21:51:00.001-04:00

Click here to watch Joanna Dolgoff, MD on WABC on Eyewitness News.

http://abclocal.go.com/wabc/story?section=news&id=6431034

The Greenvale School Gets Even Healthier!

2008-10-03T11:02:00.002-04:00

www.DrWeigh.com

I had the opportunity to meet with a head administrator and the head of nutrition at the Greenvale School. I would first like to thank them for welcoming me so warmly. They were very cooperative and listened carefully to my suggestions. It is great to see our schools take such an interest in our children's health. Some suggestions they are considering include offering fruit every morning with their morning snack, serving fat-free salad dressing, using reduced-fat cheese products, and offering reduced-calorie whole wheat bread. I can't wait to see the changes!

Let me know if you would like me to talk to your child's school!

Do we really need to drink 6-8 cups of water a day?

2008-10-02T12:23:00.003-04:00

www.DrWeigh.com

Do we really need to drink 6-8 (eight ounce) cups of water a day? Contrary to what you might hear from many 'diet experts', there are no conclusive scientific studies proving that 6-8 cups of water a day promotes health.

Some weight loss programs advise people to drink 6-8 glasses of water a day so they don't confuse hunger and thirst. Dehydration can definitely be misinterpreted as hunger, but it doesn't require that much water to prevent dehydration. 4 glasses of water a day should be sufficient. Any intake above that will not have much effect.

Some programs claim that drinking 6-8 cups of water a day will decrease headaches, flush toxins, and clear skin. These maladies may be caused by dehydration, but as I previously wrote, 4 glasses of water a day should be sufficient to prevent dehydration and therefore prevent these problems.

One study from Germany maintained that drinking 6-8 cups of water daily caused an increase in metabolic rate. Looking more closely at the data, scientists realized that this increase in metabolic rate was so minimal that it was insignificant.

So- don't worry about chugging water all day. But don't let yourself get dehydrated, either. Four eight ounce glasses of water a day should be sufficient. And don't forget that caffeine is a diuretic. You must drink an extra cup of water for each cup of caffeinated beverage you ingest!

Not all frozen yogurt is created equal!

2008-10-01T16:01:00.002-04:00

www.DrWeigh.com

There seems to be some confusion about frozen yogurt and ice cream.

In my program, low-fat frozen yogurt is generally a green light food. But Ben & Jerry's low fat yogurt is a yellow light food. Why? Because Ben & Jerry's yogurt is a 'premium' frozen yogurt, which means that it has a lot more calories than your basic low-fat frozen yogurt. The same is true for ice cream. Premium ice creams, like Haagen Dazs, contain many more calories than regular ice cream.

Many people aren't aware of the large difference in calories between regular frozen yogurt (or ice cream) and premium brands. So be aware when you are indulging. You may be getting more than you bargained for!

How to survive a holiday dinner.

2008-09-29T14:45:00.002-04:00

www.drweigh.com

The Jewish Holidays are here again. Those of you who celebrate them know what that means- LOTS OF FOOD! How can you enjoy this holiday (or any holiday) without gaining weight? It is a struggle, especially if you have family pushing unhealthy dishes on you.

I will share my survival strategy. I pick my favorite unhealthy dish and make sure that I eat a reasonable portion of it. Knowing that I will be able to indulge in something wonderful makes it easier to pass on the less-wonderful, but still tasty, dishes.

I love noodle kugel. My grandmother used to make the best kugel and although nobody's can compare to hers, I still do love it! So I will be eating noodle kugel at my Rosh Hashana dinner. I will not, however, be eating brisket this year. I really enjoy brisket, but not as much as noodle kugel. So I will resist the the brisket in an effort to keep my calorie intake in control. I will also pass on the other fattening foods and concentrate on the (few) healthy options available. I will have turkey and vegetables with my noodle kugel.

The same goes for dessert. Offer to bring fruit salad to your dinner, even if the host doesn't ask you to. This way you can ensure that there will be a healthy dessert option. Don't waste calories on desserts that you can eat any time. So pass on those store-bought brownies and cookies. Instead, opt for the desserts you don't often get to eat. I am going to have a (small) piece of my Aunt Robin's famous brownies. They are decadent and she doesn't make them often. And I will enjoy every bite!

L' Shana Tovah!

2008-09-27T14:57:00.001-04:00

Technorati Profile

Write to me!

2008-09-27T14:54:00.001-04:00

www.drweigh.com

I just want to let you know that I welcome all of your questions and comments. I can see that you are reading my blog- so write to me! I promise to write back.

My child MUST eat McDonalds!?!

2008-09-26T09:14:00.002-04:00

www.drweigh.com

As shocking as this may be, some mothers are insisting that their children be allowed to eat McDonalds for lunch during school. The Roslyn Middle School principal told the district Health and Safety Committee that each day at lunch, many mothers drive to the school to drop off fast food for their children to eat at lunchtime. What? I can't imagine being so insistent that my child eat something so unhealthy for lunch that I would stop what I am doing during the day, drive to a fast food restaurant, wait on line, and then drive the food to school. And for what? So my child wouldn't have to eat a turkey sandwich for lunch?

The Middle School will be sending home a note explaining that parents may not drop off store-bought lunches in the middle of the day. But what I think is more concerning is that these parents don't realize how harmful this food is for their children. It's one thing to bring a child to Burger King as a treat (although I don't actually do this with my kids). But it's quite another to make sure that this food is a staple of their diet and to go through so much effort to make sure they have constant access to it.

Moms- regardless of the changes made in our school lunch system, nothing beats a brown bag lunch. When you make your child's lunch, you are in complete control of what they are eating. Let's bring back the turkey sandwich.

My ideal school lunch: 2 slices of reduced-calorie whole wheat bread
6 slices of turkey breast, 5 slices of roast beef, OR 4 slices of ham
1 slice of fat-free cheese

1 yogurt or 1 piece of string cheese

100 calorie pack of something yummy

water or crystal light

Roslyn School District

2008-09-25T08:22:00.003-04:00

www.drweigh.com

I had a great day yesterday. I was invited to attend a Health and Safety Committee meeting for the Roslyn School District. Various topics were discussed, including the nutritional value of the foods served in the school cafeterias. I was thrilled to discover that the district had hired somebody to revamp the school lunch offerings. She has already made major strides, including serving whole wheat thin crust pizza made with 2% reduced fat cheese (instead of regular pizza). She also had all the school district deep fryers recycled into scrap metal, since she refuses to allow anything deep fried to be served in Roslyn schools. But what made me even happier was the fact that she (and the entire district, including the Superintendent) were completely open to hearing my suggestions. In fact, we have scheduled a meeting to go through the food choices from start to finish! It is fabulous that our schools are starting to take our children's health more seriously.

There is something that you all can do... please call your school board representatives and your PTA presidents and let them know that you are concerned about the foods offered at your local school. I have been learning a lot about how the school systems work. It seems that it is almost impossible to get anything accomplished without the support of the parents and the PTA. So please make sure that your community leaders know how strongly you feel about this issue! Get involved! Our children need all of our help to ensure their safe futures.

McDonald's does it again

2008-09-24T09:05:00.002-04:00

www.drweigh.com

Well... McDonald's has done it again. Have you guys seen their new ads for the 'third of a pounder' hamburger? What happened- our children weren't getting heavy enough with the quarter pounder so they decided to increase the serving size? Were that many people leaving McDonald's hungry? I'm sorry but nobody should be eating such a large serving size. It's no wonder that the patients in my office have no concept of how much they should eat. When I show them a model of a portion of pasta, they are shocked. They ask, 'how come I am given five times that amount when I go to a restaurant?" Unfortunately, I have no answer for them.

Parents- please be aware of how much your children are eating, especially in restaurants. It is best to order one dish for two children to split, especially with pasta. Restaurant portions are so large and we don't want our children to become accustomed to eating an entire restaurant plate. Get them used to sharing from an early age. Make sure your children understand that restaurant portions are very inflated.

I'm back!

2008-09-22T21:31:00.003-04:00

www.drweigh.com

Hi everybody! I'm sorry for the blogging hiatus but I have been very busy. My practice has undergone lots of changes.

First- we have a new name. We are now called 'Dr. Dolgoff's Weigh: Child and Adolescent Weight Management Program. The change was due to trademark stuff.

Second- we have a new location. We are now at 216 Willis Avenue in Roslyn Heights, N.Y. We now have a suite of offices all to ourself! It feels so great to have so much more space.

Third- my practice have grown. We now have a fabulous Registered Dietician, Lori Palma and a great Social Worker, Danna Gordon. And Marianne Belziti is our incredible Patient Coordinator.

Our new website is www.drweigh.com.

You can reach us at our new e-mail addresses:

Joanna Dolgoff, MD jdmd@drweigh.com
Lori Palma, RD lprd@drweigh.com
Danna Gordon, SW dgsw@drweigh.com
Marianne Belziti mb@drweigh.com

Our phone number is still 516-801-0022. Feel free to reach out to us at anytime!

I'm in the same boat!

2008-08-25T10:28:00.003-04:00

www.thelighterweigh.com

Last Thursday night, I was preparing for a presentation I am giving on 'How To Feed Your Picky Eater'. I was putting together all my tips for parents when I realized it was time for dinner. My nanny had prepared steak (a lean cut trimmed of all fat), mashed potatoes (without butter, milk, or oil) and string beans. Zachary immediately began to throw himself around. "I HATE STEAK!" he screamed. "I WANT TO EAT PIZZA. I AM NOT GOING TO EAT STEAK!" I explained to him that we had eaten pizza the day before at a party and today we eating something else. He would not budge. It was as though I were being tested... was I really prepared to give a lecture about what to do with a picky eater? We would soon find out. I put my foot down. "You will eat what Katie made or you will go hungry. I know that you love mashed potatoes and you need to learn to eat more than just pizza." Zachary told me he would not eat anything and I said that was fine with me. Dinner was served and placed in front of him. Danielle, of course, sat smiling and saying, "Mommy, I love this meal! I'm a good girl, right?" "Yes," I said. "You are a good girl." Danielle and I began to eat and Zachary just sat there. "Can I have peanut butter and jelly?" he asked. "That's healthy." I explained that even though PB&J is healthy, he had to learn to eat with the family. Eventually he took a bite of the potatoes... and then a bite of meat. He ate half the plate by the time dinner was over. At the end of the meal, he asked, "Can we have pizza tomorrow?" I told him I would think about it.

All in all, it was a successful meal. I think I passed the test!

A nice family outing...

2008-08-22T21:51:00.003-04:00

I want to suggest a great family activity. My husband and I take our kids hiking on many Sundays. We love to explore new areas and spend time together, doing something active. It shows our kids how much we value exercise. In fact, my husband and I spend most Friday evenings (our date night) either hiking or biking. We can use the time to chat about nothing or talk about bigger issues. Then we head to a local restaurant for dinner- just the two of us. It is a tradition that we both cherish. And it is great for our children to see how much we look forward to going out and working up a sweat. They are always begging to come with us. That's why our Sundays are so special. They get to join in with us- and learn how much fun exercise can be. Our friends joke with us... "So- hiked any mountains recently?" And we usually respond, "Actually, we did!"

Cholesterol medicine promotes donuts?

2008-08-20T21:11:00.002-04:00

I was walking in my office and saw the funniest thing: a box of munchkins with a sticker promoting a new cholesterol drup. A drug rep had brought it to the office? What kind of message is that sending? Some things are too ridiculous for words.

Are mozzarella sticks healthy?

2008-08-19T21:41:00.002-04:00

www.thelighterweigh.com

I was at a party yesterday and my son took a mozzarella stick from a waiter and asked me, "Mommy, is this healthy?" I had to laugh. "No, sweetheart. It is definitely not healthy." But it was helpful to hear him ask me that. It reminded me that we are not born knowing what to eat. It really is something that has to be learned. We can't assume that our bodies will make the correct choices. I was also glad that my son knew enough to ask. Many children wouldn't care. Of course, after I told him that they were very unhealthy, he informed me that he wanted to eat them anyway. I responded that it was his body and he could make unhealthy choices if he wanted to. In the end, he ate two bites of it and he was done.

Everything in Moderation, Including Moderation

2008-08-18T09:00:00.002-04:00

www.thelighterweigh.com

A patient came into my office last week, extremely upset. She had been following the plan perfectly for a month and had lost an incredible six pounds already. But she went to a party this week and, according to the patient, 'totally blew it'. She was practically in tears. After calming her down, we discussed the party in more detail. Although she was out of 'red lights', she ate two large cookies. I asked her if they tasted good. She looked at me in surprise. "Yes," she said. "They were delicious." So I told her the only thing I was upset about was that she was feeling guilty about it. I explained that healthy eating is a lifestyle change- not a short term deal. In order to keep this up for the long term, we have to allow ourselves some wiggle room. Nobody can be perfect all of the time- and even if we could, what fun would that be? I am a realist. If we aim for perfection, we are guaranteed to fail. I told my patient that I am proud that she ate two cookies and then immediately returned to her healthy eating. That is the key to success. As my mother always says, 'Everything in moderation, including moderation'.

By the way- she lost two more pounds last week, despite eating the cookies. She was shocked and thrilled- and so was I.

Healthy IHOP

2008-08-14T21:10:00.002-04:00

www.thelighterweigh.com

I had a very pleasant surprise this past weekend. As I mentioned last week, Danielle's birthday was this weekend. She got to pick the restaurant for her birthday breakfast and wanted IHOP. So to IHOP we went. And there on the menu- IHOP's healthy breakfasts for kids. They had a few options, all under 600 calories and 15 grams of fat. Still a lot of calories but I am very impressed with the effort. I ordered my kids the 'fruit face'- a buttermilk pancake decorated with a fruit face, small amount of whipped cream, and strawberry yogurt to use to decorate. They LOVED it- and even left a large amount of the pancake over. I have to say that I will definitely be back at IHOP in the near future!

A delicious and healthy side dish... YUM!

2008-08-13T21:08:00.002-04:00

www.thelighterweigh.com

I made the most delicious side dish the other day. I took a small sweet potato and baked it in the oven for 45 minutes at 400 degrees. I didn't wrap it in tin foil or anything- just sat it on the rack. When I took it out of the oven, I cut it in half and sprayed it with I Can't Believe It's Not Butter spray. Then I added cinnamon and Splenda and mashed the insides up. I can't believe how good it was. The skin was crisp and the inside was warm and soft. The ICBINB spray, cinnamon, and Splenda made it taste like dessert. My kids loved it! And it was so easy.

Just thought I would share... Enjoy!

The Olympics... Sponsored by McDonald's???

2008-08-12T18:26:00.002-04:00

www.thelighterweigh.com

Like many of you, my husband and I have been enjoying the Olympics. I love to watch the athletes move- their muscles are so well-defined and beautiful. But I had to laugh when I saw the commercial with the Olympic athletes talking about McDonald's. How often do you think they actually eat that kind of food? Probably never. What kind of a message is this sending to our children? They see these icons promoting that kind of garbage and think that it is okay to eat. They get the message that it is part of a healthy diet. I expect more of these Olympic athletes. It is disappointing to see them selling out like that. I would love to see them race/compete after eating a Big Mac and large fries.

Also- a follow-up to my post about the birthday party. There were sixteen three year-olds. Two of them asked for a second mini-cupcake and one asked for a third (but only licked the icing off of each one). And I offered seconds three or four times! So it seems that serving smaller portion sizes really did lead to fewer calories consumed. Try it at your child's next in-class birthday celebration!

Birthday parties in school

2008-08-07T18:47:00.002-04:00

www.thelighterweigh.com

As those of you who know me already know, I am against parents bringing unhealthy treats for the class to celebrate their child's birthday. Our children are exposed to so much fattening temptation and there is no need for us to make it worse. I can't tell you how many children have cried in my office because they are trying to lose weight and are faced with 'birthday cupcakes' weekly. On the one hand, they want to be good but it is hard to resist when all the other kids are scarfing them down. Why do we need to celebrate with fattening food? Wouldn't birthday watermelon suffice

I believe that a parent has the right to send whatever they want to for their own child. Let the parent give the birthday child a birthday cupcake. But it is not right for a parent to give somebody else's child a food that his/her parent may not allow.

Okay- so that is what I believe. But that is not the rule and all the parents bring in birthday treats. It is now my daughter's birthday. What do I do?

This is a real issue and besides being a pediatrician/child weight specialist, I am also a mommy. Do I really want to be the only one to bring in fruit? It's one thing if that is the rule; it is quite another thing to have the whole class annoyed that Danielle's mommy didn't bring cupcakes. I wish that wouldn't be the case, but I know it would be. And how would Danielle feel?

I have been struggling with this for days. Here is the solution I came up with. Instead of making large or even regular size cupcakes, Danielle and I made mini-cupcakes and I used applesauce in place of half of the oil. There are 17 children in her camp class and we made 40 mini-cupcakes. I plan to serve each child one cupcake but they can have more if they want more. Psychologically, the children are more likely to eat one mini- cupcake and be satisfied than they are to eat half of a larger cupcake, even though they would be eating the same amount. I am very curious to see how many of the three year olds go back for seconds. By doing this, I feel like I am not being completely hypocritical (just slightly!) Everything is okay in moderation and there is nothing wrong with eating a mini-cupcake. Thirty years ago, they were probably considered regular-sized cupcakes.

So- it will be an interesting experiment. I will let you all know how it turns out. I am also interested in hearing your thoughts about all of this.

Now I've seen it all...

2008-08-05T22:25:00.002-04:00

www.thelighterweigh.com

Now I have seen it all... I went out for dinner in the city last night to celebrate my father-in-law's birthday. We went to a great restaurant called Fresco di Scotto. The waiter began to recite the daily specials and I thought I misheard him. "Excuse me," I said. "Can you repeat the last appetizer, please." He said, "Sure. We are serving fried tomatoes." Fried tomatoes??? Are they kidding? Are we frying everything these days? I've heard of the movie- but I didn't think people actually ate them. What's next? Fried lettuce? Will we destroy every healthy food by deep-frying it? Soon there will be no healthy options left. Fried baby formula, anyone?

How can my child be overweight? He doesn't eat much junk food.

2008-08-01T19:53:00.002-04:00

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Almost all of my patients tell me that they don't understand why their child is heavy when he/she doesn't eat much junk food. "He has a pretty healthy diet. We almost never eat fast food. Why is he overweight?"

The answer is easy... portion sizes.

Almost everybody overestimates portion sizes. Think back to the 1950s. Most dinners consisted of meat and potatoes yet people were much thinner. Why? Because they ate much less than we eat now. One serving of a piece is chicken or meat is the size of a deck of cards or the size of the palm of your hand minus fingers. How often do you really eat that little? But back in the day, that was standard and people didn't starve to death. A serving of pasta is about one cup (depending on age). Yet when you order pasta in a restaurant, you are often served four cups or more! Even if you only eat half of your dish, you have still eaten twice as much as necessary.

We need to reset our understanding of normal serving sizes. I don't suggest you do it all at once. If you suddenly cut your servings to ideal serving sizes, you will feel starving. What I do suggest is gradually decreasing your serving sizes. If you normally eat two cups of pasta with your meal, decrease to one and a half cups for a week and then decrease to one cup. Do the same with your protein. If you are feeling hungry, add more vegetables. If you do it slowly, you won't notice the change as much. But you will notice the scale moving down!

Have a Lighter Weigh Day!

How to get yourself to exercise when you are tired.

2008-07-31T20:34:00.002-04:00

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Sometimes it takes a lot of motivation to get yourself to exercise. You know you should do it, but you are so comfortable on the couch. Or you have so much on your to-do list and think that you don't have the time. Believe me- I've been there. So how do I get myself moving? I tell myself that I am only going to exercise for 15 minutes. And who doesn't have 15 minutes to spare? I make myself put on my sneakers, thinking that I can do anything for just 15 minutes. And nine times out of ten, I am so into the workout at 15 minutes that I continue for my usual hour. But there are definitely days when, after those 15 minutes of torture, I turn around and head inside my house. And that's okay too.

The Most Effective Way To Get Your Child To Love Exercise...

2008-07-30T08:57:00.003-04:00

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Studies conclusively show that there is one thing parents can do to get their children to exercise- and that is to exercise themselves. Children of active parents are much more likely to be active than children of more sedentary parents. Let your children see that you enjoy exercise. And if you don't love to break a sweat? Fake it... You don't want your children to think of exercise as a chore or a burden. It should be fun. If you don't like to run, find other activities that you do enjoy.

My husband and I love to go for long bike rides together. We hop on our bikes (with helmets, of course) and explore nearby neighborhoods. It is great exercise and great 'alone' time for us. Now that our children are getting older, they beg to come riding with us. So now we often go to a local park and ride bicycles as a family. You have no idea how cute our two year old looks on her tricycle! Sometimes Doug and I will rollerblade or run while our children ride. Zachary (our five year old) loves to have races- I run while he rides his bike. No matter how fast I run (and believe me, I am competitive enough that I try to win with all my might), he always wins. It is wonderful for his self-confidence.

I love to run- and the kids also want to try to run with me. So when I come back from a long run, I will take the kids and we will all run around the block together. They tend to tire out quickly, but I love the fact that they see running with mommy as a treat. Zachary used to run half a block with me and now he runs two blocks. As he gets older, that distance will keep increasing until my own running buddy!

Truthfully, I used to hate exercise. I never exercised in high school. When I got to college, one of my roommates was an all-national lacrosse and field hockey player- (hi Lisa!). She was my exercise inspiration. I began to exercise to become as lean as she was. She would take me running and I would curse the entire time. She even took me to the lacrosse field- but when she saw my awkward attempts at holding the lacrosse stick, she quickly dropped that idea and we went back to running. At first, I didn't like to run. Then I met two girls (hi Kara and Jessica!) who were aerobics instructors (while still attending Princeton). They took me to a few aerobics classes and I fell in love. I loved the camaraderie of the class, the pulsating loud music, and the feeling of my heart racing in my chest. I took more and more classes- and eventually became an instructor myself. Once I was in better shape, Lisa and I gave running another try- and I loved it. I can't thank these girls enough. By observing them, I learned that exercise could be fun- exactly like what I am asking you to do for your children. These girls have remained my life-long friends and were all bridesmaids at my wedding. To this day, they are some of my closest confidantes.

The bottom line is that children need to see that you value exercise and think of it as fun. If they see you moaning and groaning every time you put your sneakers on, they will not want to try it themselves. Even worse, if they see you lying on the couch and not exercising, they will learn that exercise is not important enough to even try. So go lace up those sneakers and get moving!

But I only ate half the sandwich...

2008-07-27T16:04:00.002-04:00

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It is interesting how serving size really does influence our perception of how much we are eating.

We were upstate this weekend and ordered sandwiches from a new restaurant. I got my favorite (turkey, ham, lettuce, tomato, onion, and honey mustard). When the food arrived, we could not believe the size of thesandwiches! Each one was a huge hero. I picked up half of my sandwich and began to eat. Three quarters of the way through, I was no longer hungry. Yet I found myself continuing to eat because it was "only half of the sandwich so it shouldn't be too much". Mid-bite, I stopped myself, hearing my own voice in my head. How many times have I counseled patients to stop eating as soon as they were full, regardless of how much was left on the plate? How many times have I observed that when served larger portions, people almost always tend to eat more than they need to? I asked myself to put the sandwich down and not let myself fall into the same trap that plagues children (and adults) throughout the country.

So what happened? I put the sandwich down... and then picked it up and finished it. I can't tell you why- I just felt the unfinished piece calling to me. I wish I could say that I was strong enough to resist the temptation- but I was not.

Now I have to try to learn from it. I have known for a while that I don't feel full until I clean my plate. No matter how hard I try, it is very difficult for me to leave food on my plate. So over the last six months, I have made some changes. I switched from dinner-sized plates to salad plates so I trick myself into thinking I am eating more than I am actually eating. I serve myself very small helpings, knowing that I can always go back for more. At a restaurant, I call over the waiter the moment I feel full so I don't have the opportunity to pick at my plate. I usually ask him to wrap it up so I can eat it (or what usually happens- leave it in my fridge until it is barely recognizable and then throw it out) another day. I am famous at my local frozen yogurt store for ordering a small non-fat cone and asking them to give me 'much less' than the normal small serving. Again- I know that if they give it to me, I will eat it- and their smalls are super big!

So what can I do with this sandwich? I can cut the half in half before I start eating and only put one piece on my plate or I can make myself IMMEDIATELY throw the rest of the sandwich in the garbage as soon as I feel full. I will let you know what happens the next time we order from that restaurant.

East Hills, N.Y. is a healthy place to live!

2008-07-25T13:29:00.003-04:00

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I am proud of East Hills, N.Y. If every town took the steps that East Hills is taking to ensure its children's health, America might be able to pull itself out of this child obesity epidemic.

I was frustrated with the lack of healthy food choices offered at our local pool. After one brief discussion with Mayor Koblenz, the situation was immediately rectified! Plans were already underway to turn the pool lunch cafe over to new management. Just days later, I received a phone call from Jim Zanfardino, owner of Delicacies, a wonderful deli in the town of Roslyn. Delicacies is taking over the lunch cafe and Jim asked to meet with me to set up a healthy menu for the children and adults of East Hills. I then received a phone call from the Mayor himself, making sure that Jim had called me.

Today's meeting was so refreshing. Delicacies Deli was open to every one of my healthy suggestions! They are set to offer grilled cheese sandwiches made with reduced-calorie, whole wheat bread and low-fat cheese, prepared without butter or oil, along with a list of MANY other healthy lunch choices. Delicacies will also offer sliced cucumber, fresh fruit, baked potato chips, and pretzels as side dishes. Desserts will include no sugar added fudgsicles and sugar-free ice pops.

I hope that East Hills can serve as a model for other areas. As Delicacies owner, Jim, put it "it isn't that hard to offer healthy options." So why aren't other delis, pools, and towns taking the time to change their menus? I am not sure. Hopefully, word will get out about the healthy changes at East Hills, prompting others to follow suit.

I want to give my thanks and appreciation to Mayor Michael Koblenz and Delicacies Deli.

I hope that residents of this area will let them know that their committment to our children's health is greatly appreciated. Residents of other communities should talk to their community leaders about what they can do to make healthy changes.

Does 'kid-friendly' mean 'fattening'?

2008-07-23T12:59:00.002-04:00

It seems that the phrase 'kid-friendly' has come to mean 'fattening'. When did this happen?

I was on the phone with the owner of a local day camp today, discussing the camp's meal plan. Before I could get into the subject, the owner informed me that the camp had to serve 'kid-friendly' food and was unwilling to change the menu. (* In the owner's defense, the camp does offer healthy options in addition to the less healthy hot lunches. This particular camp does a good job of accommodating campers- so this is not meant to lash out at this owner at all.)

What struck me was his choice of words- as if there were no way to offer healthy 'kid-friendly' foods. Are there healthy 'kid-friendly' foods? You certainly wouldn't think so from looking at children's menus at restaurants. By constantly offering children chicken nuggets and french fries as options, aren't we turning these unhealthy meals into 'kids' meals'?

Why can't we come up with some healthy foods that children like? Or turn some of the less healthy foods into healthier foods by making small tweaks- for example, serving low-fat or fat-free cheese on grilled cheese sandwiches and grilling them without butter. Why can't Burger King's 'apple fries' become the next child food staple? How about replacing fried chicken nuggets with grilled chicken nuggets- serving them with barbeque sauce or some other sauce to keep the taste alive?

What if we changed the way we think about food altogether? We could suggest that fried foods are 'adult' foods, only appropriate for children in small doses. Why are these foods all that different from cigarettes? Cigarettes have terrible medical consequences- just like fatty foods. Cigarettes are addictive- just like fatty foods. And cigarettes provide a quick 'high'- just like these fatty foods. Can we reshape our thinking to recategorize these foods? Sure they taste great (like cigarettes supposedly feel great)- but they are certainly not great for us. Maybe this analogy is a stretch- but it does make a certain point.

I do know that children (and many adults) will turn to these unhealthy foods if they are offered. Children are too young to understand the consequences of their decisions. Parents must be the ones to realize that their food choices impact their children's health.

We need to redefine 'kid-friendly' foods because it is not 'friendly' to offer our children foods that can harm them.

Dr. Dolgoff's Lighter Weigh- at home

2008-07-21T20:55:00.002-04:00

www.thelighterweigh.com

NBC News featured my child and adolescent weight management program nationally last week and the response has been incredible. I am receiving calls and e-mails from all over the country. So I have come up with Dr. Dolgoff's Lighter Weigh- at home version. Consultations are done via telephone and features include a personalized nutrition plan personally devised by me, weekly 25-minute phone consultations, e-mail questions answered at no additional charge, monthly live chats, weekly e-newsletters, a Dr. Dolgoff-recommended scale, and my rewards program (stickers and prizes for progress).

I was all set to start- until my attorney told me that I may need to be licensed in each individual state before I am able to start counseling out-of-state patients. So please be patient while I look into this matter. I promise to get back to you all as soon as possible.

Thanks for your patience!

Joanna Dolgoff, M.D.

Parents must speak up!

2008-07-20T15:43:00.002-04:00

www.thelighterweigh.com

It has been a very hot weekend here in New York and like many parents, I have spent the weekend at the local pool club. And like most local pool clubs, the snack bar area only serves junk. I looked at the menu and had a difficult time finding something healthy that the average child would want to eat. Sure they had salads (with full-fat dressings)- but few children will eat salad for lunch. Our pool club has a no strict substitutions policy so I couldn't even make their "healthy" wrap sandwich into a "healthy" lunch. At about 300 calories just for the wrap itself, wraps are not healthy at all. And the wrap sandwiches at our pool come with full-fat cheese and mayonnaise. The children's menu is typical- pizza, chicken nuggets and fries, and grilled cheese (glistening from all the butter and oil) with fries.

Snack time is no better. Snack choices are regular potato chips, ices, ice cream, and a $7 small fruit salad. Would it kill them to throw in some pretzels or a healthy granola bar? Even a 100-calorie pack of something would be great.

Today I had enough. I cornered our local Mayor (who runs our pool club) and told him how unhappy I was with the choices offered. To my surprise, he was very amenable to my suggestions. He agreed to have me sit down with the snack bar manager to give my recommendations. Just like that- no arguing, no nagging.

Maybe if every parent spoke up, we could make some change. Let's all give it a try. Make sure the owners of your local pools, restaurants, and other eating establishments know that we want (we demand) healthy options for our children.

Child Obesity and Diabetes

2008-07-17T20:55:00.002-04:00

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Obesity is a major risk factor for the development of diabetes.

Type II diabetes used to be called “Adult Onset” diabetes. The name has recently changed to Type II diabetes due to the large number of children developing what used to be an exclusively adult problem. Not long ago, nearly all childhood diabestes was Type I. Now nearly half are Type II. Being overweight is the single strongest risk factor for Type II diabetes.

Let me explain how obesity causes Type II diabetes. Insulin is produced by the pancreas and helps control blood sugar. When you eat, starch is broken down into simple sugars that enter the bloodstream. Sugar causes the release of insulin. Some sugar is used immediately as energy. Insulin takes the excess sugar out of the blood and helps store it in body tissues such as the liver where it can be converted to fat.

Insulin does not work as well in the obese. This is called “insulin resistance”. The body responds to insulin resistance by making more insulin. Increased insulin is not good for the body. Insulin causes increased salt retention and increased constriction of blood vessels, leading to high blood pressure. Insulin also causes the formation of LDL (bad cholesterol) and the breakdown of HDL (good cholesterol).

When insulin resistance first develops, sugar levels are kept under control by the compensatory production of increased insulin. Eventually, the body can no longer compensate and can’t keep sugar levels under control. Blood sugar levels rise and the patient develops type II diabetes.

Health risks of Type II diabetes include kidney failure, blindness, heart disease, and peripheral vascular disease. An adult diagnosed with Type II diabetes may require kidney dialysis or develop a heart attack at age 60 or 70. Ateen diagnosed with Type II diabetes may develop these problems in their 30s or 40s.

Type II diabetes that develops during childhood or adolescence is extremely dangerous. The only way to prevent the development of Type II diabetes is WEIGHT LOSS.

Medical Risks of Child Obesity- Focus on Heart Disease

2008-07-15T21:55:00.003-04:00

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No previous U.S. generation has raised children likely to have a shorter life expectancy than its parents. Epidemiologists at the CDC predict that obesity will soon overtake smoking as the nation's leading cause of preventable death. In the last two decades, doctors have been finding cases of what used to be "adult" diseases in overweight teenagers and children as young as age 6. New research indicates that childhood obesity itself may shorten one's life span, even if that person is not obese as an adult. It is imperative to recognize and treat childhood overweight as soon as possible in order to maximize life span.

Medical complications of obesity include:

Coronary Artery Disease
Congestive Heart Failure
Type II Diabetes Mellitus
High Blood Pressure
High Cholesterol
Stroke
Liver Disease
Gall Bladder DiseaseSeveral Kinds of Cancer
Osteoarthritis
Other Musculoskeletal Problems
Asthma
Sleep Apnea
Infertility in Women
Depression
Other Psychiatric Illnesses

Heart disease is the #1 killer of men and women in the United States. Chief risk factors include overweight, inactivity, hypertension, diabetes, high cholesterol, and smoking. A Harvard study of individuals age 13-18, followed over 50 years, showed that obese boys were twice as likely to die from heart disease versus normal weight boys. Obesity that develops in childhood or adolescence causes a greater risk of early death than obesity that starts in adulthood. Autopsies of children who have died in accidents have shown abnormal fatty changes in the hearts of overweight children as young as 5 years old. It is clear that heart disease can begin at a very early age. According to the American Heart Association, a heart-healthy diet from an early age lowers cholesterol and, if continued, decreases the risk of coronary artery disease in adulthood.

Injecting insulin while eating McDonald's

2008-07-14T19:54:00.002-04:00

My children and I stopped at McDonald's for breakfast this morning. We were on the road traveling back home from a weekend away and were stopped in major traffic. The kids were starving and there was nothing else in sight. We each had an Egg McMuffin(at 300 calories each). Not a great breakfast but also not terrible. We finished it off by sharing a fruit, walnut, and yogurt salad.

But I couldn't believe what I saw in that McDonald's. There was a morbidly obese couple eating next to us. They each had ordered two breakfast sandwiches and hash browns. Before eating, the woman pulled out a syringe (of what I am assuming was insulin) and gave herself an injection.

What will it take for some of us to realize that being obese has terrible health consequences? The fact that she needed insulin was not enough to get this woman to stop eating McDonald's. I understand that I don't know the full story of this woman's life, and perhaps she usually eats healthy and was caught in a tough situation, like my family was. But this woman is not alone. Looking around McDonald's, there were many obese families. Something in our society really needs to change before we all eat ourselves to death.

Apple Fries Update

2008-07-12T15:40:00.002-04:00

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We stopped at a reststop on our way upstate today because my daughter had to use the bathroom. When my husband returned from taking her, I noticed he had a Burger King bag in his hands. My first instinct was to get annoyed. I said, "Doug, you know I don't like you or the kids to eat that junk". He smiled and pulled out two orders of apple fries. "I knew you wanted to see what these looked like". He was right. I threw out the empty bag and handed the kids the "fries". They were so excited. "Mommy- these look like French fries", my son giggled. They really did. I tried one and they were fresh, crisp, and yummy. My children ate them all and gave them a thumbs up. What a great idea! (By the way, I threw the low fat caramel dipping sauce away with the bag, figuring it wasn't necessary- but I looked at the nutrition label first and the sauce only had 35 calories. Not necessary- but not too bad. I am impressed with Burger King's ingenuity and I hope they continue to introduce other healthy, fun options for kids.

Children on Cholesterol Meds- My Thoughts

2008-07-10T19:22:00.002-04:00

www.thelighterweigh.com

I am torn about this issue. On the one hand, we cannot just sit back and watch our children eat themselves to death. One out of every three children is overweight and at risk for medical problems due to their health. There are more children with high cholesterol than ever before. Children are now commonly developing diseases that used to be exclusively adult diseases. The CDC says this generation will be the first generation in history to die younger than their parents- all due to their increased weight and all the problems that go with it. An overweight adult with high cholesterol and diabetes may have a heart attack in their 60s- but a child who develops these illnesses may have a heart attack in their 30s. We must do whatever we can to prevent some of these diseases. How can we not try a medicine that seems to be safe and effective?

At the same time, we must also realize that there are no studies of the long term effects of these medications and there is no hard data that lowering cholesterol by using these drugs will definitively lower the risk of heart disease. So I can understand why some are hesitant.

My bottom line opinion: we must give nutritional and exercise changes a really strong effort first. As the AAP recommends, parents should seek the expertise of a child weight management physician. If that truly does not lower the cholesterol, I think we should give the medications. I think we are obligated to try whatever we can. We know that children with high cholesterol are at severe risk of medical problems and we don't know that the medicines will do any harm... There is no clear-cut answer, and I would love to hear your arguments either way.

Thanks for reading.

Children on Cholesterol Meds?

2008-07-09T20:52:00.003-04:00

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The American Academy of Pediatrics came out with some controversial guidelines this week. I will summarize them for you:

1) All children should follow a healthy diet, including low-fat dairy products for all children older than 2 years. Reduced fat dairy products should also be used in children age 12 months to 2 years who have a family history of overweight, high cholesterol levels, or heart disease and in children age 12 months to 2 years who themselves are overweight.

2) Children and teens with a higher risk of heart disease and with high LDL ("bad cholesterol") levels include NUTRITIONAL COUNSELING, diet changes, and increased physical activity.

3) Children with a family history of high cholesterol or early heart disease, children whose family history is unknown, and children with other risk factors such as overweight, high blood pressure, cigarette smoking, or diabetes, should have their cholesterol levels tested with a fasting blood test between the ages of 2 and 10. Children with normal values should be rechecked every 3 to 5 years.
If lipid levels are high, weight management treatment should begin (NUTRITIONAL COUNSELING) and increased physical activity.
Children age 8 years and older who have an EXTREMELY high LDL level should consider cholesterol-lowering medications.

Let me explain why this is so controversial.

1) We don't know the long term side effects of these medications in children.
2) We don't know for sure that these medications will decrease the incidence of heart disease in children. Cholesterol increases the risk of heart disease and the medications do lower cholesterol- but do they actually decrease the risk of heart disease?

We do know that to date, these medications are safe in adults. We do know that in middle-aged men with high cholesterol, these medications decrease the risk of heart disease. Evidence does not clearly show that they decrease the risk of heart disease in women and there have been no studies in children.

So the question is: if diet and exercise are not enough, should we try these medications in children and hope they do more good than harm, or do we let these children continue to have dangerously high cholesterol levels? Pediatricians are very divided on this issue.

Before I share my thoughts, I would like to hear some of yours.

Shocked at Chili's

2008-07-08T09:21:00.002-04:00

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I was at Chili's the other day and was completely shocked at what I saw. I cannot believe the size of the lunch plates... and I cannot believe how unhealthy the food is. I observed families (some heavy, some not) digging into plates of bacon cheeseburgers, french fries, and nachos- without giving it a second thought. There didn't seem to be any hesitation about eating these foods that are filled with trans fats, saturated fats, calories, and cholesterol. I watched an 8-year old eat an entire plate of mozzarella sticks- as an appetizer! How could a parent allow their child to eat like that? Even the salads are nightmares.

I ordered shrimp fajitas and asked for unmarinated shrimp. I also asked if the entire dish could be cooked without butter or oil (or as little as possible). I asked for lettuce leaves instead of tortillas and extra guacamole instead of sour cream. When the dish was brought to the table, it was glistening with oil. I asked the server and she said, "We didn't use oil to cook it but the vegetables are premarinated in an oil sauce". PREMARINATED IN AN OIL SAUCE? Even veggies have to be full of oil. I guess it was my fault for eating at a restaurant like that. It just shows you that there are tons of secret ways restaurants stick oil and other unhealthy items into the food. Next time I will order a grilled chicken breast (with Buffalo dipping sauce on the side for an extra kick), a dry baked potato, and some steamed veggies (with no oil). Let's hope that works out better.

The bottom line- beware of eating at restaurants like this. Really quiz your server about what is in your dish. And don't be afraid to ask for substitutions.

Eating for sport

2008-07-04T15:59:00.002-04:00

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The Nathan's hot dog eating contest pretty much sums up everything that is wrong with our country. Eating has become our new national sport. I couldn't believe that ESPN was covering this spectacle. I was so nauseous watching these people shoving hot dogs into their mouths, in front of hundreds of screaming "fans". Would people have the same enthusiasm watching an alocoholic drink himself into a stupor or watching a smoker attempt to smoke as many cigarettes as possible in as short a time as possible? No- because we understand that drinking too much and smoking too much are dangerous to our health. Yet overeating is just as dangerous- and much more common. As a nation, we have failed to realize this scary fact. So we continue to encourage each other to keep eating- in fact, at times we even cheer each other on, pretending that there is nothing to worry about. But there is a lot to worry about. And until we realize that, the obesity epidemic will continue.

Early sign of pre-diabetes

2008-07-02T21:29:00.004-04:00

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There is a little-known very obvious sign of pre-diabetes often seen in overweight children; it is called acanthosis nigricans. Acanthosis nigricans is a darkening and thickening of the skin found in skin folds and creases; it is most obvious in the back of the neck, just underneath the hairline.
Acanthosis nigricans is one of the first things that I look for when examining an overweight patient. Acanthosis nigricans is usually seen with conditions that increase insulin levels, such as type 2 diabetes or being overweight. High insulin levels can trigger activity in skin cells, resulting in this dark, thick, velvety skin. Acanthosis nigricans can also be caused by medicines such as human growth hormone and oral contraceptives (aka "the pill"). There is no specific treatment for acanthosis nigricans, although weight loss may decrease its appearance. I always check fasting glucose and insulin levels to make sure that the patient has not yet developed diabetes. Acanthosis nigricans is a sign that a patient's weight is starting to affect his/her health. It should be a wake-up call that weight loss is needed immediately to prevent the development of diabetes. If your child is overweight, be sure to check their neck and make sure that they do not have this sign of "hyperinsulinemia" (higher than normal insulin levels). The absence of acanthosis nigricans, however, does not mean that your child does not have pre-diabetes or diabetes. Any overweight child should have their fasting glucose and insulin levels checked as a precaution.