Can You Lose Weight Over the Holidays? 5 Weight Management Strategies for Your Family

This is a difficult time of year for most people to make healthy choices. We are very busy, weather can be icky, and we are surrounded by unhealthy food at every turn.

We experience all of those obstacles, THEN we take a 2 week winter break! If not organized carefully, we can start the new year several pounds heavier.

Here is a list of strategies that parents and kids find helpful to maintain their weight over the holiday season.

1) Manage the food gifts. As the chocolates and food baskets come in to the house, make a plan  to get them out of the house as quickly as possible! To reduce temptation for everyone, consider donating them to a shelter, giving them to a neighbor or sharing them at work.

2) Do something active EVERYDAY! You have the time - use it! This is a great opportunity to plan family hikes and bike rides. Celebrate winter and bundle up to ice skate with friends, walk in the neighborhood and play games at the park.

3) Change-up the Stocking Stuffers. If you (or Santa) usually put a lot of candy in the stockings, consider small gifts instead. Kids and Teens love to receive small items like Chapstick, socks, toys, lotions, iphone or itouch cases or lipgloss.

4) Plan meals ahead. Make sure there are plenty of healthy choices available. Set out or bring washed grapes, clementines or cut vegetables so you know there are plenty of healthy options around the house.

5) Limit the choices. Studies show that people eat less if there are fewer choices available. Offer or bring one kind of pie instead of three!

6) Do something active EVERYDAY! Oops... did I say that already??

Have a healthy, happy holiday!

Are You Worried About Your Child’s Weight? Easy Changes to Make Around the House

All families can benefit from making these healthy changes around the house:

1)   Switch to nonfat milk and light cheese

2)   Get rid of snack foods like pretzels, chips, crackers

3)   Make fresh fruit available (washed grapes on the counter works wonders!)

4)  Set our washed, peeled and cut vegetables BEFORE dinner

5)   Cook your favorite meals with less oil and butter. Consider using an oil spray.

6)   Pack a healthy lunch (see my previous blog post for lunch ideas)

7)   Avoid having treats and sodas in the house - instead set aside 1 or 2 nights a week as special dessert night and go out for a scoop of ice cream.

8) Have fruit for dessert - every night!

9) Get some exercise – together. Do an evening walk right after dinner 3x a week.

http://weekofmenus.blogspot.com/2010/01/fruit-mosaics-rainy-day-activity.html

If you are worried about your child's weight but you are not sure if they are overweight, check their BMI percentile Kid/Teen BMI Calculator. 

Healthy Turkey Day Tips for Your Family: Creating a Healthier Thanksgiving Tradition

Here are some great tips for a healthier holiday!

Thanksgiving Day – 

Before the Turkey Dinner

Do not skip breakfast and lunch  - eat normal meals until the big one!

Do something active in the morning – run in  a local turkey trot, organize a family game of soccer or a neighborhood flag football game, go on a family hike or bike ride.

Preparing the Food

• Decide which traditions you want to keep – then add some new, healthier ones
• Offer cut veggies and dip for pre-dinner snacks
• Offer fewer choices of desserts – instead of having 5 different types of pie and wanting one of each, serve 1 kind of pie. Research shows that if there are more choices, we will eat more
• Don’t eat too late – eat around 4 or 5 pm so you have plenty of time to digest before bed.
• Don’t linger too long at the dinner table – you will eat (and drink) more!
• Serve (and drink) a lot of water! Make it festive, add sliced limes and cranberries to sparkling water. 

After Dinner

• Send leftovers home with guests
• Spend Friday doing something fun and active if you aren’t hitting the store.
• Keep some leftovers for Friday then set a goal to get them out of the house by Monday!

If you are going to someone else's house:

1) Offer to bring veggies and dip or salad so you know you have some healthy choices

2) Bring a couple of bottle of sparkling water which is festive and appreciated by host!

3) Bring some clementine oranges for dessert.

3 quick recipe suggestions:

1. Grilled Green Beans – toss green beans with a little olive oil, salt and pepper than put in oven at 450 for about 10 minutes. 
2. Mashed potatoes – substitute chicken broth and nonfat milk to keep flavor but avoid the extra calories
3. Offer fruit as a dessert option ( you will be amazed at how fast it disappears!)

Healthy Halloween Tips! Expert of the Month at Lucile Packard Children's Hospital

I am honored to be the "Expert of the Month" at Lucile Packard Children's Hospital.

www.snack-girl.com

Article and original link:

STANFORD, Calif.--(BUSINESS WIRE)--With Halloween spookily approaching, dealing with the annual tidal wave of sugar can be a real challenge for parents. While everyone wants kids to enjoy the day, the candy cargo seems to be getting bigger every year, with parties at school and friends’ houses increasing the loot. That’s why we sat down to get some healthy Halloween tips from Thea Runyan, MPH, at Lucile Packard Children’s Hospital at Stanford. Runyan is the lead behavior coach for the Pediatric Weight Control Program, part of the hospital’s multidisciplinary Center for Healthy Weight.

“Regardless of whether a child has a weight issue, it's vital that he or she learn moderation, and the skill of making healthy choices”

“Regardless of whether a child has a weight issue, it's vital that he or she learn moderation, and the skill of making healthy choices,” Runyan says. “Research shows that kids don't simply ‘outgrow’ the urge to eat unhealthily if they don't possess the tools to do so.”

Here are a few of Runyan’s healthy Halloween strategies:

• One increasingly popular approach is telling kids -- especially younger kids -- about the "Switch Witch" or the "Halloween Ghost." The kids put their loot on the doorstep, and this figure takes it that night, replacing it with something fun but not candy. (Note: Parents must resist eating it, too!)
• Some older kids enjoy trading their candy for cash. Some dentists will buy back kids' candy. Some schools even set up programs where kids can donate the candy to U.S. troops.
• Some parents hand out fun, non-candy items: spider rings, pretzels, stickers and tattoos, for instance. Get creative. For Halloween parties, make "fingers" out of string cheese.
• Don't buy your candy until a day or two before you hand it out. Otherwise, it's too tempting to eat it beforehand. Or, buy candy you or your children don't like. Hate dark chocolate? Make that the treat you give out.
• Emphasize the fun of trick-or-treating, rather than the subsequent feast. And when the trick-or-treating is over, have the kids pick out their favorite 20 pieces to keep. To many parents' surprise, Runyan says, kids are often perfectly satisfied keeping just 20 pieces

http://www.businesswire.com/news/home/20131016006209/en/Tips-Halloween-Candy-Fun-Calories-Packard-Children’s

Motivating Your Child to Lose Weight

Motivation is a tough nut to crack. Everyone is motivated by different things. This could not be more true

than it is for children. Some of the children I work with are motivated to reach their goal with the expectation of an extrinsic (external) reward from day one through month six. Other children never find a reward system motivating. Many children that I work with seem to be initially motivated by an external reward and after a few months are satisfied with meeting their goals and making progress that they become internally motivated to continue with their behavior change - this is the ideal scenario but does not happen to everyone!

Every child, every person, is different but it is very worthwhile for parents to work with their child to figure out what motivates their child so they can continue to positively encourage and support them while they are making healthy changes.

That being said - there are "good" rewards and "not-so-good" rewards 

(I hesitate to say bad).

I recently used this example with a group of parents: "You know when you wake up on Sunday and you feel like you should go on a family outing? That is the perfect opportunity to create a reward for healthy behaviors that you want to enforce!" 

In general, rewards should NOT be:

• Expensive
• Food Related or
• Overshadow the real reward which is to feel good and be healthy!

Rewards SHOULD be:

• Something that interests and motivates the child - not just something the parent would like!
• Given to the child very soon after the child reaches his/her goal
• Active!
• Completed together with parent and perhaps other family members

Successful Reward Ideas (the short list):

• Hike, bike ride, walk
• Visit/picnic in the park 
• Walk and/or visit the library 
• Bowling
• Ice skating
• Zoo
• Trampoline place
• Bounce house place
• Museum 
• Game night (hours of monopoly, Poker!)
• Puzzle night
• Trip to craft store for an activity

Have fun with your kids and celebrate their success. No matter how insignificant it may seem,  small progress is GOOD progress!

How Much Exercise Does My Child Really Need?

This question comes up a lot when I work with families. 

How much exercise do our kids really need?

Here are the National Guidelines:

Children and adolescents should have 60 minutes =(1 hour) 

or more of physical activity DAILY!

•  Aerobic: Most of the 60 or more minutes a day should be either moderate- or vigorous-intensity aerobic physical activity and should include vigorous-intensity physical activity at least 3 days a week
• Muscle-strengthening: As part of their 60 or more minutes of daily physical activity, children and adolescents should include muscle-strengthening physical activity on at least 3 days of the week.
• Bone-strengthening: As part of their 60 or more minutes of daily physical activity, children and adolescents should include bone-strengthening physical activity on at least 3 days of the week.

Source: U.S. Department of Health and Human Services. Physical Activity Guidelines for Americans. Washington, DC: U.S. Department of Health and Human Services; 2008.

The bottom line is that we want our kids moving EVERY DAY - more than what they do at school. As parents, it is easy for us to say that our kids exercise enough at school but the reality is that they don't. Unfortunately, PE is not yet a priority in schools so it is our responsibility to provide additional opportunities for our kids to move.

When I work with families, I ask them to focus on increasing the amount of physical activity outside of the school day. Here are some ideas:

• Walk or bike to school
• If school is too far, drive part way and walk the rest of the way
• Enroll in organized sport programs (there are so many levels now from non-competitive to highly competitive)
• City Parks and Recreation departments have great programs that are reasonable priced! This is great way to try something new...
• Talk to your school PTA about a walking or running club that takes place before school. Incentive kids for every lap or mile.
• Make family time ACTIVE! Go for a hike, bike ride or walk in the neighborhood.
• Suggest non-traditional sports like fencing, rock climbing, ice skating and hockey.
• Consider buying an inexpensive pedometer that records step and encourage them to work up to 10,000 steps a day.

Reminders: 
1) 60 minutes a day is the goal. It is okay if you child is not htere yet - encourage them to start at 20 minutes a day for 7 days, then 30, then 40 etc.
Also, exercise can take place in 10 minute increments. This makes it easier to achieve a goal

2) Exercise is not an option. This is what I say to my kids and my students "Which activity are you going to do" or "What are you going to do to get your exercise today?"

Empowering Your Kids to Make Healthy Choices: Budgeting 101

I was talking with a good friend who is very concerned about her child's weight and does not know what to do. They are fighting a lot over food and she is very upset about how this is affecting their relationship. She has tried all of the typical avenues to get help: physicians (several), dietitian (many), more sports, but nothing is working.

Although she knows my program is successful, like many families, the cost and time commitment are daunting but now she feels desperate. This is a typical pattern for many families that I see. Many other solutions are sought before finally participating in the weight control program where I teach.

But I digress... here is a very valuable tool that will help kids make healthy choices:

BUDGETING 101
In this particular case, the child really wanted a certain special treat and the mom was saying no -  it became a constant battle. I suggested she talk to her daughter about budgeting her treats and let her decide when and what her treat would be. Although very difficult, Mom could not say a word as long it is in her daughter's weekly budget for treats (red light foods).

How to budget:
1) To budget treats most effectively, it helps to have a baseline or an understanding of  how many treats (or red light foods) your child eats in a week. If your child is overweight, they should really try to eat fewer treats (red light foods).

2) After you and your child figure out how many treats they are eating each week, try to set a goal to eat fewer the following week. For example, perhaps your child eats 5 treats a day or 35 a week. Ask them if they can eat 4 a day instead of 5 - then they are at 28 a week.

3) Next, set aside 28 pennies (or beads, erasers etc). There are couple of ways to do this. One is to put 28 pennies in a jar and each time you eat a treat, move it to another jar. Then all week you can see how many are left. BUT, if there is a particular treat you want on Friday night, or you are going to a party on the weekend, you may want to set aside a certain # of pennies AHEAD of time. You are budgeting and planning ahead  for that treat.

In this case, my friend's child wanted a special treat that is the equivalent of at least 3 red lights. I told her that if her child budgets for it, eats fewer treat the other days, and plans for this one treat, the child can have it, AND mom can't say a word...

Do you know what the child did? She decided to split the red light treat with her mom instead of eating the entire thing herself:)

Trick #1: To track the treats (Red Light Foods):  Buy a 7 day pill box

Kids like to put the # of treats (pennies or beads) they plan to have in each day - if they have a special event, they can move them around and add extra to Saturday if there is a big party planned.

This tool is very empowering for the child and it is very liberating for the parent!

Good Luck. Let me know how it goes!

Advocating for a Healthier Environment for our Kids!

My small victories...

• "No Food Birthday" guidelines adopted at 3/6 schools in school district! (those of you who know schools, know that this is a huge accomplishment!)
• Implementation of Stoplight Nutrition at many grade levels in a K-8 school district to teach kids how to make healthy choices.
• Invitations to talk to coaches and parents involved in organized youth sport programs about healthy snacks (or no snacks) at games! Fruit and Water Only!
• City based conversations about community health fairs and farmers markets to increase access to fresh fruit and vegetables.
• Providing more PE in schools!
• Presentations to camp counselors to reduce their consumption of sugary drinks, encourage healthy snacks, and be a good role model for their campers! 
• Staff Wellness - Desk to 5K (a teacher lost 50 lbs!)
• School Assemblies local private and public schools that encourage healthy choices.
• Safe Routes to School - encouraging walking and biking to school

Supporting Your Overweight Child: Healthy Lifestyle Checklist for Families

Healthy Lifestyle Checklist for Families 

□ Do something active every day.

□ Limit TV, computer/video game time to 2 hours/per day

□ Eat dinner as a family at a regular time as often as possible

□ Drink lots of water

□ Limit candy, chips, soda and juice

□ Drink non-fat milk

□ Limit fast food to once a month

□ Eat breakfast, lunch and dinner everyday. Don’t skip meals!

□ Don’t reward with food

□ Offer a variety of different foods

□ Avoid scheduling activities around mealtimes

□ Be a healthy role model!

Creating Healthy Habits: Setting Limits Around Food

Setting reasonable limits around food is critical to creating healthy habits for your children and family. Here are a few great rules/suggestions that I have collected over the years from families, pediatricians and psychologists:

• Three Bite Rule - Eat what is prepared for dinner (assuming it is reasonable) or you must try 3 bites before you leave the table.

• Do Not be a Short Order Cook – see the Three Bite Rule. Kids can try three bites and if they still don’t like it, they can be excused from dinner – for the night!  

Do Not go into the kitchen to make them mac and cheese! Pediatricians have told me time and again that it is OK for a child to go to bed hungry. Remember, it may not even be about the food. Your children are testing you to see if they can get what they want. Your children will not starve if they end up going to bed without dinner.  Hopefully, if you are able to stick to your rule, they will learn that they need to at least try to eat what is served – or they won’t get dinner. 

• Kitchen is closed at 7 pm. Close the kitchen! It is very reasonable to say that NO ONE can go in the kitchen after dinner for food (nonfat milk, tea and water can be exceptions). Your entire family will be healthier if you implement this rule.

• Create Dessert Night(s) Select 1-2 nights a week for Dessert Night. Eating dessert every night is not a healthy habit to teach our kids. Many of the families I work with who are now struggling with their weight, say that they grew up in homes that had dessert every night - those habits often get repeated in our own households. We do want to create a healthier attitude towards dessert including learning how to budget and plan a head for a special treat. Setting aside a couple nights a week for dessert is very reasonable. Try to eat it out of the house to make it a special event. Also, enjoying dessert out of the house will reduce the chance of tempting leftovers.

Making Healthy Changes in YOUR Community

Perhaps it is my public health background, but I am committed to making change which is why I continue to work at Stanford, volunteer on the PTA board, implement a Coordinated School Health Program in our school district, advise local youth sports organization and serve in city government. 

I need to be in situations where I feel like I can make a difference, even in my small community. I believe that parents have a huge voice in creating these changes and collectively, these small victories can make a big impact towards creating a healthy environment for all kids. 

I want to encourage and empower parents to make changes in your communities. You have a strong voice and are in positions that can help support changes. For example, if you are a member of PTA and/or serve on the PTA board at your school, you can get a group of parents together to evaluate the school lunches, the treat/party policy, the PE program and the district's wellness policy.

Other ways you can make a difference:

• If you are a youth sports coach: Ask parents to bring only fruit and water to games. I still prefer no snacks, especially as kids get older. They are often on they way out to a meal after a game anyway. 
• If you have a child in youth sports, volunteer to be the snack parent and (with the coaches permission) implement a healthy snack  policy or tell parents that you and the coach decided you don't need snacks because they are usually going out to eat right after the game. I have found that most parents are actually RELIEVED to not have to worry about snacks.
• Talk to your child's teacher about alternative ideas to celebrate birthdays instead of food and treats. Again, MOST teachers are relieved. They find it to be a real pain to distribute birthday treats and then they have to deal with sugared up kids all day.
• Talk to the school principal about what the school treat policy is during the school day and at school events. 
• Talk to the Superintendent about the district's Wellness Policy. If it is outdated, as many are, offer to help create a task force to look at it more closely.
• Offer to be involved in organizing a school event (book fair, dance, jog a thon, etc.) and encourage healthy snacks. Find other parents who agree with your mission - they are out there - and there are more than you think.
• Instead of food fundraisers at your school (cookie dough, chocolates etc.) suggest a walk-a-thon or jog-a-thon instead. Not only are they great community events, they make a lot of money!

PARENTS: Do not underestimate your ability to make a strong 

impact that will result in positive 

changes for your own child and the community.

REMEMBER: parents, teachers, coaches and administrators  have a responsibility to teach children HOW to make healthy choices and support an environment that supports and encourages those choices!! 

Packing a Healthy Lunch

Despite recent efforts to improve the health of school lunches, they are still falling short. Most families that I work with, give up on the school lunch and resort to packing it themselves.

Below is a basic framework that you and your children can use to build your own lunch.

Here is a list of lunch ideas:

Additional Suggestions:

• Drinks 
• water or 1% or nonfat milk. Maybe you make a deal with your child that they can have juice 1x a week. 
• Make sure the juice box is not more than 6 oz.
• Treats 
• Agree to pack a dessert 1-2 days a week and limit it to 2 small cookies or a small pudding. 
• Putting in a note or little toy/stickers is a great way to brighten their day :)

The "Team" Approach to Kids Weight Control

What really works when it comes to helping children with their weight? There is a list of common themes that I have collected over the years from successful families and one of them is the TEAM approach.

Parents and children who work together as a TEAM to make healthy changes, create a healthy environment, and continually communicate and support each other, tend to be more successful than families where the parent(s) is/are not actively involved in a positive and supportive way. Families where a child is signaled out for being overweight; or where a parent contributes to an unhealthy environment by purchasing and preparing red light foods, eating red light foods in front of the child, taking them out to fast food or treating siblings differently...struggle

So, what does the TEAM approach look like?

•  Parents are positive and non-judgmental of their child's choices. This is hard - it is very hard to watch your child grab an extra cookie - but very important to remember. If a child thinks they are being judged for their food choices, the less likely they will be honest about the choices they are making, therefore, less like to make healthy changes. 
• Parents must be willing to make changes in the house that may be difficult for themselves and other family members like not buying red light foods and eating out less often.
• Parents need to be active participants in the process by exercising with the kids, supporting kids activities and helping to prepare healthy green and yellow light foods.

Try taking a deep breath, taking a step back, and being a team player rather than the parent or the "food police".

Things That Make Me Sad...

• A caregiver who comes in with her child for a follow up appointment* and says that they are making changes – they don’t salt the bacon any more.  
•  A parent who comes in with child for a follow-up. Child has been doing amazingly well several months post program, but suddenly his BMI increases by several percentage points. Child says there are too many redlight foods in the house so it is really hard for him to make healthy choices. Parent  says that it is too hard to keep the house free of red lights because of sibling(s) who don’t [currently] have a weight issue. What is a child supposed to do when they can't shop or cook????
• A child that has to switch houses every week and one parent is compliant and the other parent does not want anything to do with the program so sabotages by taking the child out to eat every night and buys their favorite red light foods – just to prove a point.
•  When one parent is fully engaged and supporting the child but the other parent refuses to make changes and continues to eat Redlight foods in front of the child who is trying to make changes.
• When a parent and child come to see me and I ask the child how they are doing with exercise. Then the parent responds to me (even though I asked the child) that they just did not have time these past couple of weeks.
• When a parent and child come to see me and have to bring a brother or sister. The sibling is eating a bag of candy as they walk in to my office….

I have 3 children (who have VERY different body types) so I know parenting is hard. Scheduling is very hard. Each child is different etc., but if a child needs extra tutoring for math because they are failing, don't you do everything you can to make that happen? This is your child or grandchild’s health…what is more important than that? Who cares how you do in school if you can’t participate in PE or a school sport? Who cares how you do in school if you are sick, tired, sleep deprived and depressed? Who cares how you do in school if you are teased and feel badly about yourself?

Please tell me, what is more important than your child’s health?

*follow-up means they have completed a 6 month behavior change program

Tips for Parents to Help Their Overweight Child

*John was 10 and he came to class with his mom, Joan. Joan was slender and fit and was one of the many parents who did not understand how their child became overweight. The two other siblings did not have a weight problem and Dad was also active and fit.

*Jessica was 12 and came to class with her mom. Her mom, Lisa, was overweight and always struggled with her weight. She was hoping her daughter would get some tools to make healthy choices so she would not end up an overweight adult. She had a younger brother who was too young for the program, but it seemed that he was on a similar weight track as his mom and sister. The whole family would benefit from some education and coaching.

These are two very different but fairly typical family situations that often come up in the same class. So what advice do I give these parents?

Regardless of the reasons why they enrolled, the advice remains quite similar for both situations. The top 5 tips and advice I give parents who are trying to support their overweight child:

1) Have parents understand and accept that, they play a very large role in their child's success because they buy and cook the food, enroll them in activities and drive them to restaurants and fast food.

2) Children need to be in a supportive home environment to be successful.

What does this mean?

• Remove all tempting red lights from the house (even if all other family members are not overweight)
• Eat out less often (it is too hard to make healthy choices when eating out!) and learn how to make healthy versions restaurant favorites at home.
• Stock up on favorite healthy fruits and vegetables that are cut and ready to eat.
• Plan fun, ACTIVE family time. 
• Explain to the entire family that these changes are healthy for everyone in the family.
• Create shopping lists and plan meals together.

3) Be a good role model! Despite what we wish, children do as we do, not as we say. Even if you struggle with your own food and exercise choices, this is a perfect time to support your child and make changes together. How?

• Keep track of your own red-light foods (then try to eat fewer each week)
• Increase the amount you exercise (if you only exercise 1x a week, try for 3x a week)
• It is OK to admit to your child that you are struggling - it can be bonding!
• Don't complain! Be positive and non-judgmental.

4) Do not treat your child differently from other children in the family. I can't tell you how many times I have had a family come in for a meeting with me and the younger sibling was eating a bag of candy or chips. The parents would look at me sheepishly, then defensively state that they knew this was bad but actually it is ok becuase that child was underweight.

• OK - really? You are coming in to see me!! Couldn't the sibling at least keep it in the car?
• I don't care how underweight your young child is, no one needs a bag of candy or chips for snack
• Most importantly, you are singling out the child who is struggling with their weight. Imagine how they must feel making all of these changes while a sibling or other parent is eating treats (and unhealthy foods) in front of them. After you try to imagine how that feels - then think about the  message you are sending to both children..

Please do not allow others (spouse, siblings etc.) to eat red-light foods in front of your child that is trying to make healthy changes and control their weight. If necessary, have them lock their treats in the trunk of a car!

5) Remember -  you can only control what happens in your own house. Use that opportunity and let go of what happens outside of the house (this does not include the times you don't feel like cooking dinner an decide to eat out)

• Don't be afraid to set limits around food and TV
• For Example: kitchen closes at 7 pm for everyone! Allow only 1 hour of TV per day and max of 1 hour of computer time. 
• You may get some gruff at first, but after a couple of days when your kids figure out you are serious, they will accept these rules. Stay Strong!

http://www.nourishinteractive.com

*names and genders may be changed to protect identities

Vacation: How to make healthy choices AND enjoy your vacation!

Going on vacation and trying to make healthy choices is difficult. Although we want to enjoy our vacation and relax some of our normal rules and restrictions, it does not have to be license to go crazy and eat everything. There are ways to enjoy your vacation AND make healthy choices.

Here are some of my standard vacation tips:

1) Try to stay in a condo or home where you can prepare your own meals. 
If you are in a hotel, use your hotel refrigerator to store healthy snacks like yogurt, string cheese, carrots and milk for cereal so you can enjoy simple, healthy breakfasts instead of hitting the hotel restaurant or the nearby bakery! Also, try to keep some fruit and plenty of water in your room.

2) Walk!
Whenever you can, be active. Walk the city, take a hike, go on a bike ride, and go to museums. Not only is it a great way to see a new place, you can get your exercise without even noticing.

3) Plan meals ahead of time.
When you travel, you will eat out and eating out makes it more challenging to make healthy choices. If you plan ahead and look at restaurant menus before you eat, you are more likely to make better choices. Look at menus online or before you enter the restaurant and talk to your child about healthy choices. The key is to have this conversation BEFORE you sit down to eat.


4) Don't wait until you are starving to eat.
I learned this first hand this summer. We would often wait just a little to long to eat lunch, then we would all be starving, eat too much at lunch then not be hungry at the normal dinner hour and have to eat dinner late. You can see the pattern. Try to stick to a schedule as much as possible. Eat before you are starving or you and the kids will be too hungry to make healthy choices (and you will all be less grumpy).

5) Treats are OK!
You are on vacation so treats are inevitable. BUT, it does not have to be a free for all. You can still have a good time, eat healthy AND limit treats. Try to set a limit at 1 - 2 treats (Red Lights) a day. For instance, if my daughter chose to have soda at lunch (which we don't have at home) then that counted as a treat and she could have one more treat after dinner. This is when breakfast is tricky! On vacation, it is easy for those red lights to be readily available at breakfast. Watch out and see how you can budget - perhaps you allow one red light per meal.

Key messages:

• Enjoy your vacation and try new, delicious food but do not use it as an excuse to eat whatever you want, whenever you want.

• Most importantly, remind yourself that when you get home, you will get back on track. Then, when you get home, make sure you get back on track!

Should We Pay Our Kids to Make Healthy Choices?

My first reaction was to be shocked that model Heidi Klum pays her kids to eat healthy foods. But then I relaxed and was able to have a very interesting conversation with some of my friends. One of whom pays her children for getting A’s. How is that different she asked me? Well, I don’t think it is, but the question is, is it effective? I am not sure that it is. 

In both instances (healthy choices and grades), we are trying to change a behavior that is not intrinsic to the child – meaning the child is not internally motivated to do so. As a result, we (parents, teachers) are looking for extrinsic or external ways to motivate, hoping to ignite that fire within. This is not a new approach to behavior change; teachers do it, parents do it, grandparents do it, coaches do it, but does it work?

It may work for some, but in general, in my experience, I don’t think it really works for long-term change. There is tons of research on motivation but the fact remains that everyone is motivated by different things and rewarding a child for a desired behavior needs to tap into what motivates that particular child. Having three kids of my own, this is not easy and varies significantly depending on the child.

When I work with families in the pediatric weight control program, we work together to set specific and achievable goals around food and exercise. We also ask the parents and kids to work together to come up with a motivating reward to help achieve these goals, but these rewards have very specific guidelines:

1)      NO food (healthy or otherwise)
2)      Should be active (hiking, biking)
3)      Should be together (parent and child)
4)      NO money or expensive gifts
5)      It must be delivered immediately (within a week of achieving the goal)
6)      Ideally, it is something that interests the child

Parents need to come up with rewards that they can provide [potentially] every week for 25 weeks!

What I have learned is that most children are motivated by relatively simple rewards. Spending time with a parent while doing a fun activity seems to be reward enough for many. By month 3 of a 6 month program, most (not all) students seem motivated by their own success and feelings of empowerment and control. 

We know that rewards can positively influence behavior, but can't we just keep it simple and meaningful? Parents, hang on to your money and spend time with your child doing an activity you both enjoy.