Jews
Not Exempt from Childhood Obesity Epidemic
www.jvalley.org
January 2010
Health indicators across all
ethnicities repeatedly show an alarming
increase in the incidence of overweight
and obesity, both nationally and globally.
Of surprise to many, is the specific
mention of the Jewish community many areas
of the country.
In some areas of the U.S., a child is
approximately twice as likely to be obese
as the average American child. A survey in
six Chicago communities that involved
face-to-face interviews with 250 Jewish
adults over a year and a half 2003 and
2004 that 54 percent of children ages 2 to
12 years old were overweight, with an
additional 26 percent defined as obese (on
average 30 pounds over a healthy
weight-for-weight at any age). This
striking finding was found in a community
that had a higher income level when
compared to the general population, good
access to health care, and an education
level that greatly exceeded national and
local area averages.
Unhealthy food and a sedentary
lifestyle beset all segments of American
society, but some characteristics specific
to the Jewish religion, and more
specifically to the Orthodox community
Include the tradition of large and holiday
Shabbat and holiday meals; a busy
lifestyle that often precludes taking time
to prepare healthy low-fat, low-calorie
meals; and for children In Jewish day
schools, a long school day that doesn't
allow much time for sports or other
physical activities. It is often pointed
out that many Orthodox Jews work several
jobs or work longer hours at the job they
have to afford their children's day school
tuition.
In addition, many of us still operate
within the legacy of our Eastern European
ancestors, who feared starvation and,
therefore, revered chubby babies and urged
children to "clean their plates."
What we need to realize now Is that
teaching healthy family lifestyle patterns
must be part of this ethical and moral
education, and receive as much attention
and effort as the other long-accepted
priorities of parenting. Maintaining a
healthy lifestyle in a world of excess and
unlimited choices requires parental
limits, and that is why healthy weight
management is a parenting issue.
Our world has changed in the past
thirty years. When most of today's parents
were kids there weren't any computers,
video games, cable TV or fast-food
restaurants on every corner. Most kids
spent their days riding bikes, climbing
trees, and playing outside In the
neighborhood until dinner. The majority of
families ate dinner together, at a kitchen
table, and ate a home-cooked meal. Today's
parents are just learning themselves that
they need the skills and tools necessary
to make healthy lifestyle changes and
choices. The majority of us were not
taught what we now know is needed to
develop life patterns of health and
balance.
For a child, extra weight and feeling
different and outcast as a direct result,
is as important as a learning disorder or
any other area of functioning that needs
support and help. Eating lots of fruits
and vegetables, limiting screen time to
two hours a day, getting at least one hour
of physical activity a day, and almost no
sweetened beverages need to be discussed
in the same breath as telling the truth,
being respectful, doing homework and
chores, and following rules.
Experts have extensively studied human
behavior over the ages and have shown that
90 percent of everything we do on a dally
basis is habit. Habits are acquired,
learned behaviors that we do without even
thinking about it. How we treat people,
how we spend money, what we say, how we
eat. Ninety percent of the time we are on
autopilot. We do things the way we have
always done them.
When a family is ready to make changes,
where do they start? A frequent mistake is
to do the "all or nothing" approach. Rudy
Leidel, a pediatrician, said, "Obesity,
like baseball, is a game of inches." A
tiny difference of expenditure and intake
(error of judgement, in baseball) over a
long period of time can have a profound
effect. An excess 100 calories/day over
one year causes an increase of 10 pounds.
Conversely, a deficit of 100 calories/day
(i.e. one slice of bread OR one teaspoon
of butter) over one year will yield a loss
of 10 pounds. Small change can have big
effects if maintained over a long period
of time.
An example of a family that made
lifestyle changes to great effect, is the
Andrews family (name changed to maintain
confidentiality). They made a family
commitment to better health, instead of
just "singling" out the child originally
designated as having a weight problem.
They decided as a family to limit their
meals away from home to once a week, and
to avoid fast food restaurants. Previously
they had routinely stopped at Taco Bell or
Arby's at the last minute when afternoon
activities keep them away from home until
past dinnertime.
They also committed to limiting
television and video games to weekends,
and to get up and "be active" during
commercials. On days they came home
directly after school, an afternoon snack
that included a protein food was prepared
for the kids. Afterwards, at least 30
minutes would be spent outside (weather
permitting) playing before homework was
started. Instead of eating their dinner in
front ofthe TV, the family ate together at
the dinner table for a minimum of fifteen
minutes, without the TV or any other
interruptions. As recommended, they served
the meal from the kitchen, only bringing
the fruit and vegetable dishes to the
table. This reminded them to have second
helpings of fruits and vegetables. Juice
and soda consumption, as well as all other
sugar-sweetened beverages was reduced to a
small glass of orange juice (4 oz.) with
breakfast, and soda only at birthday
parties and special events. They chose two
nights of the week to designate as
"dessert night."
Fruit and vegetables could be eaten at
any time with a goal of five servings a
day. Specific to this family was that both
of the boys disliked most fruits and
vegetables, and the parents were somewhat
limited themselves. To encourage an
increased consumption of both, the
acceptable vegetable to all, carrots, was
served every night along with one other
vegetable that varied. Each family member
was encouraged to try anything new at
least once, and alternative cooking
preparation methods were tried. Currently,
one of the boys is now routinely eating
several different kind of fruits, and
three different vegetables, and the other
boy is eating apples consistently, and
will eat broccoli on a regular basis.
Their mother has actually found quite a
few fruits she enjoys and has found
several more vegetables she likes.
The child originally referred to BACTK
has slowed his rate of weight gain as
compared to height enough to now be
consistently within an appropriate
percentage BMI-for-age, and his brother is
benefiting from the family changes in that
he has avoided his own likely increased
rate of weight gain versus height that was
inevitable given the pattern of his family
genetics. Most striking is that the child
referred to BACTK is routinely active,
playing basketball and football. When he
started with BACTK over a year ago, he did
not feel coordinated or confident enough
to participate in these sports, and now he
loves to tell us how much faster he can
run and that he can jump rope easily. Of
importance to his parents, his cholesterol
level is now normal, and the signs and
symptoms he had suggesting the development
of diabetes without any lifestyle changes
were eliminated.
Becoming healthier is a process. It
takes time and understanding to replace
unwanted habits with habits consistent
with life long health.
We can learn how to have one
reasonable-sized serving of kugel or
latkes, instead of the "heaping" helping
often taken and usually followed by
additional helpings. There always will be
more kugel and latkes.
Dr. Jamie Wallach is a Log Gatos
physician who works with Bay Are Committed
to Kids, a medically supervised lifestyle
and weight management practice. She can be
reached at (408) 356-6900.
|
