Helping Kids Build Healthy Active Lives: AAP Policy Explained

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By Natalie D. Muth, MD, MPH, RDN, FAAP, FACSM

Parents often feel overwhelmed by the flood of advice they get about their children’s health. As a pediatrician and dietitian who is also a parent, I know how it feelsespecially when it comes to helping your child be their healthiest self and preventing problems from
childhood obesity.

News stories warn about the dangers of highly processed foods, sugary drinks and too much screen time on our kids. We know firsthand the challenges of raising children and teens who are mentally and physically healthy in environments that makes that exceedingly difficult.

Making the healthy choice the easy choice

With our newly updated clinical
report,the American Academy of Pediatrics (AAP) aims to mobilize and support parents, pediatricians, and communities and tackle these issues together.

We need to do this at every level, from supporting individual children and families to advocating for healthier schools, communities and policies that make the healthy choice the easy choice. Our common goal: to ensure kids have access to what they need to live healthier, more active lives.

Why healthy living and weight is about more than nutrition and exercise

Our report provides tools and resources to help optimize health regardless of a child’s weight. That said, the guidance is based on the best science on strategies that can help prevent obesity at every stage, from infancy through adolescence.

It turns out, this is about much more than nutrition and physical activity. While these are key factors that govern a child’s health and weight, they are among a variety of influences.

Key factors that affect a child’s health and weight

  • Nutrition. Setting regular meal and snack times can support healthy weight. Another key: having healthful foods such as fruits, vegetables and whole grains on hand while minimizing highly processed foods and sugary drinks. We also know it helps when children learn to use cues of hunger and fullness to guide what they eat and drink, rather than other triggers such as the amount of food on their plate.
  • Physical activity. Kids need physical activity built into
    every day—whether that’s playing sports, playing
    outdoors, helping with family chores, walking or biking to school, engaging in physical education, taking a family walk or any other physical activity they enjoy.
  • Sleep. When kids (and adults) don’t get enough sleep, their bodies release stress hormones to help them get through the day. These biological patterns affect appetite and the way our bodies burn (or store) excess calories. Studies link insufficient sleep with weight gain, and sleep loss can aggravate health issues such as
    diabetes. Plus, poor sleep is associated with decreased focus and attention and behavioral concerns.
  • Healthy tech use. This issue is closely related to sleep, since screen time before bed
    disrupts sleep cycles. But it’s also a factor in making time for healthy activities that get us moving. Gaming, TV, smartphones and other media devices can consume the hours our kids need for free play, sports and socializing. Children who eat while using screens also risk mindless and excess food intake. Too much media use can also negatively impact mental health and well being.
  • Emotional & social issues. Feeling loved, seen and appreciated are
    just as central to your child’s health as nutrition and exercise. The brain and the body are one system – so when kids feel safe and secure, their bodies function well. When they are threatened by hurtful issues such as
    racism,
    abuse,
    bullying or pressure to look or act a certain way (often fueled by
    social media), their health can suffer.

Tackling the issues you can control: 6 practical tips for parents

1. Help kids understand what’s on their plate.

Learning about good nutrition can be a family affair. Start with the easy-to-use tools at
MyPlate.gov to get kids involved in choosing foods they enjoy that are good for them. This resource takes into account a family’s culture and traditions too, giving examples of healthy meals that include familiar foods. Pair this knowledge with a team approach to choosing, planning and making food to give kids a more active role in what they eat.

2. Make

water your drink of choice.

The healthiest beverage is plain water. Limit access to sweet drinks including 100% fruit juice, sodas, sports drinks and fruit drinks as much as possible. Ideally, aim for one sweet drink or fewer per week (and not at all for infants and toddlers). Bonus: drinking plenty of water
cleanses your child’s teeth and gums, preventing cavities now while setting the stage for lifelong dental health.

3. Limit

ultra-processed foods.

Ultra-processed foods (think anything with a crinkly bag or long ingredient list of difficult-to-pronounce words) are everywhere. It may not be realistic to avoid them altogether. But try to limit their access when possible and help children and teens learn the benefits of eating whole foods like fruits and vegetables. You can also talk with them about the health risks of too much “junk food,” which generally are loaded in sugar and salt, do not increase feelings of fullness, and prompt overeating.

4. Create a

family media plan.

Kids (and grownups!) will benefit from sensible screen time limits that make room for other healthy activities. You can engage your kids in creating a plan for the whole family to follow. A family media plan can also help prevent media use from interfering with adequate sleep.

5. Build movement into your daily life.

In an age when we spend far
too much time sitting, it can be challenging to get up and move more. But when parents make it a priority to work movement into family routines, kids will benefit.

Organized sports aren’t the only option, though they’re an excellent way to build health and fitness. Families can also enjoy walking, biking, swimming, physical
chores and active vacations that include hiking,
water sports and more. Indoors, you can try
active gaming or online fitness classes to strengthen muscles, build coordination and release tension.

6. Make stress management a family priority.

Just like exercise, kids will follow the example that parents set for them. If your work, school and social schedules are jammed with so many commitments that there’s no room for healthy downtime, consider what you can let go. Rest and relaxation rebuild the body’s systems after the challenges of a tough day or week, so reserve time for them (and encourage kids to do the same). For tips on helping tweens and teens create their own relaxation routines, check out
this article.

Challenges that families can’t solve alone

Parents and caregivers influence a child’s home environment and daily routines around mealtimes, sleep, active and screen use. But if the surrounding environment does not support these healthy routines, even the best-intentioned parent caregiver, or motivated child or adolescent faces an uphill battle.

For example, it’s much easier to raise a healthy, active child when:

  • Neighborhoods offer plenty of safe spaces where kids can run, jump, play and enjoy team sports. This includes safe routes to walk and ride bikes to school.

  • Families have access to fresh, nutritious food close to home at prices they can afford, as well as services and resources such as cooking classes and nutrition programs. These make it easier to prepare more healthful home-cooked meals.

  • School cafeteria standards support healthy nutrition, including what is available “a la carte.” This helps children and adolescents choose healthier options by default.

  • Media and screen use is in healthy balance and monitored by adults, with policies in place to protect children and adolescents from the negative effects of excess or inappropriate screen use.

  • Later school start times are adopted in middle and high schools to support better sleep

  • Nutrition labels and other policies are in place to decrease consumption and availability of foods and beverages that pose a significant health risks to kids. This includes ultra-processed foods and sugary drinks. At the same time, these policies can increase the availability and affordability of foods that promote health

  • Children, adolescents, and their families do not experience racism, toxic stress, housing or food insecurity, safety risks or other social determinants of health and well-being

Most of us don’t live in ideal places like this. So, we need support from schools, health care systems and the wider community to create healthier lives for our kids.

How your child’s doctor can support you

Partnering with your child’s doctor can help you create healthy sleep routines, set reasonable limits on screen time and navigate the sources of stress your child will encounter in the larger world.

For example, pediatricians and health care teams can:

  • Learn about a family’s culture, habits and routines as well as any challenges they face in adopting healthy eating, physical activity and stress management routines.

  • Offer practical ways for parents to tackle specific issues—for example, the challenge of setting regular
    family mealtimes, which have been shown to support healthy weight in kids.

  • Understand the impact that social factors—also called
    social determinants of health—might have on a family’s well-being.

  • Show compassion and concern for individual and family needs, exploring ways that parents can care for children who face discrimination, bullying, abuse or extreme social pressures that can harm their health.

  • Support children and families affected by
    eating disorders, starting with regular screening that helps identify eating struggles early.

  • When kids need help reaching a healthier weight, explore possible solutions with families in an open, non-judgmental way.

  • Work with parents and kids to create a treatment plan that emphasizes good health today while shaping skills that will benefit them long into the future.

More information

About Dr Muth


Natalie Muth MD, MPH, RDN, FAAP, FACSMNatalie Muth MD, MPH, RDN, FAAP, FACSM, is a lead author of the AAP clinical report, “The Role of the Pediatrician in the Promotion of Healthy, Active Living.” As a pediatrician and registered dietitian, Dr. Muth founded and directs the WELL healthy living clinic at Children’s Primary Care Medical Group in San Diego and is co-author of the AAP-published resource The Clinician’s Guide to Pediatric Nutrition. An adjunct professor at the UCLA School of Public Health, Dr. Muth a national spokesperson for the AAP and an award-winning author of parenting books The Family Fit Plan and
The Picky Eater Project, available in paperback and e-book form through the
AAP Bookstore.


The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

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