t’s time for kids to go back to school, but it’s also time for parents to honestly assess their children’s weight, health, diet and activity levels. Most parents and caregivers are not aware that children can be (and are) overweight. In fact, a recent study showed that only 36% of parents of overweight or obese children actually recognized that their child had a weight problem. Overweight and obesity are diet-related health problems, since food choices affect children’s health and weight. With overweight, type-2 diabetes, and hypertension becoming epidemics among children, this fall might be a good time to take steps to make healthful lifestyle changes in your family’s routine and help your children achieve super health.

First, your kids are taking their behavioral cues from you (for better or worse, you’re their nutritional role model). Setting a good example for kids by eating right and exercising is one of the best things you can do to help them grow into healthy adults. If your kids see you eating and enjoying healthy foods, they are more likely to want to eat healthy foods themselves. The same principle holds true for physical activity.

Second, there is a division of responsibility in the parent-child feeding relationship. It is up to you to offer a variety of healthy foods to your child, but it is up to them to decide if and how much they will eat. Children must have the autonomy to decide how much or how little of that food they will eat and they should not be told to eat more than they want or to stop eating if they are still hungry, since this can lead to overeating and life-long struggles with food.

Third, the earlier you start to feed children healthful foods, the fewer food fights there will be. Ideally, children need to be exposed to the flavors of vegetables and other wholesome, nutritious foods before age two (age five at the latest) —in order to fully instill in them a fondness for these foods. The more exposure to overly sweet and salty foods they have at a very young age, the harder it will be to change their food preferences.

Dilemma: Kids don’t want to eat their vegetables.

Explanation: Children need to eat vegetables since they provide nutrients and fiber that are essential to growth, development and a healthy immune system. Furthermore, produce intake is inversely associated with obesity risk, so the more fruit and vegetables that kids (and adults) eat, the lower the risk of being obese. Therefore, learning to love vegetables should be a top priority. Refusing veggies is a very common problem among children, so take heart. Picky eaters can be difficult, especially between ages two and five. Some experts think pickiness is actually “food neophobia,” or fear of new foods, especially those foods with a bitter taste—like vegetables—but this can be overcome with patience and communication with your child.

Solution: Eat your veggies. Your children are watching what you eat as early as infancy, so if you are not modeling a love of vegetables and other healthful foods, they will not be enthusiastic about them either. If they see you enjoying vegetables, they will be much more likely to eat them themselves and research now shows that the more produce you eat, the more they will eat. Taste preferences are formed very early, so the sooner that moms start eating vegetables, the better – taste preferences can even be influenced in the womb and through breast milk!

To create excitement about healthy food, bring your kids into the kitchen. When kids are involved in food preparation, they are more likely to taste new foods due to both familiarity and a sense of pride in what they have created. Familiarity is really the key to increasing the variety of foods that children will eat. Kids need an average of ten exposures to a new food before they start to assimilate it into their diets, so be patient but not pushy. Offer a small amount that they can look at, smell, touch and put in their mouths if they want, but don’t force them to swallow it. In fact, as a rule you should never force a child to eat anything. Instead, allow kids to feel comfortable with a new food before they eat it. You can also take the kitchen concept one step further and try growing your own fruit and vegetables with your kids. A new study shows that kids with vegetable gardens are twice as likely to eat five servings of produce a day as kids who don’t grow anything. A home garden has the double benefit of deepening kids’ connection to healthy foods and increasing the amount of physical activity they do since gardening is physical labor.

Dilemma: Kids only want to eat junk food.

Explanation: Children are genetically programmed to prefer sweet tastes, so candy and treats will naturally be their first choice. However, kids who eat junk food regularly are much more likely to be overweight and have weight-related health problems.

Solution: Create a healthy home environment. As a parent or caregiver, your responsibility in the feeding relationship is to offer healthful choices to your child and let them choose among those good options. If there is unhealthy food in the house, the child will naturally zero in on it. Therefore, I advise you to keep your home free of junk food, soft drinks and candy, so that there are only good choices to be made.

Stock your refrigerator and pantry with a variety of minimally processed nutritious foods: vegetables, fruit, lean proteins, whole grains, dairy and healthful fats. Call these foods “everyday foods” and make them the basis of everyone’s diet. Make sure that healthful snacks are easily accessible at home by, for example, having carrots and broccoli cut up, fruit washed, hummus or guacamole made and edamame defrosted.

Although unhealthy foods do not belong in the house, that doesn’t mean they are all off limits. No food should be completely forbidden, since that makes it even more desirable. Allow treats to be eaten freely on special occasions such as birthdays and holidays and go out for ice cream or dessert once or twice a week to help children learn what a moderate treat intake should be. Also, avoid the temptation to reward with food or to give any kind of reward for good eating behavior. Rewarding children for doing something they should be doing (like eating broccoli) with junk food only makes them like the junk food more and the important task (i.e., eating broccoli) even less.

Dilemma: Kids overfeed themselves.

Explanation: Children are born with the innate sense of knowing when they are full enough to stop eating. However, they can lose touch with their satiety when they eat while on the go or when there are many distractions, like eating in front of the TV. Being forced to clean their plate or being told when to stop eating can also contribute to this disconnect. If a child is overweight, parents often fear that the problem will only get worse if the child keeps eating. However, a child who is told that they can’t have something will only want it more (and will usually find a way to get it). Restricting food can lead to anxious or disordered eating behaviors that are carried into adulthood. Also, waiting too long between meals or snacks can make a child so hungry that they eat more than they should.

Solution: Be consistent with how you offer and prepare food. It is up to children to decide if and how much of a healthful food they will eat. In order for this to work the way it should, you must respect your child’s individuality and you must be faithful to your commitment to offer healthful meals and snacks to your family.

Providing meals and snacks at regular intervals is important to allow children to develop an appetite and then learn to satisfy it with wholesome foods. Remember that children have smaller stomachs, so they can’t eat as much as adults can at one sitting. Your child may need to eat every two to three hours in order to stay fueled throughout the day. Having an eating schedule will reassure children that there will be food to eat when they are hungry so they don’t feel the need to stuff themselves in preparation for starvation.

If your child tends to eat more than what is appropriate and he or she is overweight, there are some non-judgmental things that you can do. For instance, at mealtimes, plate everyone’s food in the kitchen and serve it at the table instead of serving family style. This will help prevent everyone from putting more food than they need on their plates. Use smaller plates so that less food looks like more, since a large plate with normal portions of food can easily look empty. Serve foods in appropriate portion sizes (about the size of a child’s fist), since studies have shown that when large portions of food are offered to children, they tend to eat more. See the chart on the facing page for information on how much food a child should eat from each food group according to their age. Finally, provide minimally processed foods that are nutritious and low in calories, such as vegetables, lean proteins and whole intact grains, as these foods tend to be the most filling.

Dilemma: Too much TV time.

Explanation: The average American child spends over 3 hours a day watching TV and another 3-4 with other media like video games and computers. Studies show that the more time kids and adults spend watching television, the more they weigh. Overweight children eat 50% of their dinners in front of the television while healthy weight children eat fewer than 35% of their dinners in front of the tube. Commercials for foods like sugary cereals and soft drinks also provide feeding cues (signals to eat) and can have a lot of influence on kid’s food choices.

Solution: Turn off the televisions. A two-hour total daily time limit on televisions, computers and sedentary video games is recommended by most child health experts. TV should not be part of any meal, regardless of your child’s weight, since it distracts from eating, which means that satiety goes unnoticed and extra food (and calories) is consumed. Eventually, children who eat while watching TV will want to eat every time they sit down in front of it, no matter whether they are hungry or whether it is actually a mealtime. Television at any time of the day is strongly associated with overweight, since kids spend time sitting instead of moving around. Set a time limit on sedentary TV viewing and remove TVs from bedrooms and eating areas in order to teach children healthy eating, sleeping and leisure time habits and help them achieve a healthy weight.

Dilemma: Too much sitting and not enough moving.

Explanation: Children need physical activity in order to grow properly, develop motor skills, maintain a healthy body weight and build a strong immune system. Moderate to vigorous exercise is good for brain development and cognition, as studies show that physically fit kids perform better in school. Exercise promotes self esteem and increases blood flow to the brain to help increase memory, concentration and mood. Like adults, most children are not as active as they should be, which contributes to excess weight gain since excess calories from food are not being burned up. Many schools have cut back on the time allotted for physical education (P.E.) and recess, which contributes further to children’s sedentary lifestyles. The good news is that for every hour of physical activity a child engages in, the risk of obesity drops by ten percent. At least 60 minutes of structured physical activity a day is recommended for most children, and toddlers need several additional hours of free play.

Solution: Make physical activity fun. Physical activity should be fun and playful for kids; it should never be something they dislike or feel bad about. If you want this healthy habit to stick, retaining the fun and playfulness of physical activity should be the goal rather than making it drudgery. Organized competitive sports are only one way to bring exercise into your child’s life, but they are not the best option for all children. Noncompetitive activities such as dance, yoga, biking, and walking can be good alternatives to soccer and other game sports. Being active as a family by taking walks (or walking somewhere instead of driving), hiking or swimming is a good way to model healthy behavior and spend quality time together. For children who prefer to be active on their own, active video games, like Wii Fit, could be a good way to help them get more activity into their day.

Helping your child achieve health is a family affair that requires the right balance of toughness and tenderness from parents. It is important to stay firm in your commitment to healthful eating and activity, but be flexible enough to allow treats and lazy days sometimes. We all have room to make improvements in our eating and activity level and right now is the best time to start assessing and changing in these areas. Altering habits is challenging for everyone, but the benefit of raising a super-healthy kid will be worth the effort.

Gelson’s registered dietitian, Jessica Siegel, has a Masters in Public Health. However, she is not a doctor and her nutritional recommendations are not tailored to specific health problems. Consult your physician before beginning any nutritional program. To contact Jessica, please call her at 1-800-GELSONS (435-7667).