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WSJ: How to Give Your Child A Longer Life
Excellent article! (Reposting all of it, because some people may
not have seen it--and top-posting, because it makes sense here
Most parents would never dream of putting a child in a car without a
seat belt. They would never allow a child to ride a bike without a
helmet or cook on a stove unattended. And they have good reason:
Accidents are the leading cause of death in young people.
But what about the things that will end up killing most of our kids
once they reach adulthood? How do you protect your child from heart
disease, cancer, strokes, diabetes and high blood pressure -- ailments
that typically don't strike until well into middle age?
It may be hard to believe that the health decisions you make for a
five-year-old today will still count when he or she is 50. But a
growing body of evidence shows that childhood is actually the best
time to start protecting an aging body, buckling it in for a lifetime
of good health.
Many studies now show that adult afflictions like heart disease and
high blood pressure clearly have their origins in early
childhood. Autopsies of children who died in accidents found that
fatty streaks start forming on the aorta as early as the age of three,
and the damage shows up in the coronary arteries by the age of 10.
"It all starts in childhood," says Gerald S. Berenson, a Tulane
University physician who founded the Bogalusa Heart Study, a
continuing 30-year study of 14,000 children and young adults, making
it perhaps the longest and most-detailed study of children in the
world. "Half these kids are going to die of heart disease eventually,"
Dr. Berenson says, "but we know there is a window of opportunity where
parents can have an impact."
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Indeed, in some cases, childhood presents the only window of
opportunity to markedly influence certain aspects of adult
health. Growth and cell division in many parts of the body occur only
in childhood, which is why the foods and nutrients children consume in
their early years can influence lifelong health -- a concept known as
Height, for example, is mostly determined during the first five years
of life, influenced by both genetics and nutrition. Bone and tooth
strength -- and subsequently a woman's risk for osteoporosis -- is
almost entirely decided by the end of adolescence, which is why
calcium intake in kids and teens, and exercise in young girls, is so
important. And many experts believe that if obesity occurs in
childhood, when the number and size of fat cells is largely
determined, a child is saddled with far more fat cells for life than
she would have developed had she stayed slim into young adulthood.
Eating behavior and food preferences, perhaps the biggest determinants
of long-term health, are primarily decided in childhood and
adolescence. Studies show that eating habits and obesity can affect
risk for premature cancer, diabetes, liver and heart disease, and many
other health problems. And while adults certainly have the power to
change their eating patterns, much of how we eat and what we like to
eat is powerfully programmed by our experiences in childhood, making
us exceedingly resistant to change as adults.
Many parents, of course, already know that healthy eating habits,
exercise and weight management are the keys to long-term health. The
problem is, how do they make their kids follow those practices? A
wholesale change in household habits seems like an insurmountable
challenge in a world of supersized meals, soda machines in schools and
grocery-stores filled with sugar-laden kid food.
But surprisingly, influencing a child's lifelong health isn't about
big changes. Hundreds of scientific studies support the notion that a
series of small, subtle shifts in the way we raise our children can
translate into huge advantages well into adulthood.
"I think small changes are interpreted by the body much differently
than we perceive them to be," says Henry Anhalt, director of pediatric
endocrinology and founder of the Kids Weight Down program at
Maimonides Medical Center in New York. "Any change, any improvement --
even if it seems trivial -- may have far-reaching implications."
So here's a look at the small, simple changes a parent can make that
can have a powerful influence on the health, happiness and life span
of a child.
Cut Back the Juice
Most parents think juice, packed with vitamin C and other nutrients,
is good for kids. But despite the extra nutrition, juices are still
mostly sugar, and many experts put them in the same category as
sugared soft drinks, which have clearly been shown to contribute to
While a glass of orange juice with breakfast is fine, obesity experts
are concerned that so many kids seem to be drinking juice as their
preferred beverage throughout the day. Parents should switch kids to
water and low-fat milk. If a child simply won't make the switch and
continues to drink a large amount of juice, Dr. Anhalt would opt for
diet soda or sugar-free drink mixes.
That stance may seem surprising, but studies show that liquid calories
don't fill us up, so sugared juice and carbonated drinks simply add
calories on top of those we'd eat anyway.
Sit Down to a Family Meal
When more than 18,000 adolescents were asked about their eating
habits, a strong trend emerged. Kids who sat down to evening meals
with their parents consumed more fruits, vegetables and dairy foods,
and they were less likely to skip breakfast, than children who didn't
eat with their parents, according to a May report in the Journal of
Adolescent Health. This summer, a Finnish study of more than 400 10-
and 11-year-olds found that children with no regular family dinner ate
sweets and fast foods far more often than those with a regular family
dinner. And the trend holds up with older kids. A study of nearly
5,000 middle- and high-school students in the Minneapolis-St. Paul
area found that kids who frequently ate with their families ate more
fruits, vegetables, grains and calcium-rich foods and drank fewer soft
The lesson is that when parents are present at the table, the meal is
more likely to be healthful and the kids are more likely to eat it.
Encourage Sporting Friendships
Research suggests that a child who exercises regularly may grow up to
be an adult who exercises regularly. But even if a kid doesn't
continue exercising as an adult, there's a strong argument that
childhood exercise can still affect longevity. That's because kids who
exercise are less likely to be overweight at a young age, which can
influence health later in life. And, in the case of young girls,
exercise in the teen years can affect long-term osteoporosis risk. A
study released just yesterday in the journal Pediatrics showed that
the bone mineral accrued during two years of exercise in early puberty
was the equivalent of three to five years of postmenopausal bone loss.
One simple solution to keeping kids active may be to work with other
parents and sign kids up for sports with their friends. When Purdue
University researchers surveyed 164 sixth-graders in Lebanon, Ind.,
about their attitudes and participation in exercise, they found that
the most physically active kids were those who had a close friend
taking part in the same activity.
"We focus on peers a great deal when we worry about negative health
behaviors like smoking or drugs," says Alan Smith, professor of health
and kinesiology at Purdue. "But when it comes to healthy behaviors, we
forget that there is this powerful social agent in kids' lives."
To further improve a child's chance of sticking with exercise as an
adult, encourage individual sports he or she can continue into
adulthood. A Johns Hopkins study found that college students who
played individual sports, like tennis or golf, were far more likely to
continue their sport well into adulthood than were peers in team
sports like football or baseball.
And the best time to sign a kid up for a sport outside school may be
around seventh and eighth grade. The Bogalusa study found that kids
became more sedentary in those grades than they were as fifth- and
sixth-graders. The biggest drop in physical activity tends to occur as
kids move from middle school to high school, where they may get busier
and school-based team sports become more exclusive.
Don't Mix Food and TV
Many people think turning off the TV set is a way to encourage kids to
be more active, but television's real harm may be its impact on
childhood eating habits.
A 1999 study of 192 third- and fourth-graders in two San Jose, Calif.,
schools allowed half the kids to watch their usual amount of
television, while half took part in a school-based intervention that
used games and monitoring devices to reduce TV watching by about
Although all the children continued to grow, the kids in the TV group
posted far bigger relative increases in measures of body-mass index,
skinfold tests, waist circumference and waist-to-hip ratio than the
kids who watched less TV.
But the non-TV kids' smaller weight gain wasn't because they were more
active. The study didn't find any increase in kid's physical activity
levels or cardiovascular health, as measured by a fitness test.
What the study did show is that turning off the television reduced the
amount of time kids spent eating in front of a television. It also
appeared to reduce the amount of high-fat foods they ate.
Other studies support the notion that kids and adults ingest more
calories when eating in front of TV or at the movies, probably because
the distraction makes them less aware of what they're eating. Some
studies suggest food advertising on TV influences the types of snacks
kids choose. And families who watch television during dinner eat less
fruits and vegetables and more higher-fat foods, according to a
January study of 277 Minneapolis-St. Paul parents, published in the
Journal of Nutrition Education and Behavior.
The average child today spends about four hours in front of the
television set. The American Academy of Pediatrics recommends cutting
that to no more than two hours. A June 2002 Cincinnati study found
that more than two hours of daily television was a risk factor for
higher weight. In July, a Boston University study showed that kids who
watched three hours or more of television per day had 39% more body
fat than similar kids who watched less than 1.75 hours per day.
"In virtually every study, television viewing comes up having one of
the strongest correlations with childhood obesity," says Walter
Willett, professor at the Harvard School of Public Health. "Parents
really do have to limit television watching in children -- it's way
out of control."
Keep Offering Rejected Foods
One of the strongest determinants of lifelong health is a diet that
includes a wide variety of fruits, vegetables and other healthy
foods. But getting kids to develop preferences for those foods doesn't
always happen naturally.
Children are born with a preference for sweet and salty foods, but
they have to learn to like everything else. And kids, like animals,
have a natural protective tendency to reject an unknown taste --
that's what kept our ancestors from eating poison berries. But many
parents misinterpret this instinctive response to new foods. "Parents
see the kid shudder and spit food out as reflecting some dislike that
can't be changed, so they tend not to offer it again," says Leann
L. Birch, professor of human development and family studies at
Pennsylvania State University.
As a result, parents should continue to offer foods that their kids
don't seem to like. In infants, two or three tries with a new food
usually works. In studies of two-year-olds, fruits and cheeses had to
be offered five to 10 times before a child showed a preference for the
food. Tufts University nutritionist Susan Roberts, co-author of
"Feeding Your Child for Lifelong Health," uses a "rule of 15,"
suggesting parents need to offer a food at least 15 times before a
child will accept it. She notes that parents should wait anywhere from
a few days to two weeks before bringing back a rejected food.
But it's important that parents maintain a low-key approach when
offering any food. Many experts suggest putting the food on the table
and encouraging just one bite, and not reacting positively or
negatively whether the child likes it or not. Studies show that when
kids are cajoled into eating a food or even rewarded or praised for
eating it, the child often develops an aversion to the food.
That's what Penn State researchers found when they gave four-year-olds
rewards like stickers and television viewing for eating vegetables or
finishing a milk drink. Later, the kids were asked to taste the same
foods and select a picture showing how they felt about it. The
children expressed dislike for the foods they had been encouraged to
eat, even with seemingly positive reinforcement.
So while bribes and encouragement may prompt a child to eat a food in
the short term, over time he will develop an aversion to foods he
associates with parental control, just as he would develop an aversion
to a food that made him ill. "If you reward kids for eating things
they feel neutral about, they come to like them less," says Dr. Birch.
Control the Food in the House, Not the Kids
Research shows that parents who try to exert too much control over a
child's eating end up doing more harm than good. This doesn't mean
parents should allow a child to eat anything he or she wants. Parents
should pack the refrigerator and cupboards with healthy foods, put
balanced meals on the table and keep undesirable foods out of the
But once the shopping and cooking is done, leave your kid
alone. Trying to control a child's eating behavior will invariably
backfire, encouraging a child to overeat instead.
In one study, five-year-olds with mothers who tightly controlled their
food intake showed significant increases in overeating by the age of
seven and posted additional increases by the age of nine, according to
an August study in the American Journal of Clinical Nutrition. In a
Penn State study, preschoolers were fed lunch until they said they
weren't hungry. The children were then left alone in a room with a
variety of snack foods. Kids accustomed to lots of food rules ended up
binging on the snacks, while the kids who didn't face many food
restrictions weren't interested. Restricting food teaches a child "if
it's here now, whether I'm hungry or not, I better eat it, because
it's the only chance I'm going to get," says Dr. Birch.
The biggest problem seems to occur when parents allow certain foods
into the house -- like soda, snack foods and ice cream -- and then
tell kids they can't have them. The better strategy is to keep
less-healthful food out of the house, and then bring it in on special
occasions, letting kids have control over eating it.
Impose Strict Driving Rules
While diseases of aging will kill most of us, car accidents continue
to have a big impact on life expectancy. Medical students are often
told that the single biggest influence they can have on patients'
health is to remind them to buckle their seat belts.
The risk of dying in a car accident peaks between the ages of 15 and
24, the age group that accounts for more than 10,000 annual fatalities
and 36% of annual motor-vehicle deaths. Night-time driving and driving
with other teens in the car dramatically increase a teen's risk for a
fatal accident. But studies show that strict driving rules for teens
can sharply reduce teen death and accident rates. After North Carolina
adopted some of the nation's strictest laws on teen driving, fatal
crashes involving teens fell by 57%.
Before letting a teen drive alone, parents should keep a driving log,
documenting 50 hours of adult-supervised driving over a six-month
period, including 10 hours at night. Teens should never be allowed to
drive after 9 p.m. and shouldn't be allowed to carry other passengers
unless an adult is present. Studies show the biggest benefit comes if
the rules are imposed until the teen reaches 18.
Set the Example
At every age of a child's development, parental example remains a
dominant way to influence behavior. Babies are more likely to put food
in their mouths when they see a parent eat it, and toddlers,
preschoolers and elementary-school kids are more likely to accept
foods their parents like. Indeed, when a child refuses a food, the
best strategy is for the parent to say, "That's OK, I'll eat it."
What you don't eat is important, too. Parents struggling with their
own poor eating habits should consume less-healthful foods at the
office, out of their kids' sight. And not buying junk food sets the
example as well. "Someone is bringing the soft drinks and snacks into
the home," says Barry M. Popkin, nutrition professor at the University
of North Carolina-Chapel Hill. "The parents may be doing it because
the kids are nagging them, but the parents are still doing it."
Children are strongly tuned into their parents' eating preferences. A
June Penn State study found that girls were more likely to be picky
eaters if their mothers didn't eat a variety of vegetables. Parental
preferences are the only way to explain why kids in certain cultures
are willing to eat spicy foods that the body is normally programmed to
Several studies show that whether a parent or family member smokes is
often the single biggest determinant of teen smoking, and the vast
majority of addicted smokers started the habit in their teen years. So
the simple act of quitting smoking on the part of a parent can
dramatically lower a child's lifetime risk for smoking addiction,
cancer and heart disease.
Parents who exercise are also more likely to have kids who
exercise. But parents who don't have good exercise habits can still
help their kids develop them. Researchers from the State University of
New York's University at Albany monitored 180 nine-year-old girls and
their parents. While kids with active parents were more likely to be
active themselves, the study also found that kids were also more
active when a parent provided extensive logistical support. So a
parent, usually a mother, who takes the time to learn about sports
activities, sign kids up and shuttle them around can set the example
about the importance of exercise, even if she doesn't exercise much
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