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Lean Plate Club
Talk About Nutrition and Health

Sally Squires
Washington Post Health and Nutrition Writer
Tuesday, May 20, 2008 1:00 PM

Confused about nutrition? Wondering how to fit in more physical activity? Welcome to the Lean Plate Club. Ask Sally Squires, nationally syndicated Lean Plate Club columnist for the Washington Post, about eating smart and moving more every Tuesday at 1 p.m. ET. Sally draws upon her master's degree in nutrition from Columbia University to preside over the lively Lean Plate Club web chat. Whether you're trying to reach a healthier weight or simply maintain it, you'll find plenty of tips and strategies.

Share your own food finds, creative workouts and secrets for healthy, great tasting meals. We'll cheer your successes and help with your setbacks. (None of this, of course, is a substitute for medical advice.) E-mail Sally, author of the newly published Secrets of the Lean Plate Club (St. Martin's Press) at leanplateclub@washpost.com.

Or just sign up for the free Lean Plate Club e-mail newsletter. The Lean Plate Club column appears Tuesdays in the Washington Post Health section and is nationally syndicated by the Washington Post Writers Group. www.leanplateclub.com/group.

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Discussion Transcripts

A transcript follows.

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Sally Squires: Welcome to the Lean Plate Club!

One of our topics up for discussion today is the childhood obesity epidemic. I hope you have had a chance to see the large childhood obesity project that we've been doing here at the Post. It's been a collaboration between the news and Web sides of the paper and I think you will be informed and intrigued by all the various parts, which continue through the week.

The LPC e-mail newsletters should be hitting your in boxes now. If you live in San Diego, Sacramento, San Franscisco or Denver, I'd love to know if you'd like to read the Lean Plate Club column in your hometown newspaper. There are papers in those cities that are interested in running the column. E-mail me at leanplateclub@washpost.com

Also, confused about health and unhealthy fat? I'd love to talk with you for an upcoming Lean Plate Club column. Please send me your questions with name and phone number to leanplateclub@washpost.com

Now on to the chat!

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Phoenix: You asked why I think we have an obesity epidemic. Only 15 percent of the public is obese (BMI above 30) so 85 percent of the public is NOT obese. Why is something that only affects 15 percent of the public called an "epidemic"? NOTE: BMI "overweight" category IS normal weight for many people - that's just playing with the numbers. And as far as the "childhood obesity epidemic" this is even more of a crock. The worst estimates put 1 in 5 children as "overweight" that's 20 percent of the kids so 80 percent of the kids are NOT even overweight. Did you know that the constant battering by the media has caused many older kids to start smoking to "control their weight"? Because the media makes it look like it's "okay" to do "anything" to avoid obesity. And you know, SMOKING really cuts the life short (There is NO evidence that obesity alone raises risks significantly).

Sally Squires: I understand what you're saying Phoenix, but 2/3 of the adult population is overweight or obese. And we are seeing rising health problems because of that added weight.

Also, rates of childhood obesity have tripled in the past 25 years. If we don't halt this trend, this generation of kids could be the first in a long time not to outlive their parents and grandparents. So that seems worthy of note, don't you think?

I agree with you that smoking is extremely dangerous for all ages, but think that we can address both health messages simultaneously. Other thoughts?

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Chatham, IL: Do we have an "obesity epidemic"? Yes!

What to do? Education is the only way out of this, IMHO. People need understand nutrition and the importance of healthy lifestyles. We need to eat more fruits and Vegetables, more whole grains, and more fish -- while cutting back substantially on processed foods of all sorts and red and porcessed meats. We need to understand the need for greater physical activity every day and do it.

Sally Squires: Hear, hear! I couldn't have said it better myself. Thanks for weighing in. Other thoughts?

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Northeast: I just wanted to say how heartening your article was today. When I grew up, I went to a school system that was held in high regard. Unforunately, not only was home ec. only offered to females, but the "cooking" part was really -baking- (and cake decorating). We never learned any cooking skills or how to cook anything practical. It's wonderful to hear that they are learning practical cooking skills and that courses are being taken by men and women!

Sally Squires: Not only are they taken by boys and girls, but what surprised me is that boys quite outnumber the girls! Call me sexist, but I never expected that. Sorry guys. I won't make that mistake again. And I loved visiting that class. Thanks to Rosemary Molle and to the wonderful Yorktown High School principal Raymond Pasi (who happens to also be a Lean Plate Club member) for letting me visit, as well as to all the fine students that I met. It was quite a pleasure.

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Great Falls, Va.: I find it amazing that people struggle to figure out the causes of the obesity crisis. We have 2 school age kids (8 and 6). It is amazing how everywhere they go, they are bombarded with junk food. At their schools (one public, one private), every birthday, holiday, Friday, parent visit, or whatever is an excuse for cake, cupcakes, candy, etc. - and not just a piece - often it amounts to a big bag of candy (maybe 20-30 pieces) for something like St. Patrick's Day (not just a traditional candy-fest like Halloween) - often in combination with pizza, cake and ice cream (all on the same day). My wife and I are not health food fanatics - while we do try to eat a balanced diet, we often enjoy ice cream, cake and candy (and our kids do the same). However, we are viewed as crazy or not being in the spirit of things if we suggest that every event should not be a festival of candy. What's strange, is that the adults at these events go out of their way to encourage kids to overeat junk. If a parent brings in cupcakes to school, they push to get the kids to eat them - even if the kids already had cake that day because it was someone else's birthday, and they already got a "goodie bag" full of candy to take home. If a kid actually says no (which is a lot to expect), the parent will continue to push. Somehow we've decided showering our kids with junk food is good parenting. Is it hard to figure out what the result of that is?

Sally Squires: I couldn't agree more. In fact, the National Academy of Science new school food guidelines say that foods supplied by parents ought to meet healthy nutritional standards too.

And why not celebrate birthdays at school without food treats? Kids generally wind up getting two, three or four celebrations between home, various activities and school. I bet we could find other ways to keep this to one cake per birthday, don't you think? Or is that taking the fun out of everything?

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Des Moines, Iowa: I know we have an obesity epidemic -- you can see it. I was an obese child, myself, so it breaks my heart to see all these children and know what they are going through. I do believe we have a societal problem with so many inter-related contributors. The solution to the epidemic, however, has to come from us: the parents and families.

The school that my twin boys attend is trying to raise money to build a walking/running track. I've identified a grant that I think we could qualify for, but we need more than just a track: we need some kind of programs that the school can implement that will enable them to track fitness improvements at both the individual and aggregate levels. Any ideas out there? Where can I find this type of program?

LOVED this feature. Thank you so much for bringing much needed attention to this issue.

Sally Squires: You might check out the President's Council on Physical Fitness and Sports. You could set up a fitness group free on-line for your school. Also check out NASPE, the National Association for Sport and Physical Education. Find them in Reston, Va. Phone number is 703-476-3410.

We'll try to post a link in a minute. You might also check out the Robert Wood Johnson Foundation, the Centers for Disease Control and Prevention and the Kellogg Foundation.

Hope that helps and you'll let us know how it goes.

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At Home, Va.: Great column on teaching life skills today, but please tell me the photo that ran with it was staged.... both of those students are headed for an ER if they are being taught to cut sausage (or anything else) while holding it in their hand. Don't the ER docs refer to this Sunday morning accident as the "Bagel"?

Sally Squires: No photos were staged! We're not allowed to do that in the newspaper biz, so guess I need to take a closer look at the pictures. I can say that everyone seemed to have all their digits intake and were quite happy.

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Washington, DC: A few years ago I read a Harvard study that said one of the leading reasons behind weight gain is that people no longer have eating "rules" and instead graze all day long. The rules I grew up with--no snacking between meals(after school excepted), no eating in front of others who don't have food, no eating in the living room (where in the old days, the TV always was), no eating in school outside of lunch--are all gone. Structured eating is a thing of the past and I've noticed that I now eat all day long without paying attention, so it's no wonder I struggle with my weight.

Sally Squires: That mindless eating can be a real sabotager of a healthy weight. And you're right: it is now accepted to eat--or drink--nearly everywhere, from the car, to the street, to the office. We eat in front of each other and don't even think to offer food to others. Maybe we should make no food zones. What do you think?

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washingtonpost.com: fitness.gov

Sally Squires: Here's one of the links for the President's Council on Physical Fitness and Sports.

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Breakfast: I have a REALLY hard time getting my 11-year-old to eat breakfast. I hate to have her leave the house without having eaten anything, but her lunchtime at school is 10:30 a.m. (her teacher refers to it as brunch). When I ask her to suggest things that aren't full of sugar (she knows sweetened cereal isn't an option) she suggests bagels with cream cheese or yogurt, but then doesn't eat it when it's in the house. My daughter does like making milkshakes and will do it on her own if I let her -- how good/bad is Carnation Instant Breakfast if it's all I can get her to consume?

Sally Squires: I just tried to get the nutritional info on Carnation Instant Breakfast but can't readily find it on their Web site. Let me take a moment for a mini-rant: in putting together this obesity package, I perused many food company Web sites and I urge them to make finding the nutrition information easier. It was frustrating, difficult and extremely time consuming. So whether to chalk this up to poor Web design or a reluctance to give ingredients to consumers, I can't say. But I sure wish they would change it.

Whew! Glad to get that off my chest.

Now, Carnation Instant Breakfast is certainly better than no breakfast. You might also consider some meal replacement bars. Kashi has some good choices. So does Larabar. Whole wheat toast would be fine for your daughter. You get whole wheat English muffins too. You might get her engaged in baking muffins together. Pride of ownership might make her more likely to grab them in the a.m.

Also, smoothies--home-made if possible--can be quite portable and easy going down in the morning.

Hope that helps. Other suggestions out there?

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Herndon, Va.: I agree with the other suggestions offered here today for addressing the obesity trend among children, but I'd also like to bring attention to one other contributor: the food industry and its marketing to children. I find it appalling that kids are being targeted as easy consumers for foods that are clearly questionable. Even the new trend of "nutritious" whole grain cereals contain a high amount of sugar, or, worse, high fructose corn syrup.

Sally Squires: Okay, I know people may not believe me when I say this, but high fructose corn syrup is no worse than any other sugar. Having said that, there is an awful lot of food marketing directly to kids. The Kaiser Family Foundation wrote a whole report on this. The viral marketing that is down on the Internet is one of the most insidious problems out there. But there are also plenty of commercials that are enticing kids too. As parents, we need to be sure that they are enticed to healthier choices wherever possible.

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"overweight" BMI numbers: I disagree with Phoenix. The BMI calculator makes sense. I've been within a pound or two of the "overweight" category, and let me tell you, it's not a weight that is good for me, looks good on me, or gives me a good energy level. Activity, portion control and smart food choices are part of my daily routine; they are healthy habits that keep me in that good BMI range. The ranges are also not all that restrictive: at 5-2 mine is 101-136 pounds - a 35 pound spread. I'm in the upper end of that, but I find it to be a good guideline.

Sally Squires: I agree with you. In fact, look back at the old Metropolitan Weight Tables for a sober look at how much our body weight is creeping upward.

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lazy attitudes and bad decision making: I have to agree with Great Falls. I also think part of the problem is laziness. Kids, parents, educators, etc. We expect kids to make choices that we're not showing them if we give them fast food on a night of soccer practice, or because we're in a rush to get to a meeting. We expect that they'll have proper nutrition in school while they're not with us, but there's the whole party/cupcake/celebration problem. We expect kids to want to play outside rather than watch tv or play video games.

We can enforce by example, we can enforce by monitoring, and we can enforce by getting involved. But it means actually doing something, and we're quite the lazy nation...

Sally Squires: Modeling--the psychological word for what you describe--is one of THE most powerful tools that parents have. Nothing sends a worse message than saying to a kid, you have to eat your vegetables, but I don't. Or you have to workout, but I can sit in this chair. Actions really do speak louder than words. And I think there are fun ways for both parents and kids to do more of these healthy habits together, don't you?

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Maryland: I send in cupcakes without frosting - just a few sprinkles. Everyone wants to celebrate. This is just one way to cut down on the sugar, and mess. Besides who wants to deal with a bunch of kids on a sugar buzz.

Sally Squires: That's a great idea! Another thing that can help is to send in fruit with mini-cupcakes. It's the kind of dessert flip that I learned about at the Culinary Institute. It really works. You can have a little cake--and fruit--and eat them both too! Thanks.

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New York Mom: My husband teaches in a school district that decided to adopt policies that promote a more healthy lifestyle. Some examples of changes made were only water, juice or milk in the vending machines, teachers being role models and not eating and drinking "junk" in front of the students and teachers only allowed to serve healthy foods during class celebrations. This also meant that parents could not bring in cupcakes, etc for class b-day parties and needed to come up with other options. I thought these were all great ideas and couldn't believe that many parents were upset...they wanted the "right" to let their children eat cupcakes and other junk foods, etc at parties. I don't think junk food is necessary for a celebration...

Sally Squires: Food is certainly not necessary for a celebration. And just think if we made some celebrations opportunities to move rather than just to sit and eat! Also, I could see picking a day of the month to celebrate all birthdays in that particular month. Then for each actual birthday, doing something else special.

What do you think?

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Washington, D.C.: Hi Sally -

What is a good way to talk about portion control with hungry and growing kids?

I was interested in your note in the paper that kids should serve their own portions. I'm guessing my kids will have the same lifelong battles with weight that my husband and I are (barely) managing have had and am interested in teaching them about nutrition and (harder!) portion control -- they are young enough now that I can control what their choices are -- diet is mostly whole wheat grains esp. pasta, low-fat cheese, lots of fruits and veggies (mostly raw with lowfat dips like hummus) and some lean meat, nuts and beans. Things I think you call Green light foods for the most part -- but should these really be unlimited? (BTW, I do also give my kids the the occasional ice cream or fries or whatever, simply because I don't want these to be too forbidden...but I try to make these less-nutritious foods no more than once a day. Which is hard by the way because it seems like every day there is a birthday party at school or cookies on a playdate or whatever..and then I have to be the one to deny the treat after dinner! Usually I just try to find a more healthy substitute, ie "how about we make smoothies with yogurt and banana for dessert?")

In any case, for me,I find I can gain weight eating too much of even health food so portion control is important -- but I hate to "cut them off" even though sometimes when they say they are still hungry I think they are bored, or the (healthy) food tastes good they will just eat it until it is gone. Should I really just lay off and let them decide when they are done. For the moment I have tried to let them serve themselves while not putting an endless supply of food in the noodle bowl, for example.

Sally Squires: Having them serve themselves is really important. As a parent, your job is simply to get the food on the table. And of course, you want that food to be healthful, great tasting and inviting. So you have your work cut out.

Their job is to decide what and how much to eat. That will keep them occupied too.

By the way, these philosophies are based on research done at Penn State by Barbara Rolls and Lee Ann Birch among others.

Also, this doesn't mean that kids get endless access to the kitchen. Meals can still be at specific times and the kitchen can and should shut down at night.

But for now, keep letting them fill their own plates. And that's a great idea to limit how much food is on the table so as to minimize unlimited portions.

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Arlington, VA: Now I am scared to send my kid to school! Here was I worried about the menu at the preschool he will be attending next year and it turns out the real harm comes from other parents of grade school kids. I don't get it. As a mother of a toddler, I find myself laughing with other parents about how we apologize if we don't pack a lunch that is 100 percent nutritious. Could this be the start of a new trend or will we all start pushing sugar by Kindergarten?

I do find that friend and relatives are already pushing junk food on my young son. They are shocked and appalled that we haven't yet given him juice or chicken nuggests.

I found today's articles to be very interesting. But I also found it sad that so many people were pushing for "programs." While I understand the need for education, what happened to just having fun? I think forcing kids to exercise JUST to exercise is bound to lead to failure. I know it's easier to say than do, but go out and have FUN with your kids. Play tag, kickball, follow-the-leader (my son's personal favorite).

Sally Squires: I'm with you. But here's the sad part: some schools are forbidding kickball and other such sports. I can't believe that either! And many schools don't have PE programs.

But yes, fun and joy. Those are the real ingredients that I think we are all often missing. Me inincluded! And I'm taking steps to rectify that. How about all of you?

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Snacking between meals: An earlier poster said they were taught not to snack between meals. This statement has really been thrown out the window. You are now supposed to eat 5 small meals to maintain health, weight, blood sugar, etc. But it's healthy stuff - graze on fruit or nuts - not chocolate and potato chips!

Sally Squires: I wouldn't say that the idea of three healthy meals has gone by the wayside. Those mini-meals were originally aimed at people who were on the cusp of having diabetes. They are designed to help keep blood sugar stable.

But here's the downside: you have to make sure that these are truly mini-meals. And that's often hard for many people to do. I have also interviewed at least one scientist who thought that the cycle of feeling slightly hungry, waiting a little bit to get to a meal and then eatinn reasonably, may be a better cycle on the pancreas, which produces insulin. As she put it, we evolved without having a lot of access to food. So it's a natural rhythm to feel hungry and then spend a little time seeking food. That gives the pancreas a bit of a workout. She thinks that's a good thing, rather than just shoveling food in our mouths the minute that hunger strikes. Interesting theory. Whether it will hold up is to be determined.

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Information overload: Hi, I'm a big believer in healthy eating as well as all things in moderation. I'd like to maintain my currently healthy weight, which has been stable for years.

The problem is that I'm practically paralyzed at the store with all the nutrition information. It's like I feel guilty if I get that occasional bag of pita chips or put a little butter or cheese on an otherwise healthy dinner. So I deny myself all but the most stringently nutritious, low calorie food, then end up feeling like I'm really sacrificing. Then I'm a sucker for whatever treat is available at work, even though it's much "worse" for me than the pita chips. Intellectually, I know it's ok to have a little treat now and then, but it's hard to remember that when looking at a food label.

Does anyone else suffer from food label overload and nutrition guilt?

Sally Squires: You bet they do! I hear this often from many people. I hope that through this column, Web chat, e-mail newsletter and more that we take away that guilt. I believe that we can be a force for healthy eating and physical activity WITHOUT the guilt. No foods should be forbidden. No one food causes weight gain. It's the calories in vs. the calories out that matter. And as you know, by making foods forbidden, you can sometimes increase your desire for them.

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Centreville, Va: Very interesting series this week about young lives at risk. I was wondering if you could give me some advice regarding family eating patterns. My husband's family has what he calls "the fat gene" where every sibling is at least 30 pounds overweight. One sibling is probably 100 pounds overweight. They grew up drinking sodas at almost every meal, chips or snacks frequently, high carb low fruit/veggie diet. My family is more fruits & veggies, sodas were a special treat, and lots of outside activity. I strive to pass that on to our 2 little children ages 2 and 4. Here's the problem, whenever we visit his family the adults are constantly pushing chips and sodas on our kids. No 2 year old needs to be drinking Coke-and no, Grammy, diet coke is not a good substitute! I'll bring juice boxes and pretzels when we visit but I'm always the bad guy. The bad part is the carryover to our house where we do have chips and sodas (for adults) and the little guys beg for them and hubby gives in. What to do?

Sally Squires: This is one of toughest challenges for families. (And you thought deciding where to spend Christmas or how to decorate the tree was challenging!)

There are a couple of things that you might consider, but you likely will need your spouse's help with this. First, if you only visit your husband's family once in a while, you may want to go with the flow as in when in Rome, do what the Romans do.

If you see them frequently, this will not work long term. So, you might get them to offer some healthier options. Perhaps baked chips. Or veggie chips. Or whole grain. You might take along a measure cup and special bag for each child. They get to fill that up with whatever they want. But then, they're done. That might help with portion control.

And there's nothing wrong with you bringing some healthier options. You could also let each child choose one special treat to have at Granny's. Or even two. But then, they're done.

I'd also bring plenty of diversions so that food isn't the only thing that captures their attention. How about some new games or small toys that could be presented at Granny's so that food isn't the star attraction?

Other thoughts? We'd love to hear from those who also confront this problem.

Finally, at home you and your husband need to agtee what you will keep in the house--and what you won't.

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washingtonpost.com: Smarts About Snacks:Pitch for More Healthful Fare Proves a Tough Sell to Schools (Post, May 19)

Sally Squires: As mentioned previously in the chat.

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Maryland: My 18-year-old son was chronically obese from third grade on. He left for his freshman year in college at 260 pounds. He ended the year at 190. The difference? He started a daily weight lifting routine. This, in turn, made him want to change his dietary habits. I think there is a close link between exercise and diet. It seems that if you can get kids into an exercise routine, often a better diet will follow. Do studies show that?

Sally Squires: There is some behavior change research that suggests if you can make one change you may be more likely to make others. Sounds like that's what happened with your son. And in a minute, I'll post a recent LPC column about the Subway sandwich guy, Jared, who did much the same. That's why in Secrets of the Lean Plate Club--a book that I wrote with assistance from all of you--I encourage readers to make one eating change weekly and one activity change weekly. It really can work as your son has shown so well! Thanks.

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washingtonpost.com: Subway's Biggest Loser (Post, April 1)

Sally Squires: As promised, here's the column on Jared.

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Cincinnati, Ohio: The childhood obesity epidemic is a result of eating non-natural foods that line our grocery shelves and lack of exercise. If everyone would eat whole foods, not packaged ones, we would all be alot healthier. If the package lists anything other that what you would expect for the item, don't eat it. If cookies are made with flour, sugar, eggs & butter its better than chemical fillers. It seems our bodies are not reacting to the chemicals and fillers very well.

Sally Squires: I don't know if there is rigorous research to back that up, but I also find that when I eat food that is less processed that I feel much better. And I can tell you that our canine companion had some major health problems until we started making his food from scratch every day. He's healthier and our vet bills have been eliminated--except for regularly check-ups, of course.

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Washington, D.C.: I was an obese 12-year-old and I can remember exactly how it happened. All my friends moved off our block and the summer was extremely hot -- 90 degrees for weeks and I never ventured outside. I painted most of the rooms in my parent's house for an allowance. I returned to school and I, John, Chuck and several of our friends had grown really fat. Our parents were happy because we changed from picky eaters to voracious eaters. At one point my mother made me 2 sandwiches to take to lunch, plus chips, jerky, carrots, an apple, etc. Probably more lunch than I eat now as an adult. I ballooned to 140 lbs by age 12. My mother was happy because I stayed inside, read and did homework. I was shocked at age 14, after new friends had moved in and I had a lawnmowing job, that I was 142 lbs and 6 inches taller than I was 2-3 years earlier. My issue wasn't that I ate a lot of junk food -- I would sneak peanut butter sandwiches, cracker and cheese, cereal and fruit. It was that I was eating 7 times a day and never leaving the house. What I know to be true for me was that my parents loved that I improved studying, loved that I painted their house, loved that I ate well and was a good reader and didn't really want me outside in "code red days," but all those things contributed to my rapid weight gain. I see my son has the same problems now- we don't get out every day because we live in a townhouse and don't have a good yard and one family makes themselves the pariahs of the neighborhood who no one wants to see.

Sally Squires: What great insight into how weight can accumulate despite the best of intentions. And I challenge you to find nearby parks and trails for you and your son. Get bikes. Do the local parcourse. Or get Dance Dance Revolution indoors or other things that can keep you both really active together so that he doesn't repeat your experience.

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Arlington, Va.: The articles this week have (unintentionally) driven home how confusing all this stuff can be, even to journalists.

The article on vending machines in the high school kept pointing out how much fat was in all the snacks, as though that should be the primary concern. Yes, fat drives up calories, but the Snapple with no fat also has no nutritional value; the milk that has fat also has protein and calcium.

Then there was the photograph of fruit punch that was 100% juice accompanying an article that warned about how something can be 100% natural and still have high fructose corn syrup. Yes, but if it has HFCS, it isn't 100% juice.

If people who have an entire work day to make sure they're conveying relevant and accurate information can't get it right, people who are shopping at high speeds and with cranky kids are really in trouble. It's easy to say "Stick to food from the edge of the store," but most people don't want to be the mean mommy who denies kids the simple delights of a juicebox. (I am mean, but it's a gift. I can't teach it.)

Sally Squires: Nobody wants to tbe mean mommy--or daddy. But part of parenting is saying no. And sadly, an incorrect product photo was posted on that article but the text is correct. And it illustrates another point: how many products there are and why we all need to read those labels carefully.

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Sally Squires: Thanks to all for a great chat. We can continue the conversation on the Lean Plate Club social network and discussion group, at www.leanplateclub.com/group. I post there nearly every day and so do many other Lean Plate Club members.

Winners today are Maryland, New York, Arlington and Ohio. Please send me your name and address to leanplateclub@washpost.com, with winner in the subject line for faster handling.

And don't forget: if you live in San Francisco, Sacramento, Denver or San Diego and would like to read the Lean Plate Club column in your hometown paper, I'd love to hear from you.

Until next week: Eat smart and move more with the Lean Plate Club!

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