A new federally funded study finds that children can learn to eat smart and move more if their parents give them access to healthy food, encourage regular physical activity and demonstrate good habits themselves.
Known as the Dietary Intervention Study in Children (DISC), this is the first to test the effects of a low-fat regimen on growth and development in children with elevated blood cholesterol, a key risk factor for premature heart disease.
The results "offer valuable lessons for finding effective ways to help children develop healthier eating habits -- a critical need in light of the rising rates of obesity and related conditions among children," said Elizabeth G. Nabel, director of the National Heart, Lung, and Blood Institute (NHLBI), which funded DISC.
When the study began, high-fat snack foods, dessert and pizza accounted for about a third of the daily calories consumed by its 663 participants, aged 8 to 10, just as they do for most children today.
All participants were encouraged to get 60 minutes a day of physical activity. Half the youngsters and their parents were then randomly assigned to a year-long, intensive program that included group meetings, individual sessions with registered dietitians, behavioral training and advice about boosting daily physical activity. These children and their families also received a DISC guide that categorized food into three groups:
* "Go" foods that the selected participants and their parents were urged to eat "almost anytime" because they are nutrient-rich and contain little saturated fat, trans fat or cholesterol. These included fruit and vegetables; whole grains; lean meat and poultry without the skin; egg substitutes and egg whites; beans and nonfat or 1 percent dairy products; water and diet soda.
* "Slow" or "sometimes" foods that are higher in fat and cholesterol, including Canadian bacon, lean ground beef, low-fat salad dressings and mayonnaise; 2 percent milk and 100 percent fruit juice, sports drinks and dried fruit.
* "Whoa" foods that the researchers advised those in the test group to eat only "once in a while" because they are calorie-dense and high in unhealthy fat. Examples include french fries, fruit in heavy syrup, fatty cuts of meat, chicken with the skin, whole eggs, cookies, cake, buttered popcorn, whole milk and regular soda.
The other participants served as a control group that received standard educational material on heart-healthy eating, but no additional guidance.
Not only did the lower-calorie, low-fat regimen have no adverse effects on growth or development, but the study found that children in the test group learned healthy habits that lasted. Three years after the study began, kids in the intervention group consumed 67 percent of their calories from heart-healthy "go" foods, compared with 57 percent for the control group. That shows, Nabel said, that "families can learn to enjoy healthy foods and to be selective about their food choices" if they have "the right tools to help them make positive lifestyle changes."
To provide those tools, the National Institutes of Health last week launched the We Can! program for children and their families to help reduce obesity, increase physical activity and cut sedentary behavior. Thirty-five sites, including several in Maryland and Northern Virginia, are using the program. Agencies in Montgomery, Howard and Arlington counties have agreed to use the program in their communities. Here are some of the suggestions they're making:
Help your kids reach for "go" foods. That includes the usual healthy suspects, especially more fruit and vegetables (sans added sauces, fat or sugar); whole grains; lean protein, including beans, tofu, egg whites or egg substitutes; and healthy fat, such as nuts. Find examples of healthy "Go" recipes at www.washingtonpost.com/leanplateclub.
Get your kids moving. Children are more likely to be active -- and stay active -- if you do physical activities with them. A few options: Walk to school or to the playground. Shoot hoops with your kids. Bike. Play catch. Toss a Frisbee, jump rope or play tetherball. Practice soccer. Hit a tennis ball against a wall. Or just walk through the woods. It all adds up to good activity.
Fists are for food. Standard serving sizes are usually too large for most kids, so We Can! advises using the size of your child's fist as an age-appropriate portion size for food.
Quench thirst with a Michigan Strait. In other words, drink water. Another option: nonfat milk, which is loaded with bone-building calcium.
Serve dessert. Just make it fruit. The study found that even children who otherwise improved their eating habits fell short on fruit. "Throughout the day, kids don't get served fruit -- not at school, not after school, not as snacks at sports," said Linda Van Horn, professor of preventive medicine at Northwestern University and lead author of the study, which appears in the journal Pediatrics. "That's where we wished we had shored up intake a bit more."
Make fruit part of each meal. Add fruit to breakfast cereal. Provide a fruit salad with lunch. Van Horn adds bowls of strawberries, watermelon chunks and other fruit to her teenage sons' get-togethers, which include healthy pizza (find an easy recipe for DISC pizza at www.leanplateclub.com) and a hearty salad. As Van Horn said, "Hungry kids will eat whatever is there -- even the healthy stuff."
To get a free copy of the NHLBI We Can! Program, call toll-free 1-866-35WECAN or log on to: www.nhlbi.nih.gov/health/public/heart/obesity/wecan/index.htm
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