Last month, I saw a handful of pediatric patients brought in by their Orthodox Jewish mothers worried about their children’s weight gain. I have found that the mothers in this community are extraordinarily thoughtful and attentive to needs of their kids. And these women are quite privy to the myriad problems presented by childhood obesity that include pre-diabetes and diabetes, heart disease, hyperlipidemia, sleep apnea, early puberty, and gastrointestinal challenges. Oh, and let’s not forget the long-term psychological problems and self-esteem issues that can result from being targeted as a “fat kid.”
This isn’t just a Jewish problem, needless to say. According to the Centers for Disease Control and Prevention, 17% of children and adolescents aged 2 to 19 (or nearly 12.5 million) are obese. That doesn’t include overweight kids; obese means that one’s body mass index (BMI), which correlates with percentage of body fat, is 30 or higher. A child is obese if their weight is more than 20% higher than the ideal weight for a boy or girl of their age and height. Obesity is turning into the biggest health concern of our age. It is the one of the leading causes of death worldwide and is a public health concern of epidemic proportions. (1) Look around any mall in America, and you’ll get a good illustration.
As I spoke with these kids in my office, it became clear to me that it was difficult for them to get any meaningful exercise, as they spend long hours in school without much recess or playtime. Organized sports don’t exist in the Orthodox Jewish community. One mother suggested she have her child walk on the treadmill but how boring for an 11-year old boy! Another challenge I face with children is their reliance on bread and bread products. When I told these poor mothers that they’d have to remove wheat (including spelt) as a primary food group, they were definitely exasperated. And, hey, I understand. It’s not easy to find easy, delicious meals and snacks that kids will actually eat. A lot of kids exist on potatoes, bread and pasta. But it doesn’t work, especially when the child isn’t active and is gaining 20 pounds each year.
So, what do I tell these parents? Focus on the GenoType diet recommendations of beneficial foods and don’t worry so much about how many avoids their child is consuming. These will fall away eventually when the only things on offer are good proteins, vegetables, fruits and the appropriate grains. Special occasions, like Shabbat, are a time to have treats but food should not be used as a reward. I try to shift these families into looking at food as fuel not as recreation. These mothers I’ve met are amazing cooks and will go to any lengths to prepare wholesome sweets for their kids, so I encourage them to make sweets with agave syrup or maple syrup, dark chocolate, dried fruits and the like. With one mother, I came up with a dynamite recipe for oat flour bread, which was allowable on her son’s diet. I advise mothers that the more innovation and creativity you bring to the table, the better off your kid will be.
And exercise is a must. No matter how late they get home from school, I encourage mothers to take their kids for a 20 minute walk around the neighborhood, with longer walks and bike rides on the weekends. I counsel mothers to get their kids involved in the process of cooking and choosing their foods so they learn the how’s and why’s of making good food choices down the road. For those prone to obesity (whether it be genetic, environmental or behavioral), keeping at a healthy weight is often a lifetime task. To the 11-year old boy who couldn’t imagine a life without his daily spelt cookies, I told him to take it a day at a time and to realize that one of the best things about the GenoType Diet is that the restriction loosens once you reach your target weight (or other health goal). Spelt cookies, I told him, are in your future.
- Barness LA, Opitz JM, Gilbert-Barness E (December 2007). “Obesity: genetic, molecular, and environmental aspects”. Am. J. Med. Genet. A 143A (24): 3016–34.