Linda Frankenbach:  Hello everybody, welcome to FitsmiForMoms Radio. I’m Linda Frankenbach, the founder of FitsmiForMoms and Fitsmi which, as I hope you know, is an online community of parents of overweight children. We at FitsmiForMoms hope that we can provide valuable support, professional help, education, and particularly help parents know what to do and what to say to help their overweight children. FitsmiForMoms has a companion site for overweight teen girls, Fitsmi.com. And at Fitsmi, teen girls find a very supportive community of other girls like them. They get professional advice, help on how to feel good about themselves, how to look good, and easy tools to get healthy.

Today on our show we are delighted to be interviewing the Meal Makeover Moms. The Meal Makeover Moms are two terrific dietitians and moms who started their website, MealMakeoverMoms.com, to help parents get kids to eat healthy, and to eat well balanced meals. Their site provides a whole array of support for parents including recipes, blogs, and they also have a radio show. These two gals are very busy; not only do they run this site, but they have written two books, The Moms’ Guide to Meals Makeover, and No Whine with Dinner. That second book provides 150 healthy and kid-tested recipes. We do a little bio of each of our guests; Janice Newell Bissex, who is a registered dietitian, has been a number of things in her career, the nutritional director for the New England Heart Center in Boston, she was a nutrition consultant for four years to the US Senate, an interesting job I’m sure, she spent ten years at the Boston Harbor Hotel where she was consulting on nutrition. She wrote a monthly meal makeover column for Nick Jr., and she has appeared on CNN, PBS, New England Cable News, Fox, and been covered in Newsweek, Boston Herald, Readers’ Digest and Parent magazine, a lot having to do with the books that she has teamed with Liz in writing. She is a member of the ADA and she is a trustee of a local charter school where she has gotten very much involved in what gets eaten there. She has degrees in Food and Nutrition from the University of Maine, a Masters from BU, she trained at the Culinary Institute of America, and she is the mom of two daughters, 18 and 11. Welcome Janice.

Janice Bissex: Thank you.

LF: And Liz, also an extremely impressive and broad resume. Liz is also a registered dietitian. She is an award-winning journalist and speaker. She is the co-author of the books that I mentioned earlier with Janice. She has written and reported on nutrition and health for CNN, PBS, The Health Network, Time Life Medical, ABC Boston, she has appeared on the Today Show, and she hosts the Meal Makeover segment for Everwell Video Services which runs in physicians’ offices. I think both she and Janice have won awards for Best Mom Food Bloggers and Best Family Food Blogs, from respectively Babble.com and—I’m sorry, this one I missed, I think it’s The Food Blog, and she received the American Heart Association Howard Blakeslee Award for Health Journalism while at CNN. And she is the winner of the American Dietitic Association President’s Circle Award for Nutrition and Education. She has a degree in Nutrition and Dietitics from the University of Rhode Island, a Masters from BU, she also studied at a culinary arts school in Cambridge, and she also has two children, and she has two sons, one who is 11, and the other who is 16. Again, welcome Liz and Janice, and we are so happy to have you.

Let me start with a question about what you’ve been doing and how you got to this. You have—as I’ve just talked about, you’ve done many things together. You’re running a website, you have written books—how did you two decide to pursue this path and pursue this path together.

LW: Well, thank you again for having us on the show. And this is Liz, I have to go back into our website and update the website because my kids are 16 and 13, so wow, talk about having a house full of hungry teenagers. But when Janice and I connected back in 2000, a long time ago, we connected as many moms do; you know, at the playground, over lunch, talking about all the challenges parents were facing feeding their children. And as dietitians and moms we were starting to get very concerned about the growing rate of childhood obesity and overweight—we were getting very concerned about just the overall poor nutrition in the American diet. You know, parents would say to us, Hey, you’re a dietitian. How do I get my child off chicken nuggets, or how do I break free of the mac and cheese rut? And so we felt like there was a need for well tested, kid-friendly nutritious recipes, and there weren’t many at the time. So we decided to write our first book, The Moms’ Guide to Meal Makeovers, and we became the meal makeover moms, because we love nothing more than taking family favorites and giving them a healthy makeover. Not necessarily to be fat free and sugar free, but to have great flavor, to be nutrient rich, and to be moderate in all those things that we’re supposed to eat less of. And so we were very driven by just a community of moms on the playground. Now of course it’s a community of moms on the internet and community of interested teens and kids, and it’s all about social media as well as the real life playground, and so we’ve had a great time connecting with moms virtually and in person, and really tailoring our recipes to meet their needs.

LF: Terrific. Really valuable. What year was it that you wrote the Moms’ Guide to Meal Makeovers?

JB: It came out in 2004, early 2004. We started working on it in 2001. It took us a couple years.

LF: Right. And No Whine with Dinner is more recent, yes?

JB: Yes, No Whine with Dinner came out last year, 2011.

LW: And we really wrote that book because, you know, we had done the makeover book, and then we decided, after hearing from so many more moms that their kids were picky and just wouldn’t eat a vegetable, we decided why don’t we come up with a book that really is targeted more at the picky eater crowd, although the recipes are terrific and they’re great for everybody. My husband’s not picky and he certainly loves every recipe in the book. So things change and adapt, but you know, we really do love the whole just tailoring recipes to meet everybody’s taste bud needs, which is good flavor.

LF: Terrific. What kind of research went into your books?

JB: Well for No Whine with Dinner what we decided to do was send out a survey to our mom community. And we had some dads reply to the survey as well, but a couple of the questions that we asked them—first was, What is the number one obstacle to getting your children to eat healthy, well balanced meals? And the number one was picky eaters who whine and complain. That was 51% of moms said that was their number one obstacle. You know, we also asked—it takes too much time, or it’s too expensive to eat healthy, and those were a very, very distant second and third. Which is how we really focused the second book on this whole picky eater concept. So what we did was we made sure that every recipe in the book was tested by moms and their kids across the country, and we actually had some testers in I think Germany and Australia as well. So we sent all the recipes out, and we said, Okay, here’s a recipe, test it. And they’d test it with their children and they would send us feedback. They would say maybe it needs more flavor, it’s too spicy, it’s not spicy enough. We’d go back to the kitchen, we’d tweak the recipe, and then we would send the recipe back out to families. And we did that until all the feedback that we got was, Wow, my kids loved this recipe. So that’s some of the research that went into this book. We also asked them, which foods do your children refuse to eat the most, and you might guess that number one was vegetables; 57% of moms said their kids refused to eat vegetables often. Beans were number two, 48%, and then seafood was 43%. So we especially tried to get these foods to taste really, really good in the book so that we could increase the consumption in kids and families.

LF: You surveyed a large number of parents, over 600, yes?

LW: Yes.

JB: Yes, we did.

LF: That’s a significant sample, which is really terrific. Did you find that the parents of younger children and older children had the same issues, or were they really different issues when you got into the teens.

LW: Yeah, you know, that’s a great question. Kids tend to be pickier when they’re younger, because just like it takes a long time to learn how to ride a bike, or a long time to learn how to read and write, for some kids it takes a long time to learn how to eat a variety of foods. That’s why if you do have a picky eater, you have to persevere. You’ve got to hang in there, don’t give up, because eventually children do learn. If we’re patient and we really work at it, they do learn to love a variety of foods, and so hopefully by the time a child is a tween or a teen they’ve worked their way out of it. But the problem for many teens of course is that they have a very busy, on the go, independent lifestyle today, and so many are making choices based on what’s at the local convenience store, and even for my son, my older son, when he was in middle school and really asserting his independence, he would stop by the donut shop on the way home. He went through a big donut phase, and so we just hope that all we can do is lay the foundation when they’re younger, and then even if they stray to the donuts, they’re going to come back to the fruits and veggies because you laid the groundwork.

LF: Right, you know we also did a lot of research when we were developing our websites, and we heard a couple of interesting things that make me stop when you say that too much time, or don’t have the time to cook good meals was a distant second to the whining and complaining. I mean, we heard from moms about their busy lives, but we also heard that teenage kids social lives would often be based in fast food restaurants.

JB: Right.

LF: Which was interesting. It’s kind of like your son going to the donut shop, but for many of them it’s like sort of that’s where they’d meet, whether it was a Starbucks and drink a thousand calorie latte, or a McDonalds. In your research and your coming up with these recipes, did the fast food culture play any role in what you thought about or what you heard, or what you did?

LW: Probably moreso in the first book, because we did makeovers of all these sort of classic recipes, but getting back to your point of the fast food hangout, you know, our kids today don’t sort of run and around and play as much as they used to, just running around the neighborhood, getting on their bikes and going, and we don’t have sort of these neighborhood rec centers as much as we used to, and I think that’s fueled this too. And then because there are more restaurants than ever before, kids do tend to gravitate and hang out, which really puts the pressure on these restaurants to have healthier offerings, certainly, so that when kids do walk in they can make some sensible choices hopefully. You know, I know Starbucks has fruit and yogurt and granola parfaits. That’s a terrific choice if you’re out at a fast food type of a restaurant or a coffee shop for example.

JB: And most of the places do have healthy choices, it’s a matter of educating the kids. So that’s something the parents can do. They can say, hey, let’s go on the website. I know you like to hang out at—whatever, McDonalds with your friends, and you know, that’s okay, that’s fun to do. Let’s look and see what are some of the healthier choices to eat there.

LW: Right, good point.

LF: It seems to me that parents have a particular obstacle when it comes to the fast food culture. You know, we read much about the fact that that magic combination of sugar, salt and fat, as exemplified by a Snicker bar, as talked about in the wonderful book, The End of Overeating is such an attractive thing to our taste buds, that those kinds of combinations, when they exist in fast food, and so on, kind of lure people away from some of the more nutrition dense, healthy foods. So it would seem to me that your recipe book kind of bears the burden of that a little bit, because you are in some ways, in terms of the kids’ taste buds, competing with those kinds of things. Is that right?

JB: That is true. And that’s why we test our recipes so vigorously and we have a lot of different kids try them, to make sure that they do have that taste. It’s not the taste of a fast food burger, and hopefully, you know, we can get the kids away from thinking that that’s the norm, that that over-salted, over-sugared fatty food is really good. I think we’ve veered in the past few decades.

LW: We need to really wean their taste buds, and I think we do that with No Whine with Dinner. If you look at our Grab and Go Granola Bars, which is our homemade version of a granola bar, we had that—that one, we tested probably the most because we really had to get it right. It relies on ingredients like nuts and dried fruit, whole grain cereal, we use a few little mini chocolate chips, we use some honey in their, and so it all holds together, everything is chopped up into fine little bits because, you know, kids don’t love all those chunks and lumps, and this bar is so flavorful, it’s so satisfying, but it’s not this extreme of this high sugar, fake-o granola bar. It’s real, it’s hearty, it’s nutrient rich, it’s homemade, and best of all kids love it. I’d say that’s probably one of the most popular recipes in our book. It’s a great snack, it’s a great grab and go breakfast. It could even be a dessert, and nothing like a glass of low fat milk to wash that down. And so that’s the kind of thing we do. We know that flavor is key, we use sugar, we just don’t use a ton of it. We use white flour, but we also use whole wheat. We don’t use a lot of butter, we use canola oil, a heart healthy oil, instead. So these are all substitutions we make, but they are terrific when it comes to working well in recipe development. Adds flavor, adds nutrition, helps to lighten things up.

LF: So you talked about your granola bar, which I think I’m going to have to get your book and get that recipe, but what else are some healthy snack strategies for busy families?

JB: Well, you know, we look at snacks as sort of a great way to fill in the nutritional gaps in a kid’s diet. So you don’t look at it as a treat. You want to have a lot of mini-meals throughout the day because kids really need their calories, and they need them sort of spaced out throughout the day. So you want to look to fruits and vegetables, and whole grains, to kind of try to get more of those since most kids don’t eat enough. Smoothies, that’s a great way to get some extra fruit in the diet.

LW: Oh, tell them about the Mom’s Mango Smoothie.

JB: Oh yeah. Mom’s Mango Smoothie; my 12-year-old daughter, that’s her favorite smoothie, and it’s got some frozen mango and some mango juice and yogurt, and it’s just a really delicious, frosty treat. So you don’t have to tell kids that it’s actually good for them. You can just say, Here’s a special treat when you get home from school. You can do things like peanut butter on bananas. That’s something that, you know, if you’re going out to a sporting event, or you’re going to be working out, you know, you need some calories, some good quality calories. Things like hummus, hummus with carrots, guacamole or salsa with some nice baked tortilla chips. You know, things that kids like. Kids like crunch, they like sweet, so you really need to look to see what would appeal to a kid but also, again, what will fill in some of the nutritional gaps in their diet.

LF: And I know one of the big issues we have today is understanding appropriate portions. How do you advise mothers on that, when it comes to snacks? Is it, you know, two bananas with peanut butter on it? Is that good? Or is it 25 carrots with hummus? How do you…

LW: Well, you know, it really depends on the child, and it depends on the child’s age certainly, and it depends how many hours ’til dinner. I will tell you, when Josh and Simon get home from school they’re starving, and so I will give them quite a substantial snack, but I know that dinner is a few hours away and they’re going to be hungry. That’s so important, you know, just in general, we do live in this nation of portion distortion—you’ve probably heard that term before—where everything has been super-sized. And by the way, watching the movie Super Size Me is not a bad idea because it really is a documentary and it really does put this whole super-sized portion issue in perspective. You can have smaller plates; that sort of tricks the eye, you think you’re having more food, if you will. I always start with smaller portions at dinner because I like to have seconds. But if I were to start with huge portions, but I still like to have seconds, that would be a problem. So start small, and then when you take seconds it equals a normal portion, and then slow down. You know, so many families sit and eat dinner in front of the television, or they eat on the go. And they’re not eating mindfully. So we really want to slow down, put on that soft music, focus on the family, focus on conversation, savor and taste and enjoy the flavor of your food. Slow it down, take a breath, and by slowing down people will eat less. Soup is another great way if you’re concerned about portions. We have a recipe in No Whine with Dinner for Tuscan minestrone soup. I just made it for the kids the other night, and my husband and myself, and it’s got cannellini beans, and sautéed carrot and onion and zucchini, and you cut the vegetables up small and they cook down and they caramelize—it’s really yummy, and so this soup is so full of volume because it’s a liquid. It really fills you up, but the calories aren’t that great. And so it’s a nice way to keep, you know, portions and calories in control.

LF: Right. So you’ve created a book with 150 recipes and you offer them on your website. Can you give us a sense, from everything you’ve done, what are sort of like top five favorites? Do we know that?

JB: Boy, let’s see.

LW: Well, we said the granola bars.

JB: Yeah, the granola bars definitely.

LW: How about the Black Bean Brownies?

JB: Yes, we have a recipe for Black Bean Brownies that are by far the number one searched item on our blog, Meal Makeover Mom’s Kitchen, and people absolutely love these Black Bean Brownies. They’re delicious, they’re fudgy, you would never know that there was a can of black beans in these brownies.

LW: All pulverized in there.

LF: Great. So have you substituted black beans for flour?

LW: Well, it’s really a fat replacer more than anything and Janice is turning to the recipe now to refresh her mind.

JB: My simple mind.

LF: This is really interesting, I’ve never heard of anything like this. So I’d expect our listeners would…

JB: Yeah, it’s got three large eggs, three tablespoons canola, three quarter cup of sugar, a half cup of cocoa powder, it’s got a can of black beans, a little bit of peppermint extract, baking powder, a little bit of salt, and some little mini chocolate chips. And it is just—it’s really good.

LW: Really good. There’s another food blogger who actually just made those and she blogs about it, and she said her husband was very skeptical and then in the next photo on her blog you just see a plate with crumbs on it. So people love it. And they also love our recipe—this is the second most searched recipe on our blog—which is Smiley Face Casserole, it’s also in the book, and it’s a makeover of tater tot casserole. So it’s got lots of veggies, and it’s very lean ground beef. You could use lean turkey if you would prefer, and we use smiley faced baked french fries on top. So instead of having those tater tots these are the smile fries. And you can find those in the market in the freezer section, so it’s cute, it’s playful, and we’ve got three or four veggies in there, carrots and zucchini and mushrooms, and I think onion. So it’s a great way to get more veggies, good protein from that lean meat, so it’s a nice makeover. And I think the original recipe calls for a stick or two of butter, which was ridiculous. So we use low fat cheese. We don’t go fat free, we use a reduced fat cheese, and that adds that nice creaminess to it that everybody sort of loves and expects.

JB: Another recipe that I…

LF: Go ahead…

JB: Layers of Love Ravioli Lasagna. I really like that recipe because it’s fast, it’s easy. You basically layer frozen cheese ravioli with some tomato sauce and cheese, and you put a layer in the middle of sautéed Swiss chard.

LW: Or you could use spinach.

JB: You could use spinach, you could use chopped kale, but you sauté it in garlic and olive oil, so it’s got some great flavor, so it’s like a lasagna but it’s very, very quick to assemble, and then you just pop it in the oven for 35 or 40 minutes and you’re good to go.

LF: And it’s really layers of vegetables. Is that what you were saying?

JB: Well, yeah, you’ve got Swiss chard which is just chock full of great nutrients, and yeah, it’s got some garlic and pasta sauce. It’s just great.

LW: Yeah, and you know, we used jarred pasta sauce. If you make homemade, then use that instead, but you know, we’re busy moms, we like the convenience. We just read labels and, you know, some products are better than others. Some are pretty salty, so you do want to compare labels and find a pasta sauce you like, and if you have a picky eater at home, make sure the pasta sauce you choose doesn’t have lumps and chunks in it, because that could be a big turn-off for kids. You know, texture is huge. Even for some adults texture is pretty critical, so if smooth is the way to go, then you need to buy a product that your family is going to enjoy.

LF: You hear lots of people talking about reducing the amount of white sugar that you consume. I heard you say that the black bean recipe had three quarters of a cup of sugar. Do you have any kind of rules, regulations around the use of sugar in what you’re doing?

JB: What we tend to do is use the least amount of sugar to still have a great tasting product. And I think the original recipe for these brownies had a cup and a half of sugar in them.

LW: Probably.

JB: And we cut that in half. So that’s what we try to do. We are not anti-sugar, because I think a little bit of sugar makes food taste good, some foods, so we just keep it to a minimum.

LW: You know, and I do find that a lot of so-called healthy recipes that are low fat are loaded with sugar. I’d rather add a little extra fat but use good fat, say canola oil or olive oil, and then not have to add so much sugar to compensate. Food’s a balancing act, and Janice and I spent a lot of time in her kitchen—we mess up her kitchen and we create lots of dishes. And we do lots of recipe testing until we nail it, and we say, Ahh, this is something we would like to feed our kids every week, and now we’re ready to share it with the world.

LF: So we just talked about I think your top four, your favorites. Are those top four the ones that you would suggest to a mom she use if she’s got a particularly picky eater, or do you have some others that you think are just the best when someone’s terribly picky.

LW: Wow, that’s a tough one. You know, I think one of the best vegetable recipes in the book is called Mommy’s Edamame, and edamame are soy beans. And so if you buy the edamame frozen, in the pod, you boil them up like it calls for on the package directions, drain them, and then toss in a bowl with some extra virgin olive oil and a sprinkle of kosher salt. Now the kids can pick up these pods and pop the beans out into their mouths and chew them, and they’re really playful and its fun, because some of the pods have one or two beans, some have four, and so you pop them out and it’s just so much fun. And if you have a child who’s a little skittish when it comes to green food, that’s your perfect entrée into the world of green food. Food’s so individual. I think the key is for people to visit our website, peruse our books, and see what appeals to them because every single person is different. There’s no one size fits all approach. You know, in my household we don’t really love green bell peppers, but we love red and we love yellow. My husband doesn’t like cucumbers so I just don’t give him any, and the rest of us eat the cucumber. You know, we give each other a pass. We cut each other some slack, and after a while you kind of get to figure out what the family loves and what the family doesn’t love. It doesn’t mean that, you know, I’m not going to try to give my kids certain foods that maybe they rejected before. With my husband it might be a lost cause. He’s, you know, in his forties, so I’m going to give up on that. But with the kids, you know, if there’s a certain food that they don’t like one day, I’m going to try it again. Believe me. Or I might change up the texture or the presentation. Never give up, but also accept it. At some point you have to accept it.

JB: And bear in mind too that some kids prefer raw vegetables to cooked. Which is always amazing to me. My daughter likes raw cauliflower and raw broccoli, and I don’t at all. I just don’t like that flavor.

LW: And she likes frozen peas and frozen blueberries, and a lot of kids like that, they like to eat the vegetable or the fruit frozen. Frozen grapes.

JB: So you want to try a variety of different things. In our book, No Whine with Dinner we have a chapter, it’s called 50 Mom Secrets for Getting Picky Eaters to Try New Foods, and these are 50 strategies that we got from our survey that we sent out, and they’re all very different. And so one strategy might work for one picky eater, and then another one might work for, you know, someone else, but certainly out of 50 I think people can find a few things to try if they have picky eaters.

LF: So for the really rushed family, does your book or your website offer some suggestions of those really, really fast meals that are healthy, and can you suggest one or two?

LW: Yeah, I mean we do have a lot that can be made in less than 30 minutes. Quesadillas is one of them. I always keep whole wheat flour tortillas on hand, and you can stuff those with any leftover meat, chicken, beans, we always add some canned beans, bell pepper, we sauté those a little bit. You can add a little bit of barbeque sauce or a little tiny bit of salsa, and you just make these quesadillas, and everyone loves quesadillas. And then you can dip them in a little bit of reduced fat sour cream or salsa or guacamole, or sliced avocado, and that’s always a big hit with my kids. You could make a simple cheese omelet. I sauté up, again, I love red bell peppers. Sometimes I’ll put a little spinach, maybe some feta cheese, and whip up an omelet. That takes maybe ten minutes. And also, boil up some water as soon as you get home, before you do anything. Before you feed the dog or unpack the backpacks, and boil water, and then just throw in either some tortellini or some pasta, and add a little bit of pesto sauce to it. You can add some broccoli for the last two or three minutes while the pasta is cooking, drain it, add some pesto sauce, add a little bit of parmesan cheese, you have a very, very simple but quick meal that’s healthy. We usually get the pasta that is half whole wheat and half white.

LF: Terrific. I’ve got to stop you there, unfortunately we’re about out of time, but I thank you both so much. These are great ideas. I think our listeners ought to go check out the Mom’s Guide to Meal Makeover, No Whine with Dinner, and your website, MealMakeoverMoms.com, because you guys have just great ideas. And we thank you both very much. We hope to talk to you again soon, and I’m going to go try to make that black bean brownie recipe as soon as possible. Can’t wait.

LW: Thanks for having us.

JB: Thanks, it’s been great.

LF: Thank you, okay, bye-bye now.

At fitmsi.com and fitsmiForMoms.com, we try to empower teen girls struggling with their weight to take control of their own health and we try to help parents help kids reach their goals.  It takes the interest and effort of a person’s entire community to help kids get and stay on track through adulthood.  According to a recent study, a parent’s pro-active involvement in the home is clearly a factor in helping kids get healthy.  But parents can’t help their child achieve a healthy weight if they don’t even perceive a problem in the first place.  Research done by Strong4Life, sponsored by Children’s Healthcare of Atlanta, revealed that 75 percent of parents whose children are overweight or obese don’t see a problem.

If we don’t start sending direct messages to adults about the severe health risks caused by obesity, then we are risking entire families.  Ads like “Stop Sugarcoating it Georgia,” which are really aimed at parents more than kids, as well as Bloomberg’s subway billboards targeting adults (many of whom are parents) are an important step in the complicated issue of childhood/adolescent and adult obesity because the first step is to get people’s attention.

But after the shock and awe that the campaign elicits, it’s essential to offer effective tools and support for families to begin the process of healthy living.  At fitsmi.com and fitsmiForMoms.com we learned early in our research with overweight teens and their moms that they need a realistic plan that gives them clear directives about food and exercise and also helps them feel better about themselves. And they need support from peers, peer mentors or professionals to cheer them on and keep them on track.  That’s why we designed fitsmi’s Change Machine to be not just a personal tracker but a girl-only social network, taking full advantage of peer support, as well as a gateway tool for cost-effective personal and group coaching, which we will be adding in spring 2012.

The Strong4Life and Bloomberg videos and billboards are a bold and, yes, controversial contribution to creating awareness of the seriousness of this country’s obesity epidemic.  So now that the conversation has started, let’s get going.  At fitsmi and fitsmiForMoms, we are dedicated to being an effective and affordable solution to overweight teen girls and their parents.

1.  Feeling the love for tomatoes, go for minestrone! A tomato-based soup is the perfect vehicle for delivering lycopene – a cancer fighting antioxidant that becomes more potent with heat. Not to mention minestrone is the perfect type of soup to use up leftover veggies. Dice up vegetables, like green beans, zucchini, broccoli and follow this recipe. The longer you let the soup hang out, the better the flavors will be. So make a big batch on a weekend morning to enjoy later in the day and everyone in your house will be thanking you for the yummy smells!

2.  Got leftover chicken from a family dinner? Chicken noodle soup is calling you! Shred 1 to 2 cooked chicken breasts using two forks to pull apart the meat and set aside. Bust out 1 onion, 1 large carrot and 2 celery stalks. Dice everything up and put in a large pot, pour in 4 cups of chicken or veggie broth and 2 cups of water and heat over medium. Once the mixture starts to bubble, pour in 1 cup whole wheat noodles and a pinch of salt and pepper. After 15 minutes, toss in the chicken and stir. Voila! Just like that you have 4 servings of homemade chicken noodle soup. You can even package it up and freeze individual portions for a cold and rainy day!

3.  Whoever said potatoes were bad for you?! Reap the benefits of this high-fiber food with a fresh batch of potato soup. Use this low-fat version as a guide and leave half of the skin on the potatoes for an extra vitamin boost. Stir in ¼ cup of low-fat cheddar cheese to your portion, and you’ll get enough protein and fiber to keep you full for hours.

4.  Split pea soup gets a low-maintenance makeover! This soup often gets a bad rap from the younger crowd (something about the name?), but we promise this tasty version will have them coming back for more.  Not only is split pea soup filling, but those little peas pack a mean protein punch too. Plus you get a healthy serving of iron to keep your energy up for an active, 10,000-step day!

5.  And, if you’re in a pinch between school, homework and extracurricular activities reach for a can of low-sodium vegetable soup. Look for something tomato or broth-based to really fill up your grumbling tummy! Toss in half a cup of frozen spinach and half a cup of canned beans, like garbanzos or black beans, when heating up the soup.  You don’t have to sacrifice their health just because everyone’s in a mad rush!
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photo credit: The Unseasoned Wok via photopin cc

Here are a few fast tips for getting your children, tweens and teens on The Health Train.

1. Talk as a family about why choosing healthy food is important to your kid’s well-being

As kids reach for soda and sugary snacks to soothe themselves and quench their appetites, they may not be aware that the empty calories add up to health consequences. Soda is loaded with sugar (about 13 teaspoons per can) artificial sweeteners, caffeine and empty calories (about 150 in a regular soda).  Choosing foods that are fuel for the body, rather than focusing on dieting is critical to health. Check out Dr. Lynne Printable Grocery List and ask your kids what they like. Have them make their own whole foods grocery lists and take them with you to then grocery store.

2. Make exercise part of your family’s day, every day

According to the President’s Council on Physical Fitness children and teens need 60 minutes of activity each day for their health. Exercise can be done in as little as 15 minute increments. Walk the dog as a family, kick the soccer ball in the drive-way, or skip rope in between television commercials.  That time is well spent and adds up to a daily exercise regimen for health and obesity prevention.

3. Compliment what your kids/teens do well

In our society we tend to focus on the poor choices our kids/teens make instead of focussing on what they do well. When your teen reaches for that apple instead of a cookie after school, comment on how that is a smart choice for their health.  Join in when your teen goes for a bike ride or walks the perimeter of the shopping mall.  Participating in health together with a positive mental attitude matters.

4. Focus on a positive body image for your teen

In the teen years, we can feel self-conscious as our bodies grow and change. Dieting becomes more problematic as teens may focus on limiting calories instead of eating whole foods for fuel and nutrition. Help your teen develop a positive body image by discussing that all body types are fine, we just want to develop the healthiest body for our own style and body type.

5. Skip the “Fat Talk”

Sometimes as parents, we talk a lot about fat and not enough about health. “Fat Talk” around the dinner table or with our friends models for our children and teens a lack of respect for ourselves and our bodies.  Skip the comments like “I’m fat,” “I feel guilty cause I ate some cake,” and practice sentences like “My body enjoyed that healthy meal,” “It’s great to have a little cake, I just stop at one piece.” Read Dr. Robyn Silverman’s and Dr. Lynne Kenney’s collaborative article on “Hold the fat talk.”

6. Limit sedentary screen time

The TV, video games and time spent in front of the computer can be relaxing and even addicting. Keep an eye on how much screen time you and your kids are spending in your own home. After an hour of TV or computer time, get up and dance, do a few sit-ups, take a walk or play on the trampoline for a few minutes. Too much screen time means too much down-time for kids who need to move to stay healthy.

7. Sit down for family dinner

Research shows that families who dine together experience less teen obesity, teen pregnancy and addiction. Take the time to sit and eat as a family for 30 minutes or so each day. If dinner is a challenge due to sports and activities, sit down for breakfast. That time spent as a family adds up to better relationships and lifestyle choices.  Check out Dr. Cuneo’s dinner together for more tips and ideas.

8. Eat less fast food

Fast food may be convenient in the short-run but disastrous in the long-run. Start by simply observing how often you all stop for fast food. A typical fast-food meal is 800-1,000 calories, about half of what your child or teen needs each day. A teen with moderate fitness activity who weighs 125 pounds needs 1,750 calories per day.

So if you do need the convenience, stop at places that offer salads (without the dressing or dressing on the side; salsa and greek yogurt are good dressings) or sandwiches with veggies.

Helping children, tweens, and teens focus on health and exercise instead of fat is boarding the train to better health.

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photo credit: austinanomic via photopin cc

“I was very concerned about my youngest daughter who was headed down a path where she was going to be struggling with weight like I was,” says Troyer, 46. “I felt I could not tell her to eat less or healthier until I showed her that you can eat yummy meals and be healthy and maintain a healthy weight. Our focus has not been on weight loss but overall health and creating a lifestyle that promotes health and well being.  For lack of a better phrase, we wanted to create for our family “a well balanced life.”

Vanessa, left, after losing 100 pounds.

So here is what she did:

* She created several excel spreadsheets with weekly meal plans listing calories. She rotates the meals so the family doesn’t get bored of eating the same thing over and over.

* She adapts recipes that are high in calories by swapping ingredients to make them healthy. “We have made quiches that are absolutely savory and cut the calories and fat in half,” she says. “We do the same with desserts and muffins.”

* Her youngest daughter has joined a swim club and is swimming three nights a week for two hours, and her oldest daughter does yoga at home with a free online class. Both Troyer and her husband work out at a local gym a few times a week and walk to the beach every weekend morning (about two miles).

Here are some more of Vanessa’s tips:

What’s the top food-related change you made in your house?

I removed all foods that were high in fat, sugar, and carbohydrates. I created a weekly menu planner with the caloric intake for each item, breaking it down by the actual ingredient. This way they could exchange for another item if they preferred to eat something not on the list. For example, they could exchange two whole-wheat pitas (159 calories each) instead of the whole-wheat bagel  (140 calories) on that day’s breakfast menu.

What was your biggest challenge?

Restaurant meals and birthday parties where the only offerings are snacks, pizza, or greasy fries.

With her daughter.

How did you overcome it?

We decided that each week the kids could have a splurge meal.  This allowed them to “save face” at parties, not feel deprived, and not have to explain anything about their food choices.  To our pleasant surprise, once the girls started eating healthier they didn’t enjoy some of the junk food they had eaten previously.

What’s your favorite healthy recipe?

We make Greek Tacos often during the week as it is filling and quick. We use veggie crumbles, toast a whole wheat pita, cut in half and stuff each side with 4 ounces of veggie meat, 2 tablespoons of tzatziki (yogurt, cucumber, garlic sauce), chopped tomatoes, roasted peppers and fat-free feta cheese.

What do you wish someone had told you about healthy eating?

I wish I knew how many calories I was eating. At one point in my life I would drive through McDonalds every morning on my way into work and order the Sausage McGriddle breakfast sandwich — a whopping 420 calories (200 from fat) and 22 grams of fat!  I now will drive through only if traveling and if McDonald’s is my only choice, I’ll order a Fruit and Yogurt Parfait (7 ounce) 130 calories (20 from fat) and 2 grams of fat.

What else would you like to change in your own life or your family’s?

I would like us to be more active on a daily basis and not just weekends. Not only does it allow more quality family time away from electronics, but you get a bonus as you get to work off calories and stress! A boring exercise program can be viewed as a punishment or dreaded chore to kids being asked to work out. But throwing a Frisbee at the beach after dinner is something the entire family enjoys and can really work up a sweat when played on the sand.

What was the most important way you helped your daughters with their weight issues?

We only spoke of weight as an indicator pointing to our overall health and well being. We never said anything about appearance or self-esteem, but we did not dismiss it at the same time.  Now more than ever, girls measure their self worth by their appearance –  sad but very true.  The media does a good job of making sure that girls who are heavier than the televised ideal feel inadequate.  It’s truly a shame that they do not cast girls who represent what most real girls look like.  As parents, we also lead by example. We worked out, ate right, and felt better when taking care of our health. It is harder to eat poorly when everyone around you is conscientious about their eating.

How many times a day do you see your kids slouched around a screen?  Celebrity trainer, Parenting magazine fitness editor, and co-author of the book Sneaky Fitness: Fun Foolproof Ways To Slip Fitness Into Your Child’s Everyday Life, Larysa DiDio discusses the best ideas from over 100 games and activities she developed to get any kid off the couch in this transcript from the Jan 3 fitsmiForMoms Radio Show with host Linda Frankenbach (if you prefer to listen to the podcast, you can find it here).

Linda Frankenbach: Happy New Year everyone, and welcome to FitsmiForMoms Radio. I’m Linda Frankenbach, the founder and CEO of FitsmiForMoms and Fitsmi. Our company, as you all, I hope, know, really is focused on trying to help overweight teenage girls who struggle with their weight, and to also help the parents of overweight kids in any way that we can. And both of those sites and these radio shows try to work together to help you, parents, figure out what to do to help your kids. And we’re really happy to have you for our inaugural show in 2012. Those who listen to us live will note that our time has changed. We are now Tuesday afternoons, every other Tuesday at 3:30, and we alternate with our radio show for Fitsmi, which is also Tuesdays at 3:30.

So thank you so much for joining us today. Today our guest is Larysa DiDio. Larysa comes with a fascinating background, has done so many things in terms of fitness and kids. I’ll give you her bio. She is the fitness editor for Parenting magazine, and she runs a fitness facility, PFX, in Pleasantville, New York, which was one of the first gyms to offer classes specifically for kids; one called Boot Camp Baby, and Get Fit for Prom, and both of them have attracted national scholarships from Canyon Ranch and others. Larysa is also a trainer who works with celebrities, and professional and Olympic athletes. She is ambassador to Best Bones Forever, a government campaign to get girls healthy, and in 2008 she created Get Fit with Larysa, a DVD for tween girls which was designed not only to help them get fit, but to help them build self-confidence. She is an unofficial contributor to the training badge, or the fitness badge for the Girl Scouts, and she contributes to Girls’ Life. But more recently she has published a book; she is the co-author of a book called, “Sneaky Fitness: Fun, Foolproof Ways To Slip Fitness Into Your Child’s Everyday Life,” and we are very happy to have Larysa with us today, who is going to discuss a lot of what she has in that book, and we hope that these ideas are going to be really helpful to you. So welcome Larysa. So glad to have you.

Larysa DiDio:  Thank you. It is so fun to be here. I’m so excited to be on your first, your inaugural show for 2012. I’m hoping, and I think it’s going to prove to be a phenomenal year. I’m really excited about this year.

LF: Well that’s terrific. I’m going to start—you’ve done so many interesting things in fitness and so on, and I’m really interested in finding out, what is it that brought you to start focusing on fitness for kids?

LD: Okay, well, I was reading a couple of questions that you sent to me and I was thinking about this, because I’ve been in fitness for so long, for over 20 years, and I was trying to think, How did I get to really concentrate on kids? And I think it started when I was a child, and when I was a child I loved doing—I loved being active, and I loved doing obstacle courses, and my dad would set up obstacle courses for me in the backyard, and my friends, I would time my friends. Because I had such fun doing it, I said everybody must have as much fun as I did, and I got them going, and I sort of was their personal trainer at eight to eleven years old, which is kind of funny. Then in my early teens I was quite thin, and was made fun of because I was thin and I felt very weak, and I took it upon myself to speak with the gym teacher and ask him what I should do in order to buff up or get a little stronger. And he suggested that I go into the weight room, and he gave me a program for the weight room, and I was one of the few girls in the weight room training. And I found real comfort in the weight room, even though I was an athlete, but I found comfort there because I found it to be a non-competitive atmosphere. I thought that people were—the kids there were on programs, they were mature, we were all just competing with ourselves, and I loved it. And I got my friends to come, and it really took off, and I thought to myself, If I’m feeling like this, everybody else should feel like this. They should have the opportunity to be empowered the way I was empowered. So I continued with my fitness quest. I went to college, and I was training my adult clients in my early twenties, in my mid-twenties, and the kids, their kids, would jump in and want to work out with us, from as young as three years old to as old as twelve years old, and most gyms don’t allow kids, because of insurance reasons, and because they don’t want to actually have to take the time to show kids what to do, because they take a little more practice or a little more instruction, because they’re not used to being in a gym—that the kids really, this was new to kids. That they really had an interest in doing it, so—and many of them, and increasingly so, needed it. So I would work with the kids and the parents together, and not only was it great for the kids to work out, but it also was a great bonding experience for parents and kids alike. So that’s how it really started, and then I started working more and more with just children. I found how great—and I was reminded of how great I felt working out at such a young age, and so grateful to the ones who helped me, and helped empower me through fitness, that I really felt a mission to share the same and help other kids in the same way, and the more I worked with kids, the more I saw how it even helped them even more.

For example I trained a girl named Allie, and she’s 11 years old, and she was very overweight. She is in a private school in New York City, and her headmaster came to me and said, “I’m not sure what you can do, but we’re having trouble with this girl who’s overweight. She’s being ridiculed, really her confidence has gone down, her grades have gone down. I’m thinking maybe she needs a little fitness, maybe you can help her, maybe you can empower her in some way.” I worked with her for a year and her teachers, the teachers—actually three teachers—went to the headmaster and said, “What psychologist is she seeing, because we’ve never seen such a difference in a girl in a year?” and the truth was she wasn’t seeing a psychologist, she was just empowered through fitness and strength training with me. So what I did, and the more I work with kids, the more gratifying and empowering it is for me, so that’s really how I moved forward, and then writing the book was just a way for me to connect with as many kids as possible. So that really, that’s how I started with children, and I continue to—it’s my mission really to be able to end the childhood obesity epidemic in every way, shape, form that I can starting with one to a thousand kids at a time.

LF: Well, that’s fabulous. That’s a great story. There was something you said there that really—I think it is important for us to talk about a bit more. You know, all of us who are working with kids, trying to help, know that feeling better about yourself is a really important step in the road to getting more healthy, and you talked about how fitness alone, and the support that that gave to the gal you were talking about, really changed not only her health, but how she felt about herself. Can you just talk a little bit more about why you think that’s the case?

LD: Here’s the low-down. Children who are overweight, they are at a predisposition, and increasingly so, for adult-onset maladies such as diabetes, cardiovascular disease. It’s really amazing that now they’re finding 13-year-olds with high cholesterol, and they’re putting 14-year-olds on diabetes medications. This is awful enough physically, and if you tell a 14-year-old child that she can’t be overweight because it’s not great for her body to be overweight because she can develop diabetes, and actually you can tell the parents the same thing; they can develop diabetes or cardiovascular disease. This doesn’t resonate. They don’t see it, it’s not tangible. What’s diabetes? It’s high blood sugar, it’s—whatever. So the physical issue and the physical problems that go along with being overweight are bad enough, but the most immediate consequence of a child being overweight, as told by the children themselves, is social discrimination. And it comes in the form of a) being ridiculed, b) teased—just being ousted from groups, being made fun of. Imagine what it’s like to be picked last for the kickball team every day of your life. This is what these kids go through, and I’m not sure if you saw today on the news, that Georgia has started a new ad campaign. They launched a new ad campaign trying to end the obesity crisis in their state. Their state has the most amount, they have one million kids who are either overweight or obese. They have the most amount of kids in their state in the United States, and the posters and the projections that they have in the pictures, and the quotes along with it, are a little—they’re a little riveting and they’re a little horrifying at times, and people are sort of a little horrified by it, and it was on the Today Show today, and I think that…

LF: Can you just talk, before you go on, just talk about what it was about the ads? Because I think there’s going to be some talk about this. We did hear about it.

LD: Sure, yeah. There’s a picture of an overweight girl, and underneath there’s a caption, “I don’t go to school because I feel like I’m fat, so I want to be home schooled.” And that, actually, you know, I work with seven girls who are home schooled as a result of being overweight and being ridiculed. One of the major reasons why kids want to be home schooled is because they’re too embarrassed—so the issue that I’m having here is that parents think—people are horrified in New York City, and, I don’t know, I guess, there was the Today Show and they were talking about people in New York City, how horrified they are at the images of these kids being overweight, and the quotes underneath them, but I think that this is the message that needs to be sent to parents. Because the only thing that’s going to get parents to think is by putting themselves in their children’s shoes. Like I said, if you, and it’s my experience, if you tell the parents that their kids are going to get diabetes or cardiovascular disease, or cholesterol, it’s so foreign for them that they don’t really think about that. But you tell a parent that their kid is sitting in the corner crying and huddled up because she feels so badly because she’s getting made fun of, that sort of hits home. And I find it’s the catalyst that allows and brings about change in the home, where change really needs to occur.

LF: That’s really an important observation, and we have heard from many clinicians and others how challenged they often are to get families to come. And I’m interested in what you’ve done in terms of your boot camp and your exercise thing, and those girls you just mentioned who are being home schooled. What was the—what got them to you? What was the catalyst? Was the girl the factor, the main factor, was the mom? The dad? What do you think pushed them over that line where they said, We need to get help?

LD: I think, and I know, that it’s typically the mother, and sometimes the father, because fathers are definitely getting more involved in their daughters’ lives, but it’s the mother responding to their child either 1) not fitting into pants, trying to go to the mall and realizing that they can’t fit into “normal sized jeans” and feeling how badly their child felt when they couldn’t do that. So it’s not really the ridicule that their getting in school, it’s how badly they’re feeling about themselves in day to day life at home.

LF: And have there been cases where the girls somehow found out about you and pushed mom or dad to get there?

LD: Typically it’s parents—well a child has pushed to come see me when they know other kids and other friends that I have helped, and they feel like I can help them too. And actually most of the time it’s the mother who’s the catalyst, but the mother sort of steps aside towards, you know, the middle of our sessions, and it’s the child who really continues the relationship with me and actually books the sessions with me. So a 10-year-old or an 11-year-old seeing the difference and seeing the difference in how she feels is the one who will push her mother to book sessions with me, or email me or text me, I need to work out again, I need to work out again. Because I’m looking good, I’m feeling good. And that—when it gets to that point, which is usually pretty quickly, within two or three weeks, I feel very, very happy because then they’re taking charge of their lives and really I find that it’s working. And it happens very quickly, and it has never not happened with any girl that I’ve worked with.

LF: And how long does your program generally last?

LD: Typically kids work with me for between two and four months, which is about what they need in order to keep them going. Then sometimes they’ll take four to six months off and then they’ll come back sort of like for another boot camp for another six to eight weeks. It typically goes along with their school schedules. I may not see them during the summer, so they’ll take two months off during the summer, which is fine, and they’ll feel just like an adult, in September, that they sort of need a boot camp to come back. But they always use my principles. Once—the principles that I use in teaching and training my clients are ones that can be used over and for the rest of their lives, which is why my programs are usually—it’s permanent lifestyle change, as opposed to just a weight loss program or a get fit program. It’s a permanent lifestyle change. So they can take my tips with them, and although they like seeing me and they like me pushing them, and they like to work with me, and sometimes they need just a little added boost, they can use the exercises and the principles that I give them even when I’m not with them.

LF: And just to wrap up this section, if someone, one of our listeners, lives in the New York area and would like to get involved with your program, how would they reach you?

LD: The best way would be to email me. You can go on my website or you can just email me: larysa@larysadidio.com.

LF: That’s terrific, and final question about your program. How expensive is it? I know that there are scholarships that are available, which is just fabulous, and how much would a family expect to pay for a program like this?

LD: I’m unique because I’m a celebrity trainer in New York City, so I’m a little—I may be on the higher end, but I have other trainers in my gym and in my facility, and in surrounding areas, that I can recommend that I’ve taught how to train, using my training methods, but for an hour session, between $40 and $125 for the hour. Per session. But there are also classes that we teach in our gym, it’s FitnessXperts.com that you can pay about $10 per session, per class. There are a group of kids. Also the Ys in your area. YMCA is a great source for kids’ fitness programs.

LF: That’s really, really helpful. Let’s talk now about your book.

LD: You know, can I add just one more thing about kids’ fitness? DVDs are really great, and if you were looking for something that’s a little more affordable for your child, if you go on to something called collagevideo.com you can find videos there for under $10 a video, and also you can go onto Fit TV, which is actually on TV, and you can find, for free through your cable, exercise DVDs there. And kids do love exercising in their home and on DVDs when they can pick different things, so that’s also a great option.

LF: That’s a really important point. Glad you made it. And we certainly do believe, with both of our sites, that there are possibilities for help that you can get digitally. You can get them by connecting to the right places, and I’m glad you mentioned those couple of places. We really think it’s important to make parents and kids aware of where they can get help locally, and nationally.

So you obviously have learned a lot in your years of doing this, and you wrote this book, “Sneaky Fitness: Fun, Foolproof Ways To Slip Fitness Into Your Child’s Everyday Life,” so tell us a little bit about what this book suggests. Maybe just run us through the top ten things that a parent can do to slip fitness into her or his child’s life?

LD: This book was—I wrote this book because I wanted to give parents a way to get kids to exercise without them knowing it and without the fight. Not saying that kids shouldn’t traditionally exercise, because I believe in traditional exercise, I believe in the hour of gym time, and I believe in after school activities and intramurals, but I wanted something in addition that would get kids motivated to run and just be active daily, sort of like everyone was 10 years ago, 20 years ago, where we would just go outside and play. I wanted to bring back the play and the activity back into playtime for kids, so this book was written as in response to that. I also wanted parents to know that—if you go through my book there are components of fitness, and they are, some of the five that I use are, balance, strength, agility, cardiovascular, and flexibility. So the kids, the play that kids are doing outside isn’t just necessarily fun play. They think it’s fun play, which is phenomenal, but underneath there are smart components of exercise that are benefiting your children now, and will for the rest of their lives, even if they only do an activity once. Then it benefits them in many ways, and there’s something called muscle memory; once you do an activity once, your muscles will remember how to do it and they’ll remember which muscles to use and how to perform the exercise, even if they haven’t done it in a while, which is why if you took ballet as a kid, and you haven’t done it in a while, you know, your knees may be a little creaky, but 30 years later you can go into a plie, or you can go into a pirouette. So I just wanted parents to know, and to give them sort of a source for getting their kids to play and have fun, but also give them a source of looking at what their play is actually doing for their kid.

LF: And one more question before you tell us what some of these great ideas are. What age group of kids are you targeting, are you talking about in this book?

LD: So we target three different age groups, and I think that’s a strong point because I think that motivation is the key to fitness, and what motivates a three-year-old or a toddler won’t necessarily of course motivate a tween child. So we break it into three different groups. So there are activities for toddlers and preschool ages, so that’s between two and four, five, you could be five years old. Then school-aged kids from five to nine, and then tweens, from 10 to 14. And the toddlers are at the beginning of the book, then it goes to the school-aged kids and then the tweens. That’s not to say that—there are also activities in here that we recommend as a family. So if a family has kids of differing age groups, we have activities that sort of everybody can do together. But that’s how we sort of break them up.

LF: Great. So let’s start, since you’re—obviously the ideas are age-driven—let’s start with that oldest group. I think many of the parents who listen to us are coming to us because of Fitsmi, which is targeted to girls, teenage girls. Now let’s talk about a couple of—with the amount of time we have, maybe two or three great ideas for how to get 10 to 14-year-olds out there working at it?

LD: Yes, the number one way that I love to get kids to exercise is something that I call—an activity that I call in the book, Your American Idol. Kids love American Idol. Tween girls love bands, they love pretending to be in a band, they love pretending to be on TV dancing. They absolutely love it. Combine that with their love of YouTube, and flip cameras, and recording themselves. It makes for such a great activity, and an active activity. So it’s actually making their own music video. They would prepare by looking at a video on TV or on YouTube, a clean one preferably, ’cause you know you have to watch as a parent of a tween, and MTV and the things that are out there, so you have to sort of monitor that. But preparing the dance moves, and actually my tween son does this with his friends. The new LMFAO video, called Party Rock, it’s the best, most fun video to dance to. And we, and his friends, and they asked me to help them, we learned probably seven moves from that video, we put it together, practiced for a good three days, three or four days, just practicing. Then we put it to music and videotaped it, and so the next couple of days we were videotaping different backgrounds. We did it outside, we did it inside, and this is not something really parents have to do with their kids. They just asked me to do it with them and I thought—I love dancing so it was fun, but it’s a great activity, especially for tweens to do, and it’s super, super active.

LF: Great idea. Girls like that. Boys like it too?

LD: Boys love it. My son, yes. And they love videotaping themselves, and actually boys and girls love to do it together.

LF: And then they upload it…

LD: And it’s actually one of the few activities you can get tween boys and girls to do together.

LF: Well, that sounds like fun. We might ask if we can get some of those videos on our site.

LD: Oh, I would love it. Yeah, my kids would love it.

LF: That would be great fun, and great fun for our Fitsmi users to do the same thing. We love that idea. What else?

A Bosu Balance Trainer

LD: I also plant items. There’s something called a Bosu. It’s a half of a ball, or you can use a trampoline, a mini-trampoline. If you plant items around your house that kids love to jump on, and readily jump on. Have you ever seen those balance balls? They’re big and you can sit on them? And you do exercises on them?

LF: Sure.

LD: Put that in a room, or put a half of a ball, or put a trampoline in a room. A tween kid just goes to them. You have to jump on them, you have to sit on them and bounce on them. So my kids actually don’t sit on couches, and they don’t sit on my chairs. I don’t even have to tell them to bounce. They actually would prefer to jump on this Bosu and bounce up and down while they watch TV, because kids are going to watch TV, let’s face it. They’re going to watch TV, so better that as they’re watching TV they’re more active. And jumping can burn up to 250 calories in an hour. So my kids will—and they don’t even realize that they’re getting tired. So after 20 or 25 minutes, they’re jumping on this thing, just because it’s fun and it’s mindless activity, while they’re watching TV.

LF: Great. Great idea, particularly understanding that kids will watch TV, and often parents have big fights over that, but here’s a way to combine something really positive with TV. How about one more for this age group?

LD: Okay, another great one, this age group really loves to be—to work with the community and donate to the community, and honestly I find that any kind of drive, whether it be a car wash, or, when we were in middle school we did something called a rocking-chair-a-thon. And we sat in rocking chairs and rocked all night for 24 hours, if you can believe it, to raise money. So they love to be involved, and they love to organize, and they love to donate and be involved in the community. So to help them organize an event that would be active. We also—you know what, we also had an eighth grade Alliance Run for the Blind, and it was to help blind kids in the area, and we had a relay. And all night we would run one lap around the town. And it was in a small town so it was easy to do that. But all night we had a relay, and I think I ended up running twenty laps in one day, but it was really fun, so not only—it was social, which was fun, and kids love to be part of a group, so we all did it together. It was active, and it also gave back to the community. So it was a total great program. So that’s a great way to get tweens active.

LF: So last question about this group. Often when the idea comes from the parent it is, by definition, a bad idea. How do you get over that with your kid and have the kid sort of take the idea on as his or her own, and not push it off because it comes from mom or dad.

LD: Right, well there are a couple of ways that you can do that. You can either 1) plant ideas. I love planting. I just put a brochure down, or mention it, because kids will listen to their parents. You don’t think that they’re listening when they’re tweens, but they’re actually listening. But they don’t want you to know that it came exactly from you. So you can plant, like during—you’re having dinner and you say, You know, I heard that there’s a great rock-a-thon going on at the church next Friday. And just let it go. And then maybe throw a rock-a-thon pamphlet out, and that is the best way to do it. And if kids are interested they’ll look at it, and they’ll pick it up and throw it out as their own idea. I actually do this with my husband; don’t tell him that. But it’s called planting, and it’s a great way to do it. The other way to do it is enlist their friends. Because even though a child won’t listen to their own parent, in the tween setting, a kid—the friend of your child, will listen to his or her parents more than his own parents. So you can actually talk to your child’s friend, and get them excited about an idea, and they will rope your own child into the activity. That works all the time.

LF: That sounds terrific.

LD: It works all the time. It’s foolproof.

LF: So just for parents who have younger kids too, we’re short on time, but very quickly, a good idea for a younger kid.

LD: Well, kids love to help. School aged kids love to help, they love to feel helpful around the house. Even younger kids love that, so whenever I’m doing chores, they actually, interestingly enough, love to do chores. So I’ll make a list of things that we need to do in order for them to feel helpful around the house, and they’ll march to doing it. Whether we’re washing the car today, or we’re cleaning the windows, here’s what we’re going to do, and the key is to—because they don’t have great—they can’t stick with one activity. They sort of need to move around—the key is to make sure that they—they don’t have great attention spans—the key is to move around in activities. So you’ll do a particular activity for ten minutes, usually ten minutes is about the max, and then move on to, say, sweeping the floors. And then move on to saying, All right, we need to really clean off the front porch today. Here’s what we’re going to do. And march to it. And play music; music is a great motivator, so when you’re doing this, play really fun, exciting music.

LF: Well, given that your kids are game to do chores, I think there’d be a lot of parents wanting to know what you’re feeding them, because, you know, the last thing they can do with their kids is get them to do chores, but love these ideas. Your book sounds terrific. We hope that parents will pick it up, check out your website if they’re in the New York area, think about those CDs and other things that have been suggested, and we thank you so very much for joining us, and we hope that we’ll talk to you some more, and we hope we’ll be able to get a bunch of your ideas up on the Fitsmi and FitsmiForMoms website. So thank you.

LD: Thank you for having me. If anyone has anymore questions, they can feel free to email me also at the email address that I provided earlier, larysa@larysadidio.com, and I’d be happy to answer all questions or help anyone in any way that I can.

LF: Terrific, terrific. Thank you so much.

LD: Thank you so much for having me. It was great, thanks.

LF: Okay, bye-bye now.

1.  Her heart broke, and she went all “mush” — at a complete loss for what to say or do.

2.  She kept her cool and said the party line, “You are built just perfect – strong and healthy.”

3.  She got really serious, shooed her other kids away, shut the door, and had a face-to-face talk with her daughter about all of the amazing things her body and mind can do besides look “thin” to other 7-year-old girls who had called her “kind of fat.”

4.  She felt desperate, telling her daughter that everyone thinks she’s “beautiful” — and that she and her friends must therefore be wrong about her looks.

5.  She felt angry and judgmental about the other girls and their mothers — what kind of messages were they sending out into the world?  How could they wound her daughter’s self-esteem like this?

6.  She stripped off her clothes (her daughter was already naked) and did a crazy, happy dance in the mirror, shaking everything she had and improvising a song along the lines of “we are perfect just the way we are.”

7.  All of the above.

Read this wonderful blog post by mom Janell Hofmann to find out the answer!

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Photo courtesy of lori.e.burleson

So this year, turn a new leaf!  Try cooking healthier versions of your kids’ favorite restaurant meals at home.  Who knows, you might stumble upon some new family faves – and not just for kids!  (And you’ll probably save some money too.)

Here are seven “Eat This Not That” recipe ideas that turn some of the worst restaurant kid meal offenders into healthy meals at home that most kids will love.

Fettucini Alfredo

Legend has it that the Cheesecake Factory does not have one single dish less than 1,000 calories, and the heart-clogging Cheesecake Factory’s Pasta Alfredo (1800 calories per serving), a kid favorite, more than lives up to its reputation. To serve your kids something healthier at home, swap out white flour pasta with a whole wheat or multigrain version that’s high in fiber. Instead of heavy cream, butter, and cheese, make a faux alfredo sauce using garbanzo beans. If pureed beans sound too weird to you, try out this recipe with laughing cow cheese as the main ingredient.

Cheese Quesadilla

On the Border Kid’s Cheese Quesadilla with Mexican Rice (1,220 calories) is loaded with  fattening cheese between two heavy flour tortillas – a stack that would weigh anyone down! For a healthier version of this kid favorite, griddle 2 whole wheat high fiber tortillas filled with ¼ to ½ cup of reduced-fat shredded cheese.  Add some veggies if your kids will tolerate them – pre-grilled red and green peppers and onions is a common combo.  If they gotta have a side of rice too, sneak some extra veggies in while cooking. In a medium pot combine 1 chopped tomato, 2 diced carrots, 1/2 chopped onion, 1/2 cup salsa, 2 and 1/4 cups water, and 1 cup brown rice. Bring the mixture to a boil and then cover with a lid and turn down to a simmer for 45 minutes. Substitute other vegetables for the carrots or tomato based on what’s in your fridge, and remember, one recipe serves 4.

Ice-Cream Sundae

The Joey Spotted Dog Sundae (1,216 calories) at Outback Steakhouse is a clear example of portion control gone wrong!  Some easy substitutions for a delicious homemade sundae are slow churned low-fat vanilla ice cream (100 to 120 calories per serving) and, instead of going Oreo-overboard like Outback Steakhouse does, crumble a 100-calorie Oreo pouch on top (automatic portion control! And kids love each having their own bag to sprinkle on). Take it a step further by creating a toppings bar for your kids complete with sliced bananas, strawberries and nuts. You might be surprised by the healthier ingredients that make it onto their sundaes!

Mac ‘n Cheese

Mac ‘n Cheese is perhaps the most popular kid comfort food. Parents like making it because it’s easy, and kids love eating it because it’s creamy and salty.  This not-so-healthy dish from a box can really go calorically wild at a restaurant – take California Pizza Kitchen’s Kids Curly Mac n’Cheese, which tosses in a few edamame beans to win parents’ approval. The healthy gesture is appreciated, but the 1,088 calories per serving are not!  Instead, try Annie’s Organic Whole Wheat Shells and White Cheddar at home.  Follow the directions on the box and throw in 1 cup of frozen shelled edamame two minutes before the noodles are done boiling. You’ll end up with 3 servings of fiber-full and protein-packed edamame mac n’cheese for only 300 calories a serving!

Chicken Nuggets/Chicken Fingers

Any chicken-nugget-o’holics in your house?  We’ve got news for you; you don’t need a vat of oil to make deliciously crisp food. Give this recipe from Cooking Light a whirl and boost the nutritional content by using whole wheat breadcrumbs. As for dipping sauces try hummus or look for all natural organic barbecue sauce (without high fructose corn syrup). Or make your own flavored ketchup using tomato paste and spices like paprika and oregano.

Cheeseburger and Fries

McDonald’s finds a way into nearly every kids diet. With a double cheeseburger, crispy fries and creamy chocolate milk, the Mighty Kids Meal (840 calories) is packed with grease, sugar, salt, and preservatives!  To make a healthy version of the classic fast-food burger meal at hone, swap beef out for lean turkey or ground chicken breast (or if you have to have beef, look for grass-fed beef) and make it a single patty burger on a whole wheat bun with an optional slice of reduced-fat cheese. Try sweet potato oven fries to deliver a healthy dose of vitamin A. Preheat your oven to 400 degrees F, slice 2 large sweet potatoes into straws. Toss in a bowl with 1 tablespoon of canola oil and 1 teaspoon sea salt. Spread onto a baking sheet in a single layer and cook for 25 to 30 minutes flipping the fries halfway through. (You can also prepare regular potatoes this way, but they might need to bake a little longer).  Nix the chocolate milk, which is high in sugar, and opt for a naturally sweet dessert like frozen grapes or a banana.

Grilled Cheese

Extraordinary grilled cheese doesn’t have to mean 800 calories per serving, but the Cheesecake Factory missed the memo! To give your kids something that feels decadent and restaurant-special, look for a whole wheat baguette in your grocery store’s bakery and slice it into 12 even pieces. Assemble the sandwiches by placing 1 piece of lowfat sliced cheese on one half and 1 Tbs. of hummus on the other. Close the sandwich and grill in a lightly oiled pan on medium, flipping after 2-3 minutes until bread is toasted and cheese is melted.  The hummus will make the cheese filling creamier and add a protein boost!  Kids and adults will love the creamy tangy filling and crusty bread!

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photo credit: Samyra Serin via photopin cc

Don’t worry that children never listen to you; worry that they are always watching you.  ~Robert Fulghum

Is your child eating too much junk food?  Overweight?  Glued to the couch and resistant to exercise?  Feeling like it’s impossible to change so why try?

Before you open your mouth to nag or sigh yet again about your problem child’s habits, take a long hard look in the mirror.  What about YOU?  Are you taking care of  your own health?  Do you exercise regularly, eat well, sleep enough?  Do you take time to relax?  Do you feel “at home” in your body or do you dread even thinking about it?  Do you feel positive and empowered when it comes to your health or do you feel hopeless, ashamed, or disgusted? Or maybe you’ve just written it off and have resigned yourself to subpar health until the day you die.  It’s okay.  You’ll manage.  You try not to think about it.  There are more important things to worry about.

But wait:  is that the message you want to send your kids?  You can talk about why they need to stop drinking soda and exercise more until you’re blue in the face, but your lifestyle and your attitude towards yourself write the headlines.  What you DO matters much more than what you SAY. (And this is especially important with teens!)

Not convinced?  Weight Loss Confidential is a book about more than 100 teens who lost weight and kept it off for a year or more; about half of their parents responded to a survey about what helped and didn’t help their overweight child.  When author Anne Fletcher asked the teens’ parents for their advice to other parents of overweight children, “the number one response was ‘Be a role model.’”  When she asked them how parents can avoid having their kids gain excessive weight, “their top response was to be living examples of healthy eating and exercise habits.”

Does this message hit home?  Take a deep breath.  No matter how body-alienated, overweight, or out of shape you are, it’s always a new day and a new year ahead.  The present matters much more than the past, especially because RIGHT NOW your child is watching YOU.  They don’t care about the two-cheeseburgers-in-a-row that you ate last year, or how 1997 was the year you gained 50 pounds and never looked back.  They care about what you do NOW.

So the bad news might be that you’ve been a terrible role model for your child’s health.  But the huge upside is that by starting the process of getting healthy yourself you will likely do more to help your child’s weight management than anything else.  It doesn’t matter if you fail to lose the 10, 30 or 100 pounds you’d like to lose.  When it comes to kids watching you, your effort, attitude, and consistency matter more than a specific outcome.  They love you the way you are, love handles and all.  But they need you to take care of your health — not only so that you’ll be a better parent, but so that you inspire them to do the same.  For many kids, it’s as simple as this:  If Mom/Dad cares about her/his health, then I will care about mine too.

So start today.  Without much fanfare, take a 15 minute daily walk.  Eat twice as many vegetables per day as you usually do.  Drink water with meals instead of soda.  Keep it simple:  pick one or two small things that you commit to changing for a week.  Then, slowly build on that every week — the 15 minute walk becomes 20, becomes 30.  Maybe for lunch you start having salads and soup instead of heavy sandwiches.  You start getting a half hour more sleep every night.  You learn how to cook some new vegetable dishes that not only you but a couple of other family members remark on as well.  A bowl of fresh fruit starts appearing on the kitchen counter.  You stop buying bulk packs of junk food.  And what do you know, one day there’s no more soda in the house.

If you can’t get motivated to get healthy on your own, do it for your children’s sake!  You’re in great company.  Not only will you start feeling and looking better yourself, but you can secretly bask in the knowledge that improving your own health is one of the best things you can do for your child’s.

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Photos by Dreamer.~’s

Enjoy this transcript from the fitsmiForMoms radio show with Dr. O on how family dynamics can be affected by weight!  If you prefer to listen to the podcast, click here.

Linda Frankenbach:       Hello all,  I want to welcome you to FitsmiForMoms Radio. I am Linda Frankenbach, the CEO and founder of FitsmiForMoms and Fitsmi.com. FitsmiForMoms Radio is part of everything we offer on FitsmiForMoms to help the moms and dads of kids who are struggling with their weight. As I hope you know, FitsmiForMoms has a companion site for teen girls who are struggling with their weight, and I’m going to spell both of these sites names because sometimes it’s a little confusing. It’s Fitsmi.com, and FitsmiForMoms.com. I should mention that Fitsmi.com offers a whole array of services to help overweight teenage girls, and a very private community they can join, and it also has a radio show that airs every other week. So I would hope that if you have a teenage girl who is struggling with her weight, you might suggest going there to her, and we hope that that will be helpful to her, as we hope this is all helpful to you.

Today we are really delighted to have with us Dr. Adekemi Oguntala, and luckily for me she is known as Dr. O to her patients.  May I call you that?

Dr. Adekemi Oguntala:            Please do. I feel like that’s really my name now.

 LF:  And Dr. O, we are really happy to have you with us.

AO:            Thank you, I’m really happy to be here. Thanks for asking.

LF:            Maybe we could start by asking what was it that drew you to teens, I guess long ago, when you began your training?

 AO:            You know, I really think adolescence, which is what people officially call it, is such an amazing time in life. I don’t think there’s any other point in life where, even though you have such strong values, you’re open to the changes that would either take your life down one path or the other. So I could never do internal medicine because adults are stuck in their ways, but teens still have a little bit of hope on the horizon in terms of trying to sway them in another direction. So I feel like it is just the perfect time to really sort of make a difference if you’re going to make one at all.

LF:            And when you work with teens are you working with—I guess you’re working with them both from the medical side, the physical side, and the emotional side?

AO:            Absolutely. Psychosocial issues, or the mental side, is a huge part of what I do. I can’t tell a teen what to do. I can only inspire a teen on what to do. And the only way I can inspire them is if I know the context from which they come, and so that’s a lot of what I do, whether it’s changing their asthma management or their weight issues, or their relationship with their parents. It all comes from the same sort of root of what I do.

LF:            You just said something I have to put a pin in, because I think it’s really an important piece of advice. You said, you can’t tell a teen what to do, you can only inspire them. I think that that advice is very important for parents, for moms and dads, and it’s also important for organizations like ours, where we’re trying to help a teenage girl in ways that are really effective, and I like that way of thinking. It’s really about inspiring because they do have very strong attitudes about what they want to do at any point.

AO:            Absolutely. I mean the more you push, the more they feel like they should not do it.

LF:            Yeah, so you say go right, and they run left.

AO:            That’s exactly right.

LF:            So, you touched on some of this, but tell us a little bit more—helpful to parents, what makes this period of life, what makes adolescence so unique?

AO:            You know, adolescence is when you’re really starting to figure out who you are. It is their job, actually. I know sometimes parents think, your job is to do your chores and get good grades and stuff like that, but really their job is to figure out who they are. Like, who are you? Are you going to be the person who is going to, you know, conquer the world, are you going to be somebody who wants to be a homemaker, or are you going to be a dad? You know, like, whoever you’re going to be, that’s what they’re figuring out. So they’re constantly trying to try on different things. Now, they’re already trying to experiment with hair colours and clothes and, you know, who they hang out with and the music they listen to, so that’s all part of that experimentation. But then on top of that they are told who they are, to a certain degree, by how the world around them perceives them. So there’s going to be, in terms of the role of the family, you know, maybe they’re the kid who always fixes the computer. You know, maybe at school they’re the kid who’s always helping people do their calculus homework. You know, so that school knows them one way, their family knows them another way, you know, their friends know them another way. And they take on these identities as well. It’s great if it’s a very positive identity, but if it’s not so positive identity, then they struggle again. Well, does that mean that that’s who I am? You know? And if that’s not something you want to be, then the struggle is very, very difficult. It can create lots of conflict in terms of how they progress through the stages of becoming who they are, and how they are perceived by others, and how confident they are in terms of their interactions with others. Maybe that’s where you get the cycling into depression and loneliness and things like that, and suicidal ideation and stuff, that seems so prevalent amongst teens.

LF:            Yes. And it seems to me that the resolution of figuring out who they are does not necessarily end at age 18 or 19. This goes on, really, for many people, for many, many years. Some would say there are many of us who never figure out quite who we are, but what from your standpoint is a normal point when things start to settle down for a young person around those issues?

AO:            You know, I think most teens start to really feel comfortable with themselves at about age 26. Oddly enough that’s about when the brain stops growing and they can feel a little bit more confident in the decisions they’re making and the experience they have, how that speaks to new decisions that they have to make, and how much their confidence in the problem-solving skills they have allows them to not be so afraid of what’s coming around the corner, whether they know it or not. So that usually throws people off too, that, I gotta wait ’til 26 until they make sense? But that’s part of the struggle of, you know, of raising somebody who may be taller than you are but doesn’t have half your brain capacity. You know, and I think if there’s one sticker I could put on a teen’s forehead that would be it. I’m not done growing, have a little patience. You know?

LF:            This is another very interesting fact, I’m sure, for parents. You know, I remember saying to my children often, you know, please let yourself grow up a bit before you make a big decision like getting married. And I always sort of felt that that kind of came in the late 20s, but I didn’t know there was any physiological basis for that, or, you know the brain growing, or that others really saw this age 26. But that is very, very interesting. I think, very helpful for a parent to understand that too.

AO:            Definitely. And one of the things I give—I give a pictorial to parents is, if you can think about it, years ago, 19, 20-year-old went to college to get married. Then they had this whole women’s revolution, and those 19 to 21-year-olds who became 40 and 50 went, Oh my God. That wasn’t what I wanted to do with my life. That was just what society said I was supposed to do with my life. I had no idea who I was when I married this person. I really wanted to be a scientist, you know? And it’s like, that’s exactly what that is. So when I do that for them, they get it. And they’re like, oh yeah, you have no business—and so what I try and do is soften that a little bit for teens and say, that’s why when you come home and you say, I’m so in love with this guy or this girl, they’re like, no way. You’re 18, 19-year-old person is so in love with this person. Your 40-year-old might not even do a double-take on this person when, you know, if things were to come about themselves later. So, you know, that’s one of the ways I gently, gently try and probe their thinking in terms of who they’re with and who they decide to become sexually active with and, you know, it’s like, think about it, you’ve got some time left and this may not be the person you want to be stuck with for the rest of your life.

LF:            Well I would think talking to kids about that, talking to teenagers about that would actually be very reassuring, because we certainly live in a society where a lot of pressure is put on kids to achieve, and I know with a college age daughter, she I think often feels pressured—you know, she’s supposed to know exactly what courses to take, or what she’s doing, or whatnot, but yet she doesn’t feel she does. And I think to be able to say to a young person, you know, don’t put that kind of pressure on yourself right now. You’re evolving and growing, and, you know, think about your—age 26 is another point. I mean that’s really interesting.

Moving on to talking about one of the areas you deal with, which is weight in teenagers. We know that over a third of teens today are considered overweight or obese, and we know that weight stigma really runs in our society, still rather unchecked even though perhaps there’s more awareness of it. Many people blame overweight people for their weight and think of them as a whole set of things; it could be lazy, sloppy, stupid, whatever. How do you see all of this uniquely affecting teens?

AO:            Well, those stereotypes actually start very young, and not only do they start by the perception of their community, but those are the same biases that the adults in their household may have. So that something like, when you’re at Thanksgiving, and they’re going in for their favourites, there may be an aunt, uncle, grandma, somebody standing there going, oh doll, you don’t want to pile your plate with that. You don’t want to have an extra dessert. You know, or just the way they look at you.

One of the things that teens just are so sensitive to, and this is partly because of their brain development. So there’s a part of their brain that is overactive and unfortunately the part that’s overactive is this part called the amygdala. In the amygdala it’s where they are quick to rage, and they perceive things more sensitively than other people do. So an adult can look at that same situation and go, I don’t get why you’re offended. But the teens would be like, Oh my God, can’t you hear it? You know? Because it’s like, No, really I can’t. So the whole thing is because they are like that. The tone of an adult’s voice, the way they say something. The lack of enthusiasm or the feigned enthusiasm are things that register on their Richter scale very high, and it’s why it makes such an impact in terms of their development—their sense of identity development. So they really do take it personally. You know, adults are saying, don’t take it personally, but that’s what they do. They do take it personally. And that’s why you either have to have a household that counteracts that kind of mentality, or you have to have somebody who has a really good sense of self. If you know who you are, then no, it doesn’t bother you as much. But most teens don’t know who they are. They’re still struggling. So it does affect them and so it becomes quite a challenge when you hear the doctor say, you hear your aunt say, you hear a parent say, and you overhear the person whispering while you’re in the ice cream aisle at the local grocery store too. That’s I think what the big issue is, that it absolutely does affect their sense of self. Because whether you’re doing it or not, they hear it. They are aware. They’re aware when they watch the show that the person who is mostly the buffoon character is overweight. You know? So you don’t have to do it so directly at home. That subtlety on top of the directness really makes a big impact.

LF:            Yes, now obviously this doesn’t end in the teen years. This kind of unchecked discrimination affects society in general. Do you want to comment about that a little bit? You know, we’re talking about what happens later in a teen’s life as they become an adult and generally what’s going on out in the society here.

AO:            So, I mean my big thing with that is that once you’ve grown up with that kind of sensitivity engrained, and you don’t have a way to counter that, either by losing the weight or what have you, it becomes a part of who you are. So whether you lose the weight or not later, you still identify, you self-identify as an overweight person. So when somebody makes a comment you still think they’re talking to you. When you go to the store, the clothing store to pick clothes, you still say to yourself, I can’t wear that. You know, I shouldn’t be seen in that because I’m too big. You know? So because of that it is a long lasting impression unfortunately that is really hard to get rid of. It’s almost like—one of the things I always say in my clinic is, I would love to give teens the gift of seeing themselves the way others do, because there’s something that happens when you don’t know that your body—you might actually say, Wow, that person’s sort of cute.

LF:            Right, right.

AO:            Then they know it’s them and they go, Oh God, but look, there’s this, and this, and this. I’m like, wait a minute. For just two seconds you thought it was okay. You know, so it’s an unusual gift to be able to give someone, and because they don’t have that luxury, they are constantly walking around essentially criticizing themselves. They no longer need the outside world to do it. They’ve taken on the role themselves. We certainly see this with people who have been directly abused as teens, and people who have unsupportive parents and the like, and we see it with people who get a lot of the subtlety or teasing or bullying that occurs, whether it be at school, or at home, or from a sibling, about some characteristic they have. You know, we’re talking about weight today, but this is the same thing about somebody who doesn’t do as well in school, somebody who doesn’t get the boyfriend until 19, you know, there’s always somebody who dresses a little more tomboy. There’s always going to be something that people choose to sort of make stand out about who this person is, rather than sort of celebrating it.

LF:            Right. Is it particularly dangerous for a teen to be extremely overweight in this period when they are defining themselves, and if so—you’ve touched on this a bit, but if so, why? Is this perhaps one of the worst periods in life to be overweight?

AO:            You know, I think so just because of the identity development involved. I also think so because we used to think, years ago, that the late onset diabetes, which, late onset used to mean 30s and 40s. Fifties even. Late onset diabetes now means, you know, the teen years. Ten years old, 15 years old. So not only do they assume this responsibility of walking around as a big person, but there’s also all these medical issues that they have to tend to. Pain in their joints, diabetes, and, you know, heart disease, high cholesterol, high blood pressure. You know, being on high blood pressure medication. This is a lot to deal with as a teenager, when you don’t really want to think of having problems. I mean, this is a time in your life where your mind set is such that, I can do anything and not get hurt. I can accomplish anything. Which is why you have so many rock stars and professional basketball players. So because their thinking is like that, it becomes very difficult to have them understand the magnitude of being overweight and the ripple effect of what can occur later. Diabetes is the leading cause of blindness in this country. How do you tell a teenager that you could go blind, you could get your leg amputated. They’re like, you’re kidding, right? I’m a teenager. I can have anything. That’s not going to happen to me.

LF:            How do you tell them, and should you tell them with those kinds of words? I mean really, really—the direct words about the comorbidities?

AO:            Well my directness comes from the root of wanting to be honest. I always tell teens, I don’t lie to teens, I lie to parents. So the whole thing is I always want the teens to know, straight up. And so because that’s the way I convey it, it doesn’t look like I’m doing scare tactics. Because I think that that’s the fine line. When somebody’s trying to scare a teen. You can’t scare someone who has no sense of fear. It just—it’s pointless. So that doesn’t ever work with teens. But what does work with them is if, again if you can inspire them. The only way you can inspire them is to come from a place of where they’re thinking. So that sense of disfigurement is a little bit more of an interesting angle than the scare tactic.

LF:            Than the medical.

AO:            Yeah. So you just allude to that. My big joke with them, when I’m trying to get them to eat healthier, which I usually go with the angle of high fiber. I never talk calories, I never talk low sugar, whatever. I say, if it has a lot of fibre in it, chances are you can eat it, and don’t worry about it. And that sort of takes me out of that meticulous counting of the calories which is such a slippery slope to anorexia. But when I tell them some of the advantages, while their parents are in the room, I say, you know, it’s a really good way of naturally suppressing your appetite so that you don’t have as much room for junk food, and it does all these things you absolutely don’t care about like preventing diabetes and colon cancer, and diverticulitis, and diverticulosis, and they usually chuckle, like, Yeah, no, I don’t care.

LF:            Yes, not now. But gee, you will later. So how does a parent handle this? I’m going to ask this in a couple of ways. First, how can a parent help his or her teen have realistic goals around weight. You know often you have a kid, and you often have adults doing this too, saying I want to lose 20 pounds before the summer, school starts, the prom. How does a parent handle that?

AO:            All right, so there’s a lot of fantasy thought that happens with teens, like, you know, they’re like, Justin Bieber’s going to drive up in limo—

LF:            And that’s after I’ve lost the 20 pounds.

AO:            Exactly, they’re going to magically lose the 20 pounds. So my whole thing—it’s a very sort of Sixteen Candles, you know, fantastical thinking and generally what I try and do is, I say it took a lot of time to get it on, it’s going to take a lot of time to get it off. I just want you to focus on doing these basic things every day. If you can add another thing every week, that’s great. But if you can just do this and this, just focus on that. Just focus on the small things. Because this is a matter of small changes having huge ripple effects.

LF:            Yes.

AO:            That’s all I want—I want a small change. Small change—what do you think you can do on this list of 13 things? And then I tell them, I can tell you before you even think about what you can and can’t do, most times when I give this list to people they do two or three things and they end up losing weight. Okay? So you clearly don’t have to do everything on the list. So I just want you to think about what you can do, realistically, what you can do every day. Do that one thing. When you think you’ve got that under control, add something else. You don’t think you’ve got that under control? Go back to the initial one thing you changed. But that usually works. Just don’t bite off the whole big—you know, you don’ teat an apple in one bite. You just take bites, bites, bites until it’s all gone. So just do the first bite. What do you think you can do? Eat breakfast every day? Great. Eat breakfast every day. Doctor, I can’t do that, I’m going to be late for school. Really? So why don’t you—on Sunday, I want you to take the cereal that I want you to eat, and take five baggies, and put the serving size in all five baggies. You don’t need milk to eat cereal. It’ll be like your new Cheetos. You can eat them at the bus stop, okay? Okay, I can do that.

LF:            Right. So the approach here which, by the way, is exactly what we have on the Fitsmi site, the real approach here is to help your child do a couple of things that are do-able and sustainable, and to keep adding things, and all of those things cumulatively will begin to help. And that’s such sound advice. It’s not the diet, the yo-yo diet and all the problems there. And, as you say, connected to anorexia for kids, for teens particularly, that’s no good.

So just stepping back for a second, what do you think—why do you think being overweight is such a problem for today’s kids and teens? This is a discussion that many are having today, and do you—I mean, there are a lot of issues we know, screen time and fast food availability, and snacking around the clock, and emotional problems, and stress, and lack of exercise, and portion control. Do you, in your work, see that there are really one or two or three of those that come to the top of the list for teens these days?

AO:            My personal observation is that nobody simply knows how to eat. It’s something we take for granted. We eat; nobody ever teaches us how to eat. So when I give them that list of 13 things, I essentially say—nobody teaches you how to eat, so usually what happens is later somebody will take Weight Watchers or Nutrisystem or whatever—substitute name here for diet program—and they’ll learn some things that they didn’t realize. They’ll go, Really? You can’t eat dessert every day? Heck no. I didn’t know that, I got dessert every day when I was a kid. You know? So something like that, they’ll have all these aha moments. So what I usually tell them afterwards is, if you look at the list of 13 things you can pick the stuff now. It might save you a lot of money. Unless you’re somebody like Queen Latifah and you’re just going to get paid to lose weight, then yeah, by all means, go ahead. The whole thing is that they sort of get like, Okay, I get it. I don’t know how to do this because no-one’s ever actually taught me.

LF:            Yes.

AO:            So once you actually teach somebody how to do it, then yeah. But they don’t know. Like, I will tell them things, and they’ll be like, Really? Juice is the same as soda in terms of sugar? Oh, my God, yeah. It’s just like, Wow. It’s just because it’s juice. There’s nothing healthy in there.

LF:            So education here for the teen and for the teen’s parents is crucial.

AO:            Absolutely. Absolutely, because they don’t know either.

LF:            No, and if it’s not happening in the home from the time a child is young, nobody knows it. Everybody’s in the dark. So we really need—and that’s again sort of what we’re trying to do—we really need to help parents as well as helping kids because they’re tied together so much in terms of behaviour. It’s interesting you put that at the top of your list. Not surprising.

AO:            And I used to see younger kids before, you know, that’s just part of our training in pediatric residency, and one of the things I used to see is parents introducing adult food too early, and then when they did introduce adult food, say, you know, they’re not eating, they’re not eating. You know, and shoving food down their throat. And I would always have to repeat this study about how they took a bunch of toddlers, put out a buffet and they just watched the toddlers eat all day. They never told them when to eat or anything. They just watched what they ate. And it turns out those toddlers eat healthy without an adult instructing them all day long. They had a little bit of sweet, but, you know, no more than what would be considered normal. That means essentially we destroy their sense of appetite and their ability to eat by making them eat when they’re not hungry. What they don’t realize is when we plot their growth chart, they’re not growing as fast, so their appetite automatically goes down. When they start to rev up, and they start eating a lot, anybody who has an adolescent boy knows this, when they’re growing they eat you out of house and home. When they’re not, they don’t. So for you to screw that up by constantly feeding them when they don’t need it, screws it up emotionally. Oh, my mom always made me chocolate chip cookies when I hurt myself. And it’s like, okay, now there’s a different association with food. And complicating that, you actually always fed them. Oh, we ate out for dinner every Thursday and Sunday night. So I’m used to the big portions and I’m used to the—you know, oh yeah, try a dessert plate.

LF:            One quick question on something that is around—we actually even interviewed someone who kind of writes about this, but what do you think about what I’ll call the fat acceptance movement, and how that affects kids?

AO:            Right, so again, I’d rather the acceptance be on the qualities that those kids have.

LF:            Makes sense.

AO:             I think it’s a little bit of a cruel joke to play on somebody who is going to have all these health complications. So my thing is, because I guess I have a version of that, is that I don’t need you to be a toothpick. I know people who have curves. You don’t have to be, like, a size 2 to be healthy. As a matter of fact there are some size 2 people who have cholesterol through the roof. But what I want—go ahead.

LF:            Sorry, we’re going to have to stop there. I hate to interrupt you mid-sentence. This has been terrific. I would love to be able to talk to you more. I can’t thank you enough for sharing all these thoughts. Perhaps we can get you on again, and explore all the things we haven’t explored. I really thank you and I think the work that you’re doing is terrific, and I think that we need more doctors like you around the country, around the world, who are doing the kinds of things you’re doing.

AO:            Thank you so much.

LF:            Thank you so much for being with us, and have a lovely July fourth weekend.

AO:            I absolutely will. Thank you so much, and you do the same.

LF:            Okay, bye-bye now.

AO:            Bye.