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A Blog from Your Kaiser Permanente Pediatricians in Northern California

All the Cool Cowboys Eat Yogurt

All the Cool Cowboys Eat Yogurt

Two of my patients, who are siblings, came into the office recently with their parent for checkups. I was a bit late coming into see them, so I started off with the all too familiar apology. Then we chatted about the weather, summer books, movies, and camps. I asked what questions they had, and they asked if they needed shots – one did, one didn’t. (It’s always awkward to explain that!)

All the while I realized I was stalling, dancing around the issue at hand – both children have weight problems. Technically speaking, their body mass indexes or BMIs are well out of the normal range, or as we physicians rather horribly term “obese.”

BMI in children is based on their height, weight, and age. There’s a wide range (from 5% to 85%) of what’s considered normal because people have different body types and muscle mass. A person with a BMI over 85%, is considered medically overweight and has an increased risk of diseases, including high blood pressure, heart disease, stroke, some cancers, and diabetes. We discuss BMI with all patients – even children – to help them prevent getting these diseases.

Both of my patients are happy and smart. One is artistic, and one is quite funny. They like each other, and are respectful and caring. How on earth was I to find the words to tell them they’re dangerously overweight without wounding their youthful confidence? Without alienating their parent?

I breathed in and began with the usual questions and followed with a display of their growth charts. It turned out the family had already been discussing making some healthy changes. They’d started walking each night. They were trying new veggies and thinking about serving sizes. I asked what they thought I wanted them to drink?

Water!
And what do you drink?
Juice! Apple and orange!

Their honesty gave me a chance to focus on an important issue – sugary drinks. I offered the rule of thumb that one 8-ounce cup of juice a day has enough calories to cause a 15-pound weight gain over a year. But their parent looked at me and said with an exhale,

But, it’s just so hard to say no.

I get it. My teen son has a close friend who I adore. They’ve known each other since preschool. I’ve watched him move from playing in the sandbox to becoming a stellar athlete, through cowboy costumes to awkward gangsta-style hats, and now to a rather stunning, clean cut young man.

He’s at my house often, and when he arrives, he heads straight for the kitchen and opens the refrigerator. Spoon in one hand, he heads to the boy-den in the garage with his bounty. It makes me happy every time. My refrigerator staples are rather boring from a kid’s perspective, but there’s something that he wanted! Cool.

We get such joy out of feeding our children. I cook well, and my kids eat well and usually healthy. But every now and then I’ll head off to the store and come home with some treats. Watching the glee that comes as the kids root around and find these is fun. But after a bit, I get a bad taste in my mouth (and it’s not from the chips or ice cream).

In fact, doing the right thing by our children means being a bit tough. Don’t buy the juice. Definitely skip the soda. Cut up the apples and put them in a central location. Skip the chips. You’ll never know what they learn to like. My son’s friend the cowboy-gangsta-lacrosse star? He devours container after container, case by case, of high-protein, low-sugar Greek yogurt. And, go figure, all this time I thought I needed to bribe them with junk.

Resources for your family

My Doctor Online:
Eat Well, Be Active, Live Better
The Truth about Juice and Other Sugary Drinks