Weight Problems and Obesity in Children

Helping Your Child Reach and Maintain a Healthy Weight

The number of children who are obese or overweight is growing at an alarming rate. Extra pounds put kids at risk of serious health problems, including diabetes, heart disease, and asthma. Childhood obesity also takes an emotional toll. Overweight children are frequently teased and excluded from team activities, which can lead to low self-esteem, negative body image, and depression. However, with the right support, encouragement, and positive role modeling, you can help your child reach and maintain a healthy weight.

Diagnosing weight problems and obesity in children

Overweight and obese children are at a greater risk of developing serious health problems such as:

type 2 diabetes high blood pressure high cholesterol bone and joint problems

asthma restless or disordered sleep patterns liver and gall bladder disease depression and low self-esteem

Kids who are unhappy with their weight may also be more likely to develop eating disorders and substance abuse problems. Diagnosing and treating weight problems and obesity in children as early as possible may reduce the risk of developing these and other serious medical conditions as they get older. Whatever your children’s weight, though, let them know that you love them and that all you want to do is help them be healthy and happy.

Is your child overweight?

Children grow at different rates at different times, so it is not always easy to tell if a child is overweight. Body mass index (BMI) uses height and weight measurements to estimate how much body fat a child has, and can be used to screen for weight and obesity problems from the age of 2. However, while BMI is usually a good indicator, it is NOT a perfect measure of body fat and can be misleading in some situations. For example, BMI can be difficult to interpret during puberty when children are experiencing periods of rapid growth.
If your child registers a high BMI-for-age measurement, your health care provider may need to perform further assessments to determine if excess fat is a problem. These assessments may include skinfold thickness measurements, plus evaluations of diet, physical activity, family history, and other appropriate health screenings. The doctor may also decide to screen for some of the medical conditions that can be associated with obesity.

Causes of weight problems and obesity in children

Understanding how children become obese or overweight in the first place is an important step toward breaking the cycle. Most cases of childhood obesity are caused by eating too much and exercising too little. Children need enough food to support healthy growth and development. But when they take in more calories than they burn throughout the day, the result is weight gain.
Many factors contribute to this growing imbalance between calories in and calories out:

• Busy families are cooking less and eating out more.
• Easy access to cheap, high-calorie fast food and junk food.
• Food portions are bigger than they used to be, both in restaurants and at home.
• Kids are consuming a huge amount of sugar in sweetened drinks and hidden in an array of foods.
• Kids spend less time actively playing outside, and more time watching TV, playing video games, and sitting at the computer.
• Many schools are eliminating or cutting back their physical education programs.

Myths and Truths about Weight Problems and Obesity in Children

MYTH: Childhood obesity is genetic, so there’s nothing you can do about it.
TRUTH: While a person’s genes do influence weight, they are only one small part of the equation. Although some children are more prone to gaining weight than others, that doesn’t mean they’re destined for weight problems. Most kids can maintain a healthy weight if they eat right and exercise.
MYTH: Children who are obese or overweight should be put on a diet.
TRUTH: Unless directed by your child’s doctor otherwise, the treatment for childhood obesity is not weight loss. The goal should be to slow or stop weight gain, allowing your child to grow into his or her ideal weight.
MYTH: It’s just baby fat. Children will outgrow the weight.
TRUTH: Childhood obesity doesn’t always lead to obesity in adulthood, but it does raise the risks dramatically. The majority of children who are overweight at any time during the preschool or elementary school are still overweight as they enter their teens. Most kids do not outgrow the problem.

Weight problems and obesity in children tip 1: Get the whole family involved

Healthy habits start at home. The best way to fight or prevent childhood obesity and weight problems is to get the whole family on a healthier track. Making better food choices and becoming more active will benefit everyone, regardless of weight. And with the whole family involved, it will be much easier for your overweight child to make lasting changes.

Leading by example

The most effective way to influence your child is by your own healthy example. If your children see you eating your vegetables, being active, and limiting your TV time, there’s a good chance that they will do the same. These habits will also have the happy side effect of helping you maintain a healthy weight.

• What you eat: Tell your child about the healthy food you are eating, while you are eating it. You might say, “I’m eating broccoli with garlic sauce. Want a bite?”
• When you cook: Cook healthily in front of your children. Better yet, give them an age-appropriate job in the kitchen. Tell them about what you are making and why it’s good for your body.
• How you move: Exercise in some way, every day. Be authentic—do things you enjoy. Tell your kids what you’re doing, and invite them to join you.
• Your free time: Avoid the television or too much computer time. Kids are much less likely to turn screens on if they are off and you are doing something they can get involved in.

Strategies for Real Life

• Recognize that you have more control than you might think. You can turn off the TV, computer, or video game. You can choose to get off the bus one stop earlier than usual and walk the rest of the way, especially when you are with your kids. You can give your family more vegetables for dinner.
• Think about the immediate benefits. If reducing the risk of future heart disease seems abstract, focus on the good things that can happen right now. You won’t feel uncomfortably full if you have a smaller portion or skip dessert. Going hiking with your teenager might lead to a wonderful talk that neither of you anticipated. A fruit salad tastes great and looks beautiful. Dancing or playing with your kids is lots of fun and can give you a great workout.
• Make small, easy changes over time. Suggesting that family members take a run together every day will probably get you lots of eye-rolling and “no-thank-you’s.” It’s easier and more appealing to start out with some new approaches to nutrition and physical activity that the whole family is really willing to try. For example, take a walk after dinner a couple of nights a week instead of turning on the TV. And, instead of chocolate cake with frosting, enjoy sliced strawberries over angel food cake.

Source: We Can! Families Finding the Balance, U.S. Dept. of Health & Human Services

Weight problems and obesity in children tip 2: Encourage healthy eating habits

Begin eating right today, as a family. Remember the importance of role modeling: there should be emphasis on what you do so that your child can follow. It is crucial to get the whole family in on the idea of eating healthily at home and away.

Making healthier food choices

Helping your child beat obesity begins with helping him or her forge a healthy relationship with food. You may need to make major changes to your eating lifestyle.

• Eat the rainbow. Serve and encourage consumption of a wide variety of fruits and vegetables. This should include red (beets, tomatoes), orange (carrots, squash), yellow (potatoes, bananas), green (lettuce, broccoli) and so on—just like eating a rainbow.
• Make breakfast a priority. Children who eat breakfast are less likely to be overweight or obese than those who skip the first meal of the day. It’s important to focus on healthy choices, though, like oatmeal, fresh fruit, whole grain cereal high in fiber and low in sugar, and low-fat milk instead of sugary cereals, donuts, or toaster pastries.
• Look for hidden sugar. Reducing the amount of candy and desserts you and your child eat is only part of the battle since sugar is also hidden in foods as diverse as bread, canned soups and vegetables, pasta sauce, margarine, instant mashed potatoes, frozen dinners, low-fat meals, fast food, and ketchup. Your body gets all it needs from sugar naturally occurring in food—so anything added amounts to nothing but a lot of empty calories. Check labels and opt for low sugar products and use fresh or frozen ingredients instead of canned goods.
• Schedule regular meal times. The majority of children like routine. If your kids know they will only get food at certain times, they will be more likely to eat what they get when they get it.
• Limit dining out. If you must eat out, avoid fast food if you can and make the healthy choices you are trying to make at home.

Weight problems and obesity in children tip 3: Don't go no fat, go good fat

For years, nutritionists have preached that a low-fat diet is the key to managing weight and preventing health problems in kids and adults alike. But not all fats contribute to weight gain. So instead of trying to cut out fat from your child’s diet, focus on replacing unhealthy fats with healthy fats.

Avoid trans fats

French fries and other fried foods may contain artificial trans fats that are dangerous to your child’s health. Fast food, packaged food, baked goods, sweets, and anything fried in vegetable oil often contain trans fat, even if the packaging claims it’s “trans fat-free.” Try to eliminate or cut back on:

• Commercially-baked goods (cookies, crackers, cakes, muffins, pie crusts, pizza dough, breads like hamburger buns)
• Packaged snack foods (crackers, microwave popcorn, chips, candy)
• Solid fats (stick margarine, vegetable shortening)
• Fried foods (French fries, fried chicken, chicken nuggets, breaded fish, hard taco shells)
• Pre-mixed products (cake mix, pancake, chocolate milk)
• Anything with “partially hydrogenated” oil listed in the ingredients

Add more healthy fats

Eating foods rich in monounsaturated and polyunsaturated fat is an important part of a healthy diet and can help a child control blood sugar and avoid diabetes. These “good” fats include:

• Avocados
• Olives
• Olive oil
• Nuts such as almonds, peanuts, macadamia nuts, hazelnuts, pecans, cashews, and walnuts
• Fatty fish such as salmon, tuna, mackerel, herring, trout, sardines, or sablefish
• Non-GMO sources of soy and tofu
• Brussels sprouts, kale, spinach
• Sunflower, sesame, and pumpkin seeds
• Flaxseed

Unsaturated oils

When cooking for you and your child, choose your oils carefully. Cold-pressed oils such as extra virgin olive oil, sesame oil and peanut oil are rich in healthy fats. The same may not be true of modern processed oils such as soybean oil, sunflower oil, corn oil, canola oil, cottonseed oil, safflower oil and vegetable oil. These oils are industrially manufactured—usually from genetically modified crops in the U.S.—using high heat and toxic solvents to extract the oil from the seeds. Many experts recommend sticking to cold-pressed oils or using butter or ghee (clarified butter) for cooking and baking.

Choose saturated fats wisely

Not all saturated fat is the same. The saturated fat in whole milk, coconut oil, or salmon is different to the saturated fat found in pizza, French fries, and processed meat products (such as ham, sausage, hot dogs, salami, and other cold cuts) which have been linked to heart disease and cancer.
Despite the saturated fat content, kids who eat whole-milk dairy products tend to have less body fat and lower levels of obesity than those who eat skim or non-fat dairy. This may be because the saturated fat in whole milk dairy makes kids feel fuller, faster, and keeps them feeling satisfied for longer, thus helping them to eat less overall. Adding a small amount of butter or olive oil to vegetables will not only improve the taste but can be far more satiating to kids.
To help your child make healthier choices, focus on the source of saturated fats consumed: A glass of whole milk or natural cheese rather than a hot dog, donut, or pastry, for example, grilled chicken or fish instead of fried chicken, or a 4 oz. portion of grass-fed beef rather than a burger and fries. Other tips to choosing saturated fat:

• Avoid saturated fat from processed meats, packaged meals, and takeout food.
• Don’t replace healthy sources of saturated fat with refined carbs or sugary snacks.
• Don’t eat just red meat (beef, pork, or lamb) but vary your child’s diet with chicken, eggs, fish, and vegetarian sources of protein.
• When you choose to serve red meat, look for "organic" and “grass-fed” to avoid antibiotics, growth hormones, and GMOs often found in industrially raised meat.
• Roast, grill, or slow cook meat and poultry instead of frying.
• Allow your child to enjoy full-fat dairy and choose organic milk, cheese, butter, and yoghurt whenever possible.
• Avoid breaded meats and vegetables and deep-fried foods.
• Avoid snack foods such as corn or potato chips.

 For more on good fats, bad fats, and the debate over saturated fat, see Choosing Healthy Fats.

Weight problems and obesity in children tip 4: Be smart about snacks and sweet food

Your home is where your child most likely eats the majority of his or her meals and snacks, so it is vital that your kitchen is stocked with healthy choices and treats.

• Don’t ban sweets entirely. While many kids' sugar consumption exceeds healthy limits, having a no sweets rule is an invitation for cravings and overindulging when given the chance. Instead, limit the amount of cookies, candies, and baked goods your child eats and introduce fruit-based snacks and desserts instead.
• Limit juice, soda, and coffee drinks. Soft drinks are loaded with sugar—“empty” calories that don’t do anything healthy for your child’s growing body. Shakes and coffee drinks can be just as bad. Many juices aren’t any better nutritionally, so encourage your child to eat a piece of fruit instead—kids love satsuma or tangerine oranges. Instead of soda, offer your child sparkling water with a twist of lime, fresh mint, or a splash of fruit juice.
• Keep snacks small. Don’t turn snacks into a meal. Limit them to 100 to 150 calories.
• Go for reduced-sugar options. When buying foods such as syrups, jellies, and sauces, opt for products labeled “reduced sugar” or “no added sugar.”
• Focus on fruit. Keep a bowl of fruit out for your children to snack on. Offer fruit as a sweet treat. Kid-friendly favorites include frozen juice bars, fruit smoothies, frozen bananas dipped in chocolate and nuts, strawberries and a dollop of whipped cream, fresh fruit added to plain yogurt, and sliced apples with peanut butter.
• Experiment with herbs and spices. Use sweet-tasting herbs and spices such as mint, cinnamon, allspice, or nutmeg to add sweetness to food without the empty calories.
• Check the sugar content of your kid’s cereal. There’s a huge disparity in the amount of added sugar between different brands of cereal, even those proclaiming to be whole grain or high in fiber. Some cereals are more than 50% sugar by weight. Try mixing a low sugar, high-fiber cereal with your child’s favorite sweetened cereal, or add fresh or dried fruit to oatmeal for a natural sweet taste.

Snacks at home
Snacks to stock up:	Snacks to cut back:
Fresh fruit and vegetables that can be taken on the go or packed in a lunch.	Soda, sweetened lemonade, fruit punch, and fruit juice with added sugar.
Whole milk and dairy products, including string cheese.	Hot dogs, fatty lunch meats, sausage, chicken nuggets.
Whole grain breads and cereals, pretzels, nuts, olives.	White bread, sugary breakfast cereals, chips.
Greek yogurt, frozen fruit juice bars, fig bars, ginger snaps.	Cookies, cakes, candy, ice cream, donuts.

Weight problems and obesity in children tip 5: Watch portion sizes

There are strategies you can employ to retrain you and your family’s appetites and avoid oversized servings when eating out.

• Learn what a regular portion size looks like. The portion sizes that you and your family are used to eating may be equal to two or three true servings. Limit portions to the size of your fist.
• Read food labels. Information about serving size and calories can be found on the backs of packaging. You may be surprised at how small the recommended portions are or how many calories are in the dish.
• Use smaller dishes. Portions will look bigger and you’ll eat less when you use small bowls or plates.
• Dish up in the kitchen. To minimize the temptation of second and third helpings, serve food on individual plates, instead of putting the serving dishes on the table.
• Divide food from large packages into smaller containers. The larger the package, the more people tend to eat without realizing it.
• Downsize orders. When eating out, share an entrée with your child or order an appetizer instead. Order half-orders or a medium size instead of a large.

Weight problems and obesity in children tip 6: Get your kid moving

Children who sit too much and move too little are at the highest risk for becoming overweight. Kids need an hour of exercise daily for optimum health. This may seem like a lot, but exercise doesn’t have to happen in a gym or all at once. Instead, try to incorporate movement into your family’s regular routine.

Exercise ideas for kids

It used to be commonplace to find children running around and playing in the streets of their neighborhoods, naturally expending energy and getting exercise. In today’s world, that’s not always an option. If you’re not comfortable letting your children roam free, you still have options for boosting their activity level.

• Play active indoor games. Put the remote away and organize some active indoor games. You can play tag (perhaps crawling tag, so that you keep messes to a minimum), hide-and-seek, or Simon Says (think jumping jacks and stretches).
• Try activity-based video games, such as those from Wii and Kinect which are played standing up and moving around—simulating dancing, skateboarding, soccer, bowling, or tennis. Once you child gains in confidence, get away from the screen and play the real thing outside. 
• Get active outside with your child. Take a walk together, bike around the neighborhood, explore a local park, visit a playground, or play in the yard. If it makes sense for your neighborhood and schedule, walk to and from activities and school.
• Do chores together. Perhaps it’s not your child’s first choice, but doing household chores is a very effective way to get exercise. Mopping, sweeping, taking out trash, dusting or vacuuming burns a surprising number of calories.
• Enroll children in after school sports or other activities. If your budget allows, sign children up to play a sport or get involved in an activity where they are physically active. The local YMCA, YWCA, or Boys’ and Girls’ Club are safe places for children to exercise and play.
• Sign up for a 5 or 10K walk/run with your child. Sometimes having a goal in mind can motivate even the most reluctant exercisers. Find a kid-friendly walk/run “race” in your area and tell your child you’ll be “training” for it together. Be sure to celebrate when you accomplish this feat.

Weight problems and obesity in children tip 7: Reduce screen time

The more time your children spend watching TV, playing video games, or using computers or mobile devices, the less time they’ll spend on active pastimes. Limits on television and computer time lead directly to your child spending more time being physically active. Remember how important it is for you to be a positive role model—yes, you may have to cut down on your own viewing habits—and have a good attitude about the change.

• Limit daily screen time. Studies show a link between screen time and obesity, so set limits on your child’s TV-watching, gaming, and web surfing. Experts recommend no more than two hours per day.
• Stop eating in front of the TV. Limit your child’s calorie intake by limiting time spent eating in front of the tube. Tell your child that, starting now, your family does all their eating at the table.
• Pick a different reward or punishment. Instead of rewarding your child with more time in front of the television or computer, promise something different, such as an outing or an activity of their choice. 

Encourage your child to develop new hobbies

Making major lifestyle changes has the potential to add more stress to a child’s life. At times, your overweight or obese child might feel singled out, sad, angry, embarrassed, or discouraged. In the past, they might have dealt with stress by eating or zoning out in front of the TV. Since this is no longer an option, help them find a healthy alternative. Ask your child what he or she might like to take up as a hobby. Hobbies can help kids boost their self-esteem, relieve stress, and provide a positive outlet.

Weight problems and obesity in children tip 8: Get involved

You can make a huge impact on your children’s health by being involved with the details of their lives.

• Talk to your children. Ask them about the school day, every day. Listen to their concerns and take action if there is something they need.
• Be in touch with teachers. Speak to your child’s teachers, especially P.E. instructors, either in person or on the phone.
• Defy busy schedules. You may feel like neither you nor your child has time for long chats about the day. This may be the toughest lifestyle change to make, due to busy schedules, but it can be done. If you need to, treat getting involved like another appointment or meeting in your day.
• Spend time with your children. You don’t have to spend all your time having heart-to-hearts. Playing, reading, cooking, or any other activity, when done together, can supply your child with the self-esteem boost he or she may need to make positive changes.

When to seek professional help for weight problems and obesity in children

There are no easy options when it comes to tackling childhood weight problems and obesity. Weight-loss surgery and medications are rarely recommended for children and adolescents. If you have changed your family’s eating and physical activity habits and your child has not reached a healthy weight, or if your doctor determines that your child’s health or emotional well-being is at risk because of his or her weight, you may want to consider a weight-control program.
Depending on your child's BMI, age, and health, your doctor may refer you to a registered dietitian, psychologist, and/or exercise physiologist for additional guidance on healthy eating, physical activity, and weight control. Again, any treatment program should address healthy eating and physical activity habits for your entire family.

More help for weight problems and obesity in children

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• Nutrition for Children and Teens: Easy Ways to Help Your Kids Eat Healthier
• Emotional Eating: How to Recognize and Stop Emotional Eating
• How to Start Exercising and Stick to It: Making Exercise an Enjoyable Part of Your Everyday Life
• Healthy Weight Loss and Dieting Tips: How to Lose Weight and Keep It Off

Cooking at home and eating out

• Eating Well on the Cheap: Saving Money on Healthy Food
• Healthy Fast Food: Tips for Making Healthier Fast Food Choices
• Choosing Healthy Fats: Good Fats, Bad Fats, and the Power of Omega-3s

Resources and references

General information about weight problems and obesity in children

Overweight and Obesity – Learn how to tell if your child is overweight, explore the causes and effects of childhood obesity, and find helpful tips for preventing weight problems. (KidsHealth)
We Can! Families Finding the Balance: A Parent Handbook (PDF) – Guide to tackling the problem of childhood obesity and making healthy changes for the whole family. (U.S. Dept. of Health & Human Services)
Helping Your Overweight Child – Parent’s guide to helping an obese or overweight child begin to eat better and be more active. (Weight-control Information Network, National Institute of Diabetes and Digestive and Kidney Diseases)
Is Dieting Okay for Kids? – Discover why the majority of overweight kids should not diet, and find out healthier strategies for combating childhood obesity. (KidsHealth)

Weight problems and obesity in children: resources for parents

Be a Healthy Role Model for Children (PDF) – Ten tips for setting a good example for your child and preventing childhood overweight and obesity. (MyPyramid.gov)
Cut Back on Sweet Treats (PDF) – Ten tips for fighting childhood obesity and overweight by cutting back on added sugar. (MyPyramid.gov)
Talking to Kids About Weight – Advice for addressing the sensitive subject of weight and offering support to an overweight or obese child. (American Dietetic Association)
Healthy at Home – List of practical tips for creating a healthy environment at home and encouraging better habits in overweight or obese children. (Get Kids In Action)

Sugar and obesity in children

Sugary Drinks and Obesity Fact Sheet – How sugary drinks are a major contributor to the current obesity epidemic. (Harvard School of Public Health)
Sugar intake, diabetes and kids – Q&A with a pediatric obesity expert about the link between added sugar and childhood weight gain and diabetes problems. (Stanford Medicine)

BMI Calculators

BMI Calculator – Use this calculator for children and teens, aged 2 through 19 years old. (CDC)
Childhood Obesity Assessment Calculator – Tool that lets you calculate your child’s Body Mass Index (BMI). (Shape Up America)

What other readers are saying

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Nutrition for Children and Teens

Easy Ways to Help Your Kids Eat Healthier

Healthy eating can stabilize children’s energy, sharpen their minds, and even out their moods. While peer pressure and TV commercials for junk food can make getting kids to eat well seem impossible, there are steps parents can take to instill healthy eating habits without turning mealtimes into a battle zone. By encouraging healthy eating habits now, you can make a huge impact on your children’s lifelong relationship with food and give them the best opportunity to grow into healthy, confident adults.

Developing healthy eating habits

Children develop a natural preference for the foods they enjoy the most, so the challenge is to make healthy choices appealing. You can do that by disguising the taste of healthy foods—adding vegetables to a beef stew, for example, or mashing carrots up with mashed potato, or adding a sweet dip to slices of apple. Of course, no matter how good your intentions, it’s always going to be difficult to convince your eight-year-old that an apple is as sweet a treat as a cookie.
The childhood impulse to imitate is strong, so it’s important you act as a role model for your kids. It’s no good asking your child to eat fruit and vegetables while you gorge on potato chips and soda.

Top tips to promote healthy childhood eating

• Focus on overall diet rather than specific foods. To promote a lifelong healthy relationship with food, kids should be eating whole, minimally processed, nutritious food—food that is as close to its natural form as possible.
• Have regular family meals. Knowing dinner is served at approximately the same time every night and that the entire family will be sitting down together is comforting and enhances appetite. Breakfast is another great time for a family meal.
• Cook more meals at home. Eating home cooked meals is healthier for the whole family.  It sets a great example for kids about the importance of food and can bring a family together—even moody teenagers love to eat tasty, home-cooked meals! Restaurant and takeout meals tend to have a lot more unhealthy fat, sugar, and salt so cooking at home can have a huge impact on your kids’ health. And if you make large batches, cooking just once or twice can be enough to feed your family for the whole week.
• Get kids involved. Children enjoy helping adults to shop for groceries, selecting what goes in their lunch box, and preparing dinner. It's also a chance for you to teach them about the nutritional values of different foods, and (for older children) how to read food labels.
• Make a variety of healthy snacks available instead of empty calorie snacks. Keep plenty of fruit, vegetables, whole grain snacks, and healthy beverages (water, milk, pure fruit juice) around and easily accessible so kids become used to reaching for healthy snacks instead of empty calorie snacks like soda, chips, or cookies.
• Limit portion sizes. Don’t insist your child cleans the plate, and never use food as a reward or bribe.

Start your child's day off right

Many different studies show that kids who enjoy breakfast every day have better memories, more stable moods and energy, score higher on tests, and miss fewer days from school. They are also less likely to experience problems with their weight.

• Eating a breakfast high in quality protein—from enriched cereal, yoghurt, milk, cheese, eggs, meat, or fish—can help overweight teenagers eat fewer calories throughout the rest of the day and lose weight.
• The ideal breakfast features plenty of “good” carbs (fruit, whole grain toast or cereal, for example) as well as high-quality protein.
• Breakfast on a weekday needn’t be time consuming. Boil some eggs at the beginning of the week and offer them to your kids each morning along with a low-sugar, high-protein cereal and whole milk, and an apple to go.
• An egg sandwich, a pot of Greek yoghurt or cottage cheese, or peanut butter on wholegrain toast can be eaten in the car on the way to school.
• You can make breakfast burritos filled with scrambled eggs, cheese, chicken, or beef on a Sunday and freeze them for your kids to eat during the week.

GMOS and pesticides: Keeping your kids safe

Genetically Modified Organisms (GMOs) are mainly engineered to make food crops resistant to toxic herbicides like Roundup (glyphosate). While the World Health Organization announced that glyphosate is “probably carcinogenic to humans,” there is still some controversy over the level of health risks posed by the use of pesticides and eating genetically-engineered food.
Since children’s brains and nervous systems are still developing, they are more sensitive to the toxic effects of pesticides than adults. Their immature liver and kidneys are also less effective at removing any pesticides they’ve ingested. Eating organic produce has been shown to reduce pesticide levels in kids, but of course, organic foods tend to be more expensive than conventionally grown produce. So how can you keep your kids safe, especially if you’re on a budget?

• Feed your kids plenty of fruits and vegetables, whether they’re organic or conventionally grown—the benefits far outweigh any potential risks. 
• When possible, goorganic for fruits and vegetables that you don’t peel before eating, such as berries, lettuce, tomatoes, or apples and choose cheaper, conventional produce for thick-skinned fruit and veggies such as oranges, bananas, avocados, or pineapples.
• Explore local farmers’ markets for less expensive organic produce.
• It’s important to wash all fruits and vegetables, but try scrubbing conventionally grown produce vigorously with a brush under running water. No amount of washing will remove pesticides taken up by the roots and stem, but you can at least remove any pesticide residue.
• When buying meat, choose organic, grass-fed whenever possible. Pesticides in animal feed tend to accumulate in the fatty tissue of the animal so trim the fat from non-organic meat before cooking. Or choose cheaper cuts of organic meat instead of prime cuts from industrially raised animals.

Dealing with picky eaters

While it can be frustrating trying to get a picky child to eat a wider variety of foods, picky eaters are going through a normal developmental stage, exerting control over their environment and expressing concern about trusting the unfamiliar. Many picky eaters also prefer a “separate compartmented plate,” where one type of food doesn’t touch another. Just as it takes numerous repetitions for advertising to convince an adult consumer to buy, it takes most children 8-10 presentations of a new food before they will openly accept it.
Rather than simply insist your child eat a new food, try the following:

• Offer a new food only when your child is hungry and rested.
• Present only one new food at a time.
• Make it fun: present the food as a game, a play-filled experience. Or cut the food into unusual shapes.
• Serve new foods with favorite foods to increase acceptance.
• Eat the new food yourself; children love to imitate.
• Have your child help to prepare foods. Often they will be more willing to try something when they helped to make it.
• Limit beverages. Picky eaters often fill up on liquids instead.
• Limit snacks to two per day.

Persuading children to eat more fruit and vegetables

Making mealtimes playful can mean healthier eating for your kids. Here are some fun, creative ways to add more fruit and vegetables to your child's diet:

• Top a bowl of whole grain cereal with a smiley face: banana slices for eyes, raisins for nose, peach or apple slice for mouth.
• Create a food collage. Use broccoli florets for trees, carrots and celery for flowers, cauliflower for clouds, and a yellow squash for a sun. Then eat your masterpiece!
• Make frozen fruit kabobs for kids using pineapple chunks, bananas, grapes, and berries.
• Go food shopping with your children. Let them see all the different fruits and vegetables and have them pick out new ones to try.
• Try fruit smoothies for a quick healthy breakfast or afternoon snack.
• Add vegetables and fruits to baked goods – blueberry pancakes, zucchini bread, carrot muffins.
• Add extra veggies to soups, stews, and sauces, grated or shredded to make them blend in.
• Adding a little tasty fat—such as butter—to cooked vegetables will not only improve the taste but can also help to fill your kids up.
• Keep lots of fresh fruit and veggies washed and available as snacks. Apples, pears, bananas, grapes, figs, carrot and celery sticks are all easy to eat on the run. Add yogurt, nut butter, or tahini for extra protein.

Limit sugar in your child's diet

One of the biggest challenges for parents is to limit the amount of sugar in their children’s diets. A child’s body gets all it needs from sugar naturally occurring in food so all this added sugar just means a lot of empty calories that contribute to tooth decay, hyperactivity, mood disorders, and increase the risk for obesity, type 2 diabetes, and even suicidal behaviors in teenagers.

How to cut down on sugar

The American Heart Association recommends that sugar intake for children is limited to 3 teaspoons (12 grams) a day. A 12-ounce soda contains up to 10 teaspoons or 40g of added sugar. Cutting back on soda, candy, and cookies is only part of the solution, though. Large amounts of added sugar can also be hidden in foods such as bread, canned soups and vegetables, frozen dinners, ketchup, and fast food. In fact, about 75% of packaged food in the U.S. contains added sugar.

• Don’t ban sweets entirely. Having a no sweets rule is an invitation for cravings and overindulging when given the chance.
• Give recipes a makeover. Many recipes taste just as good with less sugar.
• Avoid sugary drinks. One 12-oz soda has more than three times the daily recommended limit for children, while shakes and sweetened coffee drinks can be even worse. Instead, try adding a splash of fruit juice to sparkling water or blending whole milk with a banana or berries for a delicious smoothie.
• Cut down on processed foods, such as white bread and cakes, which cause blood sugar to go up and down, and can leave kids tired and sapped of energy.
• Don’t replace healthy sources of saturated fat with refined carbs or sugary snacks. It’s a mistake many of us make. Instead of letting our kids eat whole-fat yoghurt, for example, we offer them low- or no-fat versions, thinking they’re healthier but not realizing they’reoften packed with added sugar to make up for the loss of taste. Or we’ve swapped breakfast eggs for a pastry or muffin. In other words, we’ve replaced fat with something that is much worse.
• Create your own popsicles and frozen treats. Freeze 100% fruit juice in an ice-cube tray with plastic spoons as popsicle handles. Or try freezing grapes, berries, banana pieces, or peach slices, then topping with a little chocolate sauce or whipped cream for an amazing treat.

Avoid foods that impair mood

Certain foods and drinks can make kids and teens more vulnerable to mood disorders such as depression and anxiety.

• A recent study found that people who drank four or more cups of soda or sweetened fruit drinks a day—including diet versions—had a much higher risk for depression.
• Excessive amounts of caffeine from soda, energy drinks, or coffee drinks can trigger anxiety in kids and teens and may also aggravate feelings of depression when the caffeine wears off.
• A diet high in processed foods, such as fried food, sweet desserts, sugary snacks, refined flour and cereals, and processed meats, can increase a child or teen’s risk for anxiety and depression.

Healthy eating for toddlers and young children

Toddlers can be introduced to new tastes and textures as they transition from baby food to “real” food. Keep in mind that toddlers have very small stomachs. It may be better to feed them 5-6 small meals a day, rather than three large ones.
Depending on age, size, and activity level, your toddler needs between 1,000-1,400 calories a day. It is perfectly normal for your child to be ravenous one day and shun food the next. Don’t worry if your child’s diet isn’t up to par every day—as long as he or she seems satisfied and is getting a well-rounded diet.

Nutritional needs of toddlers and young children

An important part of a toddler’s diet is calcium (they need about 500 mg/day), and the best source of this nutrient is whole milk. If your kids are lactose intolerant or don’t like dairy, incorporate calcium-rich foods like fortified soy products, cereals, and orange juice into their diet.
Toddlers need 7mg a day to prevent iron deficiency, which can affect growth, learning, and behavior. In infancy, breast-milk has a readily absorbed type of iron, and baby formula and food is usually iron-fortified, so babies don’t need to worry about getting enough iron. After switching to “real” food, it's important to ensure that your child is eating good sources of iron like fortified cereals, red meat (like soft meatballs), or eggs.

Dietary guidelines for toddlers and young children
Fruits and vegetables	Two servings each per day. These may be given as snacks, such as apple or carrot slices. Also try adding veggies to soups.
Whole grains	Four daily servings. Can include buckwheat pancakes or multigrain toast for breakfast, a sandwich on wheat bread for lunch and brown rice or another whole grain as part of the evening meal.
Milk and dairy	Three servings, or one pint of whole milk per day. Cheeses, yogurt, and milk puddings are useful alternatives.
Protein	Two servings a day. Encourage your child to try a variety of proteins, such as turkey, eggs, fish, chicken, lamb, baked beans, and lentils, as well as red meat.
Vitamins and minerals	Check with your child's doctor to be certain their diet is adequately meeting the recommended nutritional needs for this age group

Healthy diets for school-age children

For kids aged 5-12, the key word is variety.Creative serving ideas will go a long way towards maintaining the healthy eating habits established in the first years of life.

Eating becomes a social activity in this stage of life. Your kids probably spend more time in school than they do at home; eat meals at friends’ houses; and adopt eating habits from their peers. It can be difficult to ensure they are getting adequate nutrition when you are not around to monitor their choices, so try to maintain regular family mealtimes.
Not only do family meals provide an opportunity to catch up on your kids’ daily lives, they also enable you to “teach by example.” Let your kids see you eating a wide variety of healthy foods while keeping your portions in check and limiting fried, junk, and processed foods. Refrain from obsessive calorie counting, though, or commenting on your own weight, so that kids don’t adopt negative associations with food.

Nutrition guidelines for school-age kids

As children develop, they require the same healthy foods adults eat, along with more vitamins and minerals to support growing bodies. This means whole grains (whole wheat, oats, barley, rice, millet, quinoa); a wide variety of fresh fruits and vegetables; calcium for growing bones (milk, yogurt, or substitutes if lactose intolerant); and healthy proteins (fish, eggs, poultry, grass-fed beef, pork, cheese, nuts, seeds, and non-GMO soy products).
Healthy fats are also important. They help to fill kids up, improve concentration, and prevent emotional health problems. Healthy fats for kids are:

• Monounsaturated fats, from olive oil, avocados, nuts (like almonds, hazelnuts, and pecans), and seeds (such as pumpkin, sesame).
• Polyunsaturated fats, including Omega-3 fatty acids, found in fatty fish, such as salmon, herring, mackerel, anchovies, and sardines, or in flaxseed and walnuts.
• Healthy saturated fats. While many health organizations maintain that eating saturated fat from any source poses a health risk, other nutrition experts believe that saturated fat from whole milk dairy, fish, poultry, and organic, grass-fed meat is healthy for both kids and adults (as opposed to unhealthy saturated fats from fried food, pizza, and processed meat products such as bacon, sausage, hot dogs, and cold cuts). In fact, research shows that eating whole-milk dairy products is linked to less body fat and lower levels of obesity.

Kids, like the rest of us, should limit:

• Trans fats, found in vegetable shortenings, some margarines, crackers, candies, cookies, snack foods, fried foods, baked goods, and other processed foods made with “partially hydrogenated” vegetable oils, even if they claim to be trans fat-free.

Dietary guidelines for school age children
Vegetables	3-5 servings per day. A serving might be one cup of raw leafy vegetables, 3/4 cup of vegetable juice, or 1/2 cup of other vegetables, raw or cooked.
Fruits	2-4 servings per day. A serving may consist of 1/2 cup of sliced fruit, 3/4 cup of fruit juice, or a medium-size whole fruit, such as an apple, banana or pear.
Whole Grains	6-11 servings per day. Each serving should equal one slice of whole grain bread, 1/2 cup of brown rice or 1 ounce of unsweetened cereal.
Protein	2-3 servings of 2-3 ounces of cooked  meat, poultry, or fish per day. A serving in this group may also consist of 1/2 cup of cooked dry beans, one egg, or 2 tablespoons of peanut butter for each ounce of meat.
Dairy products	2-3 servings (cups) per day of milk or yogurt, or natural (unprocessed) cheese.
Zinc	Studies indicate that zinc may improve memory and school performance, especially in boys. Good sources of zinc are oysters, beef, pork, liver, dried beans and peas, whole grains, fortified cereals, nuts, milk, cocoa, and poultry.

The special nutritional needs of teenagers

This is growth spurt time: kids gain about 20% of adult height and 50% of adult weight during adolescence. Because growth and change is so rapid during this period, the requirements for all nutrients increase. This is especially true of calcium and iron.

Eating disorders in teens

Adolescents and teens are at a high risk of developing anorexia, bulimia, or binge eating disorder.

Eating habits, however, are pretty well set by now, and if your child's choices are less than ideal, it can be a challenging time for a course correction. The best way to make teen dietary changes is to present information about short-term consequences of a poor diet: appearance, athletic ability, energy, and enjoyment of life. These are more important to most teens than long-term health. For example, “Calcium will help you grow taller.”  “Iron will help you do better on tests and stay up later.”

Special nutritional needs for teens
Calories	Due to all the growth and activity, adolescent boys need 2,500-2,800 per day, while girls need around 2,200 per day. It’s best to get these calories from high-quality protein, dairy, whole grains, and fruits and veggies.
Protein	In order for the body to grow and maintain muscle, teens need 45-60 grams per day. Most teenagers easily meet this need from eating meat, fish, and dairy, but vegetarians may need to increase their protein intake from non-animal sources like non-GMO soy foods, beans, and nuts.
Calcium	Many teens do not get sufficient amounts of calcium, leading to weak bones and osteoporosis later in life. Encourage teens to cut back on soda and other overly-sugary foods, which suck calcium from bones. The 1,200 mg of calcium needed per day should come from dairy, calcium-fortified juice and unsweetened cereal, and other calcium-rich foods such as sesame seeds and leafy greens like spinach.
Iron	Iron deficiency can lead to anemia, fatigue, and weakness. Boys need 12 mg each day, and teen girls, who often lose iron during menstruation, need 15 mg. Iron-rich foods include grass-fed red meat, free-range chicken, beans, nuts, enriched whole grains, and leafy greens like spinach and kale.

A “weighty” problem: children, weight and self esteem

Children who are substantially overweight or obese are at greater risk for cardiovascular disease, bone and joint problems, sleep apnea, and poor self-esteem, as well as long-term health problems in adulthood. While childhood obesity doesn’t always lead to obesity in adulthood, it does raise the risks dramatically. The majority of children who are overweight during preschool or elementary school are still overweight as they enter their teens. Most kids do not outgrow the problem.
Addressing weight problems in children requires a coordinated plan of physical activity and healthy nutrition. Unless directed by your child’s doctor, though, the treatment for childhood obesity is not weight loss. The goal should be to slow or halt weight gain, thereby allowing your child to grow into his or her ideal weight.

Think of exercise as a food group in your kid’s diet

Add physical activity to your child’s day, just as you would add fruit or veggies. To encourage physical activity, play with your kids - throw around a football; go cycling, skating, or swimming; take family walks and hikes; and help your kids find activities they enjoy by showing them different possibilities. The benefits of lifelong exercise are abundant and regular exercise can even help motivate your kids to make healthy food choices.

Kids and junk food

The truth is that it’s extremely difficult for kids to follow a healthy diet if they’re regularly eating at fast food restaurants. The food is typically high in unhealthy fat, sugar, sodium, and calories while at the same time often low in nutrients and almost totally lacking in fruits and vegetables. Still, no matter how well parents promote healthy eating, it can be difficult for any kid to avoid the temptation of junk food. Instead of eliminating junk food entirely, which tends to increase cravings even more, try to simply cut back on the times your kids eat fast food and, on the times that they do, substitute some healthier alternatives.

Kid-friendly junk food alternatives
Instead of…	Try…
French fries Ice cream Fried chicken Doughnuts or pastries Chocolate-chip cookies Potato chips	“Baked fries” grilled in the oven and salted lightly Yogurt; sorbet; fresh fruit smoothies Baked or grilled chicken Bagels; English muffins; home baked goods with less sugar Graham crackers, fig bars, vanilla wafers, fruit and caramel dip Baked vegetable chips or, for older children, nuts

Eating out with kids: fast food and restaurant nutrition for children

It might be challenging to persuade your youngster to order a salad instead of a cheeseburger, but you can steer them towards healthier options. Some important tips to remember about fast food and restaurant dining for kids:

• Avoid sodas, shakes, or sweetened coffee drinks – They’re packed with sugar (and caffeine). Switching to diet soda isn’t the answer, either, as the artificial sweetener it contains can trigger sugar cravings that contribute to weight gain. Encourage your kids to drink water or milk instead.
• Skip the fries – Consider taking along a bag of mini carrots, grapes, or other fruits and vegetables to have instead. This will add vitamins and fiber to the meal.
• Watch portion size. Stick to the children’s menu or go for the smallest size when it comes to sandwiches, burgers, and sides. Order pizza by the slice—it will satisfy your child’s craving without tempting overindulgence.
• Order the kid's meal with some substitutions – Children often love the kid's meal more for the fun box and toys than for the food. Ask to substitute healthier choices for the soda and the fries.
• Avoid fried and breaded items, such as crispy chicken sandwiches or chicken nuggets. Choose grilled chicken breast instead.
• Opt for chicken and vegetables or spaghetti with tomato sauce in a sit-down restaurant, rather than a big plate of macaroni and cheese.
• Be wise about sides. Watch menu items that come with one or more side dishes. Sides that can quickly send calories soaring include fries, chips, rice, noodles, onion rings, coleslaw, macaroni and cheese, and biscuits. Better bets are grilled vegetables, side salads, baked potato, fresh fruit cups, corn on the cob, or apple slices.

More help for child and teen nutrition

FEELING LOVED

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• Eating Well on the Cheap: Saving Money on Healthy Food
• Healthy Eating: Easy Tips for Planning a Healthy Diet and Sticking to It
• The Mediterranean Diet: Myths, Facts, and Health Benefits of a Mediterranean Diet
• Choosing Healthy Fats: Good Fats, Bad Fats, and the Power of Omega-3s
• Healthy Fast Food: Tips for Making Healthier Fast Food Choices
• Weight Problems and Obesity in Children: Helping Your Child Reach and Maintain a Healthy Weight

Resources and references

General information on nutrition for children

The Food Guide Pyramid Becomes a Plate – Article aimed at kids explains exactly how much of each food group children need to eat to stay healthy. (Kids Health)
20 Tips for Picky Eaters – Practical tips to avoid mealtime battles. (Mayo Clinic)
The Stay-Trim Family Diet – This article talks about common eating pitfalls and what you can do to help your family avoid them. (Delicious Living magazine)

Healthy eating for toddlers and young children

Healthy Eating, Part II and Healthy Eating, Part III – How to differentiate healthy from unhealthy choices for children, and the five greatest motivators for preschool children to eat healthy foods. (DrGreene.com)
Eating Tips for Children: Young Toddlers – Parental concerns and unique challenges of feeding toddlers. (Better Health/Victoria, Australia)
Eating Tips for Children: Older Toddlers – Tips to get finicky eaters on the right track. (Better Health/Victoria, Australia)

Nutrition for school-age kids

Eating Tips for Children: Primary School – The importance of breakfast, dealing with peer pressure around food, exercise and snack ideas. (Better Health/Victoria, Australia)
Early Childhood and School Age – Very detailed information on nutritional needs of children. (George Mateljan Foundation)
Nutrition for Kids: Guidelines for a Healthy Diet – Offers exact nutritional needs for different age groups and genders. (Mayo Clinic)
School Lunches – Suggestions for helping kids make better cafeteria choices; ideas for packed lunches that satisfy and taste and nutrition concerns. (Nemours Foundation)

Healthy eating for preteens and teenagers

What’s the Right Weight for Me? – A child’s guide to understanding body type, calories, exercise, and how to maintain optimal weight. (Kids Health)
Healthy Eating For Teens – Good summary of nutritional needs of teenagers, including a chart of recommended servings of different food groups. (Nutrition.com.sg)

Kids and junk food

Junk Food vs. Healthy Nutrition for Children – How to help your child maintain a healthy diet, regardless of adverse influences. (MedicineNet)

GMOs and pesticides

GMO Facts – Frequently asked questions on the use and safety of GMOs. (Non GMO Project)
Where GMOs hide in your food – Details tests that found GMOs in many packaged foods—including those labeled 'natural.' (Consumer Reports)
The Problem with Pesticides – Examines some of the potential health effects of pesticides. (Toxics Action Center)