Health: A Family Value

Raising a healthy family requires wisdom, determination — and a willingness to take the high road when convenience and convention beckon. Start with these healthy habits and you’ll be well on your way.

When I became a parent, two things became so obvious that even my sleep-deprived brain couldn’t ignore them. First: Nothing mattered as much as the health of my family. Second: Much of the world – with everything from pervasive promos for fast food and PlayStations to the diminishing number of outdoor spaces where children can play and connect with the natural world – seemed to be undermining it.

But raising a healthy family is far from impossible. In fact, it takes just a few simple strategies to start steering your entire household toward a healthier lifestyle. Instill health-respecting habits and values in your family members now and you’ll literally be giving them gifts for life: A wholesome diet, regular exercise and not smoking can eliminate 80 percent of heart disease and 70 percent of some cancers, writes author Walter Willett, MD, in Eat, Drink and Be Healthy (Free Press, 2005). Studies have also indicated that children who learn to make healthier food choices in elementary school will keep up those habits as they age.

In a world that seems to place food convenience over food quality – a world that makes sitting in front of the tube seem more appealing than running around outdoors – fostering healthy habits at home requires proactive and protracted intervention on the part of most parents.

Make no mistake: The lessons begin with you. And the very best way to teach good behavior is by modeling it. Kids spot hypocrisy even faster than they can spot where you hid the cookies. “Kids learn by mimicry,” says Janet Fulton, an epidemiologist with the Centers for Disease Control and Prevention’s Division of Nutrition and Physical Activity. “When they see you living well, it’s a lot more meaningful.”

The other cornerstone of raising a healthy family? Education. Teaching your children how their miraculous bodies work feeds their inherent curiosity, helps them understand the biological consequences of healthy and unhealthy behaviors, and prepares them to make more self-respecting choices throughout their lifetimes. Such topics are not often covered in today’s typical grade-school curriculum, so once again it falls to families to do much of the teaching.

With that in mind, here are six principles that will help endow not just your kids, but your entire household with the best health possible – for decades, and perhaps generations, to come.

1. Healthy Eating

Good nutrition is the cornerstone of lifelong health. But too often in our commercial culture, food is portrayed not as nourishment for the body, but rather as a novel entertainment or a fattening enemy.

In many households, home-cooked meals have become a thing of the past, and processed foods have become the predominant source of calories. Over time, those empty calories (and the nutritional deficits they create) contribute not just to record-high levels of childhood obesity, but also to many lifestyle-related scourges – like diabetes, heart disease and cancer – that affect tens of millions of families annually.

“It’s so important in the early years to establish healthy habits,” says Lilian Cheung, DSc, RD, director of health promotion and communication at the Harvard School of Public Health’s Department of Nutrition. Cheung, coauthor with Mavis Jukes of Be Healthy! It’s a Girl Thing: Food, Fitness and Feeling Great (Crown Books, 2003) and Eat Well & Keep Moving (Human Kinetics, 2001), suggests the following tips to encourage healthy eating:

Stock Up. Provide lots of healthy snack options, like precut fruits and vegetables. If you provide only wholesome alternatives and then let your family members choose what they like, healthy eating will become much easier. “Why preach it?” says Cheung. “Just engage them by presenting them with healthy options. Make sure your kitchen table is loaded with a rainbow of fruits, have healthy snacks in your cupboard and don’t buy all the stuff that’s advertised on TV. In fact, getting children to watch TV programs that have fewer commercials would be a big help.”

Keep junk food out of reach, out of sight or, better yet, out of the house. A 2001 study published in The Lancet found that a child’s odds of becoming obese increased 1.6 times for each additional serving of soda he or she drank per day above the daily average.

Dine together. Families that take time to eat together tend to have better nutrition. Studies show that kids who eat regularly with their families consume more fruits, vegetables and calcium and drink significantly fewer soft drinks than their peers who don’t.

They also have healthier eating habits. In their Project EAT (Eating Among Teens) study, researchers at the University of Minnesota in Minneapolis found that adolescent girls who ate at least three meals per week with their family have less than half the odds of engaging in unhealthy weight-control behaviors compared with girls who ate family meals only once or twice per week.

Eat breakfast. Starting the day with low blood sugar is bad news for anyone, but particularly for kids, because it can affect their mood and concentration in school and set them up for unhealthy snacking later. Sugary cereals can make matters worse, so offer quick and healthy foods such as bananas, berries, yogurt, hard-boiled eggs, whole-grain breads and nut butters. Let your children see you eating a healthy breakfast, too!

Be persistent (but not bossy). Don’t give up if your child balks at healthy foods. “Research has shown it may take as many as 10 or 12 times before they accept a new food,” says Cheung. But don’t push too hard. “Don’t try to stuff it down their throat,” she says. “Present a good variety to them in a relaxed atmosphere.”

Finally, don’t underestimate your children’s intelligence. If you take time to explain the basics of food quality and nutrition, and then model discerning food choices, they will probably follow suit. If you don’t know enough about nutrition to teach them, take time to learn.

2. Physical Fitness

According to the American Medical Association, studies show that people who participate in fitness activities as children continue to stay active throughout their lives. So if we want our children to enjoy a healthy future, it’s best to get them moving – now.

Sadly, the fitness of our children has become a national crisis. According to the National Association for Sport and Physical Education (NASPE), nearly half of young people age 12 to 21 and more than a third of high school students do not participate in vigorous physical activity on a regular basis. Lack of activity is one of the main culprits behind the obesity epidemic; it also increases the risk of cardiovascular disease, type 2 diabetes, certain types of cancer, addictions, stress and depression throughout life.

Now the good news: You’re starting with an advantage. George Graham, PhD, a professor of kinesiology at Penn State, notes that kids are born with a natural love of play and activity. The challenge is not so much turning kids on to exercise; rather, it’s making sure they don’t get turned off.

“At about age 10, kids make a decision about whether they’re athletic or not,” says Graham, former president of NASPE. “Once that decision is made, it’s tough to turn it around. As a result, we have millions of adults today for whom ‘exercise’ is a bad word.”

Making it a good word requires some sensitivity to your children’s individual inclinations. Some kids thrive on football, baseball or soccer. Others cringe at the idea of team sports but love dance, in-line skating or karate. “Your child needs to be the guide,” says Graham. “It’s not what you like. You may love to play golf, but if your child doesn’t, it’s not going to work.”

NASPE recommends one hour of physical activity per day for children. Julia Sweet, author of 365 Activities for Fitness, Food and Fun for the Whole Family (McGraw-Hill, 2001), suggests the following tips to encourage exercise:

Show ’em how it’s done. Like it or not, you are your kids’ most influential fitness role model. “Parents should lead by example,” says Sweet, “because our kids are watching our every move.” Struggling with your own fitness demons? Let your kids see you striving – not suffering. Complaining about your personal dread of exercise is no way to make it seem more appealing to your offspring.

Move in tandem. Making exercise a family activity not only gets everybody moving but also offers a great opportunity to connect in the spirit of fun.

Meet kids at their level. Find ways to incorporate exercise into activities that your child already enjoys. Invite their friends. Play their music.

Don’t be a dictator. One surefire way to turn kids off is to make exercise an unpleasant chore. Don’t make working out a requirement for dessert or berate them with insults when they’re short on hustle. Motivate your child with incentives and encouragement, not punishment. Do what you can to make every active experience a positive one.

Be sensitive. Respect your child’s physical limits and emotional vulnerabilities. Don’t force swimming lessons on a child who’s self-conscious about being in a bathing suit, or make a child hike with a backpack that’s too heavy. Remember: The goal here is to instill health and fitness as a shared family value, not a parental decree from on-high. Be aware, too, that negative judgments or anxieties about your own body or athletic abilities may trickle down in ways that undermine your child’s confidence and self-esteem.

3. Stress Management

No family is stress-free, and parents aren’t the only ones whose health depends on good stress-management skills. Kids from kindergarten to high school experience anxiety over things like separation from parents, bullies, grades, social and peer pressures, and body image. And while kids are resilient by nature, their lack of life perspective can also make them more vulnerable to stress and its myriad negative effects – from tummy trouble and skin rashes to bedwetting and tantrums.

“If you don’t learn good ways of handling stress when you’re younger, it predisposes you to all sorts of diseases when you’re older – depression, anxiety, heart disease, high blood pressure and stomach ailments,” says James J. Crist, PhD, a clinical psychologist from Woodbridge, Va.

The danger, says Crist, is that unless they’re presented with better alternatives, kids can easily develop unhealthy ways of coping with stress, such as emotionally shutting down, acting out aggressively, or turning to drugs and alcohol. In particular, young girls who don’t learn healthy coping skills may attempt to manage their anxieties through eating (or not eating) and are at increased risk of developing an eating disorder.

Crist, author of What to Do When You’re Scared & Worried: A Guide for Kids (Free Spirit, 2004), offers these tips for teaching healthy responses to stress:

Keep your cool. “If parents are overreactive to stressful situations, the kids pick up on it even before they have the words to describe it,” says Crist. Show your kids that mindful choices – not reactive outbursts – are the best way to resolve problems.

Keep the lines open. You won’t know your kids are stressed if you aren’t talking to them. “If you’re yelling and screaming at your kids to behave when they’re younger, don’t expect them to come to you when they have problems,” Crist says. Make a point of engaging your kids in meaningful conversations, and lending a sympathetic – not judgmental – ear. Help them identify alternatives when they feel hopeless or stuck.

Relieve pressure. Help your kids recognize stress signals (tightness or fluttering in the chest or abdomen; clenched muscles, low mood), and encourage healthy routines that help relieve stress, such as exercise, hobbies, playing a musical instrument or making art.

4. Emotional Intelligence

Stress management is just one piece of overall mental and emotional health. In recent years, psychologists have begun talking about “emotional intelligence” the same way we talk about the intellectual kind.

John Gottman, PhD, author of Raising an Emotionally Intelligent Child: The Heart of Parenting (Simon & Schuster, 1998), divides parents into two categories: those who give children guidance about emotion, and those who don’t.

He says parents who are “emotion coaches” prepare their kids to cope with the ups and downs of life. They don’t object to expressions of anger, sadness or fear in children; instead they treat such feelings as facts of life and opportunities for teaching life lessons and ways to build closer relationships. Their children, Gottman writes, tend to be physically and emotionally healthier.

In 1986, Gottman and his colleagues began a detailed study in Illinois of 56 married couples with children age 4 or 5. When they followed up three years later, children of “emotion coaches” showed better academic performance, social competence, emotional well-being and physical health. They got along better with their friends, had stronger social skills and had a more positive emotional life. They even had lower levels of stress-related hormones in their urine, lower resting heart rate, and lower rates of illnesses such as colds and flu.

Gottman outlines five basic principles of emotion coaching (learn more at www.talaris.org/spotlight_emocoaching_steps.htm):

Be aware. Learn to recognize your child’s emotions as they arise, and become aware of your own.

Build connections. Emotional situations present opportunities for intimacy and teaching between you and your child. They’re not “problems” to be solved.

Listen. Listen empathetically and validate your child’s feelings when she describes her reactions to events or certain situations. Let her know that, whatever her feelings, they are neither good nor bad, but normal.

Label. Describe and name your child’s emotions in words he can understand. Compassionately reflecting to your child when you see that he’s sad/angry/hurt helps him identify and cope more effectively.

Help. Assist your child in coming up with appropriate ways to solve problems or deal with upsetting issues or situations. Set limits on behavior, not feeling.

“When mothers and fathers use a coaching style of parenting, their children become more resilient,” writes Gottman. “The kids who are emotion-coached still get sad, angry or scared under difficult circumstances, but they are better able to soothe themselves, bounce back from distress and carry on with productive activities. In other words, they are more emotionally intelligent.”

5. Media Savvy

No matter how sensitive and evolved your parenting style, no matter how dedicated your commitment to your children’s well-being, it’s important to recognize that you are not the only ones influencing them.

Today’s kids and teens are the target of a massive, continuous and often insidious marketing barrage that promotes foods, pastimes and attitudes antithetical to both health and lasting happiness.

“The first thing parents should understand is that modern commercial technology is one of the most powerful devices that humans have ever created,” says Allen Kanner, PhD, a clinical psychologist and coeditor of Psychology and Consumer Culture: The Struggle for a Good Life in a Materialistic World (American Psychological Association, 2003). “The power is psychological and emotional. Marketing to children through the media is not simply an annoyance or trivial matter, but one that has a profound impact on them.”

The average child spends nearly 40 hours a week – the equivalent of a full-time job – consuming some type of media unrelated to school, such as TV, music, computers, newspapers, magazines and video games. Sixty-five percent of children between ages 8 and 18 have a television in their bedroom, as do 32 percent of those between ages 2 and 7, according to the nonprofit health research group Kaiser Family Foundation.

Young kids are especially vulnerable because they lack the cognitive development to critically evaluate advertising. According to the American Psychological Association (APA), children under 8 tend to accept ads as truth. The APA has recommended that advertising targeting children younger than 8 years old be restricted.

These ads aren’t exactly selling vegetables. According to researchers at Children’s Hospital Boston, the average child views 10,000 food ads per year, 95 percent of which are for fast food, soft drinks, candy or sugared cereals.

And unhealthy media messages stretch far beyond targeted advertisements. From sitcoms to magazine spreads to the mindless chitchat on morning radio shows, kids pick up unrealistic and unhealthy messages about body image, lifestyle and values. The media landscape today is a minefield of misinformation – and shielding kids from it can be a full-time job.

What can you do? Kanner, a member of the steering committee of the Campaign for a Commercial-Free Childhood, recommends the following steps:

Find allies. Talk to other parents about media-consumption guidelines. Your kids will be less vulnerable to peer pressure if their best friends have the same rules.

Walk the halls. Schools have become promotional sites for junk foods, beverages and other less-than-healthy products. Take the time to find out who’s marketing to your kids when you’re not looking.

Limit screen time. Set limits on computer and TV use. The American Academy of Pediatrics recommends no screen time for children 2 and younger, and no more than one or two hours of quality TV or videos a day for older kids.

Spot the agenda. Explain the purpose of advertising and ask your child to spot the “Want me! Buy me!” messages. Kanner says this exercise will “help the children see the manipulation” inherent in most ads.

6. Time in Nature

One simple thing can go a long way toward easing all the challenges described above: Get your family outside.

“The natural world is a treatment for unhealthy, sedentary lifestyles,” says Robin Moore, director of the Natural Learning Initiative at North Carolina State University in Raleigh. “It’s preventative. The younger the children, the more preventative it is.” Moore describes natural play as a “childhood right” that encourages vigorous exercise, healthy social relationships and creative play. And it’s no coincidence that obesity and lack of fitness are rife among children who have spent less time outdoors. Richard Louv, author of Last Child in the Woods (Algonquin, 2005), says many children suffer from what he calls “nature-deficit disorder.” (See “Nature-Deficit Disorder” in the September 2005 online archive at lifetimefitness.com/magazine.) This alienation from the natural environment, Louv contends, brings diminished use of the senses, attention difficulties, and higher rates of physical and emotional illness.

“Reducing the deficit – healing the broken bond between our young and nature – is in our self-interest,” writes Louv, “not only because aesthetics or justice demands it, but also because our mental, physical and spiritual health depend upon it.”

The healing power of nature is more than a cliché. Research has shown that time spent outdoors correlates with increased physical activity and psychological well-being in children. For example, researchers at Cornell University in Ithaca, N.Y., examined 337 rural kids between grades three and five and found that those who lived near natural areas showed fewer impacts from stress. Louv argues that childhood play in nature reduces depression, obesity and attention-deficit disorder; improves academic performance; and develops problem-solving skills, critical thinking and creativity.

What’s the best way to give your kids a dose of this preventative medicine? Get out there with them whenever you can. Discover the landscape, the elements and the beauty of nature together.

Whether you are teaching your kids respect for the natural world, or respect for their own bodies, one thing is sure: The best way to express your healthy values as a parent is to make them evident in your daily interactions with your kids. Like any other family value, healthy living is best taught, and learned, by example.

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Healthy Family Practices

Creating an environment in which your family can thrive and grow starts with a few basics.

Make Time Your Priority

Time is the most important gift we can give each other. Unfortunately, it can be hard to come by these days. “Parents can get into quite the frenzy as they attempt to juggle a wide range of commitments and responsibilities,” write Jukes and Cheung in Be Healthy! It’s a Girl Thing (Crown Books, 2003). They recommend families schedule time together so kids can get what they need most: their parents’ undivided attention.

Another benefit? Making time for family teaches kids that quality together time is a priority — a value that they’ll carry with them into adulthood and model for their own children.

Build Strong Bridges
According to the American Academy of Pediatrics (AAP), many parents think the main purpose of communication is to get information to their children. “Telling children to eat their vegetables and reminding them to look both ways before crossing the street are expressions of love and caring.” But, the AAP claims, communication has another important function: connecting you with your child emotionally. “Healthy communication — the kind that builds a strong two-way bridge — is crucial in helping your child develop a healthy personality and good relationships with you and others.”

Strengthen Your Commitment
Commitment means being together in good times and bad. You can strengthen your sense of commitment by giving time and energy to the family on a daily basis — and by developing family interests. This benefits everyone, claims Suzanna Smith, associate professor of human development and family relations at the University of Florida in Gainesville. “Committed families feel a sense of trust, belonging and unity. They solve problems together and look toward the future; this gives the family purpose and direction.” And that makes it easier to support each other through the challenges and joys of getting healthy.

You can also strengthen your family bond by discussing your family goals and values, and then writing a family mission statement or creating a family vision.

Celebrate Together
While commitment helps bring people together, it doesn’t mean the family should overshadow the individual. “Strong families know that family members will grow and develop individual identities,” writes Smith. “They affirm and appreciate positive qualities, and encourage and support each other.” Take time to celebrate the small achievements of each family member. And make gatherings — especially daily events like eating dinner together — positive so that everyone looks forward to family time.

Kermit Pattison has written for GQ, The New York Times, Runner's World and Men's Fitness.

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