I am writing you today as a pediatrician, a mother, and a colleague to enlist your help. Like, you I chose my profession because I love children, and I love to teach. When starting my practice, I was excited to teach families how to navigate through the ups and downs of child development and occasional pediatric illnesses. I looked forward to seeing my patients grow up healthy and happy. Unfortunately, so many of the children in my practice are neither healthy nor happy. Every single day I care for children suffering from what used to be considered “adult” diseases (ex: Hypertension, type 2 diabetes, chronic back pain, constipation, poor attention, and depression). All of these conditions are directly related to obesity and/or a poor diet. It is discouraging to see a child’s light being dimmed by the burden of childhood obesity. On a typical day I might see a toddler too heavy for their parents to pick up, an elementary student too winded to run on the playground, and a middle school child with hypertension.
In 2012 I started a nonprofit organization, The Doctor Yum Project, to help our community take childhood obesity head on. We educate families on how food is both the problem and the solution to achieving better health. We are teaching families how to cook again, to be patient when introducing whole foods to children, and to avoid the ubiquitous junk food traps.
The Doctor Yum Project could really use the help of concerned teachers like you. So many teachers work hard to teach kids, facing substantial odds in doing so, including teaching students who enter class with a lack of adequate sleep, exercise, and good nutrition. This can be frustrating, I’m sure.
Traditionally food, especially sugary treats, has played a role in some classroom activities. In the day-to-day routine, teachers may offer motivators like candy to help reinforce and reward good behavior or academic accomplishments. Celebrations within the classrooms may also involve sugary treats and juices. Although such treats are offered with good intentions, these snacks all add up with long term unintended consequences.
Here are some facts:
- The American Heart Association (AHA) recommends that children age 4-8 get less than 4 teaspoons of added sugar per day. However, many children surpass this recommendation before the end of breakfast. Consider that a Pop-Tart or a serving of flavored yogurt may have 4-5 teaspoons of added sugar. Kids are getting more sugar than ever in their diets from beverages, school lunches, processed foods and sweets. Despite the AHA recommendations, U.S. children age 4-8 years are getting 21 teaspoons of added sugar per day on average.
- Type 2 diabetes, mostly associated with obesity, and once rare in children, now makes up one-third of new cases of diabetes in children. Calories from sugar put us more at risk for diabetes than other types of calories.
- Offering food rewards can create unhealthy habits and relationships with food that can be difficult to break. Offering children food when they are not hungry prevents them from learning to follow their own hunger cues.
- There are many other ways to reward, inspire, and teach children without involving food rewards. Studies actually show that kids prefer non-food rewards over candy.
- Create a “Culture of Wellness” in your class with healthy traditions and non-material rewards. So many teachers spend their own money on their students. How about rewards that are free! An encouraging note to a parent or offering a child a special privilege for an accomplishment can be more meaningful than Jolly Rancher. Extra recess or a special theme day can inspire a whole class. I recently read about a teacher who rewarded her class with a “two minute dance party.” The kids loved it, and I’m guessing her students could focus better after the brief burst of movement.
- Offer fun, non-food rewards instead of sugary treats. Kids love stickers, tattoos, pencil toppers, and other very inexpensive treats. I tried giving glowing bracelets and tattoos at Halloween this year, and it was a big hit. Catalogs like the Oriental Trading Company are great for this.
- Find ways to celebrate special days that do not involve sugary treats. At my children’s school, birthdays are marked with a “sun celebration” to represent how many times a child has traveled around the sun. The child can bring in pictures from each year of their life and talk about what was special about each year.
- Encourage parents to keep the sugar and junk food out of school. Depending on the rules at your school, offer parents a list of ideas of acceptable store-bought or homemade alternatives to the usual cupcakes and candy. My experience is that fruit skewers with yogurt dip are just as special as the sweets that we think kids expect.
- Take time to educate other teachers. If you are one of the many teachers who has already taken a stand against sweet treats in your classroom, then share your position with your colleagues. Show them this letter, or share some of the ideas that work in your classroom. As we say in medicine, “See one, Do one, Teach one.”
Here are some ways teachers can join us in the fight against childhood obesity:
- Every little bit counts.
Nimali Fernando, MD, MPH
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