family practice issues and general life events

Posts tagged ‘children’

Obesity epidemic and school lunch standards

About 5 days ago, the USDA set guidelines for healthier school meals.  As a physician, I should get totally excited about that, but upon hearing the full story, I think my reaction is more of a what?  As the obesity epidemic reaches dramatic proportions, our children are not left out.  According to the American Academy of Children and Adolescent Psychiatry 16- 33% of children are obese.  This is a startling statistic but based on my patient population, I would estimate the number is closer to the 33% rather than the 16%.  But then again, I live in southeastern Oklahoma, and see a patient population of 45% Medicaid.  That is their primary insurance, it does not include those who qualify for Medicaid as a secondary insurance.  During medical school, I never imagined that I would be consulted by parents regarding their underweight child, only to determine he is the only one in the family that is on the growth chart and of a normal weight with respect to his height.  Or the number of children dragged in by their parents sure that their child has a thyroid problem, because it could not be that the only exercise the child gets is to get up off the couch to go to the bathroom between commercials, or that a large pizza is considered a serving size for them.  So I understand that obesity is a problem in our youth.  And I would applaud any efforts to help curb it, should those efforts actually make sense.

This is not an argument for whether I want to subsidize school lunches, food stamps or other government agencies.  These programs are in place, and for the moment, if we are to continue with them at least let their policies make sense.

Per the report found in Reuters  “The guidelines double the amounts of fruits and vegetables in school lunches and boost offerings of whole grain-rich foods. The new standards set maximums for calories and cut sodium and trans fat, a contributor to high cholesterol levels.”  And while I fully understand that, and the attempts to offer only fat-free or low-fat milk, and assure that proper portion sizes are given to children, I doubt that this is even possible to enforce much less implement.

My experience with cafeteria workers is that few if any realize what a proper serving size for an adult, much less a child.  I spend quite a bit counseling patients that serving sizes are roughly the size of their hand (since it is much easier to grasp and compare than carrying around a scale).  And currently, I have heard of schools allowing 2nd and 3rd servings to children.  With few exceptions there is not a child that ever needs a third tray of food.  (Those rare exceptions of underweight and active children this applies to the population that are not at that end of the spectrum)

Not to mention, the black market aspects that could foreseeable pop up.  Who is going to keep kids from bringing food from home?  I know it is being attempted in Chicago, but I remember sneaking brownies and gum into the classroom, where we weren’t allowed to eat as a child.  How are you going to determine if this is food from home, or from the cafeteria itself.

And the biggest reason that this will not work, the original proposal was blocked because potatoes were not initially allowed as a vegetable.  And pizza was also not allowed as a vegetable.  I like french fries and pizza as much as the next person, but let’s be real, health food they are not.  When the food manufacturers selling the food are allowed to dictate what constitutes health foods and what does not, there is a problem.  What child is going to pick an apple over french fries?  Will the school lunch still be able to meet the nutritional standards?  How precisely would those two be considered nutritional equivalents?

As a physician, I spend a lot of time talking to new diabetics and obese patients about their diets, and well pasta and potatoes appear to be the biggest contributors to the caloric intake.  It is what they learned from the USDA and their food pyramid.  The very same organization setting these standards.   The same organization which allowed the lobbyists to dictate the new standards.  And at what cost?

While I agree we have to start somewhere with educating the public and attempting to change the dietary habits of children before the suffer the health effects of obesity, including early onset Type 2 diabetes, hypertension, and high cholesterol, I don’t see this actually being effective.  Substituting whole wheat for white flour in pizza and spaghetti, while it looks like a wonderful idea on paper, may instead be thrown away in favor of other offering either by the school, or an entrepreneurial student.  And while I am in full support of the potential economic lesson this might lead to, it most likely will do little to help.  Nationwide standards have not helped to improve our education system, and without getting input from local officials and parents, I doubt that this will be much different.

Had change been truly desired in the school lunch program, input would have come from the parents, teachers, physicians, dietitians rather than the food industry who would have seen their potential profits cut.  The making of a pizza a vegetable merely because of its tomato paste (which is incorrect, since most use sauce which has a lesser concentration of tomatoes and tastes better) shows just what kind of answers we get from Washington.


Vancouver with kids

This morning started our vacation.  Well I guess technically yesterday did, if you want to count 3 hours at the Dallas-Fort Worth airport.  Which is not what I would call exciting or relaxing.  Especially since to begin with the self check in apparently did not want to accept my credit card and instead of asking for another card or saying anything, it just assumed we didn’t want to check in bags.  It was only after waiting an excessive amount of time, that we asked, and when checked apparently the computer just dropped the request completely.  Thank goodness we were there extremely early


Anyway today we woke up to rain.  Since it was 106 in Durant the day we left, and we had not seen rain since May, it was a welcome sight.  Anyway we got up, stopped by the concierge and headed to a cafe for breakfast.  However, since we neglected looking side to side, we walked right by Bob’s cafe, without noticing it.  IT was only when two Seven Day Adventist asked if we needed any help that we found out that we had walked by it.


After breakfast we headed towards a sky train.  Now this was exciting for the kids.  We live in a small town with little public transportation.  So a train through town is somewhat exciting.  We headed to Metro Mall because apparently the clothes in my youngest room were my oldest, so I seemed to be short of clothes for my 6 year old.


Our next stop was the Science Center.  My husband and I have been to Science centers in several states.  Not one of them was as expensive or crowded as the one in Vancouver.  Sad really.  IT shows just how far down our emphasis on education is.  In fact, last month when we tried to go to the one in Little Rock, its website said they were closed.  So that is very telling.  However, it was a very crowded attraction, and two floors of fun hands on activities.  Additionally they have little shows and an IMAX.  WE watched the show on locomotion.  Skipped the IMAX, because I have to children very sensitive to sensory.


Our next stop was the Vancouver Art Museum.  While the first floor was ok.  It included various paintings.  The second floor was filled with advertising campaigns.  I am sorry but I am not one who believes that all campaigns are art.  Some can be artistic, but just because they were created by a graphic artist, well you understand.  The upper floors consisted of very disturbing works that I don’t feel are appropriately suited for young children.

Little Rock adventure

Last weekend we took an extended weekend to take our children to the World Championship American Tae Kwon Do Association.  We decided to leave a few days early, and see what there was to see in Little Rock.  Our initial impression, not much.

Every museum that would appeal to a family with kids that was listed in the hotel book they give you, when looked up on the internet either said “Closed” or “Under Renovation”  Really?  I would think that renovations would be best in the fall or winter, but maybe they see mostly school children, so what do I know.  So then we looked up things to do in Little Rock and got the same responses.  And in fact, we found a blog that even said, “Don’t bother to look for things to do in Little Rock, because everything is either under renovation or closed.”  Apparently the blogger was as frustrated as we were.  (I do apologize for not citing this blogger correctly, but since I only remember the comment, I don’t know who to give credit to)


So we decided to try the GPS.  It suggested the Toltec Archeological Park.  Having nothing else to do, we drove the 15 miles out of Little Rock and gave it a try.  Toltec is an ancient Indian set of mound of which only three remain, the rest were knocked over by farmers, but there are two trails you can walk, and it is fairly cheap, so if you are in Little Rock, it is definitely worth checking out.

The kids enjoyed the ability to walk (run) the path stopping at the markers and learning about the Toltec.  And at least some sunk in because my oldest, who is definitely ADHD even retained some of what was read.

Sometimes you just have to sit in the dirt

And there was some shady areas, but the favorite part of the walk at least for the kids was the feeding of the turtles in the Mound Lake.

However, I would recommend doing the tour early at least in the summer, because we were definitely hot and sweaty by the end of it.  So we thought it would be the perfect time to visit the Little Rock Museum of Art.  And just in time, because they had an impressionist exhibit that was ending that weekend.

On the way back to our hotel, my husband noticed what looked like a submarine, so we had to go and investigate.  He was disturbed that he had missed that sub, but it was 11 o’clock pm when we drove into town the night before.  But it was indeed a submarine, so we decided to go take a look at the USS Razorback.

Trying out the cot

Assuming you are not claustrophobic, it is an interesting tour.  However, the stairs down and up into the sub can take your breath away

I have to climb those?


I really did not want to climb the stairs back up.  The ones down were somewhat terrifying.  Don’t ask me why.  But since I did not want to stay on the sub for the rest of my life, up the ladder I went.

Don’t get me wrong, it is an interesting tour and definitely worth checking out, if you are not claustrophobic, but it is also a little heart stopping, or at least the ladders are.  But how often do you get the chance to see a World War II sub?


Guitar lessons

I feel for my son who strives for perfection on the first attempt. He wants to play the guitar, but he is not the most coordinated of children. However, he likes math, and music seems like a natural fit, and sometimes he is able to.

However, as I sit here during his guitar lessons, he has become so frustrated because he is not perfect. And tht imperfection upsets him. I struggle to find a balance between him finding acceptance within himself, but not kill e strive for perfection. I think the desire for perfection up to a point is good. However when it becomes obsessive it biomes a problem.

However, by the middle of the lesson, he was actually starting to sound ok. We are not talking about Mozart here. (I don’t even know if you can play Mozart on a guitar). I think he is having fun. Unfortunately for him the line between fun and frustration is so slim, it is hard to tell.

We are also doing these lessons at the end of the day. Way pass the time we is at his best. though he seems interested in the fact he can make two notes sound the same and that he can tune his instrument through that.

Unfortunately his attention Span is so short it leads to frustration for both him and his teacher

Dinosaurs and other matters

Sometimes my children just amaze me.  I know all parents say that sometimes, but today my oldest just floored me.  While waiting for my youngest son’s Tae Kwon Do class, he was forcing us to play “Guess which Dinosaur I am!”  Those of you without children might wonder how can a 40 pound, 5 year old force you to play a game, well you have never met my son.  He is super persistent, and just sure that facebooking on my iPhone was not what was supposed to be going on.

Any way back to “guess the dinosaur” he was on all fours.  And since I was not paying attention, I guessed a dog.  (Like I said I was not paying that close of attention, and actually thought we were playing guess the animal).  Both boys turned to me and said, “No mommy, we are playing guess the dinosaur.”  To which Spencer added, “I am really big.”  So I guessed “Brontosaurus.”

Spencer said “No, mommy.”


“Your right mommy.”

“Mom, there is not a dinosaur called a brontosaur.  That was a mistake, they put a different dinosaurs head on the wrong body, so there is no such thing.” said Trevor, my oldest.

“Are you sure?  Who told you that?”

“My teacher, Ms. Julie.”

I don’t know about the rest of you, but I had never heard that before in my life.  And I LOVED the brontosaurus in my youth.  To learn that it never existed, well that is one more item to the list of facts from school, that were not only inaccurate.  I did look it up by the way.  He is correct.  Here is the link explaining the whole fallacy

Apparently even while they were teaching it to me in the 1980s, it was known to be incorrect since the early 20th century.  Though the head issue did not come to full light until a controversy was sparked by stamps issued by the US Postal Service in 1989.    Additionally, the lifestyle of the Apatosaur/Brontosaur  we were taught we completely wrong.  This is due to the putting the wrong head on the wrong body.  Until today I had never heard of this.  I learned it from my almost 8 year old son

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