pediatric type 2 diabetes

It’s all in the family: Preventing pediatric type 2 diabetes starts at home

June 8, 2015

“We will be the first generation to bury our children and grandchildren from complications of type 2 diabetes,” said Hermelinda Basurto, RN with the Texas A&M Health Science Center Coastal Bend Health Education Center (CBHEC) diabetes education program in Corpus Christi, Texas as she reflected on how shocking it was when a pediatric endocrinologist told her this 10 years ago.

But this is no longer a prediction. Today’s obituaries cite complications from type 2 diabetes as the cause of death for people as young as 23.

The prevalence of type 2 diabetes (previously known as adult-onset diabetes) among children and adolescents in the U.S. has increased rapidly in the last two decades and is a growing problem, according to the Centers for Disease Control and Prevention. The younger a person is when he or she develops diabetes, the more likely they are to suffer serious problems with their kidneys, heart and eyes later in life.

While genetics can predispose children to developing the disease, experts agree that lifestyle is the most significant contributor. Lack of physical activity, more fast foods and processed foods, sugary drinks and larger portion sizes are lifestyle factors that have become more common in recent years, and they are all controllable.

“Instilling a healthy lifestyle starts very early,” said David Leal, nutritionist with the Texas A&M CBHEC diabetes education program. “Everyone in the family should do it together so it’s not just a diet or workout program.  It’s about making good health a lifestyle.”

Health educators with the program encourage multiple family members to attend their diabetes education classes so they can all learn and implement healthier lifestyle choices together. Here, they share some of the advice provided in their program.

1.  Go outside and play

Lack of physical activity is unhealthy at any age, but it’s especially important for young children to get at least 60 minutes of moderate to vigorous physical activity each day.

Riding bikes, jumping rope, playing tag, swinging, sliding and playing hopscotch are just a few ways kids develop motor skills, grow muscle, improve microvascular structure, and maintain a healthy weight.

“When we talk about kids getting more physical activity, we’re talking about playing,” Leal said.  “Kids just need to go outside and play.”

Playing with other children also helps kids learn how to get along with others and provides a sense of community.

Parents can help boost their children’s outdoor play by going on family bike rides, hikes or walks, taking their children to the park or setting up play dates with other parents and their children.

2.  Limit sugary beverages

Soda and fruit drinks are the two largest sources of added sugars in the diet of U.S. youth.  These empty calories (calories that provide few or no nutrients) add up quickly and can lead to childhood obesity and type 2 diabetes.

Health educators recommend limiting juice to just one 4-ounce drink per day and cutting soda completely. And believe it or not, kids can have too much milk, too.

“Line up soda, juice and milk, and as far as calories go, their numbers are all about the same,” Leal said. “Now, milk and fruit juice have nutrients and vitamins, but you still have to limit kids’ intake to an appropriate amount.”

Limiting sugary beverages should start at infancy. Leal says bottles are intended for breast milk, formula or water only and should be used only until a baby turns one year old. Then, fill spill-proof cups primarily with water, and let them have 4 ounces of juice made from 100 percent fruit juice once per day.

But it’s never too late to cut back.  If your child has already developed a taste for soda and juice, try restricting the number of these drinks to just one per day and gradually bring it down to one or two per week.

3.  Cook at home

Many families today have both parents working outside the home. Add to that homework, extracurricular activities, non-work commitments and the daily toil of raising a family, and time becomes somewhat of a commodity. Unfortunately, these other commitments have forced food to the back burner as we mindlessly consume the most convenient options.

Quick meal solutions like fast food and frozen dinners (such as pizzas, chicken nuggets, TV dinners, etc.) are full of trans fats, preservatives, simple carbohydrates and sugar and tend to be devoid of any real nutritional value. The best way to ensure you and your family are getting the nutrition you need is to prepare meals yourself. And this doesn’t have to be elaborate or time consuming.

In fact, it can be as easy as adding a few extra ingredients to microwavable meals.

“Even just adding frozen vegetables to frozen entrees improves balance and nutrient composition of meals,” said Leal.

Slow cookers make healthy cooking less time consuming by doing most of the work for you.  Simply place all the ingredients into a crock-pot, turn it on and let it cook while you’re at work. Then, come home to a wholesome home cooked meal. Most cooking websites and magazines provide a ton of slow-cooker recipes. Look for those that contain the most vegetables and lean meats.

“Starting out, plan two meals a week and double the recipes,” Leal said. “Freeze the leftovers and reheat when needed.”

4.  Eat the rainbow

“Eat your fruits and vegetables” is a statement most of us have likely heard since we were kids, and it’s good advice.

Vegetables and fruit provide essential vitamins and minerals, fiber and other substances that support good health. They are also filling but do not contain much fat or calories, so eating them can help maintain a healthy weight without feeling hungry.

It’s important to introduce children to fruits and vegetables very early. Doing so helps kids develop a taste for them and normalizes their presence.

“Children have to be introduced to something over and over again for it to be part of their diet,” Leal said. “They might refuse it over and over, but just keep it on their plate. Tell them they don’t have to eat all of it – or even any of it – but just hold on to it. It will take time, but repeated introduction will turn it into the norm.”

Incorporate fruits and vegetables into meals and snacks by cutting them into bite-sized pieces and serving them with low-fat dip or cottage cheese. Add apple or banana slices to a peanut butter sandwich on whole wheat bread. Spread fruit-flavored yogurt on graham crackers, or add fresh berries or banana slices to breakfast cereal.

5.  Be a good example

When your children see you eating healthy foods, staying active and getting plenty of sleep, they are likely to pick up those habits, too. Make a healthy lifestyle part of your family culture and your kids won’t have to think twice about what they eat or how much physical activity they get.

“It’s not a diet, it’s healthy eating. It’s not an exercise program, it’s being active,” said Maggie Scheerer, RN, CDE with the CBHEC diabetes education program. “When everybody in your family does it together, it’s just what you do. You eat well and you stay active.”

Lindsey Hendrix VR Publisher

— Lindsey Hendrix

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