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A picture is worth a thousand words
A new nutrition makeover television series is opening parents’ eyes to change.
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Many physicians are asking: What will it take to get the American public to begin to make changes to their diet and lifestyle? The Learning Channel, or TLC, thinks that allowing people to see into the future may be the answer.
The channel’s new series, Honey We’re Killing the Kids, uses state-of-the-art computer imaging to show parents how their overweight children may look at the age of 40 if they don’t start making diet and lifestyle changes now.
The digital images are developed using information about the children’s diet, exercise habits and family medical history. The view of the future is not healthy: Research shows that overweight children often become overweight adults, with many of the accompanying medical complications.
The approach could be viewed as a scare tactic; however, Lisa Hark, PhD, RD, director of the Nutrition Education and Prevention Program at the University of Pennsylvania School of Medicine and host of Honey We’re Killing the Kids, disagrees.
“Showing the parents these images of their children is meant to motivate them,” she told Endocrine Today in an interview. “When you tell adults or teenagers, ‘You are going to get diabetes,’ it is too abstract. They don’t understand it. Their mother or grandmother may have diabetes but they don’t understand what it means to have the disease. When you show them a picture, an appearance of an overweight person in their 40s, it really makes a very big impact.”
Reaching out for help
The show is based on a successful show of the same name in the United Kingdom. TLC looked for a U.S. nutritionist to host the show and after auditioning more than 400 people, Hark was selected to host the show in July 2005. She had previous television experience working as a dietitian for NBC in Philadelphia.
The show began production in September 2005. Since then, Hark has worked with 13 families across America to overhaul bad eating habits and implement life-altering rules that will help to transform the children’s future health, with the goal of preventing chronic diseases.
All the families that appeared on the show applied through TLC.
“These parents were saying to me, ‘Oh my goodness! Please come. Please help.’ They absolutely knew there was a problem and they were reaching out for help. They were in a really good place to make changes,” Hark said.
After the families were selected for the show a team of people visited the homes and took the family’s three-day diet record, focusing specifically on the children’s eating habits.
The families completed several questionnaires and simple tests measuring weight and blood pressure. Family medical histories were also completed.
That information was used to make the digital images of the children and to help Hark develop rules to apply to each family.
“We get a sense of exactly what they are eating and drinking every day, how much TV they’re watching, how much time is spent playing video and computer games, whether the parents smoke, and how much exercise they get,” she said.
Looking to the future
Many of the children were eating massive amounts of sugar, fat and calories and typically not getting enough vitamin D and calcium, Hark said.
“I asked the parents, ‘Have you ever thought about how your child will look when they’re 40?’ Parents say that they thought their child would be healthy at 40,” Hark said. “Parents respond, ‘I thought he would just lose the weight and start exercising as he got older.’”
She said most parents had a very unrealistic perception of what was going to happen to their children’s health in the future. “They keep hoping that lightning is going to strike and their child’s future health is going to take care of itself.”
In one episode of the series, upon seeing the projection of his child at age 40, a father commented that his “future son” looked like he did now, a bad thing in his opinion.
That is where Hark’s rules come in. She works with each family for three weeks, presenting the family with a new set of rules each week.
Week one involves adjusting the family’s diet. Some of Hark’s rules include dumping the junk food from the kitchen, eating more fruits, vegetables and whole grains, grocery shopping as a family, and cooking healthy meals together.
“There is a much greater likelihood for success because I’m not holding their hands for three weeks doing everything for them,” she said. “I give them a shopping list and a three-week menu and they have to go implement it. It’s a lot of learning by doing.”
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Working as a family
Week two brings new rules about exercise and activity. The rules, more organized physical activity and limiting the television, apply to the whole family — treating overweight children is a family problem, Hark stressed.
“The parents are the ones cooking the food, buying the food, bringing it into the house,” Hark said. “The parents are the ones setting the example, they are the role models. The parents are also the ones [who] have to say ‘no’ and monitor the television viewing.”
Hark said that on weekends her team was seeing anywhere from four to nine hours a day of television, video games or computer games for each person. “There were four bedrooms in a house, five family members, and five television sets. Everyone was in a different room, zoning out with their TV,” she said
The key to being more active is turning off the television. The Centers for Disease Control and Prevention’s and American Academy of Pediatrics’ recommendation is less than two hours a day (including TV and video games).
Several families featured on the show were given television “debit” cards. Each person could watch half an hour of television a day by running a card through the system attached to the TV. When time was up, the set turned off.
The family’s mother was amazed. Without the television to watch, the children helped her clean and fold laundry. When the father was caught watching extra television he had to do yard work and clean up the entire back yard. The task reinforced that the family had to stick together as a team and also gave his children a space to play in.
Get up and go
Hark enrolled the children in a karate class, which she said helps to build confidence. In addition, the family was instructed that they should take a one-mile bike ride each day as a group.
Finding ways for your patients to exercise should be easy, Hark said.
Tell patients to go to the dollar store and buy a hockey stick and a hockey puck. Go in the driveway or to a playground and play street hockey.
“I just started that with my 7-year-old son and 12-year-old daughter. We are outside huffing and puffing, running around,” Hark said.
If people are concerned about neighborhood safety, she said they don’t have to go outside to exercise. “You can put on music inside the house and start dancing, jumping rope or even playing Twister. Anything other than watching television.”
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Gaining back control
Although Hark works with these families for three to four weeks, she acknowledges that most physicians can’t devote that much time to a patient.
She has been training medical students, residents and physicians for almost 20 years and recommends that if a physician only has one minute to discuss nutrition with a patient they should assess what the child or teenager is drinking — the same is true for adults.
“According to most experts, liquid calories in sweetened beverages are contributing significantly to the obesity problem in America. Anything other than water, physicians and nurses need to quantify. Soda, juice drinks, fruit punch, sport and energy drinks, sweetened teas, coffee drinks, all of it,” Hark said.
“Instruct parents to stop buying this stuff and remind them that they need to set a good example. They are the role models. Children need to be drinking plenty of water and low-fat milk.”
Physicians also need to get as much information as possible to quantify and document how much television the children and family are watching during the week and weekends as well. They should combine this with the time they spend playing video games and computer games and give advice to limit to less than two hours per day.
“It is also important to quantify and document how active the child is. Do they actually get out and do anything? How many hours a day, a week,” she said. Emphasize to parents that their children and teenagers need at least one hour of physical activity every day for optimal health.
Practical advice
Physicians need to feel comfortable asking parents and children about their diet and lifestyle and be able to provide practical, useful advice, Hark said.
She said physicians should also tell parents that it is okay to say no to their children when they are begging for sweets or want to watch more TV. “We need to help parents gain back the control — in regards to food — that they seem to have lost,” she said.
The show has produced great success among the families. After three weeks, Hark meets with the parents to discuss the modifications made to the family’s diet and lifestyle. Taking all of the changes into consideration, the parents are shown new, healthier images of their children at 40.
However, now the parents know that for those images to come true, the entire family needs to work together to maintain their lifestyle changes. Hark is advocating that physicians recommend Honey We’re Killing the Kids as a way to educate their patients. – by Leah Smith
For more information:
- Honey We’re Killing the Kids airs Monday nights at 9 p.m. EST on TLC. To learn more visit www.tlc.com/honey and www.lisahark.com.