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Welcome to RFK Dr. Z! Thank you Dr. Tiongson!

Please join me in welcoming Aaron Zylstra, MD - aka Dr. Z - to the Raising Fit Kids Community! And a...

Posted by Haylen_WebMD_Staff

1 Reply | Reply | Watch This Discussion Report This | Share this:Welcome to RFK Dr. Z! Thank you Dr. Tiongson! Please join me in welcoming Aaron Zylstra, MD - aka Dr. Z - to the Raising Fit Kids Community! And a...

Reply: I have a picky eater!

our rule has always been TRY ONE BITE. If you don't like it, you don't have to eat it. Even when we're...

Posted by Mrs_Temple

1 Reply | Reply | Watch This Discussion Report This | Share this:I have a picky eater! our rule has always been TRY ONE BITE. If you don't like it, you don't have to eat it. Even when we're...

Reply: Push back from child regarding exercise

Hi SoCalSuz, I've been there done that! Maybe a family activity might work. I couldn't get my son...

Posted by SweetSusieB

1 Reply | Reply | Watch This Discussion Report This | Share this:Push back from child regarding exercise Hi SoCalSuz, I've been there done that! Maybe a family activity might work. I couldn't get my son...

Questions for the First Lady re: Kids & Fitness!

Please click the link below to ask Michelle Obama questions about her Let's Move initiative , a...

Posted by Haylen_WebMD_Staff

0 Replies | Reply | Watch This Discussion Report This | Share this:Questions for the First Lady re: Kids & Fitness! Please click the link below to ask Michelle Obama questions about her Let's Move initiative , a...

Reply: Loosing weight

Brittany, You've already taken the first and most difficult step, making the decision to improve...

Posted by Chris Tiongson, MD

Brittany,

You've already taken the first and most difficult step, making the decision to improve your health! It is never easy to make changes and it can be very frustrating when the results don't seem to match the effort.

The next step, which you may have already taken, is to see your doctor for a checkup. That will give you and your doctor a starting point and a better idea of where you are at. A check up can also help your doctor see if there are some complicating health conditions that are making it hard for you to meet your goals.

Calculating your BMI and finding out the percentile or ranking, helps determine the level of increased risk of health problems, and thus helps determine how intense your personalized plan should be.

After trying the usual things (like healthier eating, increasing physical activity, cutting down sugary drinks, decreasing TV/computer/screen time) then there are other ways to ramp up.

Maybe things would be easier with a group of other kids? Sometimes a program over 10 weeks or so that includes some brief classes about cooking healthier, strategies for increasing physical activity in day-to-day activities, exploring what the barriers might be that are making it hard to change. Also, setting up a specific plan for healthy eating with a nutritionist or exercise specialist can give you a specific roadmap to follow. Sometimes it is hard to meet a less defined goal of "eating better" or "exercising more."

There are different options for kids at top of the charts, percentiles in the 99% range. There are a few very specialized centers around the country that do consider medication or surgery for some kids. It is not a first option and usually most other options have been tried before that point. I don't know if that is a good fit for you or not.

In the meantime, are there tips that other teens or parents would like to share with Brittany? Maybe a strategy that seemed to work well for your family?View Thread

Posted by Chris Tiongson, MD

1 Reply | Reply | Watch This Discussion Report This | Share this:Loosing weight Brittany, You've already taken the first and most difficult step, making the decision to improve...

Reply: Preschoolers: Physical Activity While in Child Car...

http://seattlemamadoc.seattlechildrens.org/preschoolers-m...

thanks for sharing the link. it was a good read.

Posted by Chris Tiongson, MD

1 Reply | Reply Report This | Share this:Preschoolers: Physical Activity While in Child Care thanks for sharing the link. it was a good read.

How long and how hard should kids exercise?

I got a question today from someone who is leading a program here in North Dakota to promote healthy...

Posted by Chris Tiongson, MD

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Reply: Exercise during the winter

I get "the stress of scheduling"! I live in Southern California - if we only had a helicopter, we...

Posted by Haylen_WebMD_Staff

11 Replies | Reply | Watch This Discussion Report This | Share this:Exercise during the winter I get "the stress of scheduling"! I live in Southern California - if we only had a helicopter, we...

Reply: Back to school? Were you & the kids healthy over t...

Our weather was more like October than December/January this year, so the usual sledding, skating...

Posted by Chris Tiongson, MD

1 Reply | Reply | Watch This Discussion Report This | Share this:Back to school? Were you & the kids healthy over the break? Our weather was more like October than December/January this year, so the usual sledding, skating...

10 Healthy Ways to Manage Stress Without Using Foo...

http://blogs.webmd.com/childrens-health/2012/01/10-health...

These are stressful times! And when parents are stressed, kids are stressed. A new post in the WebMD...

Posted by Haylen_WebMD_Staff

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Reply: Purple spots on 11 year old thighs

I would recommend calling your doctor's office to talk about it and to ask your follow-up questions....

Posted by Chris Tiongson, MD

3 Replies | Reply | Watch This Discussion Report This | Share this:Purple spots on 11 year old thighs I would recommend calling your doctor's office to talk about it and to ask your follow-up questions....

Reply: Child's unhealthy body image

First, I you haven't already tried to objectively talk to him about his height for weight match,...

Posted by Chris Tiongson, MD

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Reply: Are carbmaster yogurts okay to give to kids?

That makes sense, Thank you.

Posted by meekschan

5 Replies | Reply | Watch This Discussion Report This | Share this:Are carbmaster yogurts okay to give to kids? That makes sense, Thank you.

Reply: Talking to Your Kids About Their Weight

A supportive message based on health would be better. Finding things they are doing right and...

Posted by Chris Tiongson, MD

9 Replies | Reply | Watch This Discussion Report This | Share this:Talking to Your Kids About Their Weight A supportive message based on health would be better. Finding things they are doing right and...

Fall Kids Activity Challenge - Week 4

The topic is cooking with kids! How do you have fun with your kids in the kitchen and help them...

Posted by Haylen_WebMD_Staff

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Fall Kids Activity Challenge - Week 2!

The Fall Kids Activity Challenge is heating up! " Activities for the Whole Family " is the...

Posted by Haylen_WebMD_Staff

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Reply: NEW -- Join the Fall Kids Activity Challenge!

The Fall Activities Challenge is heating up and we need more ideas to share! If you don't have...

Posted by Haylen_WebMD_Staff

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Reply: BMI 3 year old

Sounds like you are setting a great example by having lots of healthy meal options at home....

Posted by Chris Tiongson, MD

Sounds like you are setting a great example by having lots of healthy meal options at home. Congratulations!

To help answer your questions about your son, we need to get an idea of his potential health risk. To do this, docs will use the Body Mass Index percentile, just like we use the growth chart percentiles to give context to the height and weight measurements over time and relative to other kids.

Studies of docs relying just on their eyeballs to determine risk based on weight show that we don't do a good job of picking out kids at risk or potentially at risk as they grow up. So the first step is to make a diagnosis based on BMI percentile for age using the child's height, weight, gender, and age.

Increased risk of health problems is greatest for BMI percentiles greater than the 95%ile for age. There is some increased risk between 85th and 94th%iles as well. I tried to calculate your child's BMI percentile but I wonder if there is a typo in your child's height above. 28 3/4" is more like the height of a 9 month old. Maybe his height is 38 3/4"?

Using the taller height and guessing your son's age to be 3 yrs and 1 month yields a BMI percentile of 91. This is not the highest risk zone, but something to pay attention to over time since there is a risk of it climbing higher as he grows up.

Limiting portion sizes is a useful strategy to encourage healthy eating habits for a lifetime. Hungry kids can always ask for more.

Studies of adults show that portion size makes a big difference. The classic popcorn bucket study is a great example. People were given free popcorn at a movie theater. Some people got large buckets and some got small buckets. Guess which group ate more popcorn? The large bucket group.

Then the twist. What about giving away stale popcorn? Even when the popcorn wasn't tasty, the large bucket people still ate more.

I think that some (many?) kids, just like adults, are capable of overeating and portion size can be an unconscious trigger to eat more.

A typical pattern that I see in my practice is kids who are maybe just a little heavy as preschoolers, then have a steep climb in BMI percentile through early elementary school years to become obese. I don't know why that happens, but it happens fairly frequently. I think your doctor has probably seen this same phenomenon and was very astute in picking up on a small increase in BMI percentile. Offering some advice at this very early stage can hopefully prevent the BMI percentile from rising higher over the next few years.View Thread

Posted by Chris Tiongson, MD

1 Reply | Reply | Watch This Discussion Report This | Share this:BMI 3 year old Sounds like you are setting a great example by having lots of healthy meal options at home....

Can your kids spot an unhealthy lunch?

Expert Hansa Bhargava, MD, FAAP, has posted in the " Your Children's Health " blog about her son's...

Posted by Haylen_WebMD_Staff

0 Replies | Reply | Watch This Discussion Report This | Share this:Can your kids spot an unhealthy lunch? Expert Hansa Bhargava, MD, FAAP, has posted in the " Your Children's Health " blog about her son's...

Reply: Back to school! What do you pack for lunch?

A Harry Potter lunchbox for me, please.

Posted by Chris Tiongson, MD

3 Replies | Reply | Watch This Discussion Report This | Share this:Back to school! What do you pack for lunch? A Harry Potter lunchbox for me, please.

School activities! How are your kids staying activ...

WOW - my daughter starts 1st grade next week! We are so active in the summer with swimming and...

Posted by Haylen_WebMD_Staff

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Reply: update- my daughters bmi

Thank you. I became overweight as a child, and still struggle with it, so I am very sensitive about it. I...

Posted by nursingbug

7 Replies | Reply | Watch This Discussion Report This | Share this:update- my daughters bmi Thank you. I became overweight as a child, and still struggle with it, so I am very sensitive about it. I...

Reply: Blood streak in phlegm

Hi Anon - I'm sorry you didn't get an answer here right away. What you found out about your...

Posted by Haylen_WebMD_Staff

1 Reply | Reply | Watch This Discussion Report This | Share this:Blood streak in phlegm Hi Anon - I'm sorry you didn't get an answer here right away. What you found out about your...

Do you or the kids "brown bag" it?

Heads up re: keeping food safe! Did you know that perishable foods in these lunches are often...

Posted by Haylen_WebMD_Staff

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Reply: Eating out with kids

Dessert is not the enemy. Part of the way my family tries to find that balance is through portion...

Posted by Chris Tiongson, MD

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Reply: Staying Active With Young Kids

http://www.webmd.com/fitness-exercise/fitness-staying-act...

My husband and I both try to stay active too. He has rec league soccer on Monday nights, which is his main...

Posted by ReikiMama

2 Replies | Reply Report This | Share this:Staying Active With Young Kids My husband and I both try to stay active too. He has rec league soccer on Monday nights, which is his main...

Parents: Bookmark this!

http://firstaid.webmd.com/default.htm

A one-stop-shop for all your first aid and emergency needs!

Posted by Haylen_WebMD_Staff

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Reply: Unhealthy eating starts early - did yours?

no I ate when I was hungry and stopped eating when I was full. Later I learned behaviors that went against...

Posted by Springisnear

1 Reply | Reply | Watch This Discussion Report This | Share this:Unhealthy eating starts early - did yours? no I ate when I was hungry and stopped eating when I was full. Later I learned behaviors that went against...

Healthy Summer Activities!

How do you keep your kids active in the summer? Do they play sports? Swimming? Spend time outside? ...

Posted by Haylen_WebMD_Staff

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Reply: Structured vs Unstructured play

That is really cool about your daughter- I wish I had taken dance as a child. I am going to rethink the...

Posted by nursingbug

Take the Poll

Do you enroll your Toddler/Preschooler in classes to boost their activity?

2 Replies | Reply | Watch This Discussion Report This | Share this:Structured vs Unstructured play That is really cool about your daughter- I wish I had taken dance as a child. I am going to rethink the...

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Aaron Zylstra, MD

Aaron Zylstra, MD (Dr. Z) is a general pediatrician at Sanford Children's in Sioux Falls, South Dakota. His practice consists of general pediatr...More

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