Researchers found that kids consume at least twice the recommended daily amounts.

American teens are taking in as much dietary salt as adults, far exceeding guidelines on healthy limits for daily consumption, research warns. The investigation tracked the week-long eating habits of more than 760 black and white high school kids. It found that, on average, teens now ingest a whopping 3,280 milligrams (mg) of sodium (salt) every day.

That amounts to more than double the uppermost recommended level of 1,500 mg of sodium per day set forth by the American Heart Association. And the upshot, researchers say, is a higher risk for adolescent obesity, given the further finding of an apparent direct link between high levels of salt intake and an increased risk for packing on the pounds.

“Even after accounting for many other risk factors that could contribute to weight, we still found that higher dietary sodium among adolescents was independently associated with a higher risk for obesity,” said study lead author Dr. Haidong Zhu.

Zhu, an assistant professor of pediatrics at the Institute of Public and Preventive Health at Georgia Regents University, and her colleagues reported their findings online on February 3, 2014, in the journal Pediatrics.

To examine salt intake among American teens, the researchers focused on healthy teens between the ages of 14 and 18, all of whom were attending local public high schools in the Augusta area. The teens were nearly evenly split across race (black and white) and gender. Up to seven times over the course of a single week, each student was repeatedly asked to recount what they ate the previous day, with particular attention paid to the amount of sugar-sweetened sodas drank and calories consumed.

Students also had their height and weight measured to calculate their body mass index (BMI) and had X-rays and MRIs to assess body-fat percentages and fatty-tissue dispersal. Their waist circumference was also measured, and fasting blood samples were taken to look for signs of obesity-related inflammation.

The result: 97 percent of the teens were found to be consuming levels of salt exceeding the AHA’s daily recommendations, with white teens taking in slightly more per day than black teens (about 3,350 mg versus 3,200 mg, on average). What’s more, the team found a direct association between ingesting high levels of salt and the risk for being overweight or obese, having a larger waist, and having higher body fat and fat mass. Concentration levels of leptin, a key hormone involved in the regulation of hunger and metabolism, were also found to rise as salt intake increased.

The finding of a direct — as opposed to indirect — link between salt intake and obesity risk is somewhat of a twist, the researchers suggested. Many previous studies have highlighted an indirect association between salt intake and obesity. Such research reflected the fact that salt typically spurs a desire to drink more sugary soda and eat more calorie-laden food.

The new study, however, found that teens who took in high amounts of salt every day were more likely to be obese regardless of their particular drinking and eating habits. Why this is the case remains unclear, the investigators said. And Zhu stressed that more research is needed.

“We didn’t look at the mechanism behind this,” she said. “Animal research does suggest that salt does directly increase obesity risk. But for now, we cannot prove any causality.” Lona Sandon, a registered dietitian and assistant professor of clinical nutrition at the University of Texas Southwestern, in Dallas, made a similar point. “With this type of study,” she said, “it is always important to point out that it is a correlation relationship, not showing a cause and effect.”

But Sandon nonetheless said the findings were “interesting” and suggested they be viewed as a kind of wake-up call. “Parents should be concerned about the quality of the diet their children are eating,” she said. “A poor-quality diet during childhood and adolescence leads to poor-quality health in adulthood.”

Her advice? “The best thing parents can do is to start by setting a good example by making healthier low-sodium food choices themselves,” she said. “Then make an effort to provide low-sodium foods, meaning mostly fresh and minimally processed foods available for the whole family at home. Limit the amount of food prepared away from home and get back in the kitchen.”

For more on sodium intake guidelines for healthy children visit the National Library of Medicine

Half the parents of overweight or obese children don’t think their kids have a weight problem, a new analysis reveals.

A review of 69 previous studies found that nearly 51 percent of parents with overweight or obese children tended to underestimate their child’s excess weight.

“They thought their children were of normal weight when their children’s BMI indicated that they are either overweight or obese,” said Dr. Rachel Thornton, a clinical pediatrician and assistant professor of pediatrics at Johns Hopkins School of Medicine.

“In my clinical practice, I am not surprised by that finding,” said Thornton, who was not involved with the study. “Parents tend to think a child who is overweight is actually normal weight.”

Body-mass index (BMI) is a measurement of body fat based on height and weight.

The effect went the other way as well, according to researcher Alyssa Lundahl and colleagues at the University of Nebraska. They conducted the evidence review, which was published online Feb. 3 and in the March print issue of the journal Pediatrics. One in seven parents of normal-weight children in the studies worried that their child might be too skinny, the researchers found.

Parents might have a hard time assessing their child’s weight because childhood obesity has become so commonplace, the researchers said. More than a third of children in the United States are overweight or obese, according to the U.S. Centers for Disease Control and Prevention. “Parents are seeing other children like their own, and think it is normal,” Thornton said. “On the other hand, I have had parents come in concerned that their child is underweight because they are thinner than the other kids on the playground.” The parents also might believe their child simply has “baby fat” that they will outgrow, Thornton said. “They believe a toddler that is a little chubby is going to grow out of it, because it’s just baby fat,” she said.

The researchers found that parents were more likely to underestimate the overweight or obese status of kids aged 2 to 5 years, but became more accurate in their ability to assess their child’s weight as the child grew older. The problem is, young kids with excess weight tend to carry those extra pounds into adolescence and adulthood, the study authors said. With that extra weight comes an increased risk of heart disease, diabetes, arthritis and cancer, according to the CDC.

These findings show that pediatricians need to take a more active role in counseling parents about their children’s weight problems, said Marlo Mittler, a registered dietitian in pediatric and adolescent medicine at Cohen Children’s Medical Center of New York, in New Hyde Park. “Pediatricians need to be more firm in saying, ‘Your kid is in trouble. Let’s take a look at this BMI chart and pinpoint the problem,’ ” Mittler said. In particular, pediatricians need to start using BMI charts more often to check a child’s weight, Thornton said. “It’s important for us to use those measurements and not simply rely on the way a child looks, because during different stages of development a child is supposed to have a different body shape than a typical adult,” she said.

Pediatricians should not pull their punches when it comes to childhood obesity, Thornton said. They need to be straight with parents about the health problems their children will face if their weight isn’t addressed. “Pediatricians need to inform parents of their children’s weight status when they are overweight,” she said. “Generally, parents are looking to the doctor to give them an assessment of whether their child’s weight is appropriate or not.”

In turn, Mittler said, parents must be ready to act if their pediatrician warns them of a health problem. “We need to not make light of it. We need to be more proactive,” she said. “It’s never too early to start. It’s OK to introduce young children to fish and grilled chicken and salad, not just things that are off the kids’ menu like mac and cheese.”

Source: WebMD; Parents of Obese Children Underestimate Weight? by Dennis Thompson

“That’s loaded with calories!”

“Are you counting your calories?”

When people talk about the calories in food, what do they mean? A calorie is a unit of measurement — but it doesn’t measure weight or length. A calorie is a unit of energy. When you hear something contains 100 calories, it’s a way of describing how much energy your body could get from eating or drinking it.

Are Calories Bad for You?

Calories aren’t bad for you. Your body needs calories for energy. But eating too many calories — and not burning enough of them off through activity — can lead to weight gain.

Most foods and drinks contain calories. Some foods, such as lettuce, contain few calories (1 cup of shredded lettuce has less than 10 calories). Other foods, like peanuts, contain a lot of calories (½ cup of peanuts has 427 calories).

You can find out how many calories are in a food by looking at the nutrition facts label. The label also will describe the components of the food — how many grams of carbohydrate, protein, and fat it contains.

Here’s how many calories are in 1 gram of each:

• carbohydrate — 4 calories
• protein — 4 calories
• fat — 9 calories

That means if you know how many grams of each one are in a food, you can calculate the total calories. You would multiply the number of grams by the number of calories in a gram of that food component. For example, if a serving of potato chips (about 20 chips) has 10 grams of fat, 90 calories are from fat. That’s 10 grams x 9 calories per gram.

Some people watch their calories if they are trying to lose weight. Most kids don’t need to do this, but all kids can benefit from eating a healthy, balanced diet that includes the right number of calories — not too many, not too few. But how do you know how many calories you need?

How Many Calories Do Kids Need?

Kids come in all sizes and each person’s body burns energy (calories) at different rates, so there isn’t one perfect number of calories that a kid should eat. But there is a recommended range for most school-age kids: 1,600 to 2,200 per day.

When they reach puberty, girls need more calories than before but they tend to need fewer calories than boys. As boys enter puberty, they may need as many as 2,500 to 3,000 calories per day, especially if they are very active. But whether they are girls or boys, kids who are active and move around a lot will need more calories than kids who don’t.

Most kids don’t have to worry about not getting enough calories because the body — and feelings of hunger — help regulate how many calories a person eats. But kids with certain medical problems may need to make sure they eat enough calories. Kids with cystic fibrosis, for instance, have to eat high-calorie foods because their bodies have trouble absorbing the nutrients and energy from food.

Kids who are overweight might have to make sure they don’t eat too many calories. (Only your doctor can say if you are overweight, so check with him or her if you’re concerned. And never go on a diet without talking to your doctor!)

If you eat more calories than your body needs, the leftover calories are converted to fat. Too much fat can lead to health problems. Often, kids who are overweight can start by avoiding high-calorie foods, such as sugary sodas, candy, and fast food, and by eating a healthy, balanced diet. Exercising and playing are really important, too, because activity burns calories.

How the Body Uses Calories

Some people mistakenly believe they have to burn off all the calories they eat or they will gain weight. This isn’t true. Your body needs some calories just to operate — to keep your heart beating and your lungs breathing. As a kid, your body also needs calories from a variety of foods to grow and develop. And you burn off some calories without even thinking about it — by walking your dog or making your bed.

But it is a great idea to play and be active for at least 1 hour and up to several hours a day. That means time spent playing sports, just running around outside, or riding your bike. It all adds up. Being active every day keeps your body strong and can help you maintain a healthy weight.

Watching TV and playing video games won’t burn many calories at all, which is why you should try to limit those activities to 1 to 2 hours per day. A person burns only about 1 calorie per minute while watching TV, about the same as sleeping!

Reviewed by: Mary L. Gavin, MD
Date reviewed: September 2013

Source: KidsHealth; Learning About Calories