Healthy Active Living and
Balance
Dr. Annick Buchholz, C.Psych.
Dr. Laurie Clark, C.Psych.
Kelly Heffernan, RD
Tonight’s Agenda
• What is health?
• Balancing busy schedules
• Health at Every Size
• Balanced eating
• Physical activity in our daily lives
• Sleep
• Body Image and Emotional Health
What Is Health?
Health is a state of complete physical, mental,
and social well-being and not merely the
absence of disease or infirmity.
World Health Organization
What is a healthy lifestyle for a child ?
Balance
Basic health behaviours
– Nutrition
– Physical Activity,
Sedentary Time
– Sleep
– Coping and Emotional
Development
Daily living activities
– School
– Homework
– Extra-curricular
Activities
– Time with family and
friends
– Chores
What is a healthy lifestyle for a parent?
Balance
Basic health behaviours
– Nutrition
– Physical Activity,
Sedentary Time
– Sleep
– Coping and Emotional
Development
Daily living activities
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Work
Chores
Extracurricular activities
Family needs
Time with family and
friends
Key Ingredients to Balance
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Schedules work
Do not over schedule
Parents self care and mental health count
Sleep matters
Setting ‘loving’ limits is important
Health at Every Size
• Diets are harmful and don’t work
• Focus on your child’s health behaviours and
not their weight
• Advocate for size diversity
• Remember to provide children with genuine
body image compliments
“You look great today”
Who is healthier?
Person A
Person B
Ht: 7 ‘1
Wt: 325 lbs
BMI: 32
%BF: 12%
WC: 90 cm
BP: 114/72
Chol: High HDL, Low LDL,
TG’s with in normal range
Ht: 5 ‘9
Wt: 138 lbs
BMI: 21
%BF: 10%
WC: 78 cm
BP: 122/84
Chol: Low HDL, High LDL and
TG
Healthy life style versus weight
BMI= 32 kg/m2
obese
BMI= 21 kg/m2
normal weight
Balanced Healthy Eating
Balanced Healthy Eating
Each Day, 6-9 year olds require:
• 5-6 Vegetables and Fruit
• 4-6 Grains
• 2-4 Milk and Alternatives
• 1-2 Meat and Alternatives
• Fluid requirements based on weight, H20
For Optimal Nutrition, Growth and Development – how?
It’s a Balancing Act
1. Meals 3-4 food groups
2. Snacks 2-3 food groups
3. Eat every 2.5-3 hours
4. Balance over the week
Balancing Healthy Eating
& the Division of Responsibility
• Parents provide structure, support and
opportunities.
• Children choose how much and whether to
eat from what the parents provide.
Ellyn Satter 2011, www.ellynsatter.com
Balancing Healthy Eating
• Food refusal is common for children
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Vegetables
Food ‘Jags’ are normal
Reintroduction is key
• Parents/caregivers, historically, in an effort to
have a ‘healthy’ child will:
• Feed frequently
• Offer large portions
• Offer preferred foods
•Offer food in response to crying
•Coerce with food when available
•Reward with food
Balancing Healthy Eating
Traditional feeding and their outcomes:
1.
Coercion to eat healthy food = Aversions/Dislikes
Balancing Healthy Eating
Traditional feeding and their outcomes:
2.
Clean your plate = Attention to external cues
Balancing Healthy Eating
Traditional feeding and their outcomes:
3.
Food restriction = Increased desire
E.g. Fisher and Birch (1999) preschool aged, allowed certain
foods and restricted others. What was the response?
Balancing Healthy Eating
How can we incorporate treat foods?
Balanced Eating &
Sugary Sweetened Beverages
• Sugary beverages include:
– Sports drinks, energy drinks fruit juice, pop, iced coffee,
specialty coffees, others
• Consumption has been gradually increasing over
the past few decades
– 20% of caloric intake for 4-18 year olds
– 30% of caloric intake for 1-3 year olds
Hassink, Seminarts Ped Surg (2009), 18, 159-167
Balanced Eating &
Sugary Sweetened Beverages
One of the main contributors to
increased energy intake for kids
AAP recommends:
– 4-6 oz (120-180 mL)/day for 1-6 year olds
– 8-12 oz (240-360 mL)/day > 6 year olds
Seach et al, Int J Obes, 34(10)1475-9, 2010
Tips to help with Balanced Eating
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Provide Structure
Eat at a table with no screen on
Have family meals more often
Make meal time enjoyable and fun
Involve kids
Encourage variety
Healthy plate
Allow treats
Limit eating out to 1x/week
Role model
Physical Activity
• Is movement that increases our heart rate and our
breathing – and requires muscles to use energy.
Physical Activity: Its Rewards
• Enhances healthy growth and development
• Promotes coordination and balance
• Improved sleep
• Increased concentration
• Better academic scores
• Improved self esteem
• Learn social skills – cooperation, teamwork, listening
Physical Activity Guidelines
Children 5-11 years
www.csep.ca/CMFiles/Guidelines/CSEP-InfoSheets-child-ENG.pdf
Intensity Talk
5-6
1
10
7-8
1
10
www.csep.ca/CMFiles/Guidelines/CSEP-InfoSheets-child-ENG.pdf
Sedentary Behaviour Guidelines
www.csep.ca/CMFiles/Guidelines/CSEP-InfoSheets-ENG-Children%20FINAL.pdf
Screen Time
• Children and screen time:
 6 hrs/day on weekdays
 7 hrs/day on weekend days*
• In 1971, average age a child started watching TV
was 4 years; today, it is 5 months**
• Canadian children spent 62% of their waking hours
being sedentary***
Leaves little time to be active!
*2010 Active Healthy Kids Canada Report Card
**Zimmerman et al. Arch Pediatr Adolesc Med. 2007
***CSEP Sedentary Behaviour Guidelines
We tell our children to be active…
But have we forgotten that in order for kids to be
active, it needs to be easy and natural for them?
What can parents do to
increase Physical Activity
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Start early in life
Role modeling
Balance screen time with active time
Variety
Dress for success
Schedule It!
Tips to Tame the Screen
• Set basic rules & weekly plans
– e.g. no screen time before homework or chores are done
– e.g. let your child choose 2 shows or computer/video games they
can watch/play each day
• No watching TV, playing with ipod during mealtimes
• Choose specific shows to watch – avoid TV on as
constant background
• Share expectations with caregivers
Childhood Obesity Resource: Obesity Society
Participation www.participation.com
Sleep Hygiene
The promotion of regular sleep
Age
Newborns (1-2 mo.)
Infants (3-11 mo.)
Toddlers (1-3 yrs)
Sleep Needs (Per 24 Hour Period)
10.5-18 hours
9-12 hours at night +
0.5 – 2 hour naps, 1-4x per day
12-14 hours
Pre-schoolers (3-5 yrs) 11-13 hours
School-aged Children 10-11 hours
(5-12 yrs)
Teenagers (12-17 yrs)
8.5-9.25 hours
Adapted from Early childhood obesity prevention policies. Institute of Medicine. 2011
Sleep Hygiene: Tips for Promoting Sleep
• Create environments that ensure restful sleep
No screen/media where children sleep
 Low noise and light levels
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• Create a bedtime routine
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Relaxing activities & tasks before bed
E.g. Bath
Brush teeth
Story/Quiet Time
Lights out
Routine, Routine, Routine!
Going beyond Health Behaviours:
Emotional Health
• We want kids to feel good about
themselves
• What is Body Image?
– How we think and feel about our bodies
– How we treat our bodies
– It is a core component of Self Esteem for people of all ages,
including kids
Body Image: Where does it come from?
Influences:
• Family – what we say & do, how we treat our own bodies
• Friends & Peers – group norms,
• Community and culture – school climate, community
celebration of diversity
• The media – a powerful influence & pressure on our youth today
– Body image messages are ever present and typically state:
• Thin women are beautiful, successful, and happy
• Muscular men are handsome and successful
Women: The Thin Ideal
Men: Muscle, Muscle, Muscle………
Educate children and youth
about how societies “image” of
ideal beauty changes across
the years.
It’s not just teens and adults
The Media also Sends Messages about Nutrition
Our kids are being targeted
by a powerful machine
Mixed Messages in
the Media around
Food
Putting It all together: The Balancing Act
6-9 Year Olds
• Kids are NOT mini adults
– They are concrete thinkers
– They have not developed insight or good self-regulation (“I am
tired so I think I will go to bed now”)
• Our messages to them need to be tailored to
their level of understanding
• Kids LOVE structure
Putting It all together: The Balancing Act
• Kids need to move but they also need downtime
• We don’t want to over-schedule our kids
• Time to recharge
• Learning emotion regulation and self-soothing skills
• Unstructured Play is just as important as structured play
– Fosters creativity and social development
– Self determination
• Schedule in downtime and unstructured play as you would
structured activities.
Talking to Kids about Nutrition, Physical
Activity and Health
• Remember Kids often think in Black & White
– Place the key on BALANCE
– Avoid referring to foods or activities as being
either “good” or “bad”
– Focus on the positive – kids respond to positive
reinforcement more than to punishment
Make the Switch
Promoting Health
Nutrition Colourful plates
All FOODS FIT
Messages to Avoid
Labelling foods as “good”
or “bad”
Counting calories, fat, etc.
Physical Activity is… Physical Activity to “work
Physical  For fun,
off” food
Activity  To connect with
Physical Activity to change
friends & family
body shape
 To feel good
Make the Switch: Positive Body Image
Don’t…
• Keep glossy diet fitness & fashion magazines around
• Criticize your own appearance or clothes in front of children
• Comment on child’s weight/shape
Do…
• Teach children to be critical of the media & its messages
• Focus on the Instrumental, not the Ornamental
• Provide Opportunities to build self-esteem
We Need to Walk the Walk:
Parents as Role Models
• Our own health behaviors
– Engage in activity yourself and limit your own screen
time
• Make Family time Active time
• Start with Small Changes & build routine
– Walk to school (even if only part of the way) with your
kids
– A Saturday walk and then a movie
• Work at Consistency