Transcription:
Building Healthy Habits as a Family

Caitlin Whyte: You're listening to Children's Health Checkup. Welcome. I'm your host, Caitlin Whyte. Today we're talking about building healthy habits as a family, getting enough sleep exercise, and how to deal with all those screens. Joining us is our expert Otoniel Santiago, Clinical Dietician with the Get Up and Go Program at Children's Health. So tell us about the Get Up and Go Program at Children's Health and how you work as a team to help families build these healthy habits.

Otoniel Santiago: Absolutely. So as you know, our mission in Children's Health is to make life better for children. So one way that we make life better for children is providing the Get Up and Go Program, which is our umbrella name for the different programs that we have. And I'll share those with you momentarily. So our main program is the weight management program. This is a 10 week program that is free for the entire family. This program is designed to help families learn healthy lifestyle habits. For participating in this program, the families do receive a 20 week free membership to the YMCA because we are also partnered with the YMCA to provide this program to our families. And it serves a family that's English and Spanish. And the age group that we serve for this program is between six through 14. That's our main program, which is called Get Up and Go Weight Management Program.

We also have other programs too, which I spearhead in my team, which are the Type Two Diabetes Prevention Program. This is a program for children who have a family history of type two diabetes. It's a five week program. All of the programs that I'll be talking about are free for families. What we do in this program is we teach families how to use, you know, the important role of nutrition and physical activity and preventing. The age group for this is between six and 14 as well. The other program that we have, we have another one that I spearheaded it's called the Developmental Differences Program. This is a program designed for children with special needs. So if the child has autism, fragile legs, Down syndrome, this is an eight week program. That's also free for the families. And we teach the kids in their families, fundamentals of healthy eating and strategies to improve the child's acceptance of new foods, which is something that these families struggle with.

The age group for this program has between eight through 14. Some of the requirements that we have for this age group or this population is that they must be able to at least communicate some basic needs and wants. They should be able to feel comfortable participating in a group setting with peers, and must be able to participate in at least some form of low impact physical activity. And then lastly, this is our newest program is the Bariatric Program. This is a program for teenagers that are anticipating bariatric surgery, or have already gone through the surgery. So it's pre and post the program it's designed to help kids for six weeks. This is a series of the program, learn techniques to assist them during their weight loss journal. Some of the requirements that we have here also, they must be able to participate in physical activity and they must be referred by a provider in the Children's Health Bariatric Surgical Center. The other three programs that I just discussed, they are provider referred. So it doesn't have to be necessarily the physician.

It could be a dietician, it could be a nurse, a school nurse that can refer the children to the other three programs that I mentioned. But for the Bariatric Program, they must be referred by provider in the Children's Health Bariatric Surgical Center. We also have three ancillary programs that are non physician referred or provider referred. These are the Family Cooking Program. And remember, like I said, these are all under the umbrella of Get Up and Go, Family Cooking Program this program it's a four week program and we teach basic cooking skills. So our kids have to prepare healthy meals, the classes for the entire family. And the ages that we serve in this program are ages nine through 14, due to safety reasons. The other program that we have is called Planting Healthy Habits. This is a two week series and this is where kids learn how, you know, what plants and humans need to grow to be healthy. And the age group that we serve is between seven and 10 for this program.

And lastly, the other program that we have that is an ancillary program to our Get Up and Go weight management program. It's our Healthy Lifestyle After School Program. So this is a more condensed version of our 10 week program. It's provided elementary schools across North Texas in Dallas. And we focus on adopting again, the same concept, which is teaching the children, healthy lifestyle behaviors through nutrition and education programs. And the kids are in between six to 11 due to the fact that most of the kids that we serve in this program are in an elementary school.

Host: Cool. Now, a lot of components factor into building healthy habits. Can you talk about the importance of managing things like screen time and share some ways some families can do that at home?

Otoniel Santiago: Yes. First and foremost, it's important to understand that the, you know, according to the American Academy of child and adolescent psychiatry, children that spend a lot of time in screens are exposed to things that sometimes don't help the child such as violence and risk taking behaviors. There's a negative stereotype, cyber bullying, advertising aimed at children, there's things that happen. And then it can lead to other problems such as sleep problems, lower grades in schools, reading fewer books, less time with the families and friends, obviously weight problems. What goes along with spending too much time on the screen being sedentary. And then they also learn other ways I would say, they spend less time learning other ways to relax and have fun. So very important to bring that up because the American Academy of Pediatrics also recommends children below the age of 18 months. Not to have any screen time for kids 18 months, all the way up to 24, which is about two years old, at least an hour or less.

So as you start listening, the times that I'm providing you for the parents that are listening very important for you, I'm going to be providing you also with strategies that you can do as well to limit that time. For kids three to five, at least one hour and for kids six to 12 or up at least two hours per day. So you can see there that they're already putting that timeframe there. So that way your children can spend more time with you and the household doing other chores or other activities that would present them from being active. Strategies that parents can do. Obviously, everybody has a family it's creating communal screen activities, you know, to possibly engage the children in different ways, you know, breaking down screen times. Participate in regular physical activity with family, you know, going on walks, bike rides, trips to the park, model the type of behavior you want.

Obviously we teach this to our parents. We teach a class that's called division of responsibility, and that has to do with the parents being the model. And they determining the what, when, and where things happen in the household. So those are things that we teach the parents, reinforcing the message by having consistent conversations about appropriate amounts of times of screen time. Again, the biggest thing is monitoring the time on devices via either an app. There are apps available that you can actually set up for your child or use a timer to make sure that and your child is spending the time that they need to on the screen, balancing the exposure by implementing, you know, earn screen time by completing, you know, other like homework, finishing chores. So you can kind of have, or give or take aspect negotiation with your child. The older they get, obviously, you know, as they become teenagers, they become more independent. So you can actually have a better discussion with the teenager or the child as well.

So that way they can do all the things that they're supposed to do, and then they can earn these times. Another thing that parents can do is removing digital devices from the kid's bedroom or shutting them off completely a minimum, at least two hours before bedtime. Another thing that the parents can do is just build a routine, you know, their younger age, you know, and that age group of toddler all the way through eight, 10, 12, sometimes reading a story, telling the kid, you know, brush your teeth at a certain time. They say the bedtime is at eight O'clock start to routine, maybe a seven o'clock in the evening, you know, brush your teeth, get the kids ready to change, turn off devices, and then maybe read a story to the child. Those are things that are, that can be done consistently and will help the child and the parents have a success minimizing time in front of the screen.

Host: Now you mentioned the importance of getting sleep. It's often easier said than done. What are the consequences of not getting enough sleep and how can parents make sure their kids are getting the rest they need?

Otoniel Santiago: You know, sleep is very important. You know, it's our body's chance to heal and restore. It is vital for everything from Lorene stress to improving school performance, right? So when the child has lack of sleep, obviously they perform poorly in class or their focus time is lost for doing tasks that they're asked to do in school and even at home. So if your child is struggling to get enough sleep, you know, that that could be a sign that there's other things going on. You know, sometimes school could be a little bit of pressure for the child, or again, that is something that I already alluded to is that the time that they're spending on the screen time, which we know can affect sleep because of blue light. So we know that blue light does affect sleeping patterns and it also affects eyesight. So it's important to start turning those devices off during that time, at least two hours in advance for the child to get a better sleep. And again, it's creating a bedtime routine, so recommendations that are provided by the American Academy of Pediatrics.

They recommend at least children three to five, they sleep at least 10 to 13 hours. For our kiddos that are in the age group that we serve the most six through 12, at least nine to 12 hours. Now for adults, we already know that it's between seven to nine hours of sleep as you get older, but kids, if you notice that your child is sleeping a little bit longer, it's okay. You know, when they're that age group between six, 12, and maybe a little bit into their teenage years, they may sleep 12 hours or so that's okay because they're still growing and developing, but it's very important for parents to, again, monitor the time that the kids are spending on the screen, you know, whatever time they're spending on the screen, or one way to help develop the tiredness. I would say is taken your child outside to spend some energy, right? Physical activity, the more physical activity that you do can lead to more rest, stress release as well.

And then when nighttime comes around, you know, turning off lights, creating the mood for the body to be present, to going to sleep is very important in this case. So that's the biggest thing I would say for parents is creating a routine, understanding the timeframes between, you know, the age groups, how much time they should sleep and building that routine early, removing or shutting down devices. If that's the case that's causing the child to stay awake. Obviously we know that Sleep is very important because that's when we recover and perform better the next day. So we have more energy to do the things that we're supposed to do. So at least two hours before bedtime, as I mentioned before, for as those limits that you have provided for your child, understanding that depending on their age group, they're going to skip a little bit more hours than others, but it's very important for the parents to monitor what's going on with their child, even when they're teenagers as well. Because that's when we see a lot of them sleep late in the night. And then when they go to school, they're not able to perform as we would like them to do in a school setting or every day at home.

Host: Can you give us some of your best advice on how to establish healthy eating habits?

Otoniel Santiago: Yes. So the biggest thing is just start. That's as simple as I can put it, just, just start, right? Start making small changes, you know, keeping food high in protein in the house, things that kids can grab, like your yogurt, you know, low fat dairy products, vegetables, you know, whole grain foods at home, or, you know, at work or packing, things like that. The main thing is focusing on adding those healthy foods, the kids’ lifestyle or diet, right? That way they can stay away from unhealthy food. That doesn't mean that there will not be the opportunity to enjoy some of the snacks and treats that family enjoy at times. But another thing that can be done is trying to eat as a family, right? Every day in the kitchen and the dining table, this helps the children and the family focus on healthy eating is trying not to point fingers or talk down on the child. If they're not eating a food that you're providing, it's just introducing the child to the food.

And that way they can make a decision, maybe try and they can decide if this is something that they enjoy or not. That's part of the division of responsibility that we teach. Again, one thing that parents can do as well to help their children and maybe buying a healthy recipe book. I'm pretty sure a lot of parents that are listening probably have some form of recipe book that they haven't put out. So I highly suggest take it out, dust it off, blow it out, make a couple of those recipes. You don't have to cook a recipe every day, at least once a week, try something different. So you can start making those small changes as you go, you know, packing healthy lunches, if you work or the child, for school, if they they're allowed to take some form of lunch to school, pack them healthy meals. You know, that way they have more control over the things they eat.

Host: Now I know that exercise is also a big component of the Get Up and Go Program. What are some of your best tips for families on setting exercise goals together?

Otoniel Santiago: Yeah. So the biggest thing that I, that I find that I, cause this is a question that it actually comes up a lot in my classes is, you know, how do I get my kids to be more physically active in other words? Right? So the main thing is choosing activities that fits your child's age and development. If you start there, that makes the process a lot easier, right? Sometimes obviously as parents, I am a parent sometimes we are tired and the kids are full of energy, right? So we got to find ways to still participate with them in that activity. Things that you can do is allowing your child to engage in structured and unstructured activities. So structured activities. Again, if you have your child likes team sports, or they like, for example, jujitsu some form of martial arts, they like basketball or something like that. Put them in a team that way they can. That's more of a structured environment. Now unstructured activities is where you can take your kids to the park or take them outside to the back yard. If you have a trampoline, let them jump on the trampoline.

 

These are things that are unstructured. So the main thing for parents is to, again, start somewhere. Like obviously if you have children, you want to make sure that things are designed or the things that you pick will not be considered boring to your child. Because the main thing is you want to make it fun for the child to participate in the activity. Or sometimes what I suggest parents is, remember when you were a child, what were some games you played as a child, maybe introduce those games for your kids. Maybe they like them. So those are some things that they can do. You know, our children learn, like I mentioned before from us about healthy, active living, you know, again, including your family and physical activity every day, it's what's going to create that routine. And then again, back to setting a goal is maybe, you know, start with walking maybe, right? You know, you can set a goal that you're going to walk maybe twice a week for a certain amount of time or distance, right? So that's a goal that you can set up with your family.

You can take your kid with you if they have a bike and they can follow you on a bike, then have them follow you on the bike, right? So you can find activities that your child will still enjoy taking them outdoor. And obviously we know the situation that we're in now, but as long as you are socially distancing and keeping things in order, you still will be able to participate in these activities. Again, is picking something small, it doesn't have to be something big. You don't have to join a gym to be active. One thing that you can do. Another example that I will provide that I did with my children was I bought balloons. So that's something that I loved as a kid. So I have two, five gallon buckets. I filled them up with water balloons and we just went at it, a little war, but it was fun. So the kids, you know, they're happy, they're enjoying it. You know, they're getting wet at the same time, especially during this time of the summer and spring, you know, for those that live in Texas, right. If the weather gets really hot. So that was a great, you know, and we do that from time to time. So I highly suggest something like that as well.

Host: Do you have any other advice for families who are trying to take control of their health?

Otoniel Santiago: Yes. I go back and I say this again, just start, please just start. The biggest thing is one of the things that we teach in our classes is a principle called 5210, right. So the 5210 is five servings. You know, the five main, at least five servings of fruits and vegetables, two hours or less screen time. Right. Which is what we discussed earlier. An hour or more of physical activity and zero sugary drinks. Those four numbers, if you take a hold of that concept, you can start there. Right. And you can make goals out of those. Right. So, you know, I says at least five servings of fruits and vegetables a day. So an example of that, another thing that we teach is smart goals. Right. Using the acronym smart. So for example, if your goal has to be specific, right? So if you're picking, let's say the five, it has to be specific, but one clear area that you want to change. Right.

So be specific, I'm going to eat, you know, if this is the first time your child is going to start eating broccoli, then introduce broccoli maybe once or twice. So I will eat, for example, I will eat a serving of broccoli twice a week at dinner, so measurable. Right. Can I track it? Right. So that's the measurable, can I track it can be tracked, right? So that's two times a week attainable. Am I trying to take on too much? Right. That's the, the main thing, a lot of people sometimes don't make changes because they take on a lot at the same time, instead of starting small, like I said, just start and start small and start making those changes. So make sure that it's something attainable realistic. Is it possible for you to do what you're trying to do during the current situation that you're in, whatever that may be, right. So it makes sure that life is not going to get in the way in you reaching that goal realistic.

I actually timed, pardon me, set a deadline. Right? So if you're going to eat vegetables for a week, that roughly for that week, you know, twice a week for an entire week, at the end of the week, when you come back for the next week, try a different vegetable, and you can add one more day. So you can do that every week, change vegetable every week, or stick to the same goal, as long as you at least get the child or yourself to eat the broccoli. So those are things that parents and children can do together. I think these are ways that we teach our families. If they stick to the concept of 5210, zero sugary drinks, which is huge, the one hour or more physical activity, two hours or less screen time, and at least five servings of fruits, vegetables per day minimum. So you can start there.

Host: Well, thank you for your time and expertise auto. That was Otoniel Santiago, clinical dietician with the Get Up and Go Program at Children's Health. Find more information on developing healthy family habits at children's.com/healthyweight. This has been Children's Health Checkup. I'm Caitlin Whyte. Thank you for listening.