Guest: Janet Carter - Registered Dietician
Host: Dr. Linda Austin - Psychiatrist.
Announcer: Welcome to an MUSC Health Podcast.
Dr. Linda Austin: I am Dr. Linda Austin. I am talking today with Janet Carter, who is a Registered Dietician and she is the coordinator for the Heart Program at Children’s Hospital at, Medical University of South Carolina. Janet, let’s talk about exercise especially for kids who are overweight. I would think that this would be an area where, the rich get richer and the poor get poorer, that the kids who are most inclined to be athletic anyway tend to be doing that and they get good at it, and they enjoy doing it, and it is easier because their weight is low, and that the kids who certainly having weight problem tend to shy away from it more and more.
Janet Carter: Right, the kids that are heavy definitely have a problem with moving their bodies because it hurts and it is hard and they have lot of more weight to move around and it is definitely harder for them to breath and move in general.
Dr. Linda Austin: So, where do you start with these kids then?
Janet Carter: Well, I start with them as usually just getting them to at least move their bodies a little bit more than they already are. Lot of my kids are actually ? a lot of the kids in the program are actually pretty activity, but if they are not I just get them to try to move around, get familiar with their body, and feel their body, their muscles, and everything, and do things that they enjoy doing. If they like to walk, go for a walk. If they like ride their bike, go ride their bike. Some kids have trampolines, things like that of course that have all the safety equipment, but whatever they want to do that will help them just move their bodies a little bit more.
Dr. Linda Austin: When you start talking with these kids with weight problems about exercise, what kind of response do you get from them?
Janet Carter: It depends, again a lot of our kids are very active and do have a lot of energy and do enjoy being physically active, but there are certain children that I recommend that they cut back in TV time or things like that. I get the kid that to look like I am crazy basically, but we work on it and they eventually start realizing how much more energy that they will have if they start moving around more, and definitely now during the summer it is little bit easier, so they have although, when very, very hot it is little tough sometime, but lot of the kids like to go in the pool and that was sort of things.
Dr. Linda Austin: Do you recommend that parents restrict computer time or TV time as a reward that they will then get if they have exercised?
Janet Carter: It depends if the kids are not really overdoing with, what I call, screen time, which includes TV, videogames, and computer if they don’t do a lot of screen time during the day then I can be used a reward, say they exercise or play active play for half an hour and then they can may be on the computer for half an hour, but generally I shy away that. I like to have rewards be either gifts or something that is active for the kids. I don’t like to promote sedentary activities.
Dr. Linda Austin: I know that with adults in heart heath the new thinking, the new scientific search points to finding that it actually is much better for your heart to be moving even at low levels throughout the day rather than say one burst, one half hour burst of riding in the morning or something like that is. Is that also true for children?
Janet Carter: Yes, the recommendation are that you get at least a total of at least 30 minutes of physical activity during the day and if that is broken up into the three about of 10 minutes that is perfectly fine, but they do recommend increased activities of daily living, which is an addition to that which would be parking farther away from the store, taking the stairs instead of the elevator and things like that where it just in general you are moving your body more. It is not necessarily exercise per say, but you are moving your body.
Dr. Linda Austin: Now when you work with parents, do you have any strategies for kind of sneaking in extra body movement into their children’s lives?
Janet Carter: A lot of times, I just recommend that the parents do these things with their children, go for walks with their kids. The main thing that I want them to do is make sure that it is fun for the children. Children and even adults will not do physical activity unless they enjoy it at some level. If it is complete torture, it is not going to last. So basically even if the kids are just playing with friends, running around, playing tag, playing in the pool, riding their bikes, riding their scoters, that all very, very healthy for the kids and it does not have to be structured exercise, you know, lets go for a walk, lets go for a run, lets go; it doesn’t have a structured exercise program. It is just getting their bodies to move and getting their heart rate up, getting them sweaty that sort of thing.
Dr. Linda Austin: You have mentioned earlier that children tend to emulate their parents with regard to food, is the same thing true then with exercise?
Janet Carter: Absolutely, if the parents are sedentary a lot of times the kids will be sedentary as well. Obviously they are thinking that’s the way it should be or the way that is normal if their parents are that way. So, if the parents get up, and get moving, and get outside and its basically the same thing with healthy eating habits. If they make it seem it is just a normal way of life then the kids are going to be more likely to understand that it is just what they need to do.
Dr. Linda Austin: What about more structured activities, classes, lessons, teams, etc. do you recommend those?
Janet Carter: Absolutely, I think that is definitely beneficial for the kids to have that structure. Again it is not necessary, but it definitely it can be a positive thing for them to get into structured sports. If they want to do some sort of kids exercise class, Heart Health provides and exercise session on Saturday afternoons for the kids where we do a lot of playing and I like to make sure that the kids learn their different body parts and learn to feel their muscles because lot of times the kids that are heavy don’t really feel their bodies and I know lot of adults don’t either, now you can say flex your bicep and they don’t know what that means or what body part it is. So, I like to get the kids that body awareness.
Dr. Linda Austin: It seems as if over recent years, schools have for various reasons cut back on recess physical activity and physical fitness, etc. I can’t help, but I think that this has contributed to the problem.
Janet Carter: I think it has contributed. A lot of the kids in Heart Health have fayed may be once a week or it may be for half of the year or the quarter year at school and it is really disheartening. I think that we really need to have that with the kids in needs of physical education, and I think that where people just kind of forget that it is a very important part of their education is to learn how to be physically active and I really wish that it would of much larger part of their day then what it is now.
Dr. Linda Austin: When adults go into weight loss programs often times there is monitoring of weight, there may be food journals, there may be exercise journals; there might be calorie counting or carb counting or whatever. Do you do that with teenagers as well?
Janet Carter: Absolutely, I actually deal with kids as young as 10. We talk about keeping tract of their food and even it is not perfect, they bring in their food journal and it is very messy and hard to read, that is okay. I want them to learn how to monitor themselves and we weigh the children every time they come into the clinic, and I think that gives them a sense of accountability, but I also don’t want him to focus to much on that, and talk about it being more for their health then their parents, but we definitely make them accountable, and also I like to teach them to be accountable to themselves because I tell them you are not always going to coming to Heart Health for the rest of your life. You need to learn how to be accountable to you and be your own little bird on your shoulder watching what you are doing.
Dr. Linda Austin: Janet thanks so much for talking with us today.
Janet Carter: Thank you.
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