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There is an epidemic of an insidious, chronic, very-hard-to-cure disease in our country.

About 60% of Americans are either overweight or obese. Obesity comes with a high mortality rate as it leads to premature deaths from heart disease and Type II diabetes. And obese people have a high misery rate as well. They may experience painful joints from the strain of carrying excess poundage, difficulty getting jobs, and the indignity of being laughed at or discriminated against.

The best defense against obesity is prevention because losing weight and keeping it off is very difficult. Although genes play a major role in determining who puts on weight, what and how much we eat is paramount.

Fat Land by Greg Critser is a fascinating book outlining the reasons why Americans are so fat. Parents have little control over the agricultural politics and corporate decisions he writes about that have conspired to proffer huge portions of food containing lots of fat and high fructose corn syrup wherever we eat or shop. Hard to stop the advertizing and marketing blitz that lures our kids to fast food establishments. The fact that we spend over 40% of our food dollar eating out and that we often choose fast food restaurants is not going to change. We are all so busy that convenience is the leading factor in our decision about when and where to eat out.

But Critser brings up a troubling point. Our indulgent and individualistic culture has led parents to encourage children to make their own food choices both at home and in restaurants. Plus parents, worryied about the culture of thinness that brings on anorexia and bulemia, are often afraid to tell their kids to eat less. But obesity is the real weight problem in our kids — 25% of Americans under 19 are overweight or obese — while anorexia is much less common. And obesity is very harmful to kid’s health — the number of cases of Type II diabetes is soaring in children and teens.

People like me giving advice to parents have told them to avoid fights over food, to give their children choices at the table, to never nag children about how much they are eating. We also told parents that the child knows best when to stop eating.

Not true. Children on three separate occasions were offered macaroni and cheese in the correct size for age, a slightly larger serving size, and a super-sized one. Three-year-olds ate what they were supposed to, leaving larger portions uneaten. But by age five the children finished whatever tasty food was put in front of them. Plus four randomized studies showed that overweight kids repeatedly advised by their parents to eat less food were not as overweight 10 years later when compared to children who were not given such advice.

I’m changing my tune.

New suggestions for parents:

o It’s OK to tell a child who is eating too much or too often to SLOW DOWN. Tell the child this is for health reasons, not appearance.

o Serve SMALL PORTIONS from the kitchen. If food is on the table in plain view in serving dishes we are more apt to have seconds.

o FORGET ABOUT THE CLEAN PLATE CLUB. Let your kids stop eating when they are full. Don’t ever say, “If you finish your dinner, you get dessert.”

o Make your home a junk food-free zone. No pop or chips or candy on any shelf. None of you need it. If a child asks for chips or candy (“Jason’s mom always has chips!”) tell the kid that in your house when somebody wants that kind of a snack you go out to get it which is better because you get both a snack and an outing.

o Prepare healthy snacks like fruit, veggies, cheese cubes. One useful trick is to put serving size portions in little plastic snack bags so the child doesn’t even think of eating a whole package of cheese.

o At restaurants follow the TAKE-HALF-HOME-PLAN. Most restaurant portions are at least twice what is healthy to eat at one meal. Ask for a container or split an entree. Practice restraint at fast food establishments. It’s OK to let your kids have fries and soda on occasion but order the SMALL size.

o CUT DOWN TV TIME and INCREASE EXERCISE TIME for the entire family. A long family walk provides both exercise and togetherness for all.

o Slow down your own eating. You don’t have to be model-thin which is unhealthy but you can be a good role model for your kids.