In Health Quest, Pediatrician Nabs A Culprit

Neena Satija PhotoThe 10-year-old girl came into Dr. Meredith Williams’ office with unusual neck bumps. Williams quickly determined what that meant: an early sign of obesity.

Later that morning, in came another 10-year-old with a similar problem. “We would love to see her grow a bit taller without gaining too much more weight,” Williams told the child’s mother.

Williams (pictured above) had been telling her visitors that all morning in her office at the Cornell Scott-Hill Health Center on Columbus Avenue.

During that recent morning in her office, almost none of the pediatrician’s conversations with kids or their parents centered around crime, or school performance, or teen pregnancy.

They were more often about juice.

Not just that morning. These days in general.

“I think if we could get rid of all juice on the planet, we would be fine,” Williams said as she filled out her eighth medical chart around 11 a.m.

Williams has been a pediatrician at Hill Health for 16 years. These days, she estimates, at least half her patients are overweight or obese. Nationwide, the rate of childhood obesity is closer to around 20 percent.

Williams called calorie-high drinks like juice and soda a major contributor to the obesity crisis across the country and in New Haven, especially for kids.

“What do you drink at dinner time?” and “What do you drink at school?” are two questions she asks all of her patients at the clinic—whether they come in for a routine physical or for an unscheduled appointment.

Almost all her patients Monday morning answered juice or soda. One exception was 6-year-old Willy Lara, a first-grader at Washington Elementary School in West Haven. Williams has been seeing Willy since he was an infant.

After a number of conversations with parents about keeping their child’s weight down, Williams was looking forward to Willy’s appointment even before she actually saw him. “It’s looking more hopeful,” she said of his health, already noting that his weight seemed to be more on par with his height this year compared to last.

When she walked into Willy’s patient room, she saw that his mother, Fernanda, was also looking considerably slimmer.

“I lost around 50 pounds,” Fernanda Lara boasted. “I eat healthy now. And Willy too.”

“Now you know, kids don’t need sweet stuff,” Williams told her as she wrote on the chart “Mom lost 50#. Doing great!”

As Willy sat on the doctor’s table and fidgeted in his Dr. Seuss hospital gown, his 26-year-old mother and Williams discussed what he was eating and drinking. Only water, said mom; and for breakfast, cereal (the kind without too much sugar, like Cheerios or Kix) and 1 percent milk. For exercise, he bikes and walks with his mom. She attends zumba classes where “they have stuff for kids.”

“I was a little depressed” at the 50 pounds heavier weight, Lara said. “I would only wear sweatpants and watch TV all day.” Finally, her mother—and Williams—intervened. Lara still makes rice, but eats smaller portions. She boils vegetables rather than frying them. She also fits in some exercise almost every day; her son usually comes along.

Washington Elementary sends a menu home regularly for parents to review, Lara said. Her assessment of the food: “So far, so good.”

It isn’t always so easy for other kids and their parents. Cynthia, who’s 10, dances several times a week. But she was still having problems with her weight when she came in for a physical Monday.

When Williams asked Cynthia if she plays outside with her friends, she responded: “I have friends, but they stay inside.”

“I totally understand that hardly any of these kids can go outside” because they live in crime-ridden neighborhoods, Williams said after Cynthia’s appointment. If it wasn’t for dance, she added, Cynthia would have even more of a weight problem.

The lunch she’s eating at Betsy Ross Arts Magnet School in New Haven may not be helping either: Her favorite item on the menu is sweet potato fries.

And the main drink all New Haven Public Schools serve at breakfast?

100 percent juice.

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posted by: Gretchen Pritchard on October 4, 2011  3:06pm

It’s amazing how many calories a juice habit adds to the day—and kind of counter-intuitive because most of us think of real juice as a healthy food. 
I don’t enjoy drinking just water with meals or to quench thirst, and my juice habit was part of why my weight had been slowly rising for 30 years.  There are as many calories in a glass of 100% juice as there are in the same amount of soda.  Of course there are also vitamins and minerals and maybe a little fiber if it’s cider or unstrained orange juice.  But still. 

A large part of my modest weight loss campaign a year ago was achieved simply by cutting my juice 50/50 with seltzer.  I love the fizz and it disguises the sensation that the juice is “watered down.”  I wonder if kids who love soda would enjoy this technique:  replace the totally empty calories in the soda with 50% fruit juice and seltzer, get only half the calories, more vitamins and minerals, and a similar fizzy taste.

posted by: THREEFIFTHS on October 4, 2011  5:35pm

They forgot about the poison lady.Little Debbie Cakes.

Sweet Surrender: A Little Debbie Death Match
Monday, August 10, 2009

posted by: Cristina Rivera on October 5, 2011  4:05pm

I am a Registered Dietitian who works with a pediatric population. In full disclosure, I also consult for food and beverage companies including Coca-Cola, but this in no way influences the counsel I give to my patients every day.  There is no question that as a society we need to take steps towards decreasing the incidence of childhood obesity.  We should educate our children to eat a balanced diet, teach them how to enjoy treats in moderation, and, of course, encourage them to participate in physical activity. I believe this approach is more effective than asking for complete elimination of a food or beverage.

posted by: THREEFIFTHS on October 5, 2011  5:10pm

posted by: Cristina Rivera on October 5, 2011 4:05pm
I am a Registered Dietitian who works with a pediatric population. In full disclosure, I also consult for food and beverage companies including Coca-Cola

How about this full disclosure on Coca-Cola.

posted by: sharon lovett-graff on October 5, 2011  11:01pm

Did you know that New Haven Public School students are not given bottled water, or even water poured from a pitcher into a cup, with their breakfasts or lunches. No water allowed, only milk or juice. Most students don’t like white milk, or are allergic to it. I have watched hundreds of unopened cartons of milk be thrown away each morning at breakfast at local public school, and at lunch because the students don’t want to drink it.  It’s funny, I know that juice is a problem, so is chocolate milk.
Water, no calories! So when will it be included on the lunch menu? Water fountains? Did someone mention water fountains? Yes, the schools have them,  but most often teachers, and paras running the lunch waves at school, don’t allow children to get up from their seats at lunch to drink from the fountains, it’s too disruptive. Can anyone shed some light on the lack of water being offered as a beverage?

posted by: Liz on October 6, 2011  9:52pm

Wait, what’s the neck bump/weight connection? Really puzzled.

posted by: HhE on October 10, 2011  12:43pm

Schools are often the problem.  I worked at one school where the Cafeteria saw junk food as a profit center, and the entire food program was expected to support itself.  Kids could buy an ice cream from a machine (the only robot in a Science, Math, Technology magnet school).  The “snack line moved faster than the regular lunch line, and served things like nachos drowned in “cheese.”  Was it any wonder that so many kids had a weight problem?  The Health teachers tried to fight the good fight, and educate the children, but the Administration cut back Health from something the kids got every year to something they only had in the 8th grade.  (The administration, after two years, eliminated two Health Teacher positions, and tasked the remaining Health Teacher with Public Speaking classes.  Later, the administration got into some trouble with the State since it turns out they were not meeting the State minimums.)

I can understand teachers monitoring an inner city cafeteria, not wanting students to get out of their seats for water.  Maybe each student having their own—reusable—water bottle with them at all times could be the way forward.

Remember the ‘70s?  How many fat kids (what they would have been called then, prePC) where there?  Kids did NOT drink soda.  We had juice, but we also had exercise.  Kids ran around outside.  There were no video games, nor computers. 

It can still be done.  My own children are 50% height, 25% weight.  They occasionally have juice, and some ice pops and ice cream in the summer, but all of these things in moderation.  Outdoor exercise is a regular event, and screen time is a rare treat for rainy days.  Their mother is indoctrinating them in the importance of vegetables.  As parents,m we have to be committed, educated, and good role models.