Studies show that parents who engage in healthier eating and activity habits are more likely to have children who mimic these behaviors as they grow into adulthood. So, to get our children to develop healthier eating and activity behaviors, parents must first engage in these behaviors themselves.

When the balance of food intake and physical activity is disrupted, children gain excess weight and once children become overweight, their ability to self-regulate food intake may be altered and additional regulation or monitoring of food selection and quantities eaten may be needed.

Parents can shape their child's food preferences and eating behaviors by making sure healthier options are readily available. For example, remove chips, cookies and candy from the cupboards and have fresh fruit or cut up vegetable sticks readily available and visible so that when children are hungry for a snack, their only option is a healthy one. The same process works to decrease sedentary time.

Studies show that children with a TV in their bedroom spend an extra 1.5 hours per day watching TV than children who don't. Removing the TV from the bedroom reduces screen time and frees up time for more physical activity. Parents who are physically active and who include their children in these activities, can inspire a love of physical activity, games, being outdoors and play with others. Involving your child in Special Olympics can provide ample physical activity and healthy nutrition opportunities. And by adjusting the home environment, parents can shape their child's behaviors, reduce temptations, and create a health-inducing space where good habits are formed for life.

However, certain behaviors can create negative effects. Encouraging children to clean their plate, whether they are hungry or full, teaches them to ignore their internal satiety cues leading to overeating and loss of self-regulatory ability regarding food intake. Prompting or encouraging children to eat may result in increased eating time and caloric intake. Allowing children to internally regulate their intake and stop eating when they are full may be beneficial. Once children become overweight, their ability to self-regulate intake may be altered and additional regulation or monitoring of how much and what they eat may be necessary.

Equally detrimental is criticizing a child's weight, body shape and food choices. Afterall, when the environment supports health, and when parents and siblings practice healthy behaviors, everyone benefits. Instead of commenting, it's far better to role model health food and activity choices and stock your kitchen with healthy foods and beverages, making the healthy choice the easiest choice for everyone in your family.•

ABOUT THE AUTHOR:

ESTABLISHING HABITS : PEDIATRIC WAIST TO HEIGHT RATIO RESOURCES AND READINGS

NIH NATIONAL LIBRARY OF MEDICINE

Waist-to-height ratio as a risk marker for metabolic syndrome in childhood. A meta-analysis pubmed.ncbi.nlm.nih.gov/29700992

Body mass index classification misses to identify children with an elevated waist-to-height ratio at 5 years of age pubmed.ncbi.nlm.nih.gov/30287892

An exploratory study of the association between physical activity, cardiovascular fitness and body size in children with Down syndrome pubmed.ncbi.nlm.nih.gov/26366976

NATIONAL CENTER FOR BIOTECHNOLOGY INFORMATION

Waist-to-height ratio index or the prediction of overweight in children ncbi.nlm.nih.gov/pmc/articles/PMC5849367

AMERICAN ACADEMY OF PEDIATRICS

Recent Trends in Waist Circumference and Waist-Height Ratio Among US Children and Adolescents

https://pediatrics.aappublications.org/content/118/5/e1390

Cardiometabolic Risk and Body Composition in Youth With Down Syndrome publications.aap.org/pediatrics/article/144/2/e20190137/38477/Cardiometabolic- Risk-and-Body-Composition-in-Youth

Screening using Body Mass Index alone may miss every second preschooler with excess abdominal fat springer.com/gb/about-springer/media/research-news/all-english-research- news/screening-using-body-mass-index-alone-may-miss-every-second-preschooler-withexcess-stomach-fat/16131944

SAGE JOURNALS

Are there anthropometric and body composition differences between children with autism spectrum disorder and children with typical development? journals.sagepub.com/doi/abs/10.1177/1362361320987724