The following message comes from the National Institutes of Health.

What is Energy Balance?

Energy is another word for “calories.” Your energy balance is the balance of calories consumed through eating and drinking compared to calories burned through physical activity. What you eat and drink is ENERGY IN. What you burn through physical activity is ENERGY OUT.

Your ENERGY IN and OUT doesn’t have to balance every day. It’s having a balance over time that will help you stay at a healthy weight for the long term. Children need to balance their energy, too, but they’re also growing and that should be considered as well. Energy balance in children happens when the amount of ENERGY IN and ENERGY OUT supports natural growth without promoting excess weight gain.

That’s why you should take a look at the Estimated Calorie Requirement chart, to get a sense of how many calories (ENERGY IN) you and your family need on a daily basis.

Estimated Calorie Requirements

This calorie requirement chart presents estimated amounts of calories needed to maintain energy balance (and a healthy body weight) for various gender and age groups at three different levels of physical activity. The estimates are rounded to the nearest 200 calories and were determined using an equation from the Institute of Medicine (IOM).

Source: HHS/USDA Dietary Guidelines for Americans: 2005

• These levels are based on Estimated Energy Requirements (EER) from the IOM Dietary Reference Intakes macronutrients report, 2002, calculated by gender, age, and activity level for reference-sized individuals. “Reference size,” as determined by IOM, is based on median height and weight for ages up to age 18 years of age and median height and weight for that height to give a BMI of 21.5 for adult females and 22.5 for adult males.
• Sedentary means a lifestyle that includes only the light physical activity associated with typical day-to-day life.
• Moderately active means a lifestyle that includes physical activity equivalent to walking about 1.5 to 3 miles per day at 3 to 4 miles per hour, in addition to the light physical activity associated with typical day-to-day life.
• Active means a lifestyle that includes physical activity equivalent to walking more than 3 miles per day at 3 to 4 miles per hour, in addition to the light physical activity associated with typical day-to-day life.
• The calorie ranges shown are to accommodate needs of different ages within the group. For children and adolescents, more calories are needed at older ages. For adults, fewer calories are needed at older ages.

Energy Balance in Real Life

Think of it as balancing your “lifestyle budget.” For example, if you know you and your family will be going to a party and may eat more high-calorie foods than normal, then you may wish to eat fewer calories for a few days before so that it balances out. Or, you can increase your physical activity level for the few days before or after the party, so that you can burn off the extra energy.

The same applies to your kids. If they’ll be going to a birthday party and eating cake and ice cream—or other foods high in fat and added sugar—help them balance their calories the day before and/or after by providing ways for them to be more physically active.

Here’s another way of looking at energy balance in real life.

Eating just 150 calories more a day than you burn can lead to an extra 5 pounds over 6 months. That’s a gain of 10 pounds a year. If you don’t want this weight gain to happen, or you want to lose the extra weight, you can either reduce your ENERGY IN or increase your ENERGY OUT. Doing both is the best way to achieve and maintain a healthy body weight.

• Here are some ways to cut 150 calories (ENERGY IN):
  • Drink water instead of a 12-ounce regular soda
  • Order a small serving of French fries instead of a medium , or order a salad with dressing on the side instead
  • Eat an egg-white omelet (with three eggs), instead of whole eggs
  •  Use tuna canned in water (6-ounce can), instead of oil
• Here are some ways to burn 150 calories (ENERGY OUT), in just 30 minutes (for a 150 pound person):
  • Shoot hoops
  • Walk two miles
  • Do yard work (gardening, raking leaves, etc.)
  • Go for a bike ride
  • Dance with your family or friends

If you are the parent or grandparent of a preschooler you’ve got to be thinking no way does my preschooler need structured exercise!

But…the Centers for Disease Control and Prevention asks us to consider the rise in overweight children between the ages of two and five years of age. In the late 1970s, about 5% of children between 2 and 5 years old were overweight. Just recently that figure reached nearly 14%,

The National Association for Sport and Physical Education(NASPE) suggests that preschoolers (ages 3 to 5) spend at least 60 minutes a day in total on structured physical exercise that help a preschooler develop motor skills. Children need daily practice to develop motor skills. Preschoolers need an additional 60 minutes on unstructured physical activities. They should not be engaging in more than 60 minutes at a time in sedentary activities unless they are asleep.

The guidelines for toddlers, 12 to 36 months old, are similar with the exception of structured physical activity adding up to 30 minutes a day rather than 60 minutes.

Parents and grandparents make the best teachers of physical exercise and activities. Try playing the following games to make sure your preschooler or toddle meets his or her daily requirements for physical activities:

• Any kind of tag game
• Catch with balls that are the proper size and weight for size and age
• Water activities such as swimming, water exercises and games
• Riding a tricycle or a scooter
• Crawling activities
• Doing jumping jacks
• Music games and dancing to music
• Playground jungle gym

NASPE offers a  word of caution… it is best to make these daily activities fun or, as our preschoolers get older structured physical activities may become a turnoff.

Another reason to make structured physical activities fun is they are competing with hand-held devices for many a preschooler’s attention.  The problem is hand-held devices and computers are sedentary activities.

It seems that we are always being bombarded with news about the ever-expanding American waistline. There is often a new diet rage to follow. While others go to extremes, many of us, in an effort to lose weight quickly, embrace a low carbohydrate-high protein diet.

The low carb-high protein diet has become popular because of the short-term effects on weight control, but concerns have been raised about the potential cardiovascular effects over the long term. Studies exploring the issue have given mixed results, but three European studies showed a greater risk of cardiovascular mortality with such a diet.

Findings about a Low Carbohydrate-High Protein Diet

If you are on one, or thinking about going on one, please consider the findings of a study that followed young Swedish women over 15+years that was reported online in BMJ (an open-access peer-reviewed medical journal).

• Consuming a low carbohydrate-high protein diet, like the Atkins diet, may be associated with a greater risk of cardiovascular disease in women.
• A low carbohydrate diet implies low consumption of whole-grain foods, fruits, and starchy vegetables. and consequently reduced intake of fiber, vitamins, and minerals. A high protein diet may indicate higher intake of red and processed meat and thus higher intake of iron, cholesterol, and saturated fat. These single factors have previously been linked to a higher risk of major chronic diseases, including cardiovascular disease.
• A healthy diet plan for you needs to be a diet that considers your current health and medical conditions. The place to begin is with a visit to your physician, a physical, and a discussion about an eating plan and exercise tailored to your needs and health.
• When it comes to loosing weight and keeping it off. there are really no quick fixes.  Denying your body the nutrients it needs. over long periods of time will only damage your health.

 The Journal of Obesity reported on recent studies demonstrating that few children and teens pay attention to the nutritional information, especially calories, listed on the menu when ordering in fast food restaurants. They also significantly underestimate the calories in the foods they order, often by 500 or more calories.

 Eating out, for many teens, is about eating what they want with no regard for the effect it has on their weight.

According to the Journal on Obesity, eating fast foods out on a regular basis is part of in the growing problem of obesity in the U.S. Mandatory labeling of calories in foods in restaurants has been proposed as one way to help people make healthier food choices.

New York City was the first city to implement a posting calories requirement in chain restaurants. Now calorie labeling is mandated nationally by the Affordable Care Act. The law requires restaurants with 20 or more locations nationwide to post the calories in each food item either on menu boards or printed menus.

Most of the children  and teens interviewed in the studies, that took place in Boston and in New York City, were not aware of how many calories they needed each day for a healthy diet and what foods were the best choices for meeting their daily intake of calories.

The answer is not that children and teens give  up the fun of eating out in a fast food restaurant, but rather they need to learn how to eat out and keep food choices in line with their calories for the day.

Occasionally eating out at fast food restaurants as a family can be a way to help young children learn about how to use the calorie labeling to make good meal choices. Ordering based on calories and the nutritional value of each food on the menu will hopefully have carry over value to when they are making those choices on their own,  as teens, and eating out with friends.

 Children and teens need to understand the relationship between the calories they consume every day and weight gain.

Soccer Players

The American Academy of Orthopedic Surgeons offers these health tips for soccer players:

• Stay in good physical shape, even in the off-season, with regular exercise and strength training.
• Always warm up and stretch before playing.
• Always cool down and stretch after playing.
• Be sure to drink enough water before and during play.
• Always wear proper safety gear, including shin guards and shoes with ribbed soles or molded cleats.
• When the field is wet, use soccer balls made of synthetic, nonabsorbent materials, instead of leather.

Obese Youth and Gallstones

According to health information from the U.S Dept of Health and Human Services obese youth are an eight times higher risk of gallstones than youth who are not obese.

Young people should only rarely have gallstones. But doctors are treating more teens for the buildup of the hardened cholesterol-laden lumps in the gallbladder. Research finds that the risk of gallstones was higher in obese young people.

At Kaiser Permanente Southern California in Pasadena, research scientist Corinna Koebnick looked at medical records of 766 10- to 19-year-olds with gallstones, “Obese youths have a much higher risk – up to 8 times higher – than their normal-weight counterparts.” Koebnick shared that parents and kids should get together on eating right and being moreactive.

This health study in the Journal of Pediatric Gastroenterology and Nutrition was supported by the National Institutes of Health.