DEAR DOCTOR K:

My 12-year-old daughter and 14-year-old son are both overweight. What can I do to help my kids get back to a healthier weight?

DEAR READER:

Some of my patients seem to think that it doesn't matter how much their pre-teen and teenage kids eat, so long as the kids keep growing normally. And by "growing" they're thinking about height, not width. They think that you don't need to watch what you eat until you become an adult. Why? Because that's when the diseases associated with obesity -- heart attacks, strokes, diabetes -- hit you.

But what your children eat can profoundly affect their health as adults. Now is the time to teach your children to make healthy choices. Kids model your actions much more than they follow your spoken advice, especially if they are teenagers. So use this opportunity to get the whole family exercising regularly and eating sensibly.

Here are some specific things you can do to help get your kids back on track:

-- Encourage exercise every day, for at least 15 to 30 minutes.
-- Plan active family outings such as bicycling, walking, hiking and swimming.
-- Limit television, computer and video game time to one hour per day.
-- Switch to low-fat or nonfat milk and reduced-fat cheeses and yogurts.
-- Drink water instead of soda or juice.
-- Limit fried and high-fat foods.
-- Eat at least five servings each day of fruits and vegetables.
-- Serve fruits and vegetables as snacks instead of cookies, chips or ice cream.
-- Avoid high-fat sauces, salad dressings and spreads (such as butter or mayonnaise).
-- Limit how often your family eats in restaurants. When eating out, choose lower-fat items, such as a grilled chicken sandwich instead of a burger, a salad instead of fries, or pasta with tomato sauce instead of pepperoni pizza.

Being overweight during childhood increases the risk of health problems later in life. That being said, however, you should never severely cut back your child's calories. Even children who are overweight need three well-balanced meals and one or two nutritious snacks each day. They need to have enough energy to learn, play and grow to their full potential.

Never put your children on a fad diet. These diets may not have the important nutrients children need to develop.

Your kids model their behavior not only on yours, but also on their friends. Their teenage friends probably don't eat healthy. So if you don't eat healthy, the chances that your kids will is small -- no matter what advice you give them.

We have a lot more information on good food choices in our Special Health Report, "Healthy Eating: A Guide to the New Nutrition." You can find out more about it at my website.

(Dr. Komaroff is a physician and professor at Harvard Medical School. Go to his website to send questions and get additional information: www.AskDoctorK.com.)

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