Kirstin Campbell, M.D. is a pediatrician at St. Louis Children’s Hospital and an Instructor of Pediatrics at Washington University School of Medicine. She received her undergraduate education at the Johns Hopkins University in Baltimore, MD and is a graduate of the Washington University School of... View More

The news is full of stories about fat and obese Americans. People sit around and laugh at lists of cities and states with the heaviest populations. Why? Why is it funny? We are just laughing at ourselves, our neighbors and, sadly, our kids. This is a problem, a major problem. For the child or adult who struggles with excess weight, it is a daily fight for physical health and often emotional health as well.

What many people don’t recognize is that weight issues often start in our very youngest eaters. Our 2, 3, 4 year olds can be taught to eat and drink healthfully, or not. They can gain too much weight, or not. A study in this month’s Pediatrics found that children as young as two who regularly drank sugar sweetened beverages gained weight at a faster rate then children that did not and were more likely to be obese at age 5. What are these kids drinking? One single daily serving of soda, sports drinks (Gatorade, Powerade), fruit like beverages (punch, fruit flavored drinks, anything less then 100% juice), sweet tea, etc. is all it takes to head down the path of unhealthy weight gain.

What do you mean obese? A child is considered to be obese when their Body Mass Index (BMI), a number calculated by their weight related to their height, is found to be more then 95% of all other children in that age. It sounds complicated, but your doctor can easily explain where your child is on a growth curve for their height, weight, and their BMI. You can also ask for a copy to take home. These charts are very useful in helping all members of the family understand what is going on with a child’s growth and nutrition. Most families I have shared these types of graphs with are shocked at what their child is really facing, and thankful for the visual aid. Do not feel bad asking for this!

What about 100% juice? Juice does have some vitamins that kids need, but it also has lots of natural sugar. Fiber and other nutrients lost in the juicing and clarifying process result in concentration of these sugars. Eating a whole or fresh fruit is much better for your child. Pureeing fruit or creating a smoothie type beverage may make a larger variety of fruits enjoyable for your child and does not take away the nutritious value. Be careful of adding excessive amount of sugar to your smoothies. Ripe banana and other whole fruits can help balance the bite of tart berries.

What should my kid drink?

Water: most kids will not drink too much water, and bodies need water, so this is the go to calorie free beverage for tots over 1 yr

Milk: most kids can go right to 2%, 1%, or even skim milk once they are off of formula or breast milk. A 2-5 year old should drink 16 oz (4 small or 2 large glasses) of milk a day and not more then 24 ounces. Chocolate milk may help your child get their Calcium but it contains a lot of extra sugar.

Juices: You don’t need Juice. Go for the whole fruit. 100% fruit smoothies are next best. If you are going for juice try 100% juice from citrus, tomato, or even carrot, and limit your child to 4-6 ounces per day. It is also helpful to include this as part of the meal and not as refreshment between meals.

Avoid all sugar sweetened beverages as well as artificially sweetened beverages. There is no role for these in your child’s good nutrition and can lead to bad habits that are hard to break.

Ok, so my son won’t actually drink the carrot juice straight, but it does work well in smoothies and popsicles. Experiment to find what healthy options work for your family. Leave the sugar at the store and keep that money in your pocket.