Their eyes are bigger than their stomachs

Killing the fast-food monster

Everywhere we turn, we’re being assaulted with messages to "Super Size" or "Biggie Size." There’s a quick, easy secret here: You and your patients don’t have to buy it.

Yes, fast food is easy. It’s cheap, too. In fact, Chicago-based Northwestern University weight control expert Robert Kushner, MD, says never in human history has food been so plentiful and so cheap. He’s quick to add that never before in human history have we been so harried and so involved in so many tasks that we haven’t got a moment to breathe. And consequently, never before in human history have so many of our patients and their children been so fat.

Here are some mind-boggling numbers:

  • Children ages 4-6 should eat no more than 1,800 calories a day.
  • Children ages 7-10 should eat no more than 2,000 calories a day.
  • In reality, the average 8-year-old eats about 2,700 calories; a third more than he or she should.
  • This could mean a weight gain of 10-20 pounds a year — more if the child is sedentary.

You can see where this is going: By the time a child is 14, he or she could be in serious trouble.

Where’s it coming from? First, let’s put Ronald McDonald on the hot seat, just as an example. But Ronald is not alone: All fast food falls into similar categories.

Picture this: Mom is driving down the street after picking up the kids from after-school activities. It’s already 6 p.m. because she got stuck in a traffic jam on the way home. She’s tired. She’s stressed. The kids are wired and wrestling in the back seat when one of them spies the beckoning Golden Arches. In unison, they begin to chant "McDonald’s! McDonald’s!" Having reached her limit and thinking how nice it would be to get out of cooking dinner, Mom relents. Loaded down with an armload of Happy Meals and soft drinks, she sinks into a booth with a sigh of relief.

What has just happened?

First, the kids have done what they are conditioned to do by endless television commercials: Apply pressure on parents for high-fat foods with the enticement of a cheap, Happy Meal toy.

Here’s what they have in their boxes with the cheesy plastic toys:

  • hamburger: 260 calories, 13 g of fat, 30 mg of cholesterol, and 34 g of carbohydrates;
  • small fries: 210 calories, 25 g of fat, no cholesterol, 68 g of carbohydrates;
  • small Coke: 100 calories, 27 g carbohydrates.

But what are the nutritional numbers in that Happy Meal?

  • 570 calories;
  • 38 g of fat — more than two-thirds of the daily allotment of 50 g;
  • 30 mg of cholesterol;
  • 129 g of carbohydrates — almost half the recommended carbohydrate intake of 300 g a day, and they’re not good quality carbs since a lot come from sugar.

Now this would be fine if the children ate McDonald’s for dinner and nothing but rabbit food the rest of the day, but it’s likely that’s not the case. That’s not to speak of what Mom is doing to herself with the even more appalling 1,166 calories, 51 g of fat, and 95 mg of cholesterol she’s sucking down with that quarter-pound cheeseburger, large fries, and 16-ounce Coke.

So what can Mom do? She DOES have options. Here are some:

  • Grit her teeth, yell at the kids, and drive right on by McDonalds. That’s not realistic? OK.
  • Pull in — but not more than once a week. Remember, Mom and Dad are the CEOs of dietary management in the household. Whining will get the kids nowhere. Order burgers for everyone, and sides of salad. If you have to go the soft drink routine, go for diet, although there are dozens of reasons not to do that either. Better yet, persuade them to drink water.

What has been accomplished?

  • burgers — still 260 calories, 13 g of fat, 30 mg of cholesterol, and 34 g of carbs;
  • salad — 100 calories, 6 g of fat, 75 mg cholesterol, and 4 g of carbs;
  • fat-free vinaigrette dressing — 30 calories, 4 g of carbs;
  • diet soft drink — zero of everything.

That cuts the fat by one-half, the carbs by about two-thirds, and the calories by about 40%. The cholesterol is still a little high, but it’s not a problem if this is a rare treat. Congratulations! This is a filling, nutritious meal. Mom and Dad have taken back their power!

(For a list of Centers for Obesity Research and Education locations where primary care physicians and their staffs can receive training in managing weight for all ages, visit: www.uchsc.edu/core.)