Salon.com > Ayala Laufer-Cahana

Explaining the quirks of childhood BMI

Fri, 18 Jun 2010 17:19:00 +0000

A friend of mine said she has a dumb obesity-related question for me: How can 15 percent of kids be above the 95th percentile?

Let me explain.

My friend’s girls -- like most kids nowadays -- are monitored for obesity as part of their health screening at school. My friend looked at the screening results -- in which BMI is expressed as percentile for age and gender (more on that below) -- gave some thought to the definitions of overweight and obesity, and realized that the math just doesn’t make sense. We’re hearing time and time again that obesity has reached epidemic proportions, and that a third of our kids are overweight, half of these obese. Yet, if overweight in kids is defined as having a BMI above the 85th percentile how can a third of U.S. kids be classified as overweight? If obesity in kids is defined as having a BMI above the 95th percentile how can 15 percent of the kids be obese? There can only be 5 percent above the 95th percentile, right?

It’s not a dumb question at all, so I’d like to devote this post to some really basic concepts in the diagnosis of childhood obesity, and solve this question for those of you wondering if -- as in the imaginary Lake Wobegon of Prairie Home Companion fame -- all kids can be above average.

News flash: Organic food can still make you fat

Mon, 10 May 2010 17:01:00 +0000

A version of this story originally appeared on Dr. Ayala's Open Salon blog.

We like to eat. We especially like indulgent foods: desserts, snacks and tasty treats. We'd love to believe it's OK to heap our plates with foods we perceive as "healthy." Studies have shown time and again that foods perceived as healthy or foods with a health aura drive us -- if only subconsciously -- to eat more. Foods with "low fat" or "low calorie" claims lead to overconsumption of snacks. A study using hidden cameras at Italian restaurants showed that people dipping their bread in olive oil will eat more fat and calories than if they instead spread some butter.

How to help your kids love fruits and vegetables

Mon, 26 Apr 2010 16:27:00 +0000

Although many Americans know they should be eating more fruits and vegetables, only 11 percent actually meet the recommended minimum of five servings a day.

Many parents are worried their kids don't eat enough fruits and veggies, and this concern is actually encouraging. There's no better time to address the issue of good nutrition than in childhood. This is the time when eating habits are formed, and what we do as parents can be a lifelong gift of healthy eating and better overall health for our kids.

I think there are plenty of reasons why many American kids don't jump with joy at the sight of fruits and veggies. For one thing, our country's culinary culture doesn't encourage us to eat produce the way a Mediterranean diet, for example, might. Children are also the target of constant TV advertising: Food and beverage companies spend $2 billion a year marketing mostly unhealthful products to kids. Finally, many families -- especially those that live in low-income areas -- may not have access to tasty, affordable, high-quality produce.

So, what can we do?

A few tips for getting your kids to eat more fruits and vegetables:

Eight early childhood factors that may drive life-long obesity

Mon, 05 Apr 2010 14:06:00 +0000

A version of this post first appeared on Dr. Ayala's Open Salon blog.

It wasn't that long ago when I had newborns -- they're now a tween and teens -- and the unspoken competition between new moms was how well our babies gain weight, how high they plot on the percentile charts and how quickly they outgrow their clothes. Chubby was cute, and -- it's embarrassing to say -- many breastfeeding moms were encouraged by medical personnel to add on some formula if the baby wasn't gaining weight at a remarkable pace.

I was already a pediatrician when I had my first son. I knew better, yet I was still in tears -- like many new moms I found tears weren't hard to come by -- when a well-meaning nurse suggested I might not have enough breast milk, as my baby was on the 25th percentile, and hadn't gained much weight in the previous week. I didn't heed her advice to add formula; I knew that a happy, content baby, who is growing at his own pace, probably needs nothing.

Lactose intolerance do’s and don’ts

Mon, 15 Mar 2010 19:16:00 +0000

A version of this post first appeared on Dr. Ayala's Open Salon blog.

Are most Americans lactose intolerant? Do all dairy products contain lactose? How critical is it to stick to a lactose-free diet?

Although most of us know someone who is lactose intolerant, and "lactose intolerance" frequently comes up in health-related conversations, there are many myths and misconceptions regarding this common digestive issue. I’d like to take a look at this malady and at the findings of a recent National Institutes of Health (NIH) consensus conference on lactose intolerance, where experts in many medical fields pored over the relevant medical literature, discussed findings and developed a state-of-the-science statement that includes a few surprises.

(This post is about the common form of lactose intolerance -- primary lactose intolerance -- and is not about lactose intolerance that arises from illness or intestinal injury, or the rare cases of babies born unable to digest lactose.)

America’s school lunch disaster

Tue, 16 Feb 2010 18:01:00 +0000

A version of this post first appeared on Dr. Ayala's Open Salon blog

School food received some major media attention in the past week.

Michelle Obama launched the Let’s Move anti-obesity campaign last Tuesday, with improving school food as a major program cornerstone. Congress will reauthorize the Childhood Nutrition Act this year—with some planned overhauls and budget proposals underway. And the Obama administration wants Congress to remove sugary snacks and drinks from school vending machines.

Say what? The federal government is trying to limit big food’s footprint in our schools?

If Agriculture Secretary Tom Vilsack gets his way, he intends to do just that: "Food served in vending machines and the a la carte line shouldn't undermine our efforts to enhance the health of the school environment," he said.

A short introduction to school food

10 cooking tips for great flavor with less salt

Mon, 08 Feb 2010 20:30:00 +0000

Following up on her post last week on the medical science behind our salt consumption, Dr. Ayala Laufer-Cahana offers tips on how to easily avoid much of the sodium we unwittingly take in, and on how to boost flavor in your cooking without foregoing salt entirely. A version of this story first appeared on Dr. Ayala.

We consume, to our detriment, two-to-three times our recommended daily upper limit of salt. The bulk of this excess intake comes unnoticed and hidden in processed and restaurant (especially fast-food restaurant) foods.

The best way to deal with our salt overload is to minimize highly processed foods in our diet. (To be honest, if salt were the only issue with these highly processed foods I wouldn’t get so excited. Not everyone becomes hypertensive, and not every hypertensive person is sensitive to salt, but it so happens that salt is just one more reason, among dozens, to move on from processed foods.)

Salt to taste: A doctor’s take on sodium intake

Tue, 02 Feb 2010 18:01:00 +0000

Following up on my post a couple of weeks ago defending the use of salt at home -- ironically in support of campaigns to reduce our sodium intake -- we present a post by Ayala Laufer-Cahana, M.D., elaborating on the medical science on the matter. A version of this story first appeared on her Open Salon blog. -- Francis Lam

Salt runs in the veins of language. There are reminders everywhere of salt's former glory. The word "salary" is derived from salt (Roman soldiers were paid in salt), and salt is at the root of "sauce," "salsa" and "salad."

Ancient wars were waged over the control of salt.

Today, a modern war on salt -- salt reduction -- is looming in the horizon. And for good reason.

While salt is a dietary mineral we can't live without, most of us take in two or three times the daily recommended upper limit of salt. Extra salt is typically sneaking into our meals unnoticed through processed and restaurant foods -- and too much salt threatens the health of many people.