NewYork-Presbyterian

Pediatric Weight Management Toolkit

“Think happy thoughts and you can fly.”

-Peter Pan

DISCLAIMER: This toolkit was developed for NewYork-Presbyterian Hospital patients. This toolkit is
not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always
seek the advice of your physician or registered dietitian with any questions you may have regarding
a specific medical condition.

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TABLE OF CONTENTS

I. GETTING STARTED…………………………………………………......…3-9

II. MY FOOD ……………………………...……………………………..….10-25

III. MY EXERCISE...……………………….……………………..…………..26-29

IV. EXERCISE AND FOOD LOGS………..………………….…………...…30-31

V. REFERENCES AND RESOURCES………..……………..…………...…32-33

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 GETTING STARTED

You are reading this because you are concerned about your child’s
weight. This toolkit is specially designed for both parents and children.
Small changes now make a BIG difference later!

Today, many children are heavier than they should be and, therefore, are
facing serious health consequences that could last a lifetime. Compared
with a child who is not overweight, an overweight child is much
more likely to become an overweight adult.

As a parent, you have the greatest influence on your child’s diet and
exercise habits. You are making decisions on a daily basis that will
affect your child’s current and future nutrition and health patterns.

You won’t regret your decision to become more active in promoting

healthy eating and lifestyle habits for your children!

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 TIPS TO GET STARTED

1. TALK WITH YOUR CHILD about the importance of a healthy

diet. Remember to talk about health, not about weight.

2. NO DIET PLANS for your child.

Many diets that are popular with adults have never been tested on
children, and a healthy, balanced diet is the goal for children.

3. ALLOW SWEETS IN MODERATION, such as candy and other

snacks. Children who learn the importance of balanced eating will be
better-equipped to manage their own diet as adults.

4. GIVE YOUR CHILD OPTIONS. Focusing only on what he or she

cannot eat does not teach your child to make healthy choices.

5. FOOD IS FOR FEEDING. Do not hold back food as a punishment,

and do not offer food as a reward.

6. ENCOURAGE YOUR CHILD TO BE HEALTHY.

Communicating your interest in his or her health is more effective than
focusing on your child’s weight.

7. STRUCTURE: Have your child sit down, eat a balanced meal, and
then move on to a fun activity. Do not let your child eat in his or her
bedroom or in front of the television, constantly leaving and returning to
the table.

8. PRACTICE WHAT YOU PREACH. If you eat right, it will be

easier to get your child to eat right, as well.

9. PHYSICAL ACTIVITY is important for both you and your child.

Be active with your children, make it a family effort.

10. PROMOTE BETTER NUTRITION by having regular meal and

snack times. Restrict all-day snacking. Set times.

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 “Healthy Bodies Quiz”
Mom, Dad or Guardian: See if you are aware of the facts about
childhood obesity. You play an important role in helping your child
manage his or her weight. See answers on the top of page 32.

1. How much exercise should kids get?

A. At least one hour a week
B. At least three hours a week
C. At least one hour on most days
D. At least three hours on most days

2. A child is at a healthy weight if his or her BMI is:

A. Less than the 5th percentile
B. At the 5th percentile to less than the 85th percentiles
C. at the 85th percentile to less than the 95th percentiles
D. None of the above

3. Foods to avoid when your child is trying to lose weight, stay at a

healthy weight, or simply trying to eat healthy include:
A. Simple sugars
B. High fiber foods
C. Trans-fat
D. Both A. and C

4. For most kids, the best diet to help them lose weight would be:
A. The South Beach Diet
B. The Atkins Diet
C. A high fat diet
D. None of the above

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(Healthy Bodies Quiz, cont’d)
5. The first weight management goal for most overweight kids should
usually be to:
A. Go on a strict diet
B. Exercise for at least three hours a day
C. Not gain any more weight, or at least not gain as quickly
D. Lose 30% of their body weight

6. If your child ate this whole container of Whoppers, how many calories
would she consume?

A. 150
B. 180
C. 360
D. 450

7. Considering the average child, what’s to blame for children being

overweight or obesity?
A. Not enough exercise
B. Extra large portions
C. Too much playing video games and watching TV
D. Too much junk food
E. A combination of all of the above

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 MY COMMITMENT

I ______________________, will try my best to eat healthy, whole

foods every day, to get up and move around every day, and to make
the time to exercise.

Signature_____________________Date_______________

Witness _____________________ Date_______________

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 THE RIGHT WEIGHT FOR ME

Reaching a healthier weight is a balancing act. The secret is learning

how to balance your “energy in” and “energy out” over the long run.

“Energy in” is the calories from the foods and beverages you have each
day. “Energy out” is the calories you burn for basic body functions and
physical activity.

Look at this chart to find where your energy balance is:

Your weight will stay

the same when the
Maintaining weight calories you eat and
drink equal the
calories you burn.

You will lose weight

when the calories you
Losing
eat and drink are less
weight
than the calories you
burn.

You will gain weight

when the calories you
Gaining
eat and drink are
weight
greater than the
calories you burn.

BMI Calculator: Curious to see if your body weight is in the healthy-

for-kids range? Check out this nifty gadget below, simply click on the
Department of Health link:
http://apps.nccd.cdc.gov/dnpabmi/Calculator.aspx

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 HOW MANY CALORIES SHOULD MY CHILD EAT?

MALES FEMALES
Activity Mod. Activity Mod.
Sedentary* Active* Sedentary* Active*
level active* level active*
AGE AGE
2 1000 1000 1000 2 1000 1000 1000
3 1000 1400 1400 3 1000 1200 1400
4 1200 1400 1600 4 1200 1400 1400
5 1200 1400 1600 5 1200 1400 1600
6 1400 1600 1800 6 1200 1400 1600
7 1400 1600 1800 7 1200 1600 1800
8 1400 1600 2000 8 1400 1600 1800
9 1600 1800 2000 9 1400 1600 1800
10 1600 1800 2200 10 1400 1800 2000
11 1800 2000 2200 11 1600 1800 2000
12 1800 2200 2400 12 1600 2000 2200
13 2000 2200 2600 13 1600 2000 2200
14 2000 2400 2800 14 1800 2000 2400
15 2200 2600 3000 15 1800 2000 2400
16 2400 2800 3200 16 1800 2000 2400
17 2400 2800 3200 17 1800 2000 2400
18 2400 2800 3000 18 1800 2000 2400
19-20 2600 2800 3000 19-20 2000 2200 2400
*Calorie levels are based on the Estimated Energy Requirements (EER) and activity levels from the
Institute of Medicine Dietary Reference Intakes Macro nutrients Report, 2002.
SEDENTARY = less than 30 minutes a day of moderate physical activity in addition to daily
activities.
MOD. ACTIVE = at least 30 minutes up to 60 minutes a day of moderate physical activity in
addition to daily activities.
ACTIVE = 60 or more minutes a day of moderate physical activity in addition to daily activities.

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 MY FOOD
What’s on my plate?

Let’s take a look at your plate and see if you have all the food you need!
Grains Vegetables Fruit Group Milk Meat &
Group Group Group Beans
Group

Grains are Vegetables Some fruits are The milk The meats
foods like are foods like apples, pears, group and beans
cereal, bread, broccoli, cantaloupe includes group
spaghetti, carrots, green melon, foods like includes
rice and beans, watermelon, milk, foods like
crackers. potatoes, grapes, and yogurt, hamburgers,
spinach, and blueberries. cheese, ice chicken, fish,
Grains corn. cream and eggs, beans
give you Fruits fight off pudding. and nuts.
energy. Vegetables infections and
help keep help you heal Foods from Foods from
You can tell you healthy when you get the milk the meat and
if something and feeling hurt. group have beans group
is a whole good. calcium, are full of
grain because Fruits are a tasty which protein to
the name You should snack to eat helps to help you
usually has try to eat at every day. grow build strong
the word least one strong muscles.
“whole” in it. dark green bones and
vegetable or healthy
one orange teeth.
vegetable
each day.

Examples: Examples: Examples: Examples: Examples:

POWER X-RAY STRAWBERRY MIGHTY BURLY
PASTA; VISION EXPLOSION; MILK- BEANS,
ENERGIZER CARROTS; BANANA- MAN and CHARMING
OATMEAL TOMATO RUNNER WOMAN; CHICKEN
BUNNY BURSTS; YUMMY
DINOSAUR YOGURT
BROCCOLI
TREES
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 MY SERVINGS

CHILDREN TEENS
AGE 2-8 4-8 9-13 14-18 14-18
Gender GIRLS AND BOYS Females Males

Vegetables 4 5 6 7 8
and Fruit
(1 medium fruit
or vegetable, ½
cup frozen
or canned
vegetables or
fruit, 1 cup raw
vegetable or
fruit)

Grain 3 4 6 6 7
Products
(1 slice bread, ½
bagel, ½ cup
cooked grains,
¼ cup cold
cereal)

Milk and 2 2 3-4 3-4 3-4

Alternatives
(1 cup milk or
soy beverage,
¾ cup yogurt,
1.5 oz cheese)

Meat and 1 1 1-2 2 3

Alternatives
(3 oz meat, 2
eggs, 2 tbsp
peanut or nut
butter, ½ cup
cooked legumes)

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 YOUR TURN: Fill in your own servings

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 CALCIUM AND VITAMIN D
Calcium is so important for growing bones and healthy teeth. To keep
kids healthy, they need 1-3 servings of milk or calcium rich foods.

Ideas for calcium-rich foods at each meal:

Breakfast Lunch Snack Dinner
Pour low-fat or Add low-fat or Make a smoothie Make a salad
fat-free milk over fat-free cheese to with fruit, ice, with dark green,
your breakfast a sandwich. and low-fat or leafy vegetables.
cereal. fat-free milk.
Have a glass of Serve broccoli or
Have a cup of low-fat or fat-free Try flavored low- cooked, dry beans
low-fat or fat-free milk instead of fat or fat-free as a side dish.
yogurt. soda. milk such as
chocolate or Top salads,
Drink a glass of Have pizza or strawberry. soups, and stews
orange juice with macaroni and with low-fat
added calcium. cheese. Have a low-fat or shredded cheese.
fat-free frozen
Add low-fat or Add low-fat or yogurt. Toss tofu with
fat-free milk fat-free milk added calcium
instead of water instead of water Try some into stir fry and
to oatmeal and to tomato soup. pudding made other dishes.
hot cereal. with low-fat or
fat-free milk.
Dip fruits and
vegetables into
yogurt.

Have some low-

fat or fat-free
string cheese.

Adapted from Nourish Interactive

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 SNACK IDEAS
Snacks are very healthy to give extra energy between meals. Here is a
list of some snacks that you can prepare with your child!
ʼ Peel a banana and dip it in ʼ Toast a whole grain waffle and
yogurt. Roll in crushed cereal and top with low-fat yogurt and sliced
freeze. peaches.
ʼ Spread celery sticks with peanut ʼ Spread peanut butter on apple
butter or low-fat cream cheese. slices.
Top with raisins.
ʼ Stuff a whole-grain pita pocket ʼ Sprinkle grated Monterey Jack
with ricotta cheese and Granny cheese over a corn tortilla; fold in
Smith apple slices. Add a dash of half and microwave for twenty
cinnamon. seconds. Top with salsa.
ʼ Mix ready-to-eat cereal, dried ʼ Toss dried cranberries and
fruit and nuts in a sandwich bag for chopped walnuts in instant
an on-the-go snack. oatmeal. Mix together peanut
butter and cornflakes in a bowl.
Shape into balls and roll in crushed
graham crackers (trans-fat free).

ʼ Smear a scoop of low-fat frozen ʼ Spread mustard on a flour

yogurt on two graham crackers
(trans-fat free) and add sliced
banana to make a yummy
sandwich.
ʼ Top low-fat vanilla yogurt with
crunchy low-fat granola and
sprinkle with blueberries.
ʼ Microwave a small baked
potato. Top with reduced-fat
cheddar cheese and salsa.
ʼ Make snack kabobs. Put cubes
of low-fat cheese and grapes on
pretzel sticks.
tortilla. Top with a slice of turkey
or ham, low-fat cheese and lettuce.
Then roll it up.
ʼ Mini Pizza: Toast an English
muffin, drizzle with pizza sauce
and sprinkle with low-fat
mozzarella cheese.
ʼ Parfait: Layer vanilla yogurt and
mandarin oranges or blueberries
ʼ Inside-Out Sandwich: Spread
mustard on a slice of deli turkey.
Wrap around a sesame breadstick.

Source: American Dietetic Association

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 WHAT’S A SERVING?

Drink one glass of delicious low-fat milk every morning and

you’re on your way.

A ½ cup of cooked vegetables equals one serving.

Just a ½ cup of canned unsweetened pineapple or any other fruit

counts as one serving.

A whole carrot or a handful of baby carrots counts as one serving!

Count one piece of fresh fruit as one serving.

One cup of salad counts as one serving! A medium salad is 2

servings and a large salad makes 3 servings!

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 SET YOUR GOAL

Be a Fruit and Vegetable Kid!

These kids eat 5 to 9 servings of fruits and veggies every day. Think
about the fruits and veggies you like to eat, and then set a goal to become
a Healthy Kid.

How many servings of fruits and vegetables have you had today?

If you haven’t eaten any fruits or veggies so far today, now is the best
time to start!

That’s a start, try to eat at least 4 more fruits and vegetables today.

You’re on your way to 5 servings. Try to eat at least 3 more fruits and
vegetables today!

You’re more than halfway there! Try to eat at least 2 more fruits and
vegetables today!

You’re almost there! Just eat at least one more fruit or vegetable today!

You reached your goal! You’re a Healthy Kid! Hoo-Ray!

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23
 KIDS’ COOKBOOK

Spunky Vegetable Pizza

Ingredients Directions Nutritional
Preheat the oven to Information
¾ cup pizza sauce 450°F. Per Serving: 235
1 large pizza shell Spoon pizza sauce on calories, 13g protein,
1 cup chopped pizza shell. 8g fat (2g sat.), 29g
broccoli carbohydrate, 568mg
Put pizza shell on a
1 cup shredded carrots sodium, 15mg
cookie sheet.
½ cup sliced red or cholesterol
green bell pepper Arrange vegetables
5 to 6 ounces, over sauce.
shredded, low-fat Sprinkle on the
mozzarella or cheddar cheese.
cheese Bake for 10 minutes.
When baked, cool
pizza for 3 minutes
before slicing. Cut into
8 wedges.

Fruity Breakfast Parfait

Ingredients Directions Nutritional
In glasses, layer Information
2 cups chopped fresh pineapple, Per Serving: 258
pineapple raspberries, yogurt, calories, 6g protein, 5g
1 cup frozen raspberries, banana, and dates. fat (1g sat.), 47g
thawed Sprinkle the top carbohydrate, 43mg
1 cup low-fat vanilla with almonds. sodium, 3mg cholesterol
yogurt
1 firm, medium banana,
peeled and sliced
1/3 cup chopped dates
¼ cup sliced almonds,
toasted

www.dole5aday.com

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(Kids Cookbook, cont’d)
Crispy Winter Vegetable Salad
Ingredients Directions
4 cups broccoli florets
2 large carrots, peeled
and sliced thin
1 large red bell pepper,
seeded and sliced thin
1 bunch radishes, cut in
half
2 stalks celery, sliced
thin
1 bottle (8-ounce) fat-
free salad dressing
1 bag (1 pound) salad
Pineapple Gazpacho
Ingredients Directions
3 cups chunked pineapple,
divided
1 medium cucumber,
peeled, seeded and
chopped, divided
1 cup chopped yellow bell
pepper, divided
2/3 cup chopped red
onion, divided
1-1/4 cup pineapple juice
2 tablespoons fat-free
salad dressing
2 tablespoons granulated
sucralose sweetener or
sugar
2 tablespoons chopped
cilantro
1 tablespoon chopped
jalapeno chilies
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Nutritional
Combine Information
broccoli, carrots, red Per Serving: 58 calories,
pepper, radishes, 1g protein, 0g fat (0g
and celery with sat.), 12g carbohydrate,
salad dressing; toss. 34mg sodium, no
Cover with plastic cholesterol
wrap and refrigerate
for at least 15
minutes.
Toss with salad
mix before serving.
Combine 1 cup
pineapple chunks,
1/2 cup cucumber,
1/2 cup bell pepper
and 1/3 cup onion in
medium bowl; set
aside.
Combine
Nutritional
pineapple juice, Information
dressing, sweetener,
106 calories, 2 g fat (0
cilantro, chilies and g sat.), 0 mg
remaining pineapple
cholesterol, 102 mg
chunks, cucumber,
sodium, 23 g
bell pepper, and
onion in blender or
carbohydrate (2 g dietary
food processor. fiber, 18 g sugars), 1g
Protein, 7% Vitamin A,
Cover; blend until
105% Vitamin C, 3%
smooth. Stir into
Calcium, 4% Iron, 8%
reserved pineapple
Potassium, 7% Folate
mixture.
Cover and
refrigerate 2 hours or
until chilled. Serve.
 MY EXERCISE

Be a Fit Kid

Fit Kids feel good, have lots of energy, and grow up healthy and strong.
It’s really easy - just 30 minutes a day! Fit Kids are physically active
every day. It doesn't matter what you do, you just gotta move! Being a
Fit Kid also means eating 5-9 servings of fruits and vegetables every day,
so be sure to eat your fruits and vegetables, just like us.

What does physical activity do for my body?

Physical activity gets lots of oxygen to your brain, so you can think
clearly and do your best.

Running, walking, and biking keep your heart strong. A happy, healthy
heart pumps blood and oxygen from your head to your toes

Being active also gives your skin a healthy glow.

Being active outside and breathing all that fresh air, keeps your lungs in
perfect shape.

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Physical activity builds strong muscles and bones. It keeps you in shape
and at a healthy weight.

Fun Fitness Activities

On your own:
 Ride your bike through the park or around the neighborhood
 Take your dog for a brisk walk
 Shoot some hoops
 Practice tennis shots against a backstop
 Hit a bucket of golf balls at the driving range
 Turn on the radio and dance around
 Ride a stationary bike or walk on the treadmill
 Walk around the house while you talk on the phone

With a Friend:
 Enjoy a hike together at a park
 Play a round of golf and carry your clubs
 Try something new, yoga, line-dancing, kayaking
 Take an active vacation, canoeing, mountain biking, hiking

With Your Parents:

 Play catch, Frisbee or kick a soccer ball around in the yard
 Splash or swim in the pool
 Jump rope
 Play hopscotch or run through the sprinkler
 Plant a garden

Adapted from www.dole5aday.com and www.allkids.org

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 FUN WAYS TO STAY ACTIVE AND FIT!

Run like a gorilla Walk like a spider Hop like a bunny

Stretch like a cat Have family contests: Wheel barrel races

who can jump rope
the longest?

Potato sack races Ice skating party Get up early with your
Bowling party children to walk the
Touch football party dog

Do jumping jacks Take a family walk Go on a family bike

together after dinner after dinner ride through the
neighborhood

Create sidewalk art Fly a kite on a grassy Enjoy a playground at

with chalk and play field or beach a school or a park
hopscotch

Play Duck, Duck, Sledding Bowling Visit a swimming

Goose or London Tag park, Batting cages,
Bridge Hiking Miniature golf

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 EXERCISE LOG
Keeping a log of your exercise will help you see how much you are
moving per day. This is important to know in order to keep your bones
strong and body fit!

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 MY 24-HOUR FOOD DIARY
Try to see if you can log ALL of the foods and drinks you have in
one whole day! Keeping track of what you eat will help keep you
strong and healthy!

Is this a typical day? Please circle one Yes/ No

Time Amount Description of Food or Beverage

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Answer Key to Healthy Bodies Quiz:
7.E
6.D
5.C
4.D
3.D
2.B
1.C
Adapted from http://pediatrics.about.com

References and Resources:

The American Dietetic Association

1-800-366-1655
www.eatright.org

International Food Information Council Foundation

(202) 296-6540
www.ific.org

National Eating Disorders Association

1-800-931-2237
www.nationaleatingdisorders.org

Overeaters Anonymous Headquarters

(505) 891-2664
http://overeatersanonymous.org

President’s Council on Physical Fitness and Sports

(202) 690-9000
www.fitness.gov

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 

CUT THIS COOL

BOOK-MARK OUT!

REMEMBER TO
EAT BREAKFAST:
Having a good breakfast
every morning is what
fit, healthy kids do.

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