AAP Voices Blog

When my friend, Natalie Muth, set out to write the AAP Policy statement “The Role of the Pediatrician in the Promotion of Healthy Active Living,” I immediately volunteered to help. Like many of my colleagues in health care, I wound up (maybe subconsciously) in an area of medicine where I have a personal history – obesity care. As a general pediatrician, I feel my role is empowering pediatric primary care providers to be more effective helping their patients and families who struggle on a personal level with this modern-day epidemic.

When you do have a personal connection to a disease, you always run the risk of projecting your experience onto your patients. However, that deep personal experience can sometimes provide a different or more nuanced perspective that others may not have. For me, this paper made me reflect on the role my mother played in helping me achieve a healthier life. She has been gone for more than 20 years now. I wish I had figured out sooner what she did so I could have thanked her more specifically for it. 

I am the youngest of four children, and the older three are very musically talented.  The three of them took a myriad of lessons, had leads in musicals, commanded piano recitals, performed in multiple bands, and filled the house with music. My brother, the next one up from me, can seemingly play any stringed instrument and has a family band that performs at bluegrass festivals and open jam sessions on a regular basis. He has even written original songs for each of his grandchildren. 

Into this family strolls the very loved little brother whose body shape was quite a bit different than the rest of the crew. And somehow, without me realizing it until decades later, my mother cultivated not a skill in music, but a love of swimming. While my accolades were more on the “Coach’s” and “Most Improved Award” level and not the Junior Olympic cut or league champion level, I grew attached to the water. Swimming led to lifeguarding, swimming instruction and comfort with water skiing, canoeing, and rafting. In my adult years, it led to masters’ swimming, triathlons and eventually distance running and cycling. An ongoing love of working out and exercising was also produced. Lastly, swimming connected me to communities whose members encourage and challenge each other.

Never forcing anything, my mother somehow kept me going even though she was not a swimmer. Despite having to manage a household since my father was on the road regularly during the week, she figured out how to get me to every swim meet and practice even when I complained and made it tough on her. As a busy mother who had to make choices, she cultivated something other than music that her youngest child needed more. I think she embodied the gist of this policy statement. 

Parents aren’t there to coerce. They are there, with the help and reinforcement of their family pediatrician, to know each child may need something different. They provide a good example, and they offer support. For many of our patients, this means fostering a love of healthy food, access to fun and sustainable activities, adequate sleep, and strong social bonds. In my life, it made all the difference. Let’s actively look to do the same for our patients.

Here are some concrete examples of promoting active, healthy living that have worked in my practice:

1. Don’t forget the simple statements. Sometimes patients and parents are ready to adopt a healthy habit and a gentle nudge is all they need.
2. Encourage wide sampling of activity. You don’t know if you are a solo or team athlete, if strength or conditioning is your special talent or if you have a better time of day to be active until you try them all out.
3. Strength training can help your patients with obesity shine. Rather than feeling like they can’t keep up with their jack rabbit-built classmates, your patients with obesity will probably rock it in the weight room. Play to their strength (which just happens to be strength).
4. Repetitive eating isn’t all bad. Picky eating, if it is healthy food, is fine. Being a boring, routine eater can often prevent you from making bad on-the-fly choices.
5. Sleep really is important and blue light messes it up. Getting those screens as far away from where you sleep is worth the effort.