I decided on the specialty of pediatrics because it is a happy field. Kids get better! Most of the time.You get to know families .Watch children grow and develop into good people. Pediatricians primarily focus on a child's health while they are under our care.  Our goal is to get them through childhood healthy . We specialize in preventive guidance including vaccines, acute and chronic childhood illness, childhood behavior, and childhood safety.

To us childhood health outcomes refer to diseases that we document which begin in childhood.

The diseases which occur after they grow up are a whole other story in a much larger internal medicine textbook . Which generally speaking is not on a pediatrician's bookshelf. The saying “little kids little problems big kids big problems”, assumes the big problems of heart disease, diabetes, cancer, by in large are part of adult medicine and not the venue of pediatricians.

We pay very little attention to a long term healthy lifestyle approach that focuses primarily on life long nutritional excellence. Nutritional health has a very narrow perspective in Pediatrics. We help introduce food, guide parents to the best nutrients for their children to help grow healthy, and avoid obesity. But very few physician's have the type of concentrated lifestyle training in nutritional medicine to have a significant impact on a child’s lifelong health .

Like many other pediatricians, over the years of practicing I had noticed a tremendous increase in the number of overweight children even before childhood obesity and diabetes became a recognized concern. With these observations was a realization that the parenting focus had not been keeping up with the changes in family dynamics namely poor diet, video games, screen time, and parental busy-ness.  I have tried to change this by working with families to make substantial improvements in weight and exercise of overweight children for years. I've instituted many programs and consultations in order to help parents change their children’s eating and exercise habits and lower their weight. I even began a sports and Nutrition Center with a dietitian as well as a psychologist in my office.

But successful nutrition and exercise modification which resulted in lower weight and improved fitness parameters were few and far between. Without meaningful and long term family adoption of change there is little hope to improve the child's weight and health.

      I have had difficulty in getting parents with overweight children to improve their lifestyle and consistently participate in nutrition counseling. It is very challenging to change an unhealthy pattern that has already been established even as young as 2 years of age. Family food habits and cultural tendencies are ingrained early. But as hard as it is for an adult facing health issues to change their habits it is even more complex to change a child's eating and exercise behavior. Try pleading your case and rationalizing with a five year old who has already developed a taste for sweets, fried foods,  fatty meats, and salty foods. Not to mention eating processed snacks at every chance.

The conclusion that is obvious if you have been a pediatrician for any length of time is that if we don't start early with a health and nutrition conscious approach the chances of creating the template for a healthy lifestyle later is difficult .It's important to start from the beginning by developing your child's taste for nutritious food. Food and health values related to diet and exercise have to become a priority just like vaccines, illness prevention, car seats, seat belts, smoking, and home safety. This is not luck of the genetic lottery but a given. If you and your family do not eat healthy and make good nutrition a priority and move regularly ; illness will be part of your child’s life sooner rather than later. Poor nutrition choices will accelerate disease resulting from childhood obesity and poor lifestyle including diabetes, heart disease , hypertension,and cancer.

It’s never too early to start eating healthy . The markers of disease are forming right below the surface attacking your children from an early age.If you start early there is a better chance to prevent poor health and chronic disease before the damage is done. Raising your children healthy is the mindset I try to  promote . Starting early from the beginning by developing tastes for good food is the surest way to help your child lead a healthy life .

Setting the tone for good nutrition early is as important as anything else you're going to do for your child. Most of the parents of my patients worry about all sorts of diseases from autism to cancer  . Everyone is very much on alert for anything wrong with their children especially fever , cough, and developmental problems but a healthy diet is the one thing you can control. It is a gift you can give your child for a good life.

Warren Krantz MD

HealthfulMD

Author of "Start health, Stay healthy"