Bob Berkowitz will let you eat fast food, but fie on the french fries.
Just because he is director of the University of Pennsylvania’s Weight and Eating Disorder Clinic doesn’t mean Berkowitz is a culinary spoilsport.
To prove it, he sat down to lunch at a McDonald’s in Philadelphia to talk about good nutrition, the clinic’s child-obesity study, our food-obsessed culture–and his favorite dessert.
He ordered a grilled chicken sandwich with no mayonnaise, a garden salad and a diet Coke. We also get a double cheeseburger with bacon, large fries, Coke and apple pie–for comparison’s sake. He nibbles on the chicken, which he says is very good.
Q–Why are children getting fatter?
A–The American food environment is relatively toxic. A high-fat, high-calorie, high-salt meal on a repeated basis is going to get people in trouble. Youngsters are going to go for these (he points to a box of fries the size of a paperback). They take a very good food, a potato, and fry it. These are in the neighborhood of 400 to 500 calories and 50 percent fat.
You have 700 for the hamburger. The apple pie has plenty of hidden fat. It’s in the crust. A regular 12-ounce soda has 140 calories and 9 teaspoons of sugar. That’s about 1,500 calories. Most children shouldn’t be eating more than 2,000 calories in a day.
We say you can go to McDonald’s, but instead of a double cheeseburger with bacon, have a small hamburger. Or this grilled chicken, which is in the neighborhood of 300 calories. They’ll say that doesn’t fill me up. This will fill you up (he points to the salad).
You can still have a good time at McDonald’s. Just don’t eat the fries. They have 14 calories per fry.
Q–How serious is the problem?
A–In the last 15 years, there has been a 30 percent increase in the number of people overweight and obese in this country. Projections are it is going to get worse, not better.
If it were just cosmetic, I wouldn’t be so worried. But what has us worried is cardiovascular disease, heart attacks, stroke, high blood pressure, diabetes. Now we’re seeing Type II diabetes in children. That’s adult-onset diabetes, which in most people is directly related to body weight. A few years ago, I saw my first 300-pound 10-year-old.
In the 1980s, when we started to zoom up was when the remote control came out. All these energy-saving devices, the energy they’re saving is in our bodies.
Q–How do we get children to eat healthier?
A–I think we have to get away from food treats. You don’t see them giving away toys with healthful meals. We have to make food that’s healthy very appealing and very tasty. With a little bit of creativity and ingenuity families can do this.
The country needs to promote healthy eating better. When you look at all the fast-food marketing to children, it’s analogous to tobacco marketing. Super-sizing. Big Gulp. It’s absolute junk food.
It’s one thing if it’s adults, but it’s children. People should have ethical standards when they promote products to children. These are babies chewing on . . . (he looks at the fries).
The fast-food industry says it’s just once in a while, but families are eating out more.
Q–Are parents to blame?
A–I don’t pick on the parents. It’s the whole culture. Are parents responsible for kids’ smoking? I take a much more systems view. Parents can promote healthy living, but kids still live in a world that stimulates unhealthy habits.
Q–Describe the child-obesity study.
A–There are 30 families. It’s funded by the National Institutes for Health. We’re still recruiting for children 13 to 17 years old who are 30 percent overweight (215-898-7314). Half the kids are taking Meridia, a medicine that enhances satiety and increases two chemicals in the brain. One is serotonin and the other is norepinephrine. They work to help induce satiety and in some degree to reduce hunger. It’s FDA-approved for 16 and above. The study is to see if it’s relatively safe and effective in (younger children).
The average weight loss in six months has been 14 pounds. It ranges from a gain of 5 pounds to a loss of 36 pounds. What’s neat is the whole family is involved in the behavior program. Everybody has to change their eating habits and exercise so everybody is going in the same direction.
Despite the frightening epidemic, there are hardly any treatment programs like this. Health insurance doesn’t pay. This study is free. We have a 13-year-old who lost 28 pounds. She looks wonderful. Her mood is so much better. She has so much more confidence. She looks you in the eye. There’s a twinkle in her eye.
Q–Do you practice what you preach?
A–My son (who is 20) will still be found spontaneously eating fruit. It’s really quite a joy. We didn’t have much junk in the house. He had a little outside, an ice cream or a small piece of candy. We lived in California, where fruits and vegetables are wonderful. He loves grapes, he loves oranges.
Living in our culture, he eats his share of fast food, but it’s on his mind. He’ll say I can eat this until my cholesterol level goes up.
Q–Your favorite junk food?
A–I’m a dessert person. It’s probably going to have to do with chocolate. Vanilla ice cream over a thick chocolate brownie, maybe with a touch of whipped cream and, of course, a cherry.
As we get older we tend to put on weight, so I try to walk and eat right. But I try to be sensible about it and not get stressed out about it, be positive and enjoy life. Moderation is what it’s about.
