September 18, 2013

Healthy family habits

Learn how families can integrate healthy practices into their daily lives – promoting healthy behaviors both in the home and at school.

In today’s world, it can be tough to find time to ensure your family is engaging in healthful habits. Family Physician Lucy Douglass, MD, joins us to explain how families can integrate healthy practices into their daily lives — promoting healthy behaviors both in the home and at school. We also hear from high school student Ariana Kemp, who made positive changes for herself and ultimately contributed to the improved overall health of her family.

In today’s world, it can be tough to find time to ensure your family is engaging in healthful habits. Family Physician Lucy Douglass, MD, joins us to explain how families can integrate healthy practices into their daily lives — promoting healthy behaviors both in the home and at school. We also hear from high school student Ariana Kemp, who made positive changes for herself and ultimately contributed to the improved overall health of her family.

Read transcript below.

About the guests
Lucy Douglass, MD, is a family physician formerly with Kaiser Permanente in Portland, Ore.

Ariana Kemp is a family friend of the show’s host, Joyce Gottesfeld, who was wowed by the way the teen helped change the lives of her whole family by making healthier choices.

Episode host
Joyce Gottesfeld, MD, is an OB/GYN with Kaiser Permanente Colorado, where she’s worked 17 years. She’s a wife, proud mother of three girls, runner and blogger.

Learn more
Helpful information and tools for adopting healthy habits — both for yourself and your family — can be found at the following resources on the Web:


DR. GOTTESFELD: Welcome to Total Health Radio. I’m your host, Dr. Joyce Gottesfeld. Joining us today is Dr. Lucy Douglass. She’s a family physician with Kaiser Permanente. She’s got two kids of her own, and she’s here today to talk with us about healthy family habits.

DR. DOUGLASS: Yeah, thanks for having me today.

DR. GOTTESFELD: Dr. Douglass, or Lucy, if that’s okay if I call you Lucy, how does weight become a problem?

DR. DOUGLASS: There’s so many reasons why people get to where they’re at in their weight, but you know, we do live in a hectic lifestyle, and a lot of us are just not eating right and we’re not moving, so I mean it comes down to those two basic things. But how they got there could be mental health. It could be how they were raised. It could be that they have taken on too much in their life. But we all are in the same place in the end, is that we’re eating food that’s not nutritious for us and is, you know, damaging our bodies, and we’re not moving and staying active and keeping our body healthy with activity.

DR. GOTTESFELD: So when you say people aren’t eating healthy, they’re not eating right, can you be specific? What do you mean by that?

DR. DOUGLASS: Well, we’re eating way too much sugar. I mean, I think most of all of this comes down to is sugar and it’s in so many forms and it’s hidden in so many foods that it’s hard sometimes to really call it sugar or to see that it’s sugar, but you know, processed foods, sugary drinks, juices, not enough fruits and vegetables or no fruits and vegetables, not enough fiber, fast food. American diets are pretty lousy.

DR. GOTTESFELD: So okay, eat more fruits and vegetables. Don’t eat all that other stuff. Sounds easy. Why can’t we do it?

DR. DOUGLASS: Well you know, some of it is our food industry and we could sit here and talk about that for an hour. But some of it is cost, too. Sometimes it’s much easier to get a dollar hamburger than it is to make a nutritious meal. So I mean, a lot of parents or families are on budgets and it’s hard to know how to make your dollar stretch in a store and afford a healthy meal. Or they never learned how to cook. You know, a lot of people just don’t know how to make a healthy, home-cooked meal.

DR. GOTTESFELD: You know what, I have three daughters and I don’t know how to cook. It drives me crazy. I mean I guess I’m, they’re alive so I must be feeding them something, but…
DR. DOUGLASS: You must be doing okay.

DR. GOTTESFELD: So you talked about cost, you talked about convenience and those are huge obstacles. So what are some things that families can do, then, to try and overcome these obstacles so that they’re eating more healthy food?

DR. DOUGLASS: Well, in my family, and what I tell my patients is, is I try to, you know, even if you just start with one meal a week, just one healthy meal that is made together a week, you know, research shows that kids who eat meals with their families eat more fruits and vegetables and fewer calories than those who do not. So if you’re making one meal a week, that can be significant. And, you know, I let my kids help in the kitchen. It gets messy. And you have to have some patience. But it really makes them buy into what we’re cooking, you know, if you’re making broccoli and you just plop that on a plate in front of a 2-1/2-year-old, they’re probably not going to be that interested in it. But if you let them wash it and maybe even break it up before you cooked it, they’d be a lot more interested in it. Or we’ll go to the store and I let them choose what we’re going to eat, you know. Choose a vegetable, make it simple, but get them involved in it. And then, you know, we’re really lucky. We have a little bit of, we have some raised beds that we garden and gardening and letting them grow their own foods certainly helps buy into trying new foods.

DR. GOTTESFELD: I know a lot of families where the kids just, they refuse to eat vegetables. I’m thinking of one family and this one mom says, “My daughter doesn’t eat vegetables. She doesn’t eat them. She won’t eat them.” I mean, what do you, you can’t make a child eat, so I’m not sure how we can convince people how to eat these healthy foods.

DR. DOUGLASS: Well, I mean you know everybody’s a little different. We always have a “no thank you” bite. You have to take at least one no thank you bite, so I find about half the time my kids then gobble up the vegetable. So a lot of that helps. I’m not ashamed to say that I’ll put parmesan on broccoli if that makes my child eat it. You know, it’s okay to use some extra fancy ways to sort of be stealthy about your vegetable intake and still get them in. We’ll put vegetables in smoothies and they don’t know it, or put extra vegetables in tomato sauce, you know, that are, you know, sort of hidden. Cauliflower is a great meal vegetable to puree and add to either potatoes, or just eat it as potatoes, or put it in macaroni and cheese, believe it or not. Pureed cauliflower helps, you know, mixes with the cheese and makes it nice and tasty and they’ll gobble that right up.

DR. GOTTESFELD: Yeah. I actually saw a recipe for that once and I have to agree with you. I normally would not touch a cauliflower with a ten-foot pole, but put it in a blender and slap some butter on it, I probably shouldn’t say that.

DR. DOUGLASS: No, it’s great.

DR. GOTTESFELD: Okay. So that sounds good and that’s when your kids are young. So what about teenagers? Because teenagers are legendary for their powers of refusal. So what do you do with a teenager who says, “Yep, I’m not eating my vegetables. Thanks, no thanks. Not doing it”?

DR. DOUGLASS: Yeah, it’s tough. I mean I think the big thing about teens is giving them choices. And again, you know, obviously having meals together is important. Having meals together that have been cooked together that maybe your teen chose, you know. You go to the store and you say, “Well, we’re going to have vegetables for dinner, but it’s your choice.” And giving them any option is going to be a lot better than no vegetable at all. Having them help in the kitchen from a young age really makes a big difference, but you can certainly get teens involved and teens do respond to that. They might, you know, have some push back in the beginning, but if you give them the power, it really makes them want to be interested. And again, gardening or going to the farmer’s market with them, having them sort of look at all the variety of vegetables out there can help a lot.

DR. GOTTESFELD: One of my kids is a teenager, and what I would suggest, also, is all these things that you’ve said about helping in the kitchen and having a garden and having a meal together, start those habits really early when the kids are young, so that when the kids are older, that’s just the way the family operates. And there’s not as much questioning of it. I would say if you’ve been going to McDonald’s every other night and then all of a sudden you try and tell a teen to sit down and eat broccoli, maybe that’s not going to go so well.

DR. DOUGLASS: Yeah, it’s going to be a lot tougher. I agree. You know, we want to start families off in the right foot and as a family physician, I do that. You know, I start with little kids and so that does make my job easier in a lot of ways. But I do get families that have been eating poorly for a long time. One of my favorite things to do is ask them, you know, what’s a typical meal out, ‘cause it’s usually, you know, a fast food meal, and we’ll just sit right on the computer and figure out the calories. And then I’ll ask, you know, “How many calories do you think you should have in a day?” And we sort of look at what is the deficit. I mean, it’s often quite shocking to teens how many calories a meal actually is, and their parents, and how many calories they should be having in a day. And it’s a pretty good way, a good visual for them to see that I’m engaging them in what they’re eating now and what can be changed.

DR. GOTTESFELD: The other piece of this is trying to stay active and getting regular exercise. It’s calories and then the other part of the equation is calories out and burning calories and now that all their homework is done on a laptop, so much of being part of today’s culture is watching different things on television. So a lot of these kids from a young age, and certainly on through the teen years, are sitting in front of a screen and it’s really, really hard to disengage them. Now do you have any tips for families to try and become more active?

DR. DOUGLASS: This is another thing where it’s, you know, start at a young age. But you can change this at any time. I talk to teens all the time about their screen time and we try to work with parents and, you know, parents do need to be ready to make those changes, too, because they can be tough and it can be nice to kind of tune out and just be on screen time. But limiting screen time is a big one. If you’re able, walking to school and walking to the store, or just a walk around the block. But, you know, in a lot of neighborhoods, the store is really not that far, or the school is really not that far. Integrating activity into your daily life as opposed to dedicating an hour every single day at this impossible time to do activity, you’ll have a lot more long-term success if you’re just adding things into your daily routine.

DR. GOTTESFELD: Just getting back to the food issue, do you have any tips for parents on how to make sure that their kids are eating well and have healthy habits while they’re in school?

DR. DOUGLASS: Yeah. That’s a really tough one because you don’t have the control over what’s going into your child’s mouth at school. And I think the biggest thing for a parent is to advocate for healthy class snacks and rewards and parties. So, you know, the big thing is even if they’re having a healthy meal that you packed, if they’re having, you know, sweets for birthday parties and rewards, it can really add up. So, you know, just advocating for non-food prizes or extra recess or an extra activity instead of sweets can make a big difference.

DR. GOTTESFELD: I think like so much of parenting, a lot of what you referred to here really has to do with role modeling as a parent. You know, they always say in parenting that kids will model what you do and not so much what you say. And so a lot of what you talked about here, I think, goes to that. Which is that as a family, you all have to do this together. The kids are going to sort of follow your lead, so it starts with the parents. And I really love your suggestion about eating a meal together. And if you sort of gotten into some bad habits, just get started. Start with one meal a week, cook a healthy meal and at least just get started on the right path. That seemed like a really good suggestion.

DR. DOUGLASS: Yeah. There’s this ideal image of what a mother should be and that we have to do everything right, and we’re going to just destroy our kids if we don’t do everything perfect. And I think sometimes we make these recommendations and they seems so hard to attain for our patients and I always try to make sure those tiny steps, celebrate those tiny steps and those tiny changes because those are what really make a difference in our family.

DR. GOTTESFELD: Dr. Douglass, thank you so much for your insights on this. I think you gave us a lot of helpful hints that we can all start working on and good luck cooking dinner tonight with those little kids of yours.

DR. DOUGLASS: Yeah. Thank you so much. Have a good day.

DR. GOTTESFELD: You, too. Have a great day.

Part II: Ariana Kemp

DR. GOTTESFELD: Joining us now is teenager Ariana Kemp, who is a family friend of mine, and she is here to tell us about her decision to try and get her family a little bit healthier. How are you doing, Ariana?

ARIANA: I’m good. I’m happy to be here. How are you?

DR. GOTTESFELD: I’m doing well. I’m happy to be here with you. So, I remember that our families went on a trip together. And like most family vacations, there was a lot of unhealthy eating. And if I remember correctly, we all came back feeling like we needed to reform ourselves, and then I heard a story about what you tried to help your family do. Can you tell me about that?

ARIANA: Yeah. So there was a lot of unhealthy eating on our trip. We all enjoyed a lot of sweets, and that was great. But afterwards, I know were all feeling a little bit out of shape. And I love to cook; Bon Appétit is one of my favorite magazines. And they do something at the beginning of every year for the month of January called the Food Lover’s Cleanse. And so what it’s all about is using just organic and whole foods and just eating, not dieting, but trying to eat good foods and do it in a gourmet way.

DR. GOTTESFELD: So what are some examples of “good foods”?

ARIANA: Well, there was a lot of whole grains like farro and quinoa and like whole wheat couscous, good things like that, that they substituted for white bread. And they tried to eat a lot of meat that wasn’t fried or cooked in too many fats, like a lot of grilled chicken and just kind of pan seared fish and things like that.

DR. GOTTESFELD: So, I know your family very well, and they love to eat well. So, how did you convince them that they should switch from yummy white bread to quinoa?

ARIANA: Well, it wasn’t easy, but it was a lot of fun, I think, mostly just cooking all of it together. There was a lot more fun in the kitchen doing it together before meal times rather than just having mom or I make dinner and then have everyone eat together.

DR. GOTTESFELD: You have a younger sister, and kids are sort of notorious for not liking the healthier stuff. How did your sister respond?

ARIANA: Well, she was definitely skeptical at first, and she is not a big fish eater, so that wasn’t her favorite part of the plan, but we substituted. She would have chicken on a night when we had fish or something like that. I think the hardest thing for her was the pasta, and she loves pasta. So getting her to eat whole-wheat grains was a little bit more difficult, but there is like whole-wheat pasta that she ate, and that was a good substitute.

DR. GOTTESFELD: So did you talk to her about that? Did you have a conversation about why you wanted to make that switch?

ARIANA: We did a little bit. I mean, we’re both fairly healthy. She, for example, likes fruit a lot more than I do, so that was her favorite part of it which she ate a lot of fruit where I ate fish and whole grains more than she might have. But we talked more about just how we eat, you know, ice cream and things like that when it’s in the house, so we tried not to have it in the house because we both knew that that would be better for the whole eating plan.

DR. GOTTESFELD: That’s very impressive. So, do you do any of the grocery shopping, or do you go grocery shopping with your mom?

ARIANA: Well, sometimes I do, but generally, it’s just her. Recently, we have been going with her a little bit more. My sister enjoys the grocery shopping more now.

DR. GOTTESFELD: So, how has your family done since you instituted this change? Do you think everybody’s sort of kept up with or is it kind of eroding over time?

ARIANA: We’ve definitely faded out a little bit. You know, we do have junk food in the house sometimes, and we like to eat ice cream. But I think, in general, there have been parts of like our family dinners that have just become more healthy. Like last week we did have quinoa as a part of our dinner rather than making pasta to go with our chicken. So little things like that have happened, little changes.

DR. GOTTESFELD: What are some of the other new foods that you’ve tried?

ARIANA: I think the food that I had never heard of before that I’ve enjoyed the most is farro. It’s kind of like a grain, kind of rice/quinoa-like thing, and I really like it. Farro salad is one of my favorite things now.
DR. GOTTESFELD: How do you prepare it?

ARIANA: Well, you have to soak the farro first to kind of let it absorb the water, and then you can boil it similarly to rice. And my favorite thing to do is then to grill like zucchini, peppers, and onions, chop them up, and add it together to make a salad.

DR. GOTTESFELD: Okay. Clearly, you need to come to my house and make dinner. It seems to me just from talking to you about this that the key to getting a family to eat healthy is for each member of the family has to be on board with this idea of eating healthy because if you start to have one person, especially if it’s a parent, say, you know, “I don’t want to eat that stuff,” I think you’re in trouble.

ARIANA: That’s true, yeah. It can be difficult to get everybody on board, but I think as long as every member of the family is keeping an open mind, that makes it much easier to try and make the healthier transition.

DR. GOTTESFELD: How did you feel after you made this change to try and eat healthier foods at home? Did you feel better?

ARIANA: I did. Definitely. And I think, also, I play a lot of sports, and so in my athletics, it helped me feel better and just more full for my matches and things like that that it changed that also for me.

DR. GOTTESFELD: So, Ariana, if you had a message to give to some other teens who are listening to us today, what would you tell them about if they wanted to help get their family on a healthier eating track?

ARIANA: I think my main suggestion would be to get excited about something. I love food and cooking, so that was kind of my motivation, but if there’s a favorite food of yours or something that you just really want to make your goal, something that you think you can make healthier, try to incorporate that so that you have a different motivation to stay healthy.

DR. GOTTESFELD: Well, thank you, Ariana. You’ve been very inspiring. And the fact that you’ve tried some of these healthier foods and incorporated them and enjoyed them and gotten your family to enjoy them is very impressive. So thanks for sharing your story.

ARIANA: Well, thank you so much for having me. It’s been a lot of fun.

DR. GOTTESFELD: Thanks so much for joining me today on Total Health Radio. I welcome any thoughts or comments or feedback on this, so please feel free to email us at

That’s all we have for you today on Total Health Radio. I’m your host, Dr. Joyce Gottesfeld, and we’ll see you next time.