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An Overweight Teen Case Study and a Few Tips on Controlling Sodium Intake


I see a lot of overweight teenagers – I have a particular empathy for them because I also had weight problems in my teens and overcame them. They typically share a similar pattern of skimping on food during the day and overeating from 4PM on. Let me tell you about my 16 year old client Molly. Molly skips breakfast, eats a Cliff bar for an AM snack, drinks several glasses of juice and at least one Coke each day and usually has a peanut butter and jelly sandwich with either an apple or salad with chips for lunch. She admits that when she comes home she is ravenous and can’t remember anything she has eaten. Her specialty after school snack is either one quesadilla after another or several bowls of cereal. When she sits down to dinner with the family she is not hungry but eats anyway because of course Mom prepares a healthy meal. Dad has a sweet tooth and loves to end the meal with dark chocolate, a habit which Molly has taken on as well. The only time Molly will have a good source of fiber and protein is at dinner such as her chicken and broccoli that she loves.

After analyzing Molly’s eating habits, it was obvious she was eating very little protein and fiber which was the reason she was feeling hungry all the time. So my goal was to introduce protein and fiber into her food consumption during the day within the limits of her food preferences. I educated Molly and Mom on how to read food labels for protein and fiber. I showed them many high protein and fiber foods that Molly was open to trying such as the cereal Kashi Go Lean, oatmeal with yummy toppings and quinoa.

Since Mom works and Molly doesn’t prepare anything for herself she simply takes the easiest thing. After finding out her likes and dislikes I prepared a list of lunches and after school snacks that included her favorite foods (including, thankfully, her favorite – broccoli) and stressed it was her responsibility to take a few minutes each day to prepare the right foods. I suggested she continue with her protein consumption for dinner but that she lessen the portions and use some of the dinner portions for her sandwich or salad the next day. We talked about adding fiber to Molly’s lunch with such items as black beans with salsa, 100% whole wheat breads and crackers. After discussing many after school snack options, she indicated she would like to alternate a small baked potato topped with broccoli and cheese or scrambled eggs with a whole wheat English muffin. I told Molly if she substitutes all the sugar in the glasses of orange juice and cokes with non-sugar drinks then she can enjoy a nice dessert each day. Molly is thrilled that after two weeks of counseling she has lost 7 pounds.

The high blood pressure epidemic we read about is certainly visible in my practice. The new dietary guideline for those who have hypertension is to consume no more than 1500 mg/day of salt per day – quite a low amount when you consider a packet of oatmeal has 240 mg, a slice of bread has 130 mg, one oz. slice of cheese has 170 mg and a tablespoon of butter has 80 mg. The most common question is how can I enjoy food and limit my sodium? After discussing my client’s
habits I often wind up suggesting they save all their salt for one meal a day, whether it be out at a restaurant, socializing or just being in the mood for some pizza. That way they don’t deprive themselves during the day where their other meals can more easily be salt free. Common suggestions include cooking their own Quaker Oats One Minute Oatmeal, whole wheat couscous or pasta, quinoa or even legumes.
They can cook their own meats and veggies with spices like lemon pepper, garlic, onions, wine, lemon juice or low salt chicken stock and create a salad making your own salad dressing with olive oil, vinegar and herbs. Most desserts are fairly sodium free. It’s also important to keep your weight under control, exercise at least 30 minutes a day, limit alcohol to two drinks per day and drink lots of water. Finally, take your CaMg and fish oils, eat lots of fruits and veggies where I find my clients are usually able to keep their
blood pressure under control.

I am glad to inform you that both clients were covered by their health insurance.

Linda is located in her office in Alamo. She welcomes your call to discuss your nutritional concerns. Please visit for more information, past articles, helpful tips, recipes and Linda’s blog or call at (925) 855-0150.