Re: Re: Dr. H Reply re Premature Adrenarche

[Guest guest]

I can respond to the muscle weight vs fat weight and adrenarche. When Dr H

saw that Janelle had ballooned (over 95th% for weight for height - it

happened very quickly so watch for it) having both adrenarche and now obese

she wanted her building her muscles and put her on a diet. Janelle is now

50th % weight for height and we are working on the muscle building. I have

to say (this has not been tested) but, as of late she doesn't seem to have

so many signs of adrenarche as she did before. Let's hope. So after my

long wind Dr H does believe in getting the muscle mass up more than getting

them fat from my personal experience.

--

Jovanovich

****Please note - our NEW e-mail address

laura@...

"

mj_mcdonald2000@...>

Reply-To: RSS-Support

Date: Mon, 30 Dec 2002 03:25:00 -0000

To: RSS-Support

Subject: Re: Dr. H Reply re Premature Adrenarche

Resent-From: laura@...

Resent-To: bugwilder@...

Resent-Date: Sun, 29 Dec 2002 21:27:22 -0600

Hi,

I'd like to comment and also have a few questions on Dr H's

responses regarding adrenarche. If any of you remember, I posted a

link to a British Medical Journal article that shows that low birth

weight babies (under 5.6 lbs) had a 40 percent chance of becoming

insulin resistant or diabetic in adulthood. It appears from what Dr

H is saying, our kids generally fall into this 40 percent area.

According to the article, as birth weight increases, there becomes

less of a chance encountering these diseases later in life. Below is

a list showing where percentages lie as related to birth weight.

40 percent (Equal to or less than 5.5 lbs)

34 percent (5.6 to 6.5 lbs)

31 percent (6.6 to 7.5 lbs)

22 percent (7.6 to 8.5 lbs)

13 percent (8.6 to 9.5 lbs)

14 percent (Greater than 9.5 lbs)

The fact that , who is insulin resistant, was born a tiny little

pea at 4.3 lbs lends credence to this study's findings. Along

the

same vein, could someone please let me know if whether I'm

correctly

interpreting what Dr H had to say about adrenarche. She seems to

indicate that the more fat a child has, the sooner adrenarche will

start? If this is true, shouldn't we be working to increase

muscle

weight rather than fat weight in order to lower insulin resistance?

In a recent meeting with my daughter's doctor, he told me the

more

that fat cells increase relative to the muscle cells there is a

reduction in insulin function, which can lead to greater insulin

resistance. As best I can interpret what my doctor is doing, is that

he is trying to minimize the rise in blood insulin levels. This leads

me to believe that he agrees with Dr H that when insulin rises, then

adrenarche is soon to follow. I would like to know what everyone

else thinks about ways to gain muscle mass rapidly besides the GH

that is already on. I want to be primed on this subject so

that when we meet with the doctor next week I can discuss all

options. Thanks for any advice/info you can provide.

> Hello Listserve -

>

> I received a reply back from Dr. Madeleine Harbison in response to

the email I

> sent her where I consolidated Joe Blau's questions on premature

adrenarche

> with others that came up on the listserve. Here is her reply to

each of the

> questions. Salem, MAGIC RSS Division Consultant

> ***************

>

> a) What exactly is the difference between adrenarche and puberty?

>

> Dr. H Response: Adrenarche is when the adrenal gland switched from

making

> glucocortcoids and mineralocorticoids to glucocortcoids,

mineralocorticoids

> and androgens [male hormones].

>

> Puberty is when the brain switches from make LHRH in a linear

pattern to a

> pulsitile pattern. This changes the response of the pituitary from

making

> more FSH than LH to more LH than FSH. This starts the gonads to

making sex

> hormones.

>

> Does premature andrenarche imply that you will likely have

premature

> puberty?

>

> Dr. H Response: Yes, it sometimes does.

>

> c) How long after andrenarche does puberty typically begin?

>

> Dr. H Response: We do not know what starts adrenarche and we do

not know why

> adrenarche initiates puberty in some children and not in others.

It ssems to

> do so in SGA children for sure. It is hard to know when puberty

will follow

> after adrenarche starts but the more fat the child has the more

likely it is

> to start because androgens are converted to estrogens in fat.

Estrogen is

> really what controls puberty in both males and females.

>

> I believe that adrenarche starts when insulin rises. Insulin rises

earlier in

> SGA children than it does in normal children because they have

insulin

> resistance.

>

> d) What is your recommended treatment for premature adrenarche?

>

> Dr. H Response: There is no good way to treat premature adrenarche

nor is

> there a need to treat it because androgens do not cause the

problem. Estrogen

> causes the problem. If the bone age begins to advance rapidly,

giving

> Arimidex to prevent conversion of androgens to estrogen is the best

> theoretical therapy. This is experimental therapy and not

something that most

> doctors will or should use.

>

> e) In addition to drugs to forestall puberty, how often should bone

age and

> hormone levels be checked and which hormones are the most important

to watch?

>

> Dr. H Response: Meds that suppress puberty do not help with

premature

> adrenarche. When children are young, I do a BA yearly along with

> testosterone, DHEA, androstenedione, E1 and E2. When they get

older, show any

> signs of sex hormone secretion, have an advancing BA or have a

sudden growth

> spurt, I do these tests every 6 mo.

>

> f) With regards to a specific family, what happens if you have a

bone age that

> is suddenly rapidly advancing, but NO other signs of puberty,

> and the blood test hormone levels say that the child is not in

puberty yet.

> The child's bone age has always been 12-18 months delayed, and this

last time

> when she is just turning 8 years old, her bone age was only 6

months delayed.

> Could it be that the bone age was misread? Or can you she be

in " early

> puberty " with no visible signs yet?

>

> Dr. H Response: This is likely the start of adrenarche. Young

children are

> very sensitive to very small amounts, BELOW MEASURABLE, amounts of

estrogen.

> Like the period of infancy, this is the period of RSS-SGA

children's therapy

> that requires experience.

[Guest guest]

No she is not on GH but yes it would help. I just do her PT and have her

stand a lot...I figure anything will help. She did not move much before 16

months. She has been extremely hypotonic.

--

Jovanovich

****Please note - our NEW e-mail address

laura@...

"

mj_mcdonald2000@...>

Reply-To: RSS-Support

Date: Sat, 04 Jan 2003 02:50:21 -0000

To: RSS-Support

Subject: Re: Dr. H Reply re Premature Adrenarche

Resent-From: laura@...

Resent-To: bugwilder@...

Resent-Date: Fri, 3 Jan 2003 20:52:15 -0600

,

Well I have to know how you are working on muscle building. Is

Janelle on GH-- is.

> > Hello Listserve -

> >

> > I received a reply back from Dr. Madeleine Harbison in response to

> the email I

> > sent her where I consolidated Joe Blau's questions on premature

> adrenarche

> > with others that came up on the listserve. Here is her reply to

> each of the

> > questions. Salem, MAGIC RSS Division Consultant

> > ***************

> >

> > a) What exactly is the difference between adrenarche and puberty?

> >

> > Dr. H Response: Adrenarche is when the adrenal gland switched

from

> making

> > glucocortcoids and mineralocorticoids to glucocortcoids,

> mineralocorticoids

> > and androgens [male hormones].

> >

> > Puberty is when the brain switches from make LHRH in a linear

> pattern to a

> > pulsitile pattern. This changes the response of the pituitary

from

> making

> > more FSH than LH to more LH than FSH. This starts the gonads to

> making sex

> > hormones.

> >

> > Does premature andrenarche imply that you will likely have

> premature

> > puberty?

> >

> > Dr. H Response: Yes, it sometimes does.

> >

> > c) How long after andrenarche does puberty typically begin?

> >

> > Dr. H Response: We do not know what starts adrenarche and we do

> not know why

> > adrenarche initiates puberty in some children and not in others.

> It ssems to

> > do so in SGA children for sure. It is hard to know when puberty

> will follow

> > after adrenarche starts but the more fat the child has the more

> likely it is

> > to start because androgens are converted to estrogens in fat.

> Estrogen is

> > really what controls puberty in both males and females.

> >

> > I believe that adrenarche starts when insulin rises. Insulin

rises

> earlier in

> > SGA children than it does in normal children because they have

> insulin

> > resistance.

> >

> > d) What is your recommended treatment for premature adrenarche?

> >

> > Dr. H Response: There is no good way to treat premature

adrenarche

> nor is

> > there a need to treat it because androgens do not cause the

> problem. Estrogen

> > causes the problem. If the bone age begins to advance rapidly,

> giving

> > Arimidex to prevent conversion of androgens to estrogen is the

best

> > theoretical therapy. This is experimental therapy and not

> something that most

> > doctors will or should use.

> >

> > e) In addition to drugs to forestall puberty, how often should

bone

> age and

> > hormone levels be checked and which hormones are the most

important

> to watch?

> >

> > Dr. H Response: Meds that suppress puberty do not help with

> premature

> > adrenarche. When children are young, I do a BA yearly along with

> > testosterone, DHEA, androstenedione, E1 and E2. When they get

> older, show any

> > signs of sex hormone secretion, have an advancing BA or have a

> sudden growth

> > spurt, I do these tests every 6 mo.

> >

> > f) With regards to a specific family, what happens if you have a

> bone age that

> > is suddenly rapidly advancing, but NO other signs of puberty,

> > and the blood test hormone levels say that the child is not in

> puberty yet.

> > The child's bone age has always been 12-18 months delayed, and

this

> last time

> > when she is just turning 8 years old, her bone age was only 6

> months delayed.

> > Could it be that the bone age was misread? Or can you she be

> in " early

> > puberty " with no visible signs yet?

> >

> > Dr. H Response: This is likely the start of adrenarche. Young

> children are

> > very sensitive to very small amounts, BELOW MEASURABLE, amounts of

> estrogen.

> > Like the period of infancy, this is the period of RSS-SGA

> children's therapy

> > that requires experience.

>

>

>

[Guest guest]

Hi Ava:-)

I am not sure if Dr H was speculating or not but she thought if she could

get Janelle's weight down the adrenarche would slow down. From visual signs

it looks as if it has. Dr H just put her on a diet of 85-95 Kcal per

Kilogram. It just worked. Janelle its tube fed which makes this easy. I

would ask your endo again. Janelle is not taking medication for the

adrenarche.

--

Jovanovich

****Please note - our NEW e-mail address

laura@...

" house2home@...>

Reply-To: RSS-Support

Date: Sat, 04 Jan 2003 05:54:37 -0000

To: RSS-Support

Subject: Re: Dr. H Reply re Premature Adrenarche

Resent-From: laura@...

Resent-To: bugwilder@...

Resent-Date: Fri, 3 Jan 2003 23:56:39 -0600

Hi ,

Thank you so much for your information. I am rather new to all of this

and finding the listserv is the best support for me.

My daughter ita, just turned 6 and she is 95% for weight vs.

height.

Jua was an SGA (small for gestiional age...saw the ??!!! and IUGR

weighing only 2.0 lbs at 31 weeks (talk about a pea!!). We just took

her to the endo yesterday. ita was between the 3rd and 5th% for

the first 4 years then WAMMO!!...growth spurt betw jan. 21, 02 to

sept. 13, 02-- 4 " , huge weight gain, and a bone age of 8yrs, 10 months

and adrenarche. (Don't have to look for it.... it is here :-(

We have been asked to consider LUPRON by February 3. You did not say

if your child

is on treatment.... so here is a question for all.....

Is anyone currently using LUPRON and does it work for the SGA and IUGR

child????????

Also, any tips on getting ita down to 50% weight for height would

be great to hear. We exersise 3x per week but all that does is keep

her from gaining. She is and has been at 60lbs but has bouncbbed up to

62.5, Jua went from 10% to just under 50% with the spurt.

Also is the weight my fault? I have been surfing the net and this

seems a big question in the medical community regarding what brings on

adrenarcheb.

I need to understand this. Yesterday the endo began speaking about

the weight but drifted off to the adrenarche so I was not clear on

what she was saying.

Thanks,

AvaMarie

> > Hello Listserve -

> >

> > I received a reply back from Dr. Madeleine Harbison in response to

> the email I

> > sent her where I consolidated Joe Blau's questions on premature

> adrenarche

> > with others that came up on the listserve. Here is her reply to

> each of the

> > questions. Salem, MAGIC RSS Division Consultant

> > ***************

> >

> > a) What exactly is the difference between adrenarche and puberty?

> >

> > Dr. H Response: Adrenarche is when the adrenal gland switched

from

> making

> > glucocortcoids and mineralocorticoids to glucocortcoids,

> mineralocorticoids

> > and androgens [male hormones].

> >

> > Puberty is when the brain switches from make LHRH in a linear

> pattern to a

> > pulsitile pattern. This changes the response of the pituitary

from

> making

> > more FSH than LH to more LH than FSH. This starts the gonads to

> making sex

> > hormones.

> >

> > Does premature andrenarche imply that you will likely have

> premature

> > puberty?

> >

> > Dr. H Response: Yes, it sometimes does.

> >

> > c) How long after andrenarche does puberty typically begin?

> >

> > Dr. H Response: We do not know what starts adrenarche and we do

> not know why

> > adrenarche initiates puberty in some children and not in others.

> It ssems to

> > do so in SGA children for sure. It is hard to know when puberty

> will follow

> > after adrenarche starts but the more fat the child has the more

> likely it is

> > to start because androgens are converted to estrogens in fat.

> Estrogen is

> > really what controls puberty in both males and females.

> >

> > I believe that adrenarche starts when insulin rises. Insulin

rises

> earlier in

> > SGA children than it does in normal children because they have

> insulin

> > resistance.

> >

> > d) What is your recommended treatment for premature adrenarche?

> >

> > Dr. H Response: There is no good way to treat premature

adrenarche

> nor is

> > there a need to treat it because androgens do not cause the

> problem. Estrogen

> > causes the problem. If the bone age begins to advance rapidly,

> giving

> > Arimidex to prevent conversion of androgens to estrogen is the

best

> > theoretical therapy. This is experimental therapy and not

> something that most

> > doctors will or should use.

> >

> > e) In addition to drugs to forestall puberty, how often should

bone

> age and

> > hormone levels be checked and which hormones are the most

important

> to watch?

> >

> > Dr. H Response: Meds that suppress puberty do not help with

> premature

> > adrenarche. When children are young, I do a BA yearly along with

> > testosterone, DHEA, androstenedione, E1 and E2. When they get

> older, show any

> > signs of sex hormone secretion, have an advancing BA or have a

> sudden growth

> > spurt, I do these tests every 6 mo.

> >

> > f) With regards to a specific family, what happens if you have a

> bone age that

> > is suddenly rapidly advancing, but NO other signs of puberty,

> > and the blood test hormone levels say that the child is not in

> puberty yet.

> > The child's bone age has always been 12-18 months delayed, and

this

> last time

> > when she is just turning 8 years old, her bone age was only 6

> months delayed.

> > Could it be that the bone age was misread? Or can you she be

> in " early

> > puberty " with no visible signs yet?

> >

> > Dr. H Response: This is likely the start of adrenarche. Young

> children are

> > very sensitive to very small amounts, BELOW MEASURABLE, amounts of

> estrogen.

> > Like the period of infancy, this is the period of RSS-SGA

> children's therapy

> > that requires experience.

>

>

>

[Guest guest]

I would talk to the endo and a dietician. For a non RSS child I would reduce

the carbs ( do not eliminate them) increase the vegetables and supply lean

meats and avoid fats in excess. They need some fat.

--

Jovanovich

****Please note - our NEW e-mail address

laura@...

"

mj_mcdonald2000@...>

Reply-To: RSS-Support

Date: Sat, 04 Jan 2003 19:27:02 -0000

To: RSS-Support

Subject: Re: Dr. H Reply re Premature Adrenarche

Resent-From: laura@...

Resent-To: bugwilder@...

Resent-Date: Sat, 4 Jan 2003 13:31:52 -0600

,

I reread my message to you from yesterday and all I can say is that

I've been really stressed this week, so I apologize for not making

much sense in what I asked.

I guess what I'd really like to find out is whether there are any

foods or diets that you try to use to reduce fat and build muscle?

Thanks.

> > > Hello Listserve -

> > >

> > > I received a reply back from Dr. Madeleine Harbison in response

to

> > the email I

> > > sent her where I consolidated Joe Blau's questions on premature

> > adrenarche

> > > with others that came up on the listserve. Here is her reply to

> > each of the

> > > questions. Salem, MAGIC RSS Division Consultant

> > > ***************

> > >

> > > a) What exactly is the difference between adrenarche and

puberty?

> > >

> > > Dr. H Response: Adrenarche is when the adrenal gland switched

> from

> > making

> > > glucocortcoids and mineralocorticoids to glucocortcoids,

> > mineralocorticoids

> > > and androgens [male hormones].

> > >

> > > Puberty is when the brain switches from make LHRH in a linear

> > pattern to a

> > > pulsitile pattern. This changes the response of the pituitary

> from

> > making

> > > more FSH than LH to more LH than FSH. This starts the gonads to

> > making sex

> > > hormones.

> > >

> > > Does premature andrenarche imply that you will likely have

> > premature

> > > puberty?

> > >

> > > Dr. H Response: Yes, it sometimes does.

> > >

> > > c) How long after andrenarche does puberty typically begin?

> > >

> > > Dr. H Response: We do not know what starts adrenarche and we do

> > not know why

> > > adrenarche initiates puberty in some children and not in others.

> > It ssems to

> > > do so in SGA children for sure. It is hard to know when puberty

> > will follow

> > > after adrenarche starts but the more fat the child has the more

> > likely it is

> > > to start because androgens are converted to estrogens in fat.

> > Estrogen is

> > > really what controls puberty in both males and females.

> > >

> > > I believe that adrenarche starts when insulin rises. Insulin

> rises

> > earlier in

> > > SGA children than it does in normal children because they have

> > insulin

> > > resistance.

> > >

> > > d) What is your recommended treatment for premature adrenarche?

> > >

> > > Dr. H Response: There is no good way to treat premature

> adrenarche

> > nor is

> > > there a need to treat it because androgens do not cause the

> > problem. Estrogen

> > > causes the problem. If the bone age begins to advance rapidly,

> > giving

> > > Arimidex to prevent conversion of androgens to estrogen is the

> best

> > > theoretical therapy. This is experimental therapy and not

> > something that most

> > > doctors will or should use.

> > >

> > > e) In addition to drugs to forestall puberty, how often should

> bone

> > age and

> > > hormone levels be checked and which hormones are the most

> important

> > to watch?

> > >

> > > Dr. H Response: Meds that suppress puberty do not help with

> > premature

> > > adrenarche. When children are young, I do a BA yearly along

with

> > > testosterone, DHEA, androstenedione, E1 and E2. When they get

> > older, show any

> > > signs of sex hormone secretion, have an advancing BA or have a

> > sudden growth

> > > spurt, I do these tests every 6 mo.

> > >

> > > f) With regards to a specific family, what happens if you have a

> > bone age that

> > > is suddenly rapidly advancing, but NO other signs of puberty,

> > > and the blood test hormone levels say that the child is not in

> > puberty yet.

> > > The child's bone age has always been 12-18 months delayed, and

> this

> > last time

> > > when she is just turning 8 years old, her bone age was only 6

> > months delayed.

> > > Could it be that the bone age was misread? Or can you she be

> > in " early

> > > puberty " with no visible signs yet?

> > >

> > > Dr. H Response: This is likely the start of adrenarche. Young

> > children are

> > > very sensitive to very small amounts, BELOW MEASURABLE, amounts

of

> > estrogen.

> > > Like the period of infancy, this is the period of RSS-SGA

> > children's therapy

> > > that requires experience.

> >

> >

> >

[Guest guest]

I would talk to the endo and a dietician. For a non RSS child I would reduce

the carbs ( do not eliminate them) increase the vegetables and supply lean

meats and avoid fats in excess. They need some fat.

--

Jovanovich

****Please note - our NEW e-mail address

laura@...

"

mj_mcdonald2000@...>

Reply-To: RSS-Support

Date: Sat, 04 Jan 2003 19:27:02 -0000

To: RSS-Support

Subject: Re: Dr. H Reply re Premature Adrenarche

Resent-From: laura@...

Resent-To: bugwilder@...

Resent-Date: Sat, 4 Jan 2003 13:31:52 -0600

,

I reread my message to you from yesterday and all I can say is that

I've been really stressed this week, so I apologize for not making

much sense in what I asked.

I guess what I'd really like to find out is whether there are any

foods or diets that you try to use to reduce fat and build muscle?

Thanks.

> > > Hello Listserve -

> > >

> > > I received a reply back from Dr. Madeleine Harbison in response

to

> > the email I

> > > sent her where I consolidated Joe Blau's questions on premature

> > adrenarche

> > > with others that came up on the listserve. Here is her reply to

> > each of the

> > > questions. Salem, MAGIC RSS Division Consultant

> > > ***************

> > >

> > > a) What exactly is the difference between adrenarche and

puberty?

> > >

> > > Dr. H Response: Adrenarche is when the adrenal gland switched

> from

> > making

> > > glucocortcoids and mineralocorticoids to glucocortcoids,

> > mineralocorticoids

> > > and androgens [male hormones].

> > >

> > > Puberty is when the brain switches from make LHRH in a linear

> > pattern to a

> > > pulsitile pattern. This changes the response of the pituitary

> from

> > making

> > > more FSH than LH to more LH than FSH. This starts the gonads to

> > making sex

> > > hormones.

> > >

> > > Does premature andrenarche imply that you will likely have

> > premature

> > > puberty?

> > >

> > > Dr. H Response: Yes, it sometimes does.

> > >

> > > c) How long after andrenarche does puberty typically begin?

> > >

> > > Dr. H Response: We do not know what starts adrenarche and we do

> > not know why

> > > adrenarche initiates puberty in some children and not in others.

> > It ssems to

> > > do so in SGA children for sure. It is hard to know when puberty

> > will follow

> > > after adrenarche starts but the more fat the child has the more

> > likely it is

> > > to start because androgens are converted to estrogens in fat.

> > Estrogen is

> > > really what controls puberty in both males and females.

> > >

> > > I believe that adrenarche starts when insulin rises. Insulin

> rises

> > earlier in

> > > SGA children than it does in normal children because they have

> > insulin

> > > resistance.

> > >

> > > d) What is your recommended treatment for premature adrenarche?

> > >

> > > Dr. H Response: There is no good way to treat premature

> adrenarche

> > nor is

> > > there a need to treat it because androgens do not cause the

> > problem. Estrogen

> > > causes the problem. If the bone age begins to advance rapidly,

> > giving

> > > Arimidex to prevent conversion of androgens to estrogen is the

> best

> > > theoretical therapy. This is experimental therapy and not

> > something that most

> > > doctors will or should use.

> > >

> > > e) In addition to drugs to forestall puberty, how often should

> bone

> > age and

> > > hormone levels be checked and which hormones are the most

> important

> > to watch?

> > >

> > > Dr. H Response: Meds that suppress puberty do not help with

> > premature

> > > adrenarche. When children are young, I do a BA yearly along

with

> > > testosterone, DHEA, androstenedione, E1 and E2. When they get

> > older, show any

> > > signs of sex hormone secretion, have an advancing BA or have a

> > sudden growth

> > > spurt, I do these tests every 6 mo.

> > >

> > > f) With regards to a specific family, what happens if you have a

> > bone age that

> > > is suddenly rapidly advancing, but NO other signs of puberty,

> > > and the blood test hormone levels say that the child is not in

> > puberty yet.

> > > The child's bone age has always been 12-18 months delayed, and

> this

> > last time

> > > when she is just turning 8 years old, her bone age was only 6

> > months delayed.

> > > Could it be that the bone age was misread? Or can you she be

> > in " early

> > > puberty " with no visible signs yet?

> > >

> > > Dr. H Response: This is likely the start of adrenarche. Young

> > children are

> > > very sensitive to very small amounts, BELOW MEASURABLE, amounts

of

> > estrogen.

> > > Like the period of infancy, this is the period of RSS-SGA

> > children's therapy

> > > that requires experience.

> >

> >

> >

[Guest guest]

Hi ,

My name is Pat and is my grandson. Wouldn't you do this the same

way that you would with any child? I would feed good complex carbs, if you

have any problems with hypo-g, and good sources of protein. My kids love

veggies, and you could make a low fat cheese sauce to go over. Most kids

will eat them that way. Fish and chicken are good sources of protein, and

lower in fat. You'll need the protein to build muscle.

As far as exercise goes, I would find something that your child like to

do, and build from there. One of my 4 kids loved soccer and two were into

ball. the fourth wasn't into anything sports wise, but loved going on walks

with me, or bike rides, and we would have wonderful talks.

Hope this helps!

Pat (g-ma to

[Guest guest]

Hi ,

My name is Pat and is my grandson. Wouldn't you do this the same

way that you would with any child? I would feed good complex carbs, if you

have any problems with hypo-g, and good sources of protein. My kids love

veggies, and you could make a low fat cheese sauce to go over. Most kids

will eat them that way. Fish and chicken are good sources of protein, and

lower in fat. You'll need the protein to build muscle.

As far as exercise goes, I would find something that your child like to

do, and build from there. One of my 4 kids loved soccer and two were into

ball. the fourth wasn't into anything sports wise, but loved going on walks

with me, or bike rides, and we would have wonderful talks.

Hope this helps!

Pat (g-ma to