The traffic light diet can lower risk for obesity and diabetes

G REEN LIGHT! RED LIGHT! This is the sound that you may hear as children busily play an interactive game that promotes physical activity. Little did we suspect years ago that now those same words would be used in another way to help our youth eat healthy food. Childhood obesity has been on the rise over the past couple of decades and is a risk factor for the development of diabetes (“An Update,” 2004; Ogden et al., 2006). One way to combat childhood obesity is to help families learn to eat healthy foods. Although nutrition alone cannot turn the tide against obesity, proper diet is key to support a child’s healthy growth and development. Because obesity is a family issue, the whole family needs to be involved in changing food habits. Parents need to be role models for their children and not expect their children to eat broccoli and salad if they themselves are eating pizza. Families need to be positive in the process of obesity management and celebrate successes. Children will be more responsive to changes if they feel good about what they are doing. School nurses can promote this positive process to students at school and to their families via counseling sessions and newsletter articles. A popular and easy-to-use dietary education tool is the Traffic Light Diet (Collins, Warren, Neve, McCoy, & Stokes, 2006). It may also be called the Stop Light Diet, Red Light Diet, or other variations of the concept. Simply put, all foods are categorized into one of three groups: RED, YELLOW, or GREEN. When it comes to food choices, GREEN means “GO,” YELLOW means “SLOW,” and RED means “WHOA.” The classification of foods into the three groups varies slightly between the programs that developed or expanded this concept. GREEN, or GO, foods should be the first choice when deciding what to eat. These foods contain less than 2 grams of fat and are full of nutrients and/or fiber. Most fruit and vegetables are GREEN foods, as are whole wheat bread, oatmeal, fat free or 1% low-fat milk, grilled fish and shellfish, and skinless chicken or turkey. YELLOW, or SLOW, foods need to be the second choice when deciding what to eat. These foods contain 2 to 5 grams of fat. Common examples include 2% milk, 100% fruit juice, sports drinks, white grains (bread, rice, and pasta), granola, ham, and peanut butter. RED, or WHOA, foods need to be eaten sparingly. They have very little nutritional value and are high in fat, sugar, and calories. These foods contain 5 or more grams of fat. Examples of common foods include whole milk, regular hot dogs, french fries, butter, chocolates, cream cheese, sugary cereals, muffins, and soft drinks. For a more comprehensive list of foods, see the chart of GO, SLOW, and WHOA Foods (Table 1). Several books have been published about this diet. Red Light, Green Light, Eat Right is by Joanna Dolgoff, MD (2009), a pediatrician and childhood obesity specialist. The Traffic Light Diet is by Judith Willis (2004), one of the leading health experts in the United Kingdom. The originator of the Traffic Light Diet is Leonard Epstein, PhD, and his team from the State University of New York in Buffalo. Dr. Epstein developed his method as a family-based approach to childhood obesity. The Stoplight Diet for Children: An Eight-Week Program for Parents and Children was authored by Epstein and Sally Squires (1988). His version of the tool is the most commonly used. The Epstein version of the Traffic Light Diet is also the most studied. Two main goals of the diet are to limit calories and encourage the consumption of nutrient rich foods as opposed to calorie