We were out at our favorite Mexican restaurant when the conversation at the next table caught my ear. A young boy, probably about 4, had only eaten half of his rolled taco and declared he was full.

“You have half of it left, look at all that meat inside,” the mom said. “Finish it!”

The boy went on to finish the rolled taco and the dad chimed in with “I’m proud of you, son.”

What these parents didn’t realize was that they are teaching their son that his fullness doesn’t matter — and that eating more is better.

Do parents really want kids to eat like adults?
I understand why these parents did what they did. I’m sure the boy, like a lot of 4 year olds, doesn’t eat many protein foods so the mom feels better even when he eats items like rolled tacos. He probably has days he barely eats and days he eats a lot — they want his eating to be more “normal.”

The problem with normal eating, at least in this country, is that most people have difficulty navigating the current food environment without over-eating.

Yet most kids do well naturally. Research show that kids under 5 regulate their intake very well. Food intake may vary greatly from meal to meal, but young children are masters at getting the right amount of food for their bodies.

That is, if parents served balanced meals and allow children to be in charge of how much they eat.

Why it’s so hard to raise an intuitive eater
I’m the first to admit that raising an intuitive eater is hard. Society tends to accept the story above — it’s pretty commonplace for parents to get kids to eat more, or less if it’s unhealthy fare. According to a 2007 study published in Appetite, 85% of parents they try to get their child to eat more at mealtime by using reasoning, praise and food rewards.

The biggest challenge, I believe, is the psychological one. As parents we want so badly to nourish our kids that we often get lost in that desire. We fail to see the big picture and the negative consequences that our actions can have over the long-term.

I work hard to make sure my 4-year old (Big A) has an appetite for meals at home. But when we go other places, like out to dinner with friends or parties, she often snacks on what I call “appetite killers.”

When this happens — and it’s finally time to sit down to dinner she usually takes a few bites (or none at all) and is done. People often give me the look that says, “You’re going to let her get away with that?!”

But if I make her eat more of the meal, what am I teaching her? It’s better to over-eat? I do talk to her, ahead of time, about saving her appetite for the meal. And when she says she’s done I make sure to ask her if she’s full.

The bottom line: I make a point to honor her hunger and fullness, even the times I’m disappointed she didn’t eat better, because I want her to grow into an adult who does the same.

Use your kids’ eating behavior as a mirror
We are role models for our kids…they are watching us. Big A will usually come up to me and ask, “Why did you stop eating ice cream.” or “why aren’t you eating.” And I tell her it’s because I’m satisfied or preserving my hunger for the meal.

How often do you fill up on food when out, only to go and finish your meal anyway? Maybe these little kids are on to something.

While kid’s eating-behavior can drive us crazy, the emotion it stirs in us can be used as a mirror to what’s really going on. Maybe we are too controlling with our own diet or eat past fullness and ignore our body’s signals?

Either way, we need to remember that we live in a crazy food environment where single food (restaurant) portions are big enough to feed a family of 4 — and appetite killers are everywhere.

We need, more than ever, to preserve kids’ natural ability to regulate food — and to adopt this approach ourselves. We’ll be much better equipped for eating well in the modern world. And if enough people do it, maybe portions (and appetite killers) will shrink too. I can dream, can’t I?

So tell me, how do you handle your child’s ever changing appetite? Any challenges?

References
Orrell-Valente et al. “Just three more bites”: an observational analysis of parents’ socialization of children’s eating at mealtime. Appetite. 2007;48 (1):37-45

Sugar and fat. 

People of all ages prefer this taste combination.  Yeah, some people like sweeter foods and others prefer salty but as I learned in my training as a dietitian, the mixture of sugar and fat is one that is particularly pleasing to the palate.

As we talked about in our picky-eating series, kids are naturally drawn to sweet foods that are energy-dense.  And in a world where these items are literally everywhere, parents are left unsure how to deal with them.

The problem goes something like this: kids fight for these foods but their parents fight back trying to keep their intake as low as possible.  Or, parents give in because they simply don’t have the energy to fight.  Either way, the issue of how to manage sweets is one many families face.

In this series we’ll dig deep into this topic of how to raise kids who have a healthy relationship with sweets – and grow up eating them in moderation.   We’ll have expert interviews, case studies and specific strategies to get you and your family on the right track.

But first, we need to get to the heart of the problem.  Not what everyone thinks is the problem, but the real problem.

The Problem – at face value

Everybody knows that Americans eat too many energy-dense foods.  According to the 2010 Dietary Guidelines Report, foods with added sugars and solid fats contribute almost 35% of calories in the typical American’s Diet.  This is true for people of all ages – children, adolescents and adults.

Yet the Dietary Guidelines recommend 10% of total calories come from what they call “discretionary calories.”  And that’s only if people meet their nutrient needs first.  Ouch.

The bottom line: Many people are consuming high quantities of foods that offer little in the way of nourishment.  These foods are not meant to make such a large contribution to the diet of younger — and older– bodies.

The problem and solution is typically defined as “these tempting foods need to be cut back or eliminated from the diet.”  But the way we go about this can make the problem much, much worse. 

Uncovering the Problem — it’s more than taste

When parents see their kids loving sweets they often get worried, especially if their kid is at a higher percentile for weight.  This fear often drives them to cut back sweets in their child’s diet in ways that are counter-productive.   

Researchers reviewed 22 studies in the 2004 issue of Obesity Research and found that that parental restriction was the only feeding strategy associated with increased eating and weight in kids.  

Take a study published in the American Journal of Clinical Nutrition several years ago.  When offered to eat as much energy-dense foods as they wanted, girls (aged 5 to 7) of parents who restrict them from palatable foods at home were more likely to eat in the absence of hunger than the unrestricted girls.  Research also suggests that girls who eat in the absence of hunger tend to feel bad about themselves.

Studies also show that an indulgent or permissive feeding style, common in lower income homes, is associated with excess eating and higher BMI.  This is letting children eat what they want when they want and that includes plenty of energy-dense foods. 

And how about how adults feed themselves?  Many spend their time between trying to be good on a diet or healthy eating plan or eating what they want in larger quantities. Studies show most people who diet will gain their weight back plus more.

So children and adults just don’t only over-eat sweets because of taste.  The way they are fed, or feed themselves, has a major impact on whether they obsess, overeat or simply prefer energy-rich foods.  

The real problem

When I ask clients struggling with weight their biggest challenge they usually say something like “carbs,” “sweets” or “potatoes.”  They fight hard to stay away from palatable foods because they think they have to. 

This is the problem!  Deep down no one wants to give up foods that are so highly preferred by their taste buds and that includes children.  So people look for excuses to eat such foods whether it be stress, uncomfortable emotions or celebration.

No one is taught how to eat sweets in a balanced way.  In our society we see food as black or white – good/bad, healthy/unhealthy.  How many diets tell you to avoid the bad foods? How many times do you hear someone say they were “bad” or “good” due to eating?

Yeah, we hear words like “moderation” or “occasionally” but what does that mean?  Many fear that they can’t trust themselves around ice cream, cookies or a big bowl of chips.  And if they can’t trust themselves, how can they trust their children?

I believe our relationship with sweets is actually a learned behavior.  Take a look at other cultures that make less of a big deal about indulgent foods (or drinking but that’s a whole other topic).  They enjoy them without guilt and make them part of a well balanced diet.  Isn’t that what we want for our kids?

The answer to this dilemma lies somewhere in the middle of being to controlling or permissive when feeding our kids and ourselves. It’s learning to look at sweets in a whole new light. 

Like my friend and pediatric dietitian Jill Castle once told me, “You want the kid who runs by the bowl of M&Ms without even noticing it.”  Stick around for the series and I’ll help you raise a kid like that.

So tell me, what challenges does your family face when it comes to managing sweets?

References

Faith MS, Scanlon KS, Birch LL, Francis LA, Sherry B. Parent-Child feeding strategies and their relationships to child eating and weight status. Obes Res. 2004;12:1711-1722.

Fisher JO, Birch LL. Eating in the absence of hunger and overweight in girls from 5 to 7 y of age. American Journal of Clinical Nutrition. 2002;76:226-231.

Ellyn Satter Resources

You’ve probably heard that the first lady is taking on childhood obesity. On Tuesday she announced the development of a task force that will engage both private and public sectors to solve the childhood obesity problem in a generation.

The areas of focus include: helping parents make healthier food choices, making schools a healthier environment, increasing physical activity and making healthy food more accessable. In 90 days this task force will develop and announce a plan of action. I’ll be sure to keep you updated. For more on this, see Let’s Move.

There are some changes that will take place immediately. The American Academy of Pediatrics is joining the cause by enouraging pediatricians to keep a close eye on the BMIs (body mass index) of children. So if there’s a problem they will let you know.

But there is a part of me that is worried that some negatives may come out of all this attention on weight. So I jotted some of my concerns down just in case Michelle Obama — or her task force members– runs across my blog.

1. It’ll take more than healthy eating: Whenever I see a story on fighting obesity, it’s always talks about getting kids and adults to eat “healthier.” There is not a parent alive who doesn’t know that eating more fruits and vegetables is good for their children. So if pediatricians just spout of the same old advice, parents will still face the same barriers they had before, whether it’s getting kids to eat fruits and veggies or finding the time to prepare them.

But what if pediatricians asked families to change how they eat? Isn’t this what has really changed over the last 40 years? We no longer make feeding ourselves — and our families — a priority. Telling parents to start by having regular meals and snacks at the kitchen table is a great start. They can gradually add more variety including fruits and veggies.

But if children continue to graze on food, eat while watching TV, or are allowed to grab food out of the cupboard when they are bored, they are much more likely to get more calories than their bodies need. And why should we wait for a high BMI to give this advice?

2. Keep a watchful eye on eating disorders: According to The Alliance of Eating Disorders Awareness, eating disorders affect 24 million Americans. Young women with an eating disorder are 12 times more likely to die than other women their age. The most common behavior that leads to an eating disorder is dieting. Fifty-one percent of 9 and 10- year olds feel better when on a diet and 42% of 1st and 3rd grade girls want to be thin.

So very young children already have a desire to be thin. We need to watch the way we talk to our children and let them know that health is most important, not looks or weight. Pediatricians also need to be careful in how they relate messages when they find a child is overweight. I will be running an eating disorder prevention series this month to discuss ways parents can help prevent eating disorders in their children so stay tuned.

3. Size discrimination is a problem: The last acceptable form of prejudice is size discrimination. This movement could make people even more critical of those who carry excess weight. We need to educate our children that people come in all shapes and sizes. While BMI can be a helpful tool, some kids may be considered overweight but still be healthy because they are naturally bigger. Just the way some children fall off the growth charts because they are small. What we want to avoid is kids gaining an unnatural amount of weight for their body type.

4. Restrictive feeding practices don’t work with kids: With more pediatricians telling parents their children have a weight problem, some parents may start restricting their kids’ eating, which is really a form of dieting. Research shows such practices backfire, making children more likely to overeat and gain weight.

Encouraging healthy behaviors for the whole family is vital. Singling out an overweight child can do long-term damage to their self esteem, make them obsess about food and increase their risk of developing an eating disorder. All members of the family benefit from healthy habits, whether or not they carry excess weight.

So that’s it. Just some thoughts I wanted to get out there. Now I feel better.

What do you think about all this? Any solutions you want Michelle Obama to know about?

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I have two good reasons to write about weight today. First, it is Healthy Weight Week and second, new obesity statistics (childhood and adult) have been released.  And I want my readers to be in the know.

Obesity statistics published in the Journal of the American Medical Association have been updated to account for the decade that just ended.  Drum roll please… 

There was no change.  Children (except the heaviest boys from 6-19 years old) and adult women had no real increase while men’s numbers went up but from 2003 onward this wasn’t significant.  Still, almost 7 out of 10 adults (68%) are either overweight or obese.  So while the numbers haven’t gone up, most health professionals prefer they go down.   

At the same time these statistics were splattered all over the news, another interesting research study was reported.  According to a study in the Journal of Preventative Medicine, women who have had children are at the highest risk for weight gain over time.  The researchers studied 6478 Australian women and found that over ten years the women without children or a partner gained 11 pounds, those with a partner gained 15 pounds, and with a partner and a child gained 20. 

According to the International Food and Information Council, in the last decade media stories on obesity have skyrocketed.  I often wonder what effect this news really has on people.  Does hearing about weight make them want to jump on the treadmill or give up in defeat?

And if you have an overweight child, how does this news sit with you?  Will you be tempted to restrict your child’s intake?  Take away all his sweets?  All of which are things that backfire.

Clients have always told me “I know what to do, I just don’t do it.”  And this makes them feel bad, lazy even, for not doing what they think they should do.  (For a great reason not to “should” yourself see this article!)

But I think the key is identifying and removing obstacles – real and perceived.  Yes, those of us married with children are more at risk to gain weight.  We are so busy with children and responsibilities that we tend to put ourselves on the back burner.  But there’s so much we can do to help ourselves and our kids if we learned how to look at things differently.

Many of you said time was your major barrier to taking care of your own health.  So stay tuned for tips on how to remove barriers, save time and prove that being married with children does not make unnecessary weight gain inevitable.

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References

Ogden CL, Carroll MD, Curtin LR, Lamb MM, Flegal KM. Prevalence of high body mass Index in US children and adolescents, 2007-2008. JAMA. 2010;303(3):242-249.

Flegal KM, Carroll MD, Ogden CL, Curtin LR. Prevalence and trends in obesity among US adults, 1999-2008. JAMA. 2010;303(3):235-241.

Brown WJ, Hockey R, Dobson AJ. Effects of having a baby on weight gain. Am J Prev Med. 2010;38(2): 163-170.

I’ve been asked to do a teleclass for Parenting Powers. The call will take place on Tuesday, January 12th at 5pm PST (8pm EST). I will be discussing 5 easy ways parents can help prevent unnecessary weight gain in their kids. You have to be a member of Parenting Powers to join the call (it’s $9.95 to join). So if you’re interested, find out more here!

Q: I have two boys who eat great but they have completely different bodies types (one small for his age and the other more hefty.) The younger, more hefty boy has a sweet tooth and I have concerns about his weight. Do I continue to feed them the same way?

A: Yes. Continue to feed your boys the same way. To explain why this is my answer, let’s consider what would happen if you fed them differently.

If you started singling out your heavier child, he might get the idea you don’t approve of his body size (even though that’s not your intention) and this could negatively affect his self esteem. Additionally, seeing his brother eat different foods – and allowed to have seconds – could make him preoccupied with foods and eat more when he gets the chance. Research shows that restricting food intake in the overweight child is counterproductive.

Another problem with giving your thinner child more leeway when it comes to eating is that he won’t learn the healthy habits he’ll need as he gets older. Healthy feeding strategies help all children grow into weights that are right for them. Some kids will be bigger and others will be smaller and many will be somewhere in between. What you want to avoid is the unnecessary weight gain that comes from overeating and a lack of activity.

Some relevant posts on feeding strategies include, Why Children Thrive on Planned Meals and Snacks, 5 Times You Never Want to Feed Your Kids and the Book Review, Your Child’s Weight: Helping Without Harming.

In addition to feeding you’ll also want to provide your boys with plenty of opportunities for physical activity. Limiting screen time to 2 hours or less per day and only allow sugar-sweetened beverages (fruit drinks, soda etc.) on special occasions.

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The information on this site is for educational purposes only and does not take the place of medical advice. Please verify with your healthcare provider.

My daughter and I went to her friend’s 3rd birthday party. When it was time to sing happy birthday, the kids swarmed to the table full of cupcakes. When an overweight girl asked her dad for another cupcake, he said “no, one is enough.” The girl kept pleading until she was in full meltdown mode.

Around that same time my daughter asked me for another cupcake, when all she had eaten of the first was the frosting. The mom voice in me wanted to say “you didn’t even eat the cake part, no way!” But because of all I know, I said “sure.” She took one lick and announced to me that she was “all done.”

As we were leaving, I could hear the girl still asking her dad for another cupcake while my daughter had already forgotten about them.

The question every parent needs to ask themselves is the way they feed their child effective in the long run? Let’s examine a few examples and see…

1. Being overly strict with sweet foods: I understand why the father did what he did. He’s worried that his daughter is overweight and needs to limit sweets. But while his daughter might have had only one cupcake at the party (win for Dad), she was left obsessing about the sweet treat. What is the long term implication? It’s very possible she’s going to over-eat sweets the next time she gets a chance.

According to a 2007 review study published in the Journal of Public Health, parents often use restriction to help their overweight children even though research shows it backfires and contributes to further weight gain.

Now the answer is not to give your child sweets anytime they want them. Instead of saying no to their requests, tell them they can have it at another snack or meal (example: can I have a cookie momma? I don’t have that planned for today’s snack but maybe next week). Letting them know they will have a cookie at some future date (instead of yelling “no”) teaches kids that eventually they will have a cookie and when they do they can eat until they’re satisfied. For more on this see 5 Reasons Kids and Parents Thrive on Planned Mealtimes.

2. Making them eat “this” before they can eat “that:” My daughter often has cereal with fruit for breakfast. Lately she’s been eating most of the cereal and little of the fruit. When she’s done with the cereal and asks for more my mom voice tells me to say “not until you take a few bites of your fruit.” If I did that she would eat the fruit and it would make me feel better.

But what does this feeding strategy do over the long run? Which food becomes more desirable to kids – the fruit (or vegetable in other cases) or the cereal? Studies show that asking a child eat a certain food in order to get something else makes them less likely to eat the required food when left to their own devices.

And if I know my daughter, she’ll change her eating again soon. Just a few weeks ago she ate 5 clementines and only had a couple of bites of cereal.

3. Having them take a few more bites before leaving the table: Dinner is my daughter’s – and most likely other kids’ – worst meal of the day. When my daughter barely touches her dinner my mom voice tells me to say “take a few more bites.” And when its really being pushy it adds, “and if you don’t there will be no after-dinner TV.” No doubt this strategy would help get her to eat a little more at dinner time.

But over the long run something else may happen. Instead of listening to her body, she’d learn to focus on external cues to decide when she’s done, including the okay from mom or dad. I know a lot of parents don’t consider weight a problem for their picky eaters, but we all need to remind ourselves that 6 out of 10 adults are either overweight or obese. Teaching children to listen to their hunger and fullness signals is vital for their future health.

So I ignore the mom voice (again) and look my daughter in the eye and ask her if she’s sure she’s done. I ask her if her tummy is full – reminding her to check in with herself. Some kids get distracted at meals and need to be reminded of the task at hand.

Of course other strategies like serving fruits and vegetables as appetizers and making sure kids’ afternoon snack isn’t close to dinnertime can help a great deal.

But as parents we need to challenge that little voice that tells us we can control our little one’s food intake. In fact, studies show that being too controlling or permissive when feeding children is not good for them over the long run. There’s a place in the middle and I struggle to stay there every day.

So if you don’t have a feeding strategy, maybe it’s time to get one. I stick with the division of responsibility and constantly remind myself that it’s my job to provide the food – and it’s my child’s responsibility to eat how much she wants.

You’ll be seeing more posts on managing your child’s intake of sweets in the New Year.

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References:

Clark HR, Goyder E, Bissell P, Blank L, Peters J. How do parents’ child-feeding behavior influence child weight? Implications for childhood obesity policy. J Public Health. 2007. June;29(2):132-41.

Tanofsky-Kraff M, Haynos AF, Kottler LA, Yanovski SZ, Yanovski JA. Laboratory-based studies of eating among children and adolescents. Curr Nutr Food Sci. 2007;3(1):55-74.

Parents today are inundated with childhood obesity statistics. We are told that if our children are big they are likely to be overweight as adults. We are told that children are more overweight today than ever before in history. It’s no wonder that parents become anxious when their child starts moving up the growth chart. I mean, a parent cannot just will their child to be slender. Or can they?

My favorite childhood nutrition expert, Ellyn Satter, MS, RD, LCSW, provides parents with much-needed guidance in her book Your Child’s Weight: Helping without Harming. Like all her books, Satter focuses on the Division of Responsibility of feeding – adults are responsible for the when, what and where of feeding and children are responsible for the whether and how much of eating. She says that in order to help your child arrive at a weight that’s right for him or her, you need to focus on providing, not depriving. With many real life examples, she shows how depriving children backfires and can set them up for life-long weight struggles.

Satter discusses appropriate food selection, the importance of family dinners, physical activity and how parents can optimize feeding at each stage of growth – from birth through adolescence. No matter how many times I read her books, I am always amazed how simplistic and ingenious her feeding advice is. After working with overweight adults for years, I’ve witnessed firsthand how parental feeding strategies contribute to weight problems in adults.

But don’t expect the typical diet and healthy eating advice from this book. Instead, Satter gets to the heart of what causes children to balloon to weights nature did not intend for them.

This is a must read for anyone with a family history of excess weight or obesity.

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