Welcome to Raise Healthy Eater’s first expert interview. Ellyn Satter, MS, RD, LCSW is an internationally recognized authority on eating and feeding. Satter integrates her 40 years of experience in helping adults be more positive, organized and nurturing in caring for themselves and their children. She is also the author of several books including Child of Mine: Feeding with Love and Good Sense and Your Child’s Weight: Helping without Harming.

“Not knowing how important they [parents] are,” Ellyn Satter says after being asked what she believes is biggest feeding mistake parents make. “Children have a drive to grow up to be just like their parents.”

But she doesn’t push parents to eat or prepare ultra healthy meals. Instead, she emphasizes family dinners as the holy grail of raising good eaters. “There’s too much guilt and anxiety with the virtue of meals” she says. “Parents get caught up in the what of feeding when they really need to pay attention to the how.”

Satter asks busy parents to make only one change at first: eat together as a family. So whether they’re eating fast food or frozen meals, all they need to do initially is gather at the table. On her website she has a step-by-step guide for mastering family meals. And she makes the focus pleasure, not nutrition.

So her first piece of advice: start with the foods your family enjoys and build on from there. This doesn’t mean pleasure and nutrition can’t coexist, they definitely can. But Satter points out that if the meals you prepare aren’t rewarding, they won’t seem worth the effort.

This is the perfect segue into my next question: “How can moms get their kids to eat vegetables?”

In addition to being an internationally recognized feeding expert, Satter is also a mom of three (now grown) kids. When her daughter was little she wouldn’t touch a vegetable but Satter took it in stride. When she brought the topic up with other moms she found them in hysterics about their non-vegetable-eating kids.

“Don’t let vegetables be the deal breaker,” Satter says, leading to her second piece of advice for families. “Once family meals become a habit, naturally find ways to add more variety to meals, including vegetables.”

Satter says the best way to get kids to eat vegetables, or any food for that matter, is for parents to eat it and enjoy it themselves. Of course she talks about the division of responsibility – parents decide the what, when and where of feeding and children decide the whether and how much of eating. She also explains the importance of “neutral,” repeated food exposure. The bottom line: kids do best when exposed to a variety of foods with absolutely no pressure to eat.

When Satter’s daughter hit early adolescence she took up a new hobby: devouring vegetables. She noticed everyone else in her family enjoying them and realized she was missing out. She is an avid-vegetable eater today not because her parents tricked her into eating greens, but because she got to the point where she wanted to eat them.

The next question for Satter is about sweet foods: how often should parents serve dessert? She says frequency isn’t as important as how it is served. Too often, she explains, dessert is the unspoken reward that kids’ can fixate on at mealtime.

To solve this age-old dessert problem, Satter advises parents to serve a single serving of dessert with the meal. “Some kids will save it, others will eat it first and some will eat it right along with the other food,” she says. She points out that this is the one time she deviates from the division of responsibility because she advises parents to only allow their kids a single serving of dessert.

“To avoid scarcity with sweet foods,” she adds, “Make sure there’s another time (snack time for example) when they can eat all they want of the item.”

Who eats dessert with dinner? Isn’t that crazy? Not really. What this feeding strategy shows children is that sweet foods, already palatable and easy to like, are not such a big deal. They are just part of the meal like the vegetables and meat.

If you think about the nature of nutrition and behavior you can see how her approach makes perfect sense. We live in a culture where the “shoulds” of eating are all around us. Eat more fruits and vegetables. Watch the fat. And make sure you skip the tasty dessert at after dinner.

Yet despite all of this scolding, recent studies show only about 3 percent of Americans lead a healthy lifestyle. Let’s face it, it’s human nature to rebel against what you should be doing (kind of like cleaning out the sock drawer). If parents can learn to feed in a positive way, their children will grow into adults who eat nutritious foods not because they feel obligated, but because they enjoy eating them.

“The data is clear – pressure children to eat, and they’ll lose interest in food; restrict their access to palatable foods and they’ll become preoccupied with them,” Satter explains. “Just provide a variety of foods with structure, eat with your kids and trust that they know exactly how much to eat.”

Watch for part two of my interview with Ellyn Satter, where she explains the surprising benefits of raising a competent eater.

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Q: My child has been refusing to eat dinner and then begs for something else to eat 15 minutes later. What should I do?

A: Dinner can be a tough meal for children because there tends to be more grown-up food on the table. I follow the advice from Ellyn Satter’s books and consider the whole family when planning dinner instead of focusing on my picky eater. I try to prepare at least 2 meals per week that are my daughter’s favorites and do the same for my husband and me. On the nights the dinner entree is a new item or something she doesn’t typically eat, I make sure to serve at least 2 other items that she likes such as bread and fruit.

If your son goes to bed awhile after dinner consider adding a bedtime snack. That way, when he asks for food between meals you can tell him his bedtime snack is coming in a couple of hours. If you stay consistent, your son will catch on and will stop asking for food right after dinner. Eventually, he’ll start eating a wider variety of food because he knows you’re not just going to feed him his favorites.

The hardest part is accepting that some nights your little one won’t eat a balanced meal. But I believe the above strategy pays off in the long run. My daughter is finally starting to eat more of the dinners I serve after months of refusing. And by refusing I mean taking the food off her plate yelling, no, no, no! Of course, I follow the Division of Responsibility: I decide the what, when and where of feeding and she decides the whether and how much of eating.

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Dinner is only a couple of hours away but that doesn’t stop your kids from hounding you for some food, milk or juice. You can’t remember the last time they ate. Did they snack? You’re unsure because they’ve been grazing all day long. So you give them what they want and are disappointed when they only take two bites of dinner.

Having consistent meals and snacks goes a long way towards solving family food dilemmas. Here are 5 reasons your family will benefit from having regular meals and snacks without food in between.

1. It helps parents provide variety: As the parent, you are the decision maker when it comes to what, when and where your child eats. Having regular meal and snack times better equips you to feed your child all the nutrients they need to grow and thrive.

For example, when I offer my daughter a snack between meals I know what she had for breakfast and what she’ll have for lunch and dinner. This helps me offer her an appropriate snack. If it’s bean burritos for dinner I offer her veggies and dip. If she doesn’t have dairy for lunch I serve whole wheat crackers with cheese. So instead of making decisions on the fly, I have a flexible plan to ensure I’m offering her a variety of food.

2. It helps kids regulate their hunger: Ellyn Satter, MS, RD, author of several childhood nutrition books, explains how offering children food every 2-3 hours helps regulate their hunger. Balanced snacks, better thought of as mini meals, help children get from one meal to the next without getting too hungry or being too full.

Satter says that balanced mini meals are best when they contain all three of the macronutrients: protein, carbohydrate and fat. This combination helps satisfy little ones and holds their hunger for longer periods. For example, cheese and crackers provides protein, carbs and fat as does veggies dipped in hummus. Look for an upcoming post on how to plan appropriate snacks.

3. It helps solve the “mom can I have” problem: It’s in most children’s nature to try to take over your job of what and when to eat. They will try to get the food and drinks they like whenever they can get it. The problem with this strategy is kids don’t know how to plan their meals (yet). While it’s their job to decide how much to eat of what you offer them, it’s not wise to put them in charge of mealtime choices.

Having planned meals and snacks gives you the perfect response to their requests. You can say that their next meal or snack is coming real soon. And when they request a particular food you can tell them you’ll keep that in mind for future meals. Remind them that it’s your job to decide when and where they eat and they can decide whether or not to eat it.

4. It makes dinner more enjoyable: When my daughter constantly grazes before dinner she’d rather be anywhere then the dinner table. Sometimes I let this go, especially when we go to afternoon parties or visit her grandparents. My goal is to give her a snack at least 2 hours before dinner so she shows up to the table with an appetite.

When young children come to dinner hungry, but not ravenous, they are more likely to eat at least some of what is offered. They also behave better when they aren’t starved or already full.

5. It helps fight obesity? In one of Ellyn Satter’s most recent books, Your Child’s Weight: Helping without Harming, she explains how a lack of consistent meals is a possible contributor to childhood obesity. She says parents who are more laid back with feeding, and don’t offer regular meals and snacks, bring about feelings of food insecurity in their children. So kids overeat when they have access to food because they can’t count on reliable meals. But when children are offered a variety of food at consistent and frequent intervals, they are better able to regulate their hunger and get what they need.

When you think about it, it’s hard to get full and satisfied when you graze on food vs. sitting down to a balanced meal. Having regular meals and snacks may take a lot of planning, but the pay off is well worth it.

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Dealing with a picky eater can be challenging for parents. Instead of getting lured into a no-win power struggle, here are seven effective ways to help your fussy eater become less fussy.

1. Change your mindset: Does your picky eater drive you completely insane at mealtime? Try not to dwell on the frustration of it all. Instead, think of it as a normal part of their development (which it is!). Young children learn to like a variety of foods the same way they learn how to dress themselves, tie their shoes and read and write – in due time.

2. Focus on the family: Instead of focusing all of your meal-planning efforts around your fussy eater (it will only frustrate and exhaust you!), prepare and plan meals with the whole family in mind. If you haven’t invited your little one to join the family table for meals, then do so. This is where they learn the most – by watching their family eat.

3. Provide consistent meals & snacks: It’s tempting to give picky eaters the foods they want, when they want them, but this can lead to all-day grazing. Studies show kids who eat planned meals and snacks have more nutritious diets then those who eat fewer meals. When you provide your child with 3 regular meals and 2-3 snacks, without food in between, they have more opportunities to eat and be exposed to different foods. Make sure to include their favorites along with other nutritious items they may not like so much.

4. Check liquid calories: Kids have the uncanny ability to self-regulate food intake which means they can fill up on any calorie-containing item including drinks. So watch how much juice and milk they are consuming to make sure these beverages aren’t displacing other nutritious foods in their diet. Keep juice to 4-6 ounces per day for 1-6 year olds and 8-12 ounces for older kids. Kids over 2 only need 2 cups of milk per day and when they turn 8 it goes up to 3 cups.

5. Don’t leave it all for dinner: Many parents wait for dinner to try new foods or serve certain items like vegetables. But kids are least likely to eat at dinner because hunger tends to wane as the day progresses. So serve veggies and other new foods earlier in the day when you child is likely to be more receptive.

6. Don’t say a word: Believe it or not, you are not responsible for what your child eats. Your only responsibility is to provide balanced meals and snacks. Leading childhood nutrition expert Ellyn Satter, MS, RD, LCSW encourages parents to employ a Division of Responsibility – parents decide the “what” and “when” and “where” of feeding and children decide “how much” and “whether” to eat. So resist the urge to say anything to your child about how much or what they are eating – leave them to do their job.

7. Include little ones in meal planning: Ask for older kids input when planning weekly meals, make little ones helpers in the kitchen and ask for help when picking out produce. Even though you are in charge when it comes to meal planning, making children part of the process will help pique their interest.

There are no secrets or tricks to get a picky eater to eat a variety of foods. They simply need time, no pressure and repeated exposure to nutritious foods. As a parent you are their teacher. And the best way to teach is to show.

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Check out my guest blog for www.littlestomaks.com. The post details 5 toddler feeding strategies that end up doing more harm than good — and those that can actually help your little one become a healthy eater in the long run.

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People eat for reasons other than hunger. They eat when bored, to celebrate or to get through difficult times. But what no one talks about is how these habits develop in the first place. Do people engage in this behavior because food is plentiful or is it a learned behavior?

I believe the majority of eating habits are formed early in life. It took me years to get over my have-to-eat-when-I-watch-TV habit. I grew up mindlessly eating while watching my favorite programs so it’s no surprise it continued into adulthood.

As parents, we have the power to prevent our children from making food associations that cause over-eating. But like any dietary pattern, kids tend to follow their parents’ footsteps. So like most of the advice given on this blog, it applies to the whole family.

Here are 5 mistakes parents make when feeding their children – and how to fix them.

1. Eating to cure boredom: You don’t need me to tell you that kids get bored very easily. Sometimes parents offer food to distract their kids from boredom. Of course, doing this once in a while won’t hurt but getting into a regular habit of offering food to occupy time backfires. That’s because kids learn that eating is the solution to boredom. And food – when used to solve non-food problems – always makes matters worse.

Instead, stick to consistent meals and snack times for you and your children. When your kid gets bored let them feel bored. You can also suggest solutions that will help with boredom like completing chores, playing with a certain toy or working on a project. Or you can ask them what they think they should do. Soon they will learn the skills to combat boredom.

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2. Rewarding behavior with comfort foods: There are many ways parents can use food to reward children – saying they can have cookies if they finish their dinner or clean their room. If they do well in school a parent might offer a child an enticing meal or favorite food. What’s the big deal? Studies show that making certain foods accessible only after completing a specific task, increases children’s preferences for that “reward” food.

A child who engages in this reward model of eating may become an adult who searches for reward-type excuses to eat comfort foods. Whether they indulge because “it’s Friday,” they are on vacation or even during pregnancy, once they find the appropriate excuse they tend to over-eat.

Instead, provide your child (and yourself) with your favorite high-calorie, palatable foods 2-3 times a week as a regular part of meals and snacks. For example, cookies and milk as a snack on Monday, chips with lunch on Wednesday and fries over the weekend. This teaches kids how to eat the high-calorie foods as part of balanced diet – and makes comfort foods less of a focus.

3. Using food to distract from uncomfortable feelings: It’s understandable that parents want to ease their children’s bad feelings. Offering favorite foods to a child is tempting but it teaches them the wrong message – that food can cover up difficult feelings. Food only temporarily makes kids feel better and it adds a new problem of potentially being overweight.

Instead, let your child feel upset and encourage them to talk about what’s bothering them. If you find them seeking food on their own, talk to them about it. Teaching your child to accept difficult emotions as a regular part of life is an important lesson.

If you find yourself eating in response to stress or difficult emotions, find non-food ways to solve problems or ease stress. And above all, allow yourself to eat foods you love as part of your regular diet so you don’t search for excuses to eat them (like in #2).

4. Providing snacks during TV time: Studies show that excessive TV viewing in children is associated with high weights and poor eating habits. According to a 2008 study in the International Journal of Obesity, for every additional hour kids watch TV they consume 106 extra calories. This causes children to eat out of habit, not hunger.

I’m not talking about having popcorn while watching a movie on Saturday night. But making the rule of no eating while watching TV – and making sure you the parent follow it too – is a smart move. Having a designated place for meals and snacks (like the kitchen table) will decrease the likelihood that your kids will associate eating with such a sedentary activity.

5. Eating in the car: One final food association that can cause over-indulgence is eating in the car. Once a child gets used to noshing while riding in the car they will expect food in the car and want it even when they aren’t hungry. Don’t get me wrong. There are times (more like emergencies!) that you’ll need to feed your child in the car – even to distract them. Like anything, make it occasional so a habit never develops.

Mealtime should be sacred, something to be enjoyed and savored. When we bring food and eating into other “non-food” areas we not only increase the likelihood of over-eating but we leave problems unsolved. Let your children keep their gift of eating when hungry and stopping when full. And then make them your role model.

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References

Fish JO, Birch LL. Restricting access to foods and children’s eating. Appetite. 1999;32, 405-419.

Jackson DM, Djafarian K, Steward J, Speakman JR. Increased television viewing is associated with elevated body fatness but not with lower total energy expenditure in children. Am J Clin Nutr. 2009; 89(4):1031-36.

Sonneville KR, Gortmaker SL. Total energy intake, adolescent discretionary behaviors and the energy gap. Int J Obes (Lond). 2008;Suppl 6:S19-27.

AAP Policy Statement on Television Viewing

I recently taught a class to a room full of moms about toddler eating problems. I heard moms complain about how their children were no longer good eaters. The question of the day was “How do I get my toddler to eat?”

There were also some parents worried that their children were eating too much at mealtime. And with all that you hear about childhood obesity, their concern is understandable.

The way to handle both of these concerns is surprisingly simple. Let me show you why.

The responsibility of feeding a child is a two way street
Ellyn Satter, MS, RD, LCSW coined the term “The Division of Responsibility” and has done a substantial amount of research on childhood eating over the past 40 years. When you apply her theory you’ll find that it solves – and can prevent– many childhood feeding problems.

The idea is that both the parent and child have a responsibility. It’s the parent’s job to decide the “what” and “when” of feeding and the child decides “how much” to eat. Problems usually occur when someone, either parent or child, crosses this division of responsibility

Example 1: Child running the show
Little Charlie insists he gets certain foods at meals so his mom gives in afraid he’ll starve to death. As a result, his diet consists of macaroni and cheese, fries and waffles. The problem? Charlie has taken over his mom’s job of deciding “what” to eat.

If Charlie’s mom were following the Division of Responsibility, she would tell him that even though she takes his requests into consideration, it’s her job to decide what he eats – and he can decide whether or not to eat it. She plans his meals with his food preferences in mind but doesn’t resort to feeding only his favorites.

In her most recent book, Secrets of Feeding a Healthy Family: Orchestrating and Enjoying the Family Meal, Satter explains that children need ample opportunity and time to learn to like certain foods. At around 18 months of age many toddlers become skeptical of certain items, like vegetables, but this is just a stage. By continually offering foods your child may not like (without pressuring) you give him the opportunity to learn to like that food. If you take away the food, you take away the opportunity.

Example 2: Parent controlling their child’s food intake
In this example, Charlie is eating very little at meal time and his mom says “That’s all you’re gonna eat?” She even starts to make him eat at least half of his plate before he can  watch TV or play with his favorite toy.

Another example is Sadie, a girl with a hearty appetite. Her mom purposely limits how much she eats because she’s already 90th percentile for weight.  When Sadie asks for more her mom says, “That’s all there is.”

In both examples, the parent is crossing the line of responsibility by deciding how much a child eats. Why is this bad? Studies show that children tend to eat less when pressured and more when they feel food is scarce. Additionally, you want your child to maintain their ability to self-regulate intake. This is a gift that most adults would die for, to eat when hungry and stop when full.

My daughter has just started eating very little at breakfast. Do I like it? No! I could make her finish her breakfast before she gets her morning dose of Barney but what would that accomplish? She would probably come to dread eating breakfast because of the negativity of being forced to eat. We’d have a morning showdown with her crying and me saying “No Barney today.” Or I could trust that she’s not hungry and will eat her snack 2-3 hours later. She remains pleasant at breakfast and will probably start eating more in a couple of weeks.

So as parents our job is to provide the “when” and “what” of feeding. This site offers resources on how best to do your job of providing regular meals and snacks.  Watch out for future posts on Quick Dinners – mom-made super simple dinner recipes.

And when children are left to do their jobs, they relax a little and are more likely to be cooperative because they feel respected.

When parent and child divide the responsibility of eating in this way, it solves most childhood feeding problems. And it sure does make life – and mealtime—a lot more pleasant.

I highly recommend Satter’s most recent book, Secrets of Feeding a Healthy Family: Orchestrating and Enjoying the Family Meal where she explains The Division of Responsibility in detail. I will review more of her books here in the future.

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