In Kids We Trust (To Eat Well)

They'll do the right thing when left to own devices

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By
HealthDay Reporter

MONDAY, Oct. 21, 2002 (HealthDayNews) -- Parents, just learn to trust your kids at the table.

That's the message coming from childhood nutrition experts. Left to their own devices, children will know when, what and how much to eat. It's just when adults try to interfere that problems develop. That message was delivered yesterday at the American Academy of Pediatrics' national conference in Boston.

"In our culture, restrained eating has gotten to be so normative. People continually try to eat less food than they're really hungry for, so they feel constantly deprived and they're vulnerable to being enticed by certain foods that they find appealing," says Ellyn Satter, an eating specialist, family therapist and author of Child of Mine: Feeding with Love and Good Sense. "It's a pattern of being good and being bad, restraining and disinhibiting, depriving and then eating a great deal."

The result: An epidemic of overweight and obese children -- not to mention adults. According to the results of the 1999-2000 National Health and Nutrition Examination Survey (NHANES), some 15 percent of children and adolescents aged six to 19 are overweight. That's triple what the proportion was in 1980, says the U.S. Department of Health and Human Services. More than 10 percent of children aged 2 to 5 are overweight, up from 7 percent in 1994.

The idea that children have a sort of internal clock to regulate eating is fairly well accepted in nutrition circles. It's also well accepted that grownups are a kid's worst enemy in the kitchen, the dining room and in restaurants.

"We tend to screw up a kid's natural clock: We say, 'It's time for lunch. Eat.' We bring Goldfish crackers to the park just in case the kid gets hungry. If the kid doesn't eat vegetables one day, we don't serve it to them. Those are all issues where we screw up the natural clock of things," says Cathy Nonas, a registered dietician with the New York Obesity Research Center in New York City and author of Outwit Your Weight.

Satter tells of one 6-year-old girl who had been overweight since she was 18 months old. "It was all because her mother was trying to restrict her food intake and the little girl had become food-preoccupied and prone to overeating," she explains.

As it turns out, the mother was a chronic dieter and was passing her fears on to her daughter. Once the mother overcame her fears around food, she was able to feed her daughter in a more positive way and the girl shed her preoccupation with food.

None of this means that caregivers should just sit back and watch nature take its course. Parents -- and kids -- have certain responsibilities.

"Feeding demands a division of responsibility," Satter says. "When the children are old enough to eat from the family table, parents take the responsibility for what, when and where children are offered food, and children take responsibility for how much and whether they eat."

This means providing a full range of nutritious food including, from time to time, potato chips, ice cream and pizza. "The structure is that, while we eat these foods for dessert once in a while, we don't make a steady diet of them and we don't eat them all the time," Satter says. "It's not a controlled substance." This way, when potato chips appear, children can learn to consume in moderation.

Here are some more tips for helping your kids learn to rely on their inner clock:

  • Dedicate one room in the house for eating and don't eat in front of the television. "People get used to eating at all different times having nothing to do with hunger," Nonas says. "They can't self-regulate. The families have to set themselves up so that the kids can self-regulate."

  • Sit down with your kids and develop universal policies for all members of the family to abide by. These rules should be geared for good health, not weight. For instance, Nonas does not allow anybody in her house to order pepperoni pizza because not everyone likes it and it's "fat on top of fat."

  • Keep making vegetables even if your kid doesn't eat them. "They'll come around -- probably not at your house but at somebody else's," Nonas says. Even though it's a pain, you can also try separating out different vegetables on separate plates so kids can mix their own salad.

  • Don't badger the child to eat or restrict his or her food intake. "Once the food is on the table, it's up to the child to decide what and how much he or she wants to eat," Satter says.

  • Don't send your kids off to school without breakfast. That leaves them wide open to grab something less nutritious on their way.

  • Provide cut-up fruit along with cake at birthday parties and serve both at the same time. Nonas finds the fruit is always gobbled up. "Kids are much more flexible than we give them credit for," she says.

  • At fast-food restaurants, ask your kids to choose a favorite food and balance it with a salad -- or go for the medium size instead of the large.

  • Give kids separate, smaller bags of snacks. "If you ask two kids to share a bag of potato chips, they will probably eat more quickly in fear that the other is going to get more," Nonas says. "If you give them their own bag, they will be able to self-regulate better."

  • Buy pedometers for the whole family so you can take walks together. Also, convince your school to raise money through pedometer sales instead of bake sales.

  • The bottom line: "Put a variety of food on the table, sit down and eat with the kids, and just have a nice time," Satter advises. "Put the emphasis on providing rather than restricting."

What To Do

Find out more about obesity in children from the U.S. Surgeon General or the American Academy of Family Physicians. The American Dietetic Association has tips for making the most of family mealtime.

SOURCES: Ellyn Satter, R.D., eating specialist and family therapist, Madison, Wis.; Cathy Nonas, R.D., New York Obesity Research Center, New York City; Oct. 20, 2002, presentation, American Academy of Pediatrics conference, Boston

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