Children, Follow My (Eating) Cues

Feeding behaviors are solidified early in life. In general, children are wonderful examples of listening to their hunger and satiety cues. Both of my children are great examples. My son is a really big eater in the morning and into lunch time and then has a tendency to pick the rest of the day. While other days, he eats very little. My daughter, on the other hand, eats a small amount at breakfast and then slowly picks up throughout the day.  Some days, she seems to eat the amount a grown woman would eat!  But I trust she is accurately listening to her own body as remains active and her weight is following a healthy growth curve. Unfortunately, many parents confuse children when they tell them to eat because it is meal time. Parents think, “Surely they should be hungry because they haven’t eaten in several hours.” And not only do some parents make children eat, some make them clean their plates. I recently wrote a letter to a well-known, elite school here in Dallas when one of my pediatric patient’s mother (who happens to be a physician) told me they still practice the clean plate club at their school. Really?! I thought everyone has figured out by now that this is not a good thing to do. The clean plate club trains the body “untrust” its physiological signals to eat or not to eat. This approach may have started back in the Depression when food was scarce, but I see many adult patients that are still trying to unlearn what they were taught by their parents. “Do not get up from this table until your plate is clean.” Or, “If you want that dessert, you better eat everything on that plate.” Dietitians cringe at the thought, although I truly believe parents are very well-intentioned. 

One of the best food behavior gifts we can give our children is the gift of trusting in their own hunger and fullness cues. I credit my own mother for allowing me and my siblings to make our own decisions to eat or not, and I firmly believe this has been one of the foundations to my healthy relationship with food. We ate as a family at the table without distractions (this is key), which helped us in listening to our individual cues. Because of mom, I can have my favorite food under my nose and if I am not hungry, I have no desire to eat it.

Hunger Scale by Paula Ryan, MS, of
Healthiest Regards Blog.
(Click to enlarge)

Paula Ryan, MS, author of the Healthiest Regards Blog, posted a great hunger and satiety scale that I wanted to share with Mommy Dietitian readers. It’s one of the best I have seen because it also lists the consequences of waiting too long eat, or not stopping when the body says it has had enough. If you find yourself eating in the absence of hunger or waiting way too long to eat, consider printing this scale off and going back to the basics. Many people eat for reasons other than hungers like when they are stressed, mad or sad. Deal with those issues directly instead of turning to food. It may be easier said than done for some, but this can be a start to a healthier YOU in 2011. And a healthier you means a healthier family because the children are watching – and doing what you do.

Trick or Treat -- Candy, Please!

Yep! Candy is mostly sugar.  Good thing
Halloween only occurs once a year.

The reality is that the Halloween tradition is about children receiving candy as they go door to door in their Halloween costumes.  Halloween only occurs once a year, so I say, let the children enjoy some candy.   Don't get me wrong.  I love the healthier ideas out there, especially the toy and sticker alternative.  But remember, candy is not the root of all evil – it is the frequency in which it is consumed that could pose a problem.  We live in a world where our children are already around lots of candy, so we must teach them proper behaviors around eating it.  I see Halloween as a wonderful training opportunity on proper eating behaviors.  So let the kids enjoy their Halloween candy, but don’t let it be consumed endlessly after the holiday.  I allow my children to have more candy than usual on Halloween.  In fact, I let them have all the candy they want this one night per year.  My daughter has already learned firsthand that too much candy will give her a tummy ache.  We had a great discussion when she was feeling sick after eating too much icing one time that too much candy will make her body feel bad.  After Halloween comes and goes this weekend, the frequency of candy consumption will go back to how it normally is at our home – a maximum of once or twice per week.  So, my take on Halloween?  Let the kids have their candy.  And remember to use this time to teach them about the place that candy should have in their lives every other day of the year – as an occasional treat. 

Parenting Styles and Child Feeding: What Does It Mean?

Health professionals were reminded in a great study that came out in the Journal of the American Dietetic Association back in 2008 that we must address parenting styles and family dynamics if we want to be successful in implementing dietary change in families. This study is consistent with many others published.  So with that, what is your parenting style? (If you haven’t yet, take the quiz in my previous post: Parenting Styles & Family Feeding: Take the Quiz!)

The good work started by psychologist researcher, Diana Baumrind, in the 1960’s helped us identify these 3 types of parenting styles – authoritarian, authoritative and permissive parenting. Now there are psychologists adding other styles, but we will zero in on the original three. The research I have done along with my own experiences with many family interventions reveal that authoritative parenting correlates to the best family feeding practices and lowest incidence of childhood overweight. Why? Because authoritative parents have a tendency to do the things pediatric dietitians and feeding experts recommend: monitor unhealthful child behaviors such as sugar and fat consumption; positively monitor, and take responsibility to promote child health and well-being through limit setting. They also have a tendency to model healthful lifestyles, which is a key component in your child’s learning process. On the other hand, authoritarian parents tend to food restrict and/or pressure children to eat regardless of the child’s desires. Permissive parents have a tendency toward poor healthy lifestyle modeling.  Therefore, it is not surprising that authoritarian and permissive homes produce the most overweight children.

The right parenting style may make your meal
times even more enjoyable.

So what’s the take home? It is clear that children need structure and clear guidelines when it comes to all kinds of behavior. But they also need and desire to have choice in matters. So, combine clear limits with the allowance of your child to make their own choice within those guidelines. Many child feeding specialists believe that regular and consistent times for meals and snacks promote feeding confidence in a child. The choices you give your child need to be age-appropriate as well. As an example, I allow my 6 year-old daughter to choose from a large selection of healthy snacks in our refrigerator and/or pantry during snack time. They are all there for her choosing. She feels empowered to make her own choice within the acceptable selection, and I am pleased that she is having a healthy choice.

If you took the quiz and found that you lean more towards a parenting style other than authoritative, don’t be upset. Many times our parenting styles fluctuate between the three styles. For instance, I notice that I sometimes deviate towards permissiveness when I am really tired, or more authoritarian-like when I am angry. So, take heart and know that knowledge is power. This information is designed to remind all of us as parents to be invested, consistent and clear about parenting for the sake of our home atmosphere as well as for the future of our children – in all areas, including feeding. If you want to read more about Diana Baumrind’s work on parenting styles, go to UC Berkeley's Institute for Human Development page.

More Reading:

Kyung E. Rhee, Julie C. Lumeng, Danielle P. Appugliese, Niko Kaciroti and Robert H. Bradley. Parenting Styles and Overweight Status in First Grade. Pediatrics 2006;117;2047-2054.

Hubbs-Tait L, Kennedy TS, Page MC, Topham GL, Harrist AW. Parental feeding practices predict authoritative, authoritarian, and permissive parenting styles. J Am Diet Assoc. 2008 Jul;108(7):1154-61.

Wake M, Nicholson JM, Hardy P, Smith K. Preschooler obesity and parenting styles of mothers and fathers: Australian national population study. Pediatrics. 2007 Dec;120(6):e1520-7.

Kyung Rhee. Parenting Style, and Family Functioning. The ANNALS of the American Academy of Political and Social Science 2008 615: 11

Wisdom From a Foodie Dietitian

In my industry, there are different types of dietitians.  My claim is clinical dietetics and practical wellness nutrition.  Dietitians that specialize in the culinary end of eating are usually nicknamed "foodie dietitians."  Since I consider myself more of a foodie wanna be,   I recently caught up with one of my favorite true blue foodies, Robin Plotkin, RD, LD, to get her perspective on family feeding for Mommy Dietitian readers.

Robin Plotkin, RD, LD and her son having some
fun with food.

Q: What are 3 top things that families can begin doing today that would help them pull healthy dinners together faster/more efficiently?

A:
1. Make a meal plan! We make plans for our after school actives, our workouts, our social lives....it’s critical to make plans for dinner. I encourage people to start slowly-just plan for 3 nights worth of healthy dinners at home and go from there. That way, you know you have at least 3 meals covered for the week. There are great resources out there for meal planning if you are someone who struggles with this-I love http://www.sixoclockscramble.com/, http://www.mealmakeovermoms.com/ and http://www.myfridgefood.com/ are a few websites I routinely recommend.

2. Gather the groceries! Once you have the meal plans in place, having the food handy seals the deal. Take your plan, make your list and off you go! It can be on a sticky note or an Excel spreadsheet-whatever works for you. If you are a beginner at meal planning, I recommend taking recipe ingredients word for word-as you hone your skills, you will be able to mix and match ingredients and find different uses for them as you go along.

3. Relax! Kids take their cues from the parents. If you enjoy preparing healthy meals for the family and look forward to spending time around the table, the kids will, too. If you are stressed, frustrated or would rather have a root canal instead of making dinner for the family, they will know and will feed off of the negative energy that you may be inadvertently sharing with them when it comes to food.

Q: From a culinary perspective, how important do you think exposure to a variety of foods impacts a child's palate long term? Please explain.

A: Reports are showing that kids are more adventurous with their food choices these days. The traditional PB &J is giving way to more organic, healthful and locally made. In addition, kids lunchboxes are filled with more ethnic foods which shows the diversity of the foods available in terms of takeout menus. Parents want to share their excitement of their new finds with their children. Speaking from the culinary side, kids are developing more distinguished palates at an earlier age which allows more creativity and acceptance long term when it comes to food.

Q: What are some techniques that you recommend to increase food acceptance in children?

A: You’ve heard it before and you’ll hear it again-get kids involved! I’ve taught kids cooking classes for twelve years and there is a world of difference between a hands on cooking class vs. a demonstration only. When kids are encouraged to take part in the process, the sense of empowerment, self sufficiency and acceptability of the food itself skyrockets. And, the pride they feel after making something on their own to feed themselves and their family is indescribable.

Got tools? Get Cooking! At any age, kids should be allowed into the kitchen. Give them their own age appropriate tools-cutting boards, measuring cups and spoons, whisks, etc. Assign age appropriate tasks as well. Smaller kids can stir or pour, older kids can chop softer foods (i.e. Kiwi, banana, pasta) with child safe knives, and preteens and teens can take on complete recipes-start easy-scrambled eggs with cheese, guacamole, etc. Of course, adult supervision is necessary as are proper food safety and sanitation.

I also love to give fun tools and resources for parents as gifts. For example, http://www.fredandfriends.com/ has great plates, utensils, and other creative and fun tools just for kids. Ellyn Satter, RD books are terrific http://www.ellynsatter.com/ for introductions on how to feed your baby well. Cooking school gift certificates are unique gifts for kids adults alike-they allow the individual to gain confidence in the kitchen and are a lot of fun!. Finally, subscriptions to kids cooking magazines like Chop Chop (http://www.chopchop.com/) or Relish Kids (http://www.relish.com/) are gifts to encourage and inspire-all year long.

Q: Care to share one of your favorite, quick and healthy recipes that you make for your family?

A:
Easy Turkey Meat Sauce with Whole Wheat Pasta

Ingredients:2 T olive oil
1 onion, diced
1 pound lean ground turkey breast
1 jar of your favorite spaghetti sauce
Frozen broccoli, thawed (as much as you’d like)
Fresh spinach (as much as you’d like)
Oregano (to taste)
Basil (to taste)
Pepper (to taste)
Whole wheat pasta-cooked according to directions
Mozzarella cheese, grated

Directions:
Heat a large sauté pan over medium high heat. Add olive oil. Add diced onion and cook for approximately 5 minutes, or until onion becomes translucent. Add turkey and quickly break into small pieces. Once cooked through, add spaghetti sauce and allow to simmer for 5-8 minutes. Add broccoli and allow to heat through. Season with oregano, basil and pepper. Stir. Add spinach and stir, allowing it to wilt slightly. Remove from heat. Serve pasta in bowls and spoon sauce over the top. Add cheese. Enjoy!

Use the leftover sauce for Turkey Sloppy Joes, as a sauce for pizza, as filling for tacos, enchiladas or any other place you would substitute traditional meat sauce.

Robin Plotkin, RD, LD is a culinary and nutrition expert based in Dallas, Texas. She blogs, tweets, teaches, talks and tastes food for a living and wouldn’t be happier doing anything else. For more information, visit http://www.robinplotkin.com/ or her Robinsbite blog at http://www.robinplotkin.blogspot.com/.