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An Ounce Of Prevention In A Child's Diet

by David L. Katz, MD, MPH, FACPM Yale University School of Medicine

Children are just as subject to the dietary preferences that compromise health as adults are, and they lack adult restraint and insight. Children also tend to be even more averse to new foods and flavors than adults. Kids tend to like sugar, salt and fat.

Because familiarity is a strong determinant of food preferences, once a high-fat, high-sugar, high-salt diet has been adopted -- the familiarity of that dietary pattern reinforces its appeal. So, accommodating your kids can pose quite a challenge as you try to improve the way you eat. The flip side is that good eating habits in childhood tend to predict lifelong behavior, so establishing good eating habits in childhood is especially important.

Recognize that while children may be less motivated to change their diets than adults, they actually adapt to change more readily. The younger children are, the more easily they tend to acclimate to new dietary patterns. So, there will never be a better time than today to begin improving the dietary practices of your kids.

If your children are too young to understand the rationale for trying to eat a healthful diet, they are young enough to have dietary changes imposed without much discussion. Use strategies and skills for insightful shopping and food-label interpretation to make your home a “safe” nutritional environment. You can still provide all of the types of food your children are likely to request, including cookies, snacks and chips. Children wanting ice cream in a home that only stocks non-fat frozen yogurt, or sorbet, will not know the difference! (As a father of five children, I know this from personal experience!)

Maintaining such practices will be easier than establishing them. Children, like adults, will tend to resist any dietary change. But they can acclimate. Stick with your plan and your new foods for two weeks, putting up with any protests during that time. You will likely notice that the fussing is over by the end of that period. You have won!

If your children are old enough to understand the link between diet and health, discuss it with them. They may already have a weight problem, and if not, will certainly have friends that do. Children are generally no happier about being overweight than adults, and they are equally prone to stigma and ridicule by their peers, if not more so. No kid wants to be obese if they can help it. And they can.

In the same non-judgmental way that you would like your own dietary habits addressed, help your children to understand that the way they eat will influence their health. Identify healthful eating as a family priority, something to work toward and take pride in. Make eating well a family commitment.

One good way of getting young kids interested in eating well is to involve them in food preparation. Let them help you prepare the dishes you particularly want to introduce into their diets. Because they feel responsible for these dishes, they will be more likely to taste them -- and to try to like them.

Your mother probably urged you to clean your plate. Why? One generation has passed along to the next -- from the Stone Age right up to the Depression and beyond -- the fear of not having enough food! Parents can’t seem to get used to the idea that, in the modern era of epidemic obesity, the danger is eating too much rather than too little.

If you traditionally encourage “plate-cleaning,” it’s time to stop. When we all have too much to eat, there is no good reason for eating all we have! Encourage your children to eat until full. Put less on their plates, rather than asking them to eat more.

Allow your children to develop a comfortable relationship with food. Recognize that children may eat erratically, achieving balanced nutrition over a few days, but not necessarily every day. To the extent that you can, let them eat when they are hungry. Be sure to give them good, nutritious choices. Then, let them take over.

Avoid the common practice of using dessert as a reward for finishing a meal. Children, like the rest of us, will want dessert whether or not they finish their meal. If they eat past hunger to finish a meal, sweet will still appeal to them -- leading to an excess intake of calories. Instead, offer only reasonable options for dessert and make these available at limited times (e.g., only after dinner, not after lunch; only certain days of the week). Make dessert independent of what is eaten before. There is no evidence that requiring more eating on the way to dessert has ever led to improved dietary health or weight control!

Do not rule out snacking for your children, any more than for yourself. What could be better than spoiling our appetites a little, when our appetites are part of why we are an increasingly overweight society? Give your children access to nutritious snacks and give them free rein to spoil their appetites. In fact, go ahead and join them! In diet, as in all things, children respond well to role models. If you adopt and demonstrate a healthful dietary pattern (while discussing your reasons), you become a positive role model.

Hours spent watching television, rather than engaged in physical activity, are thought to be an important contributor to the epidemic of childhood obesity in the U.S., compounded by commercials for sugary, salty and fatty foods. Restrict TV viewing, or at least be aware of the exposure and the messages. By knowing what your children are being told by advertisers, you can develop appropriate messages to compensate.

Be patient, gentle, and compromising; but be firm. If you are like most parents, you would not accept your children smoking in your home just because they want to! It is time to acknowledge that (on a population basis), poor dietary habits are actually a bigger threat to our children than tobacco. Once you have solidified your own commitment to eating in a more healthful way, you are quite justified in insisting that your children accompany you. By making good use of several simple strategies, you can make the way to eating well open to your whole family.

David L. Katz, MD, MPH, FACPM is Associate Clinical Professor of Public Health & Medicine at the Yale University School of Medicine, and Director of the Yale Prevention Research Center. A board-certified specialist in both Internal Medicine and Preventive Medicine, Katz is a nutrition columnist to O, the Oprah Magazine, and author of 7 books to date, including the nutrition text used at the Harvard and Yale Medical Schools, and The Way To Eat (Sourcebooks), which details over 50 essential skills and strategies for getting around commonly encountered obstacles to lifelong nutritional health and weight control. He and his wife Catherine have 5 children (Rebecca,14; Corinda,13; Valerie,8; Natalia,7; and Gabriel,4), so the advice in this column is vigorously field-tested!

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