Author: Narmin Virani, RDN, LDN, VICE-PRESIDENT
Are you a parent? Do you want your child to develop a healthy relationship with food and their bodies? Then read on!
Some challenges you might be facing may include:
- You have to juggle school, work, and extracurricular activities
- You may be eating more meals on the go, with family meals taking a backseat
- Your children are targeted with marketing for foods that are not the most nutritious and wholesome.
- Your children might assert their independence over meal choices, and attempts to control their eating may lead to conflict and resentment.
- Your doctor or well-meaning relatives may suggest weight loss for your child.
Here is a list of suggestions that may help your child develop a healthy relationship with food and sustainable eating habits. These are based on my clinical experience and on evidence-based research by Ellyn Satter: registered dietitian and psychologist, pioneer and expert in the field of pediatric nutrition, and author of several bestselling books including “Your Child’s Weight - Helping without Harming” (2005), and “Secrets of Feeding a Healthy Family” (1999). (www.ellynsatterinstitute.org).
- Do not put your child on a diet, whether it's a calorie-restricted diet or a macronutrient-restricted one. Diets increase the risk of long-term weight cycling (Neumark-Sztainer 2012) and eating disorders (Stice 2002, Neumark-Sztainer 2006). Any deprivation-based meal plan that requires willpower to succeed, may produce short-term results, but lead to long-term weight-cycling and an unhealthy relationship with food. Restricting either types or amounts of food may lead to excessive preoccupation with food, leading to loss of control with eating, followed by feelings of guilt and shame. Rapid initial weight loss on very restricted diets may lead to loss of lean body mass.
- Focus on health, not weight. BMI does not always predict health risks. Weight cycling is a bigger risk factor for chronic diseases such as diabetes, hypertension, and heart disease than the weight itself (Montani 2015, Oh 2019, Kim 2018, Byun 2019). Studies show a correlation between BMI and the risk of chronic diseases, but not necessarily causation. Many other factors such as genetics, stress, sedentary lifestyle, weight stigma, and weight-cycling might play a role. Ironically, when healthy young people are put on diets, they lose weight, then gain more, and this weight-cycling puts them at a higher risk for chronic diseases.
- Avoid making comments about your child’s appearance, both positive and negative. If your child’s self-esteem is tied to their appearance, it can be fragile. Instead of praising your child for being beautiful, acknowledge other attributes, such as kindness, curiosity, and intelligence, to foster more robust and resilient self-esteem.
- Instill body positivity at a young age. The best way to do this is by role modeling body positivity as a parent, by not making negative comments about your appearance or that of others. Talk to your child about how models on magazine covers are artificially photoshopped, and how the beauty and fashion industries make their profits by making us feel like we would be more socially acceptable if we purchased their products.
- Don’t label foods as “good” or “bad”. This causes guilt and shame when
“bad food” is eaten. Instead of labeling certain foods as “junk foods”, use the term “play foods”. Explain that their growing bodies need nutritious foods to make them strong, just as their minds need education to make them smart. Just as weekends come after five days of school, nutritious foods also need to be balanced with play foods. Pack lunches containing nutritious choices and also small amounts of play foods, to reduce the temptation to “trade” snacks with other children. - Let children eat when they are hungry, and stop when full. Try not to control the amount or types of foods they eat, beyond offering a variety of nutritious choices. Some days the child may eat less; don’t force them to eat more. On other days they may eat more; don't comment that they are overeating. Their needs may vary day to day.
- Don’t restrict certain foods, this might bring out the “inner rebel” in the child, and make forbidden foods seem more alluring. Research shows that “food-policing” leads to sneaking and hiding food (Sonneville 2013). When you don’t keep your child’s favorite treats at home, they might overeat these foods when visiting a friend. When children know that they can have any food when they want, they might eat it slowly and mindfully, and even choose to take it or leave it on some days. Serve a variety of foods; do not insist that your child eat certain foods or avoid certain foods. Let them take their time in discovering and getting to enjoy nutritious foods. Otherwise, fruits and vegetables become “punishment foods” that are eaten with resentment, and sweets/snacks become “reward foods” that are craved even more.
- Make structured and consistent meal times a priority: Try to eat at the table, without distractions such as TV, as much as possible. Practice slow and mindful eating. Avoid skipping meals, and encourage eating balanced yet satisfying meals or snacks every four hours or so, to prevent overeating later in the day. Keep snacks on hand as a backup for busy days. If you must eat some meals in your car, try to park the vehicle first. Avoid letting your child watch television while eating a snack when they come home from school, this may lead to eating beyond fullness as a way to procrastinate with homework. Instead, let your child have a mindful snack at the kitchen table when they come home from school, and then spend some time watching TV, playing video games, or playing outside, before starting homework.
- Role model and teach mindful eating. Children imitate their parents. If they see their parents enjoying various foods, they will be more likely to want to do the same. Take the time to role model and teach children how to savor their meals using all of their senses, and identify hunger and fullness signals as a way of guiding portion size. Do this in a playful way so that your children may be inspired to continue to practice.
- Limit the number of juices and sodas kept at home. Let water be the beverage of choice for the most part.
- Make nutritious foods fun: Grow a garden with your child. Involve them in watering, pulling out weeds, and incorporating the produce in meals. Take them fruit-picking. Join a CSA (Community Supported Agriculture), to try new vegetables and fruits. Involve your child in food shopping and cooking.
- Create positive experiences around food shopping, cooking, and eating. Let your child choose some foods when shopping, including play foods. Let them make a mess while cooking and do things their way. Try to make eating a pleasant, relaxed experience free from pressure, control, and stress.
- Trust your child to eventually eat a balance of foods if given the autonomy to make choices. Parents fear that if the child is allowed to eat whatever they want, they will eat only candy or chips! This is not true and has been confirmed in studies. Have you been on a vacation or cruise with “all-you-can-eat” buffets? Have you found yourself overeating desserts on the first day, but by the last day, feeling sick of the heavy, rich food, and craving simple, homemade food? Children are the same. Once they cultivate a taste for a variety of foods, they may go through periods when they want to eat more of certain foods for a few days or weeks, but if they are still given what they want during this time, they will eventually crave foods that feel more comfortable and energizing.
- Suppose you have already gotten into a conflicted relationship with your child when it comes to eating, and have been restricting certain types of foods. In that case, chances are that when you loosen the reins, your child may overeat certain types of foods that were restricted before, but don’t get alarmed. This could be due to a combination of the built-up deprivation, and an attempt on your child’s part to test whether you mean what you say. If you do not react, they will eventually trust that they can have these foods whenever they want, and that’s when the urgency around eating these foods may fade.
- If you are the parent of a toddler who has just started eating solid foods, try sticking a reward chart on the fridge, giving them a gold star sticker every time they try even a spoonful of new food. This may invoke their adventurous spirit. Don’t insist they eat more if they refuse it beyond the first bite; keep some standard backup options on hand that the child prefers. Rest assured that they will acquire a taste for new foods over time, and eat more than just a few bites.
- Encourage healthy emotional expression: Children are sensitive and eager for their parents’ approval. Well-meaning advice given by a parent can be heard as a judgment by a child. Be sensitive to their feelings. Talk about feelings and ask how they feel when they tell you what happened during their day. Talk about how no emotion is “right” or “wrong”, and that all emotions are valid, so your child doesn’t learn to numb their feelings or distract them. Make time for your children and take an interest in activities they enjoy, even if you don’t enjoy them. This will make them receptive to your suggestions in other areas of their life. When your child asks for advice, resist the urge to give an answer right away, and instead ask what they think they should do, to encourage them to develop and trust their own instincts. Talk about different types of interpersonal communication styles (aggressive, passive, passive-aggressive, and assertive), with examples and explanations of which is the most productive style (assertive).
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References:
Neumark-Sztainer D, Wall M, et al. Dieting and unhealthy weight control behaviors during adolescence: Associations with 10-year changes in body mass index. 2012;50(1):80-86.
Stice E, Presnell K, et al. Risk factors for binge eating onset in adolescent girls: A 2-year prospective investigation. Health Psychol. 2002;21(2):131-138
Neumark-Sztainer D, Wall M, et al. Obesity, disordered eating, and eating disorders in a longitudinal study of adolescents: How do dieters fare 5 years later? J Am Diet Assoc. 2006;106(4):559-68.
Montani JP, Schutz Y, et al. Dieting and weight cycling as risk factors for cardiometabolic diseases: Who is really at risk? Obes Rev. 2015;16:(1):7-18
Oh TJ, Moon JH, et al. Body-weight fluctuation and incident Diabetes Mellitus, Cardiovascular Disease, and mortality: A 16-Year prospective cohort study. The Journal of Clinical Endocrinology & Metabolism. 2019;104(3):639–646
Kim MK, Han K, et al. Associations of variability in blood pressure, glucose and cholesterol concentrations, and body mass index with mortality and cardiovascular outcomes in the general population. Circulation. 2018;138:2627–2637
Byun S, Bello N, et al. Weight Cycling is Associated With Poorer Cardiovascular Health Assessed Using AHA’s Life’s Simple 7 in a Diverse Sample of Women Encompassing Different Life Stages. Circulation. 2019;139(1):P332
Kendrin R Sonneville, Sheryl L Rifas-Shiman, et al. Associations of parental control of feeding with eating in the absence of hunger and food sneaking, hiding, and hoarding. Child Obes. 2013; 9(4):346-9.