Helping Children Eat Right

An Interview with Susan L. Johnson, Ph.D.

Source

International Food Information Council Foundation

Forums

Related Articles

Susan L. Johnson, Ph.D., is a post-doctoral fellow with the Center for Human Nutrition at the University of Colorado School of Medicine. For the last 10 years, she has designed and conducted research on the relationship of nutrition and behavior, with a focus on the regulation of energy intake in preschool-age children. Here, Johnson focuses on the issues of parental influence on children's eating habits and the development of childhood obesity.

Do children have an innate ability to control their caloric intake?

The evidence that's available says that they do. Babies have a great ability to know when they need food and when they don't. In non- coercive settings, preschoolers also show this ability. However, there's a great deal of variability among individuals in this area, and parents have the potential, from day one, to influence whether children obey their internal cues about hunger.

What can parents do to reinforce a child's ability to follow those internal cues?

The simple answer is when a child says "I'm hungry," feed him or her, and when a child says "I'm full," stop feeding.

Of course, this is not as easy as it sounds, especially in the preschool years when kids are beginning to exercise some control over many aspects of their lives, including eating. Kids at that age can tell you whether they are full or hungry. But what often happens is that a host of issues about control in general get turned into questions about control of food. However, while it may be difficult, parents need to respect a child's internal hunger clock.

If your child comes up to you at 5:00 p.m. and says "I'm hungry," and you say "you can't have anything now, we're eating in an hour," it tells the child that the way they feel- their hunger - is not as important as the time on the clock. Instead of ignoring the child's hunger cue, you could give him or her an appetizer course, like raw vegetables, that they might be getting with the meal anyway. This response reinforces the child's appetite cues, provides a nutritious snack, and allows the parent to continue preparing the family meal.

How do parents find a balance between letting kids follow their own desires and imposing control to ensure variety?

Again, many parents wrongly assume that children are incapable of regulating their food intake, that children don't know the difference between hungry and full. Does the child know he needs some peas? No. Does a child know how much he wants to eat? Yes. Thus, the responsibility of parents is to provide the variety of foods children need and then allow them to obey their internal cues and eat as much or as little as they want.

Also, if we're beginning to err in any direction, it's making eating into an issue of individual foods and individual nutrients. We're getting too micro-oriented when, in fact, eating is not just about food. Eating occasions aren't only about limiting fat or getting enough of a certain vitamin. They also include talking about your day, engaging in discourse with people you like. If parents can focus on some of the pleasant things about eating, some of the food struggles may diminish.

What about kids who seem to want to eat all the time, the grazers?

Parents need to discriminate between a child who's possibly bored and one who's really hungry. Set some limits on what foods you'll offer and when. If a child is hungry, offer something like a banana or raisins, even a cookie. If he or she doesn't want what you offer, say "Well, that's what we're having" and explain it will be a while before the next meal. A hungry child will eat. A bored child may just skip what's offered and wait until mealtime.

What is your opinion of providing a child a sweet snack?

It seems that today eating has become a black-and-white activity with "good" food and "bad" food. But that's not the way it works.

There are decisions to be made, limits to be set, and limits to be negotiated. Is it always inappropriate to give a child a cookie? No. But it's not always appropriate either. Again, the parent has the responsibility to provide a variety of selections so that a sweet treat is just one of many foods offered in a day. In my opinion, never letting a kid have a sweet invests those foods with too much significance, which can cause problems later on.

Is controlling one's caloric intake a matter of eating fewer foods with high caloric densities or more foods with lower caloric densities?

It's a combination, but again for children the issue is more complex. Kids' stomachs are small. If you dilute the caloric density of the diet too much, the child won't be able to eat enough to satisfy his or her energy needs. Children need high-calorie snacks from time to time.

How are children influenced by their parents' control over their own eating?

In our study (Pediatrics, November/December 1994), we found that parents who could not control their eating, who didn't stop eating when they were no longer hungry, had children who also had problems controlling the amount they ate. This may indicate that children are modeling their parents' behavior or that a genetic basis exists for these similarities within a family.

In addition, we found that mothers who were dieting had daughters who were less likely to be able to regulate their intake. The opposite was true for boys. It may be that the sex of the child influences a mother's child-feeding practices.

Have you found differences between boys' and girls' ability to regulate their food intake?

We know that differences between girls and boys exist, but we don't have a clear picture of the origins of those differences. If one places a girl and a boy in equal laboratory settings so that the child is making the decisions about eating, boys will regulate better than girls. It could mean there's a biological rationale for the difference.

But considering what we know about our culture's values, the vigilance about women's eating habits and their figures, another interpretation could be that, as early as age three or four, mothers may be setting more limits on what daughters eat than they do on sons. It's a great subject for further research.

In a recent survey, kids said they were skipping more meals and eating fewer meals with their families. What do you make of this trend?

In an age where there are two wage earners in the family, there's a real dilemma, especially for the working mother, about the issue of family meals. A working mom often comes home and invests time and energy in preparing a dinner to ensure that her child gets all his or her nutrients in that one meal. But if the child isn't particularly hungry or has another activity during dinner time, that parent can end up feeling guilty and frustrated.

What the parent really needs and wants is information about what the child had to eat before coming home to dinner. I'd recommend asking an older child what they had for lunch at school that day and if they had a snack before or after softball practice; for the preschooler, I'd make an effort to know what the school or day care center offered for a snack or for lunch. The parent then has more information on which to base food decisions.

What is the relative importance of heredity and environment in the development of childhood obesity?

Obviously, both play a role. Our genetic makeup may predispose us toward obesity, but external factors-exercise, eating habits, family and working environments and our peer groups-are also important. In our research, we found that obesity is at least, in part, an inherited trait. However, we also have support for the hypothesis that parents' dieting and feeding practices can influence their kids' eating patterns and thus the kids' weight.

What's the best thing parents can do to avoid obesity in their children?

First, serve a variety of foods and let your kids see you eating them. It's been shown time and again that kids' food preferences are driven by what they eat most often. It's a matter of exposure. Children need to taste a new food eight to 10 times before they'll learn to accept it. If the parent hangs in there and doesn't give up after two or three rejections, chances are the child will learn to like a wide variety of foods, even peas and carrots.

Second, get physical. Show kids how much fun it is to be physically active. Exercise is extremely important in maintaining one's health, and active parents inspire active kids. In fact, one of best predictors of whether a child will be active is if the parents are. Dads seem to have particular influence, perhaps because they're often not around as much and therefore what they do is more noticeable.

In fact, for the overweight child, the best thing a parent can do is to find a physical activity that the child likes, provide a healthy variety of food, and place less stress on food and eating.

Credits

Reprinted from the International Food Information Council Foundation