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This weekend, my family and I watched Katie Couric’s new food documentary Fed Up.  It examines the obesity epidemic, focusing specifically on the impact of sugar and processed foods on childhood obesity.  The opening story actually features a family from Easley, South Carolina and discusses some of the problems with Southern cuisine.

Like most of these documentaries, Fed Up did present a few half-truths and contradictory statements.  However, overall we enjoyed it.  It provided a sense of the magnitude of the obesity epidemic and how many forces need to be overcome in order to make an impact– political, environmental, social, and behavioral.

My children (ages 6 and 9) found it pretty interesting.  They were particularly awestruck by the animations explaining how sugar negatively affects your body and how junk food marketers specifically try to target children.   They seemed pretty motivated to continue to eat a healthier diet at the end.  As their “nutritional gatekeeper,” I’ll take all of the outside help that I can get. Two thumbs up for that.

One constant theme throughout the documentary was how challenging it is to encourage healthy eating habits if we are raised on unhealthful foods.  Children struggled to swap out their pizza, burgers, and fries for vegetables because they didn’t like the “taste.”

This idea always leaves me scratching my head.  Children can be raised to love healthful foods.  I see it every day in my own home.  My kids love Green Monster Smoothies, Roasted Brussels Sprouts, and Kale Salad with Avocado Dressing.  They adore broccoli, edamame, carrots, green beans, asparagus, quinoa, farro, steel cut oats, fish, chicken, tofu, tempeh, and every single type of fruit.

Fed Up made me wonder why some children accept healthier foods more easily than others.  And what can caregivers do to encourage healthier eating habits?  After all, it has been estimated that up to 72% of what and how much children eat is influenced by their nutritional gatekeeper—that is, the person who shops for and prepares foods (1).   As parents, grandparents, and caregivers, we can make a significant impact.

How can we encourage children to have a lifetime of healthy eating habits?

Step 1.  Maximize the “Windows of Opportunity”

There are several “windows of opportunity” early in life that can affect eating habits long term.

~ Pregnancy and Breastfeeding

Mothers who were instructed to consume carrot juice regularly during pregnancy ended up with children who preferred the flavor of carrots (2).  This is because flavors from the mother’s diet are passed into the amniotic fluid during pregnancy and swallowed by the fetus.

These same flavors from the mother’s diet are also passed through breast milk when she breastfeeds her baby.  Because this is a sensitive period in the lifecycle, it encourages acceptance and attraction of the foods eaten by the mother (3).  Children who are fed infant formula may have more difficulty initially accepting certain flavors, such as those found in vegetables and fruits (4).

Pregnant and breastfeeding women should attempt to eat a healthful diet full of a wide variety of foods for their own health and the health of their little one.

~ Starting Solids and Finger Foods

After 4-6 months of age, infants are typically introduced food purees.  Pureeing real foods such as sweet potatoes, carrots, peas, parsnips, apples, pears, bananas, and avocado is an easy way to introduce those flavors.  When my children were little, I used the help of a Blender Baby Food Cookbook and stocked the freezer with little portions of these purees in ice cube trays.  It was cheap and easy and paid off well during childhood since they started eating these foods from the beginning.

After 9-12 months, many infants are introduced soft pieces of finger foods.  As every parent can probably attest, this also occurs during a time when little ones learn to explore the world by putting everything in their mouth.  This can be used to our advantage.  Infants of this age are likely to put anything in their mouth during this time.  So why not put something healthful in front of them?

At this time, we introduced my daughter to foods like roasted golden beets, turnips, asparagus, and carrots (as seen below).  To this day, she still loves to eat these types of foods.

1 food

Step 2.  Encourage through the Growing Years

As children grow, caregivers can continue to encourage healthy habits.

~ Be a positive role model.

The old adage “do as I say, not as I do” just doesn’t work.  We can’t expect children to practice healthful behaviors if they don’t witness us do the same.

Research has clearly demonstrated that children’s food responsiveness, enjoyment of food, and food fussiness are significantly affected by the parental modeling (5, 6, 7).  Mothers seem to play a key role.

For example, mothers who consume more fruits and vegetables tend to have daughters who are less picky and consume more fruits and vegetables (8, 9).

Let your child see you eat healthful foods because they taste good.

~ Encourage and support.

Parental encouragement and modeling of vegetable and fruit consumption has been associated with lower Body Mass Indices in children (10).

Encourage your child by offering several types of healthful foods and letting your child choose.  For example, “would you like broccoli, carrots, or green beans tonight?” or “would you like an apple or a banana for a snack?”

Take children to the grocery store or farmer’s market and let them pick out a new produce item to try.  Invite them to cook with you in the kitchen.  They are more likely to try something that they have invested their time and energy in.

Many children will experience stages of pickiness.  Just continue to offer healthful foods and be a positive role model. One study found that nearly half of children were picky eaters at some point during early childhood.  However, many eventually outgrew it (11).

Positive suggestions may also improve a child’s attitude and eating behavior about healthful foods.  For example, encourage your child with statements such as “you loved asparagus the first time that you tried it” (12).

If children seem a little resistant to a new food, don’t give up.  They may need to be exposed to it multiple times before it becomes familiar.  You can also try different preparations and recipes to see which they like best.

~ Be careful with pressure and over-restriction.

Parents tend to adapt their controlling feeding practices in response to their child’s weight (13).  For example, mothers of identical twins reported that they exerted more food restriction toward the heavier child (14).

When we are concerned about one of our children, it seems natural to exert more effort to try to regulate their food intake.  However, these efforts may have negative consequences (15).  When children feel that their food choices are overly restricted, they tend to display more emotional eating and excessive snacking (16).  I guess we always seem to want we are told we cannot have.

Healthy eating habits are important for the entire family.  No one should be singled out or treated differently due to excess weight.  Try to stock a wide variety of healthful foods in the house and purchase little to no junk food.  Visit fast food establishments less regularly.  Make the healthy choice the easy choice.

Because many healthful foods tend to be low energy density (click here to learn more), it is not necessary to be over-restrictive on these foods anyway.

~ Try not to use food as a reward. 

When we reward children with food, it may encourage them to seek those foods during stressful times.  For example, if a child is rewarded with a cookie for good behavior then he may associate the cookie with comfort and pleasure.  The next time he seeks feelings of comfort, he may choose to eat cookies to cope.  This was suggested in a study of children ages 5-7.  Children who were exposed to a mild stressor tended to consume more calories if their parents reported using food as a reward (17)

~ Encourage Children to Honor Hunger Cues

Babies tend to have a keen sense of their hunger and satiety cues.  When a baby is hungry, he will cry.  When he is full, he will stop eating, turn his head away, or even stick his tongue out to thrust unwanted food out of his mouth.  Between the ages of 3 and 5 years, children may become less responsive to internal cues of satiation and more responsive to external cues (18).  This means that children can learn to override their natural cues and eat when they are not hungry.

It is important to try to teach children to honor their hunger cues.  Learn to distinguish between appetite (a psychological craving) and hunger (a physiological craving).  Eat when you are hungry.  Don’t eat when you are not hungry.  (Learn more about the hunger scale here)

~ Seek support of health care providers.

Health care providers can provide additional information and education about the health status of your child.  They can also help to monitor growth patterns during childhood and let you know if your child is on track.  One study found that the majority (80%) of preschoolers who were classified as overweight were perceived as normal weight by their parents.  This incorrect assumption led the parents to provide more high-sugar/ high-fat foods because they did not perceive a problem (19).

~ Seek support of others.

It is important that parents, grandparents, extended family members, and caregivers play a positive role.  Regular indulgences in unhealthful foods may interfere with efforts to maintain a healthy home environment (20).  Together, we can all make a difference.