Joanna Dolgoff, M.D. is a pediatrician and child obesity expert. She is the creator of Dr. Dolgoff's Weigh: Child and Adolescent Weight Management Program (http:/www.DrWeigh.com).
Dr. Dolgoff enjoys running, biking, reading, and playing Scrabble competitively online. Most important, she is the proud mother of two children, Zachary, age 6, and Danielle, age 3. She and her husband live in Roslyn, New York. (You can read the rest of her bio on her website.)
It is not easy to teach your children healthy eating habits. Everywhere we turn, our efforts are sabotaged. Schools serve fattening lunches and have vending machines filled with candy. Fast food restaurants have become ubiquitous. And processed, pre-cooked meals are replacing home-cooked fare. Childhood obesity is rising at an alarming rate. Yet many parents of toddlers spend their energy trying to get their children to eat more- even if it means allowing them unhealthy foods! Even picky children must be taught a healthy diet and they can suffer if parents allow them to eat unhealthy foods. In our affluent society, very few suffer from malnutrition and no child will suffer from skipping a meal or two. As parents, we need to make a real effort to teach our children proper habits from an early age. If we overindulge our children’s desire for “junk” foods now, we cannot expect them to become healthy eaters as they get older.
TOP TEN PARENT MISTAKES:
1) Parents panic if children do not eat three meals a day. Many parents of toddlers consider their children “picky eaters” because they seem to eat very little, especially at mealtimes. But most toddlers do not eat three meals a day- usually they eat one “good” meal and then pick the rest of the day.
2) Parents overestimate how much their children should be eating at each meal. According to the American Academy of Pediatrics, a good guideline is that a toddler portion size should equal to about a quarter of an adult portion size.
3) Parents give up too easily when a child resists a healthy food. Infants and children are often resistant to new foods and will grimace when first introduced to something new. Keep offering the same foods repeatedly and the child is likely to accept them. Studies indicate that it often takes 10-15 experiences with a food before some children will accept it. Children are programmed to like sugary, high fat foods but often must be TAUGHT to like healthy foods. So don’t give up too early.
4) Parents model unhealthy eating habits. It is important to be consistent and “practice what you preach”. You cannot constantly eat chips and then expect your child not to. This goes for Dad and for any siblings, regardless of their weight. The entire family needs to practice healthy eating habits. Everybody’s health will benefit from a healthy diet and nobody should be eating chips and cupcakes on a regular basis.
5) Parents often rely on "fast" foods and typical toddler meals just to get their child to eat. Parents often fall into the trap of always serving chicken nuggets, pizza, and French fries because they know their child will eat them. Do not take the easy way out. Insist that your children learn to eat healthier fare.
6) Parents keep junk food in the house. If a food is in the house, children will eat it. Clear your house of junk food and offer only healthy options. Then, let your child choose whatever they want to eat (from the available choices). There is no need to have chips and candy in the house; these foods should be special treats.
7) Parents allow children to decide what they want to eat. A child can decide when to eat but the parent decides what the child eats. Parents must not allow children to make the rules. A child will not become ill if he/she misses a meal or two. If your child refuses to eat the healthy food that you serve, you should wrap it up and wait. Sooner or later he/she will be hungry and will eat it. Make it clear that your child does not make the rules- you do! Just make sure to pick a healthy food that your child usually enjoys.
8) Parents allow children to eat in front of the TV. Children eat many more calories when they are distracted by the television. Ideally, meals should be a time for the family to relax and enjoy. Turn the TV off, clear away all the toys and books, and sit at a table (not in front of the TV). Encourage family conversation.
9) Parents are not fully aware of what their children are eating each day. There was a time when families sat down to eat a home-cooked meal every night. Nowadays, both parents often work and everybody is rushing from activity to activity. Sometimes, children are left to prepare their own meals. Very few children will make healthy choices when left to their own devices. It is crucial that somebody is monitoring what the children are eating.
10) Parents encourage their children to drink juice. As a pediatrician, I am constantly asked at what age a child should be introduced to juice. I tell parents that a child should be introduced to juice in the same way he/she is introduced to chocolate- as late as possible, in small doses, and as a treat- not a diet staple. It is a very common misconception that juice is healthy. It is not. Juice is loaded with calories and sugar. It usually has some vitamin C- but children do not lack vitamin C- they get sufficient amounts from other foods. Juice is certainly not as healthy as a piece of fruit. It is much higher in sugar and not a good source of fiber. Drinking too much juice may induce a child to develop a preference for sweet drinks. The American Academy of Pediatrics recommends less than 6 oz of juice a day for children under 6 and 12 oz of juice a day for children age 7-18.
DOS AND DON’TS:
1) Do breastfeed! Of all the strategies for preventing childhood obesity, the only one with scientific evidence of efficacy is breastfeeding. The odds of becoming overweight are 20-30% lower in children who were breastfed. Interestingly, these effects are delayed- they are best seen in preadolescents and adolescents.
2) Don’t introduce solids until age 6 months. There is a common misconception that cereal helps a baby sleep through the night but there is no evidence of this.
3) Do let your child watch you enjoying healthy foods. Children always like to eat what others are eating.
4) Do not worry if your child doesn’t eat three well balanced meals with foods from all the food groups each day. Some days will always be better than others. As long is it all balances out over the course of a week or two, your child likely has a healthy diet.
5) Do try experimenting with healthy versions of your child’s favorite foods- baked chicken nuggets, homemade pizza with low fat cheese, or baked frozen french fries. You will be surprised that many children don’t notice the difference.
6) Do serve a variety of foods. Allow your child to develop a taste for more than just chicken nuggets and French fries.
7) Do not give your child a liquid nutritional supplement, such as Pediasure, without consulting your child’s pediatrician. These supplements fill your child’s stomach with liquid calories, leaving no room for solids. Your child gets full from the Pediasure and develops even less interest in eating solid foods.
8) Do let your child assist with food preparation in whatever way is possible. Your child can accompany you to the supermarket where you can discuss all the fruits and vegetables. Point out the ones that you particularly like and ask your child which he likes. Give your child choices- should we buy peas or carrots? Apples or mangos? Make a fuss out of picking a new fruit or vegetable of the week for the family to try. Let your child help cook dinner or sit with you while you cook. A child is much more likely to eat a healthy food that she has helped to prepare.
9) Do pay attention to food presentation. You want to make the meal seem like fun. Arrange vegetables into the shape of a face on the plate. Make pancakes in the shape of a snowman- or even Spongebob. Cut sandwiches into different shapes- like hearts or diamonds.
10) Do serve a fruit or vegetable with each meal. Encourage your child to take at least two bites so they get used to eating these foods.
11) Do encourage your children to eat slowly- it takes time to realize that you are full.
12) Don’t make negative or critical comments. Especially with teens, if you watch too closely or criticize too often, they will likely eat more simply to prove that they are in control.
13) Do give daily praise for your child’s healthy choices.
14) Do not force your child to eat a particular food- the more you push, the more they will resist.
15) Do not “forbid” any foods- that only makes them more desirable.
16) Do not use food as a bribe- it makes children resistant to foods that they may be neutral about- “if they have to bribe me then it must be bad”.
17) Do use low fat cooking methods that require little or no fat (i.e. broiling, steaming and roasting.
18) Do trim all fat from meat before cooking .
19) Do add fruit and vegetables to recipes whenever possible- for example, mix applesauce into waffle batter or mix blueberries or bananas into pancakes. You can also add chopped vegetables into ground meat.
20) Do serve main dishes that emphasize healthy complex carbs such as brown rice and whole wheat pasta.
21) Do not serve children whole milk (unless they are between the ages of 1 and 2 years old). Children age 2-3 should drink low fat milk and children over the age of 3 should only drink skim milk.
22) Do not encourage your child to drink juice. Serve water as often as possible and introduce Crystal Light as another alternative.
You can find Dr. Dolgoff in the following places:
E-Mail: jdmd@drweigh.com
Website: http://www.DrWeigh.com
Facebook: http://www.tinyurl.com/ JoannaDolgoff
Linked In: http://www.linkedin.com/in/ joannadolgoff
10 comments:
I didn't know juice was bad for children. My son is grown now but when he was little I thought juice was a healthy alternative. Good information! I also agree with 7.-growing up we had to eat what was on our plates, if we didn't then we went without. We had to at least try a few bites of something we might not like (liver-yuck).
I have been taking my daughter to a dietician and I was doing already everything in this article except the juice. She has been off for 3 months and has lost a considerable amount of her steriod weight from being premie. We eat a small breakfast usually non fat yogurt, followed by a snack of veg or berries later, lunch is usually a half sandwich, a snack of fruit and low fat milk, then a larger dinner with low use of carbs, fish usually sometimes chicken, and vegetables. Never do we fry we bake or grill. Once a month we do fast food maybe, and once a month she gets to go out for ice cream or some sugar, we keep it all out of house. Also she has one hour of tv time a day at night when she is drifting off to sleep, otherwise she can play outside or in the house if she wishes as long as she is active. She is picky so I keep reintroducing the same foods and eventually she takes a bite. Great post thanks for sharing.
Great post! Very informative. Luckily, I've been able to get my boys to eat healthy, and they don't even realize it. My oldest now loves whole wheat bread, and since the Game on Diet, brown rice has replaced white.
We used to give my oldest juice and then he developed bottle decay on his front teeth, after spending a lot of money to repair it, juice was banned from our house. Milk and water only, occasionally a Crystal Light-like flavoring to the water.
Thanks for your comments! I am glad you enjoyed the article.
Thank you for posting this. I am lucky to where my kids will eat a fruit and a vegetable over any other food. Yesterday my son had a choice over oodles and noodles, or green beans and he chose green beans. Some of the stuff I did not know, like the juice. My oldest son drinks juice like it is going out of style. I had no clue about that. And it is funny but WIC offers juice to kids on the WIC checks that parents recieve. Who would have thought.. :)
The AAP (American Academy of Pediatrics) has been fighting WIC over that very topic. The AAP states that there is no (or very little) nutritional value in juice and that it is not appropriate for WIC to distribute it to mothers and children. The fight still continues!
Excellent post. So sane and so informative.
Every parent should convey to the child that he is an individual in his own right apart from us and responsible for his successes and failures.
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This is an excellent post, and I see the value in most of the advice. Decreasing juice and increasing water intake makes sense - I question why a pediatrician would recommend Crystal Light (containing artificial sweeteners). (???)
According to the FDA, artificial sweeteners are perfectly safe for children. Yet study after study documents the health risks of sugar. I think it is reasonable to recommend artificial sweeteners (in moderation).
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