Tuesday, September 27, 2016

Help! My Kid Makes Me Want To Scream! How to Grow Healthy Habits

I had a friend that called me the other day, wanting some advice about her 14 year old daughter and food. “She only will eat a few certain things…she picks the unhealthiest foods when we go out, she won’t try anything healthy at home, she is gaining weight (but is not overweight), and I am scared these behaviors are going to follow her throughout life”.
While obesity is at epidemic proportions in the United States, with 2/3 of American adults and 1/3 of American children classified as overweight or obese, it is not unreasonable to be concerned. However, I think that I have some good news for my friend and all of the other anxious parents concerned about their kids food choices.

The Bad Years


Although I am a registered dietitian, a marathon runner, and a health advocate, “EatRightLeslie” didn’t always have the best nutritional patterns. Let me regress to my freshman year in high school. I was an extremely picky eater (and had always been), but it went to a new level when I was fourteen. There were several reasons for my food quirks that year. Looking back, I remember going to high school and feeling the pressure to fit in. That includes what you eat and drink. Eating the federally mandated and “balanced” school lunch was the equivalent to wearing nerd glasses, plus then as it is now, was not the most tasty or appealing meal (partly because it is a mass produced meal having to meet certain federal nutritional requirements at a very low cost). So no school lunch for me. Instead, growing up in the 80’s, we had free access to vending machines and snack lines. My lunch which was based on my picky behavior, budget of $1.50 per day, taste, and what was perceived to be socially acceptable. Based on these strict criteria, I ate (hold onto your carrot stick) three (3) Blue Bell cookies and cream ice cream sandwiches chased by a diet coke. This was not a sentinel event. This was an everyday occurrence. Surprisingly, I was not overweight and remained active, participating in gymnastics, cheerleading, all while maintaining an “A” average.
My bad habits were further enhanced by external influences, particularly my freshman US History teacher. He was an eccentric fellow and often incited debates in the class (“Prove that we have gone to the moon”), incited a complete boycott of the high school cafeteria (demanding better food), along with other items that are highly unlikely to be in the traditional curriculum for an US History teacher. For months, he read excerpts from a book called The Jungle by Upton Sinclair, which featured horrific stories about the meat packing industry during the early 1900’s. He strongly associated these meat packing plants with the school lunch. One of his favorite passages, although inspired by the book, had been tweaked to make it personal to our school and went something like this:
“Mary had a little lamb
And when she found it sickened
She sold it to GHS
And now it is sold as ……..CHICKEN”

Ironically, he was most fond of this passage on the day that we were served some form of chicken. I am became fearful and completely repulsed by the thought of ALL meat and avoided it at all costs. My mother was worried by my new eating habits and I even remember her pleading with me to eat meat and trying to convince me that the “meat was safe” that she had prepared. This just fueled my fire. As a teenager, I like all teenagers before me and since, experienced a “yen and yang” of sorts with authority including my own mother. I wanted to be the center of her universe, but only when I wanted it. I also was trying to pull away from her to express my own sense of self and independence. All of this, now, I recognize to be age appropriate and age specific behavior.

The Good News


Eventually, I (on my own) began to gradually eat certain meats again, partly I think because my mom backed off of the issue after a routine check-up by my regular doctor. As I continued to journey through high school, my interests shifted into fitness, and then to nutrition. As I began to study nutrition, I realized that fueling my body with ice cream sandwiches was not only affecting my abilities and performance, but was not well balanced or healthy. It is not that I had never heard this information, I had. Many times. But I had to “get it” myself and it had to be my idea. This again is age appropriate behavior. Keep in mind that “age appropriate” does not make it an easier pill to swallow for parents. (Remember, it is age appropriate behavior for 2 year olds to “NO” to everything).

After graduating high school and beginning college, I realized that nutrition and eating right not just a passing interest for me, but a life long passion. Please keep in mind, as I share this with you, that I am still not a perfect eater, nor do I strive to be. My goal is to be healthy, not perfect. That means following the researched and evidenced based health guidelines that keep my body healthy and functioning optimally. It also means that I don’t believe in restricting foods or food groups. This epiphany often is unsettling to clients and patients. When I ask clients or students, they assume that I eat grilled chicken, green beans, and brown rice for the meals when I am not eating a salad. They are often shocked to learn that I occasionally enjoy a steak or pizza.

So to my friend with the 14 year old daughter, here is my advice. Tread lightly. Remember that the pediatric feeding guidelines also can still apply to adolescents:

  1. Parents decide what, when, and where. This means mom (or dad) decides what food come in the house, when meals are served (or when eating time is done), and where (Preferably at the table as a family, as studies have shown that families that eat together have better nutritional habits, share more information, and increased cohesiveness in the family).
  2. Kids decide how much or whether. The worst thing you can do with a child of any age is get into a “food fight”. The kid will ALWAYS win. You cannot make a human being eat and keep it down. Even if you are able to conquer the physical aspects of force feeding (which is highly unlikely), the kid will always associate the food with a negative feeding experience and likely avoid that food for the duration. If certain foods are withheld, they will binge or hoard these foods when they do have access to them, creating a very unhealthy and distorted view of eating.
  3. Be patient. Adolescents are spreading their wings and trying to find their independence. Try to remember when you were that age. Very few teens think their parents are “cool” or know anything (even if your mom is a registered dietitian). Thankfully, this stage ends too. Providing a secure and supportive eating environment will allow them to grow through these changes, and decrease the chances of problematic eating behaviors and body dysmorphia. Remember, there are hormone fluctuations, mood swings, peer involvement, and changing appetites. Model the behavior that you want your teen to adapt.
  4. And the worse thing I think parents can do is to assess their teen’s weight in a negative manner. Although they are pulling away, teens still value your opinion. Telling your child that they are fat or making them feel as if they should be restricting food is no better than feeding them ice cream sandwiches for lunch. In fact, it can be a gateway for disordered feeding and a lifelong struggle. Focus on improving instead of critiquing. Allow your teen to trust their own hunger, appetites, and their own bodies. A little positivity goes a long way!
  5. Seek professional help when need. And then allow the professional to help. I have had several parents bring their kid to see me for various disordered eating concerns. After listening to their concerns, then the well meaning parents will tell me exactly what I need to do to treat their child. Remember, the professional has lots of experience in treating these problems and uses evidence based research to provide the best possible options for diet improvement.

I think that Ellyn Satter, RD, author of How to Get You Kid to Eat Right…But Not Too Much… sums up “Normal Eating” in the following passage:

Normal eating is being able to eat when you are hungry and continue eating until you are satisfied. It is being able to choose food you like and eat it and truly get enough of it-not just stop eating because you think you should. Normal eating is being able to use some moderate constraint in your food selection to get the right food, but not being so restrictive that you miss out on pleasurable foods. Normal eating is giving yourself permission to eat sometimes because you are happy, sad, or bored, or just because it feels good. Normal eating is three meals a day, most of the time, but it can also be choosing to munch along. It is leaving some cookies on the plate because you know that you can have some again tomorrow, or it is eating more now because they taste so wonderful when they are fresh. Normal eating is overeating at times: fueling stuffed and uncomfortable. It is also under eating at times and wishing you had more. Normal eating is trusting your body to make up for your mistakes in eating. Normal eating takes up some of your time and attention, but keeps its place as only one important are of your life.

In short, normal eating is flexible. It varies in response to your emotions, your schedule, your hunger, and your proximity to food”.

For more information on pediatric nutrition or nutrition therapy for kids and families, please contact Leslie Goudarzi, MS, RD, LD, Wellness Dietitian at the Good Shepherd Medical Center’s Institute for Healthy Living at 903-239-1551.

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