Tips for helping kids eat healthy

October 4, 2008 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 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 5-10 experiences with a food before some children will accept them. 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, including vegetables and fruits, even if it is just a tablespoon on your child's plate that he doesn't touch, to get him used to healthy foods.

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. ON THE NET: www.DrWeigh.com

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