2011-08-16

The other day I came across a news article with a headline that read, “Children as young as 5 suffer from eating disorders; 81% of 10-year-olds are afraid of being fat.” As a mother of two young girls, I was almost afraid to keep reading. Trying to balance serving the right amount of fruits and vegetables while also letting them indulge in a little treat every now and then can be tough. And worrying about how your selection of food choices may affect them in the future only adds to the difficulty. Here, Laura Cipullo, RD, CDE, shares a blueprint for your child’s nutritional intake to help you get started planning nutritional meals for your children.

-Tracey Frost Rensky, CEO and Co-founder, Citibabes

Parents today seem to take a black and white approach to their children’s nutritional intakes, otherwise known as diets. While some deprive their children of all food containing what’s now considered unhealthy for fear of weight-gain and obesity, like products containing white flour and high fructose corn syrup, the rest of the parent population only provides their children with refined and fast food. If you fall into either of these categories, you may be doing your child a disservice.

As a parent, it is important to learn how to negotiate these opposing ideals without crossing any lines. Of course, an intake of only processed food is unhealthy. Yet, on the other end of the spectrum, depriving a child of all processed food and encouraging dieting can negatively impact their relationship with food as well, resulting in binging and overeating when in the presence of those otherwise forbidden items. One landmark study, referred to as the Growing Up Today Study (GUTS), found that girls younger than 14 years of age who frequently dieted were more likely to purge, binge eat and harbor concerns about weight than peers who did not. Additionally, girls under the age of 14 whose mothers had histories of an eating disorder were almost three times more likely to purge at least weekly (1).

So how can you design the optimal blueprint for your child’s nutritional intake? Parents must determine how to strike a balance – a grey zone between the two extremes – neither supplying their children with sugar-laden food nor teaching them that this kind of food is dangerous.

First, you’ll want to begin by instituting this new mindset slowly. Step one: teach your children that food is food. They eat food, they eat snacks, and they eat meals. An example of this would be to explain that an apple is an apple, and chocolate is chocolate. An apple is a fruit that is high in vitamin C and fiber. Chocolate, on the other hand, is highly sweet and low in overall nutrition, though it does have a small dose of antioxidants (in children’s words, “cold fighting O’s”). By teaching a child that “food is food,” you eliminate the notion of “treats,” “good food” and “bad food.” Avoid labeling food with these morals and values, as this is likely to encourage eating disordered thinking. If a child is able to learn that chocolate is chocolate – it is not a “bad food” or something to be rewarded with, instead it is a food choice with less nutritional value than an apple and natural peanut butter – then you are presenting them with a choice between two real, viable options. The ultimate message that can be taken away from this exercise is that all food can be eaten sometimes. The sometimes quantifier varies amongst each food.

BREAKFAST

The first meal of the day can be identified as such, or it can be called breakfast. Labeling meal-time may not be necessary, as some children eat two mini meals in the morning: one right before leaving for school and another during mid-morning snack-time in the classroom. The most important goal of this morning meal is simply to get your child to eat.

Start by offering them two options, as choice allows children to feel in control. Ask them, “Do you want cereal and yogurt or eggs for breakfast?” If presenting them with two choices is not appropriate for your situation, you may also ask your child what he or she wants to eat, prompting them with a few examples to get them thinking about food: “Do you want pancakes or waffles or cereal?”

If your child chooses not to eat breakfast on a daily basis, then it is OK to find a compromise. The goal is to meet halfway, determining a point where you are both comfortable with the final decision. You may try asking whether they are willing to eat a yogurt or a plain waffle before or on the bus. When you ask for their input, you will quickly learn that children have preferences too, and there is a reason why they may have initially resisted the idea of this first meal. Also keep in mind that children may have difficulty with textures or associate certain foods with choking or vomiting based on past experiences.

Breakfast should incorporate the three major macronutrients: a whole grain, a lean protein and a small amount of healthy fat.

Ideal breakfast:

One egg served with natural peanut butter on a slice of whole grain toast

Greek yogurt parfait with fresh berries and oat-based granola

1-2 whole grain pancakes with yogurt and wheat germ

Less ideal but very acceptable:

One egg with margarine or butter on whole grain toast

Low-fat yogurt fruit parfait with whole grain cereal

1-2 whole grain pancakes with fresh fruit

The compromise:

Dry cereal (fiber > 3 grams/serving; carbohydrate

Granola bar (fiber > 3 grams/serving; sat fat
4 grams/serving)

Any real food: dried fruit, fresh fruit, cheese stick, peanut butter, whole wheat pasta

If possible, sit and eat this first meal with your child. Role modeling can have a positive influence on their nutritional intake and helps to decrease the development of disordered eating.

LUNCH

The second meal of the day, or lunch, should also include whole grains and/or fresh carbohydrates such as fruit, lean protein and healthy fats like avocado and peanut butter. Know your child, and don’t assume that because they enjoyed what you packed for lunch two months ago that they will want it in their brown bag this week. Often times, parents learn that their children easily become bored of the lunches that are being prepared for them. Realize that your child will like this food again in the future. Something else you should not assume is that all children enjoy sandwiches; many do not.

For this reason, it is important to keep communication open between you and your child. If you don’t ask what they are eating for lunch or why their lunch is coming home uneaten, you will never know. At the same time, however, you must also remember that as a parent, it is your responsibility to provide your child with wholesome food to help them to grow. With your gentle encouragement, your child can learn to experience and eventually embrace different flavors and textures, which will influence their choices into adulthood. While children certainly have some influence over what they eat, do not let them rule over the kitchen by convincing you to buy chips, “because a friend eats them at school.” In addition, be mindful of whether you were deprived of sweets or “treats” as a child, as many parents who felt any kind of dietary deprivation in their past allow their children to eat whatever they please in order to make up for this loss. The consequence is a child who grows up with no boundaries and who may be more likely to become obese.

Children may consume all food groups during lunch, but parents should limit items that are less nutritious.

Ideal lunch:

Peanut butter (natural ingredients with peanuts only) and banana sandwich on toasted whole grain bread and a cheese stick

Hummus with oat bran pita, carrot sticks and a light laughing cow cheese and natural applesauce

Whole wheat pasta mixed with spinach and egg whites, and a mini low-fat yogurt (Stonyfield or Horizon yogurt squeezes are good options)

Less ideal but very acceptable:

Peanut butter (natural ingredients with peanuts and salt) with real fruit jam on whole grain bread and a natural fruit leather (first ingredients fruit)

Real cheese slices (Apple Gate Farms) on whole grain bread and sweetened dried fruit (like Craisins)

Annie’s whole wheat macaroni and cheese mixed with a veggie and one Kashi TLC cookie

Heading in the right direction:

Peanut butter and real fruit jam on whole grain bread and a cookie

Grilled cheese made using PAM with whole wheat pretzels

White pasta with natural tomato sauce (Monte Bene, Walnut Acres) and apple slices

The “sometimes” lunch:

Pizza

Bagel with tuna and mayonnaise

School lunch (provided by school)

Any lunch above with chips or cookies (should be eaten

As a rule of thumb, children may consume a less nutrient-rich side or snack with their lunch two to three times a week. Doing so will help to prevent the formation of the idea that foods are considered either “good” or “bad,” while also preventing any feeling of deprivation. Research from the GUTS study shows that food deprivation aimed at weight loss via dieting and/or weight control in children leads to binging and purging later in life (1). By allowing your child to choose what snack they want now, whether it’s a cookie, a bag of baked chips or an apple, you can help them to avoid developing a poor relationship with food in the future.

SNACK

An afternoon snack is important for all children. Not only does it help to steady their afternoon energy and prevent them from grazing until dinner, but if the afternoon snack is missed, it increases their hunger before dinner, resulting in overeating. It is therefore imperative that parents plan for children to eat an afternoon snack daily. Preferably, this snack should consist of two out of the three macronutrients (whole grains or fresh carbohydrates, lean proteins and healthy fats).

To promote healthy choices during snack time, it is best to minimize the number of decisions that need to be made. Children who are faced with too many choices are more likely to make to poor decisions. This can be accomplished by limiting the types of packaged foods that are kept in the pantry. Try not to stock more than five options at a time.

Ideal Snack:

An apple with 2 tsps of natural peanut butter

Natural guacamole with veggies

Hummus and grapes

Less ideal but very acceptable:

Applesauce and a cheese stick

Natural guacamole with baked chips

Low-fat fruit yogurt with fresh fruit

Heading in the right direction:

Applesauce and whole grain goldfish

Granola bar

Premade peanut and cracker sandwiches

Low-fat ice cream

The “sometimes” snack:

Ice cream on a cone

Cookies and milk

Rainbow goldfish and juice

DINNER

And then there is the final meal of the day: dinner. If possible, make every effort you can to eat dinner with your child. If it is not possible to sit down for a family dinner, then try to join your child for at least one major meal a day. One study reported by the journal Eating Disorders set out to identify associations between family dinners and disordered eating behaviors among adolescents. Female adolescents who ate with their families most days, when compared to those who ate dinner together "never or some days," were less likely to initiate purging, binge eating, and frequent dieting (2).

Understandably, when both parents work and when children have busy, action-packed afternoon schedules, this can be quite a challenge. If family dinners are not feasible during the week, then try to squeeze them in on the weekends instead. Engaging in family dinners enables you, as a parent and role model, to lead by example, showing your child what it means to consume a healthy and moderate diet. Data drawn from project EAT provides evidence that having dinner with others has a strong link to certain markers of a person's dietary consumption, including higher intakes of fruit, vegetables and dark greens, and orange vegetables (3).

As a registered dietitian, I strongly discourage conversation that centers on food or body image while seated at the table, as this is likely to influence disordered eating. Negative comments regarding weight as spoken by a father to his son have been shown to double the likelihood of binging based on evidence from the GUTS study (1). Instead, discuss neutral topics, and refrain from watching television.

Dinner should include the three macronutrients in the form of whole grain carbohydrates or “fresh” carbohydrates like vegetables, lean proteins, and healthy fats.

Ideal Dinner:

Salmon with soba noodles and edamame

Chicken and tofu stir fry with plenty of vegetables and wild rice

Whole wheat pasta (tomato sauce made without sugar) with lean turkey meatballs and steamed spinach

Chicken or fish fajitas using whole grain tortillas

Less ideal but very acceptable:

Tilapia with rice and veggies

Chicken teriyaki with rice mixed with peas and carrots

Whole wheat pasta with pre-made turkey meatballs (low in sodium) and carrot sticks

Chicken or fish fajitas with corn or white flour tortillas

Heading in the right direction:

Whole wheat macaroni and cheese mixed with tuna fish and spinach

Bell & Evans chicken tenders with baked sweet potato fries and veggie and fruit puree

Whole wheat pasta with tomato sauce (no sugar added) and parmesan cheese

Cheese fajitas with corn and squash in a tortilla

The “sometimes” dinner:

Tuna fish with mayonnaise on a bagel

Fried chicken tenders with French fries and carrot sticks

Pizza

Kraft macaroni and cheese and a fruit cup

With the range of food made available today, it can be difficult for a parent to map out a blueprint for their child's nutritional intake that is both healthy and satisfying. To simplify this, focus on providing your child with whole foods and by incorporating the three major macronutrients (whole grains and fresh carbohydrates, lean protein and a healthy fat) into every meal and two of the three macronutrients during snack time. Limit meal and snack choices to reduce decisions.

One way to ease your child into this healthier and moderate mindset is to invite them to go grocery shopping with you and to allow them to pick out two of their snacks. Another place to expose them to new food is at the dinner table. Be a positive role model by trying new food and eating salad greens. If you and your child are dining on different meals, offer your child a taste from your plate, but do not force them. With time, your child’s palate will become more refined, their taste buds will mature, and they will begin to adopt healthier habits. Just remember to be patient along the way. Finding confidence in the ability to choose satisfying, energy-rich meals and snacks is a process – but a worthy one at that.

By Laura Cipullo, RD, CDE

Sources

(1) Field AE, Jarvaras KM, Aneja P, Kitos N, Camargo CA Jr., Taylor CB, Laird NM. Family, Peer, and Media Predictors of Becoming Eating Disordered. Arch Pediatr Adolesc Med. 2008;162(6):574-579.

(2) Haines J, Gillman MW, Rifas-Shiman S, Field AE, Austin SB. Family Dinner and Disordered Eating Behaviors in a Large Cohort of Adolescents. Eating Disord. 2010 Jan;18(1):10-24.

(3) Larson NI, Nelson MC, Neumark-Sztainer D, Story M, Hannan PJ. Making Time for Meals: Meal Structure and Associations with Dietary Intake in Young Adults. J Am Diet Assoc. 2009 Jan;109(1):72-9.

Laura Cipullo, RD, CDE, is a registered dietitian and certified diabetes educator who operates a private practice, Laura Cipullo Whole Nutrition Services LLC, which she opened in 2000. She specializes in gastrointestinal problems, diabetes, eating disorders, women’s health, and family nutrition; her holistic approach addresses these issues through a combination of medical nutrition therapy and education.

Laura, who resides in New York City with her husband and young children, shares nutrition advice with New York metro area news channels and has been featured in lifestyle and healthcare-related publications. She provides mentoring services to other registered dietitians and volunteers for food and nutrition causes, as a food professional as well as an active local resident, for special events and community service programs. Laura offers free nutrition tips on a wholesome way of eating that incorporates all foods in moderation on her website and her nutrition blog.

For more information, please visit www.LauraCipulloLLC.com or call 917.572.7137.

Show more