The Picky Eater

The Picky Eater

Picky eaters are one of the most common feeding problems I am asked about in my pediatric practice. How many times have you faced these scenarios in your home:

  • the toddler who takes two bites of food and then says “all done”
  • the child who will only eat five varieties of food and so you prepare those foods day after day
  • the child who says he wants food x, then after you prepare food x, he states he wants food y, and then after you get food y, he says, “No” he wants food z now.
  • having daily mealtime battles where you find yourself bribing, coaxing and nagging bites of food into your child’s mouth

If this sounds like your household, then read on to discover tricks on how to deal with the picky eater. Click here to get also about The Overeater.

The Picky Eater

The first goal to is to not create mealtime battles. Battles at the dinner table will usually only make a picky eater pickier. It’s not worth the battle! Realize that toddlers in that 1 to 3 year range have small appetites and don’t seem to need to eat as much. Also, life is just too exciting and there are higher priorities around other than sitting at the dinner table. As you see in all aspects of a toddler’s behavior, they are seeking a new level of independence and control. If you are trying to control them from touching the TV set, they see it as a game will try to do it and look right at you. If you are trying to control every bite of food, they see it as their job to do the opposite.

If you are dealing with older children, you need to set up some guidelines. The one bite rule can be effective for most kids. They need to at least try the bite of all foods offered, and if they don’t like it, they don’t need to eat more. As parents, we have to hide our concern about whether they eat it or not. Another game to play is the allowing them to choose to eat three of the foods offered at the meal. One of the biggest problems I see develop are those parents who make the separate “kid” and “adult” meal every night. If this is you, then make some changes! Explain to your child that it is time for them to eat the things that you are eating. Be neutral in your reaction the first few nights of eating if they are refusing foods. Don’t battle. Try to have one or two things that you know they might eat (rice, bread, fruit, soup) and then sit back and see what happens. Remarkably, most children will gradually come around to expanding their horizons.

The Picky Eater

Below are numerous ideas for encouraging the picky eater:

  • Never coax, bribe, punish, nag. Avoid the battles! Hide your anxiety and concern about eating!
  • Keep introducing new foods over again. Don’t avoid it just because they didn’t like it once, they may change their mind.
  • Don’t worry about food fads or food strikes.
  • Don’t place more value on any one food on the plate.
  • Don’t dictate how much you think your child should eat. Let your child decide how much they will eat.
  • Use the one-bite rule. Encourage gently to try all foods on the plate. If they don’t like it, that’s fine.
  • Don’t rush through the meals, some children are just slow eaters.
  • Sometimes creating games with food can be fun for older kids (we don’t want to create a choking hazard for younger kids who can’t control the food in their mouth as well). Asparagus or green bean races, where they grab one asparagus or green bean and see who can fit it in their mouth first can make foods disappear. For those baby carrots in a bag where the bag is partly open, try to see who can extract a carrot without touching the plastic bag.
  • Change your buying habits if you find your child is “stuck on” certain unhealthy foods.
  • Offer fruits as dessert. Use it on its own as dessert or add it to ice cream, pudding or cake. Make your own fruit popsicles (have your child help you, it will have more value to them) out of fresh fruit, yogurt, juice or milk.
  • Try not to use dessert as a reward.
  • Avoid lots of juices, sodas and milk as substitutes for eating real food.
  • Avoid frequent snacking habits. Avoid snacks in the car or while standing around and playing. Use the snack plan for older kids.
  • Supplement with a healthy yogurt smoothie.
  • Disguise foods and combine foods they like with those they don’t like.
  • Try not to use dessert as a reward. For those stubborn kids who try to hold out for dessert, offer dessert with the main meal. Of course, make sure it is a small, reasonable serving. Most kids will not get full with a small dessert and then they are free to “indulge” in the rest of the meal.

Essential Fatty Acids

Essential Fatty Acids

Despite all the concern about fat in our diet, the body does require fat to function. The problem is that most people are getting the wrong kinds of fats in their diet and are lacking the good fats in their diets. Babies should not be on a low-fat diet. Most of their fat should be from formula and breast milk. The total fat concentration of formulas and breast milk is around 45 to 50 percent of the total calories.

There are two types of fats:

  • The bad guys: Saturated fats are the type that can clog arteries. These fats are solid at room temperature and are found in meat, milk, and poultry. High intakes of these fats have a correlation with an increased incidence of heart disease and strokes in later life. Trans fats, often listed as hydrogenated oils, are found in margarines, vegetable shortening and many processed foods such as in peanut butter, cakes, cookies, and crackers. Although listed as an unsaturated fat in Nutrition Facts labels, they are part of the bad guys.
  • The good guys: Unsaturated fatty acids are liquid or soft at room temperature. Oils such as corn, fish, peanut, safflower, sesame, soybean, sunflower, and olive fall into this category. The fatty acids that are necessary for the body and cannot be made by the body are called essential fatty acids (EFA). Essential fatty acids are part of the good fats that have been researched and found to have numerous health benefits.
Essential Fatty Acids

Essential fatty acids help build nervous system tissue and help with the transmission of nerve impulses. They are also used by the body for the production of prostaglandins, hormone-like substances, that regulate various processes.

There are two major categories of EFA which are both considered polyunsaturated fatty acids (PUFA). These are omega-3 (the major source is alpha-linolenic acid) and omega-6 (the major source is linoleic acid). Omega-3 EFA are found in fresh oily fish (canning causes some loss of EFA) like herring, mackerel, salmon, tuna, and anchovy. Omega-3 EFA are also found in fish oil, flaxseed oil, canola oil, and walnut oil. Omega-6 oils include corn oil, safflower oil, cottonseed oil, peanut oil, sesame oil, borage oil, grape seed oil, and primrose oil. Good sources of both omega-3 and omega-6 are Great Northern beans, kidney beans, navy beans, soybeans, and soybean oil.

Getting an adequate amount of essential fatty acids may present a challenge. The Western diet has moved away from a fish diet, and most of the fats in processed foods are the bad fats. Also consider that if your child does not get adequate amounts of the basic vitamins and minerals, their body may not process the EFA that is consumed. In order for EFA to be used correctly, they need certain co-factors like vitamin A, C, E and magnesium, selenium, zinc, and copper.

Essential Fatty Acids

The primary problem is that the Western diet tends to be too high in omega-6 and too low in omega-3 fatty acid consumption. The typical American diet has a ratio of omega-6 to omega-3 of around 15 to 1. Diets with a ratio of about 4 to 1 have been shown to be healthier in research studies. One important study, known as the Lyon Diet Heart Study, looked at heart attack survivors.

Three different diets were assigned: a traditional heart diet, the “prudent” heart diet (recommended by the American Heart Association) and a modified version of the Crete diet. This last diet group received a ratio of omega-6 to omega-3 of 4 to 1.

Two years into the study, the study was stopped because survival rates of the Crete diet were so significant compared to the other two diet groups. There was a 76 percent lower risk of dying from a cardiovascular event with the Crete diet. Also laboratory animals who received a diet high in omega-6 fatty acids and low in omega-3 fatty acids had more invasive and faster growing tumors when implanted with cancer cells. Psychological tests found these animals also suffered with more difficulty through mazes and had more random behaviors.

If everything is working correctly, EFA along with their co-factors will become metabolized into prostaglandins in the body. These are important in the function of the immune system. Too much saturated fat can block the conversion of EFA to the desirable prostaglandins.

A malfunctioning immune system can lead to illness, and it also plays a role in allergies and autoimmune diseases (diseases like inflammatory bowel disease, juvenile diabetes, and juvenile rheumatoid arthritis). EFA may improve allergies, asthma, and a possible role in attention deficit disorder.

Essential Fatty Acids

If you are breastfeeding, you should make sure you are including EFA in your diet. Diets that exclude fats and EFA can cause deficiency symptoms in the breastfed infant. Signs of an EFA deficiency can include dull hair, dry skin, dandruff, excessive thirst, and frequent urination. Symptoms in infants can also include poor weight gain and poor wound healing, in addition to the symptoms listed above.

Essential fatty acids are important in the production of myelin that is being laid down in the brain. Myelin sheaths cover the brain cells which are being laid down in the first couple years of a child’s life. Omega-3 sources should be included in the mother’s diet.

Research is now examining how important supplementation of formulas with different PUFA may be on infant development. Whether these PUFA affect attention control, problem-solving ability, IQ, and visual function is the emphasis of some of these studies. DHA does appear to be important for visual development in premature infants.

A study from Australia showed that supplementation of infant formulas with a dietary omega-3 did improve visual function to the level of those found in breastfed infants. Another study showed that supplementation of formula with PUFA from birth to four months of age resulted in higher problem-solving scores at 10 months of age.

Obesity Trends

Obesity Trends

The public health alarm has sounded and most people are well aware of the increase in overweight children in the U.S. The questions we are grappling with – why is this trend occurring and what does it mean for the future of our children?

Answering the first part of this question could be stated very simply – too many calories and too little activity, but in reality it is more complex. The media marketing food and sedentary activities to our children, cheap processed food choices, the ease of fast food for stressed out parents, schools offering sodas and candies, communities that make driving necessary and walking almost impossible, and the list could go on and on.

But who is ultimately responsible for the problem?

In many cases, we need to take a good look at the family. It is not the overweight 6-year-old who is doing the grocery shopping or running to the local drive-thru to pick up dinner. Parents need to take the ultimate responsibility and this can be taken in many ways despite the challenges. Parents are still in control and they can set limits. For example, examine what foods are brought into the house (do the parents understand how to read a nutrition label?), set limits on media (does a child need a TV in their own bedroom?), decide what types of restaurants are frequented (there are better choices out there), and get involved with the schools (school boards need to hear from parents voicing concerns about food choices in the schools).  

Obesity Trends

The problems for the future of our children is not about the cosmetics of looking skinny, but more about the health impact and risks for diseases such as heart disease and diabetes. The concern with diabetes is that overweight children are being struck with a disease that was considered to be a grown-up disease for old people.

As waistlines of our children continue to expand, their lifespan will be shortened and dollars spent on healthcare in treating their diseases will skyrocket. Is this the future we wish for our children?  We as parents can not only take responsibility for what occurs in our homes, but should be out there advocating with the schools, restaurants, food industry, businesses and our government to ask them to support us to keep our kids healthy.  No one wants to be blamed for the childhood obesity epidemic, but if everyone claims they are not to blame and chooses to do nothing, well-needed changes will not happen.