By Caroline Kay Bires-Cook, MSW
 

	Introduction
	Family Role
	Parent-child Relationship and the Division of Responsibility for Feeding
	Intuitive Eating
	Normal Eating
	Food as Reward or Punishment
	Family Mealtimes
	Tips – What Parents Can Do to Promote Healthy Eating in Children
	Related Web Sites

Introduction

What does it mean to be a healthy eater? Every parent wants to raise children who have
healthy relationships to food and their bodies. Eating with family and friends can be a time of pleasure, conversation, enjoyment, and nourishment. But all too often, food and mealtimes have become arenas for power struggles, shame, guilt, and a sense of inadequacy.

Family Role

Parents play a powerful role in shaping children’s food preferences, eating habits, dietary attitudes, nutritional knowledge, cooking skills, and food shopping skills. Parents are children’s first teachers and role models concerning food and eating. Children learn more from what they see and experience than from what they are told. Thus, caregivers’ own habits around eating greatly influence their children’s lifetime relationship with food.

Parent-child Relationship and the Division of Responsibility for Feeding

Parental feeding styles influence children’s eating. Nutritionist and social worker Ellyn Satter has developed a helpful tool for parents to use to determine appropriate roles and responsibilities for feeding that have been adopted by the Centers for Disease Control and many hospital and clinic programs. Satter’s Division of Responsibility proposes that the adult caregivers are responsible for determining what, when, and where to feed children, and the child is responsible for determining how much and whether or not to eat. This simple but profound approach to family feeding encourages the child to develop and trust his or her own body’s ability to self-regulate calorie intake within safe and nutritionally sound parameters set by the parents.

Intuitive Eating

Nutritionists Evelyn Tribole and Elyse Resch teach about the concept of Intuitive Eating, a process of slowing down, paying attention, and honoring the body’s signals of hunger, fullness, and thirst. This fosters greater reconnection to the body’s natural ability to regulate eating. Social workers Jane Hirschmann and Lela Zaphiropoulos, use a similar approach to help people overcome compulsive eating with a simple but wise formula: eat when you’re hungry, eat exactly what your body craves, and stop when you are full. Their years of experience have convinced them that we can all return to our body’s natural ability to eat well, without guilt or shame, and with enjoyment. Young children are natural intuitive eaters. However, this ability can be threatened by power struggles, food used as reward or punishment, counterproductive role modeling, environments saturated with unhealthy food choices, rushed eating, and food advertising targeted at children.

Normal Eating

With so many fad diets and weight loss gimmicks out there, it can be difficult to know what “normal” eating is, and some think they need to be “perfect” at eating healthfully. However, normal eating is actually a flexible process in which you eat when you feel hungry, eat what satisfies, and know that caloric intake can vary day to day but balance out over time. There are no hard and fast rules when it comes to normal eating. Some people may find that eating three meals a day suits them while others prefer 4-6 smaller meals. What is normal will vary according to one’s lifestyle, schedule, moods, and activity levels. Moderation is key. It is important to pay attention to what you eat and focus mostly on healthy foods, but not get too caught up in a strict diet that keeps you from enjoying food, family, and meal traditions. Normal eating is about flexibility, pleasure, and listening to your body’s signals.

Food as Reward or Punishment

Unfortunately, many families use food as a reward (e.g., a cookie for good behavior) or punishment (e.g., no dessert for misbehavior). This misuse of food can disrupt children’s natural intuitive eating ability. As author Alfie Kohn (Punished by Rewards) has shown us, these practices also tend to elevate the desirability of food that is used as a reward, and decrease the desirability of food that must be eaten to receive a reward. Food used as a source of punishment or reward sets up power struggles around eating that further interrupt the child’s natural self-regulation around eating. Do you remember ever being required to “clean your plate” before leaving the table? Such rules can lead to confusion among children between their desire to please their caregivers (or just get up and play!) and their felt sense of fullness or hunger. The “clean plate club” approach may inadvertently require children to keep eating even if they are full, lead to guilt about wasting food, or simply lead some kids to associate eating with frustration, guilt, or anger.

Family Mealtimes

The family mealtime offers a great opportunity for families to develop and practice healthy eating habits. Research shows that children who eat more meals with their families consume more fruits, vegetables, and milk, while eating less fried foods and soft drinks. In turn, children who eat fewer family meals are more likely to experience overweight or obesity. The family mealtime also provides an opportunity for parents to model healthy behavior, including menu planning, food preparation, and portion size. Mealtimes should be a positive and pleasurable experience that promote positive associations with healthy eating, cooking, and socializing. Conversations that provoke anxiety, such as highly personal conflicts or disciplinary measures, are best saved for another time. Distractions such as telephone, TV, and radio are best avoided as well. Research suggests that families should aim for at least four regular family mealtimes per week.

Although it may be challenging, making the family mealtime a priority is not impossible. Creativity, flexibility and planning ahead are needed to help overcome scheduling challenges. For instance, families might try changing the time of day or meal that they eat together, incorporating a picnic into an outing or sporting event, or setting aside at least one day of the week when everyone agrees to regularly eat together. If you must eat fast food, skip the drive- through and take a few minutes to park the car and sit down inside. If your child must eat early or separately from the family to get to a sports practice or event, try sitting down with him/her at the table while he/she eats and chatting. If your family struggles to include even one shared meal per week, start with small changes. Setting aside 10 minutes to eat together counts! Even a shared snack in the afternoon or evening where family members sit down around a table together can be a good place to start.

Tips  – What parents can do to promote healthy eating in children

Here are some useful guidelines for parents and caregivers to promote healthy eating in their children.

• Remember the division of responsibility. Parents decide what, when, and where to feed their children; and children decide how much and whether or not to eat.
• Trust the child’s capability to self-regulate and mange his or her own eating, and support him or her in the choice of how much and whether or not to eat.
• Remember there are no “good” and “bad” foods. Any food can be enjoyed in moderation and balanced with other nutrients.
• Offer a range of fresh or non-processed food choices to children including fruit and vegetable options and whole grains for snacks and at every meal.
• Cultivate nutritional knowledge in your children by talking about what nutrients are found in various foods.
• Teach and guide children to listen to their bodies, and pay attention to stages of hunger and thirst.
• Help your children identify and express difficult feelings in ways other than turning to food to deal with emotional discomfort.
• Foster positive and pleasant attitudes towards eating, and avoid using rigid or coercive rules.
• Slow down! Eat slowly and mindfully, and savor your food. Sit down while eating, and take a few relaxing breaths between bites.
• Try to get some physical activity or exercise in every day. It helps balance mood and appetite, reduce stress, and improve circulation.
• Stay informed about school lunch policies and food options for children, and support changes that provide healthful options.
• Advocate for local policies to improve access to non-processed, healthy foods for all families, including those with limited transportation and income.

Related Web Sites:

• Division of Responsibility for Eating
• Intuitive Eating: Creating Healthy Relationships with Food, Mind, and Body
• The Rules of Normal Eating
• USDA Food and Nutrition Information Center
• American Dietetic Association offers Basic information about diet and exercise.
• Food and Fun for Families: information and activities about family mealtimes and nutrition for the family.
• Virginia Cooperative Extension provides a variety of information about food, nutrition, feeding, and weight management for adults and children.
• U.S. Department of Agriculture resource page for parents of preschool aged children.