Dean Ornish on Dieting: Lessons for Parents

Calories are not all the same.  Being thin doesn't mean you're healthy. And, it matters what you eat.

Those were the messages at the heart of Dean Ornish's op-ed piece, published in The New York Times last weekend. 

The New York Times

Ornish was writing in response to a study, published earlier this year that showed that following a low-carb Atkins-type diet might be a fast way to lose weight.  

Ornish made the following points: 

• "Being thin and being healthy are not the same thing. Some diets may help you lose weight but they won't keep you healthy."
• "A low-carb diet increases metabolic rates because it's stressful to the body.  Just because something increases your metabolic rate doesn't mean it's good for you.  Amphetamines will also increase your metabolism and burn calories faster, which is why they are used to help people lose weight, at least temporarily. But they stress your body and may mortgage your health in the progress."
• "What you eat is important as what you exclude—your diet needs to be high in healthful carbs like fruits, vegetables, whole grains, legumes..." The list (and you know what it is) goes on.

So what's this got to do with feeding kids? I think Ornish has tapped into an important point.  

The nutrition mindset has led us to believe, not just that a calorie is a calorie, but that nutrients are nutrients and that it doesn't really matter how we get them.

Giving kids apple juice because it's been fortified with Vitamin C is a good example of this mentality. There are other reasons to give kids juice, i.e. it's a tasty treat.  But because it's been fortified with Vitamin C?

It doesn't make sense from a nutrition perspective. It also doesn't make sense from a habits perspective. 

Read Coke Beats Juice and Water vs. Punch and Soda.

Our cultural obsession with nutrition makes parents susceptible to feeding practices that send their kids' habits in the wrong direction.

That's how parents end up feeding their kids Veggie Pirate's Booty for the spinach, or chocolate milk for the calcium.  Both send kids' habits soaring away from real fruits and vegetables and healthy dairy products and towards junk.

Chocolate milk often has more sugar than a chocolate bar.  Read Chocolate Milk vs. Chocolate Bars.

But it's also the nutrition mindset that propels parents to dumb-down snacks.

They save "nutrition" for mealtimes.  Read Do No Harm Snacking

According to Ornish:

"About 75% of the $2.8 trillion in annual healthcare costs in the United States is from chronic diseases that can often be reversed or prevented altogether by a healthy lifestyle. If we put money and effort into helping people make better food and exercise choices, we could improve our health and reduce the cost of healthcare."

But let's not wait until people need help dieting. Let's help people get it right from the get-go.  Ironically, that means paying more attention to habits than to nutrition.  After all, it's habits (not nutrition) that dictate what people—even little people— choose to eat.

~Changing the conversation from nutrition to habits.~

Kid Eats Q&A: How can I get my son to eat meat?

Thanks to Gail who sent me this question.

I have a four-year-old with a unique eating "problem." He refuses to eat meat, eggs or fish. He will eat the occasional slice of pepperoni, but that is not really what I am after. He does eat peanut butter and dairy (probably way too much) and will eat a bean or some hummus on occasion. He loves fruit and veggies--everything from kale and nori to carrots and peas. We are concerned that he does not get enough protein.

Unlike fruits and vegetables, which most parents stress about getting into their kids, your son can have a perfectly healthy life not eating meat, fish and eggs.  Many people do, all over the world.

What's more, anything you do to try to convince your son to eat these items is likely to backfire.

Here's what I suggest:

• Talk to your son about the foods he doesn't like so you can figure out his objections. If you discover that texture is the problem you can try cutting, shredding or mincing the meat.  If you discover that your son finds meat difficult to chew, you can put it into soups and stews.  Read Nix the Negativity for a list of prompts you can use to get the discussion going.

• Encourage your son to explore new foods frequently so that trying foods becomes a habit, and then make sure you rotate the objectionable foods into the rotation from time-to-time. Read Collect Clues & Eliminate the New-Food-Blues.

• Stop worrying about protein.  Your son doesn't need as much as you think.  What's more, although meat is a great source of protein, it is also a great source of fat, much of it saturated.

It goes against our national obsession with nutrition to advise letting the protein issue go, but that is exactly what I recommend.

I can tell from the description of your son’s eating habits that he’s doing just fine.  And not just in the protein-department. The habits he’s got going—lots of fruits and vegetables—will serve him well for a lifetime of healthy eating. Remember, a plant-based diet is best.

But I don’t blame you for being concerned about your son’s protein consumption.  Our cultural obsession with nutrition (as opposed to with eating right…that entails thinking about food, not nutrients) forces parents to dig deep into their children’s plates to see how they’re eating.  That's how we parents get obsessed with calcium. Read Don't Have a Cow!

Most Americans eat more protein than they need. 

I’m sure there are plenty of people who will disagree with what I’ve written.  One woman once told me that she served her children double the recommended amount of protein because she thought the government was under-bidding this one.

Lots of people must agree with her.  Surveys show:

• The average American woman (120 pounds) needs 55 grams of protein per day but consumes about 70 grams.
• The average American man (180 pounds) needs 65 grams of protein per day but consumes about 100 grams.

If you get enough calories you’ll get enough protein. 

That's not my opinion.  That's the opinion of nutrition expert Marion Nestle.

That means if your son eats a variety of real foods, including lots of fruits, vegetables and whole grains, he’ll be in great shape nutritionally. 

It is hard to know exactly how much protein your son needs, but we can come up with some ballpark figures.

According to Marion Nestle you need about half a gram of protein for every pound you weigh. 

• If your 4 year old weighs 35 pounds (around the 50th percentile), then he needs an average of 17-18 grams of protein each day.

The USDA recommends slightly more. 

• The USDA suggest 4-5 year olds take in 3-4 ounces of meat and/or beans.  Four ounces of cooked beef, poultry or pork provides roughly 20-30 grams of protein.

Really active athletes need even more protein, but I’m assuming your 4 year old isn’t training for a triathlon.

The good news is that no matter which amount you decide is “correct,” these protein goals are pretty easy to attain.

• One cup of milk (8 ounces) delivers 8 grams of protein.
• One cup of Fage Greek Yogurt contains 20 grams of protein.

Want to cut back on the dairy?  Give your son a peanut butter sandwich.

• 2 slices of Pepperidge Farm Whole Grain Bread=8 grams.
• 2 tablespoons of Smucker’s Natural Peanut Butter=7 grams.
• Add a serving of kale (2 grams) and you’ve reached your goal (17 grams).

Or how about this:

• Top a quarter cup of quinoa (5 grams) with a half-cup of black beans (7 grams).
• Serve with a side of sour cream (1 gram).

Think of the above menu as all the foods your son could consume during one day and the numbers go through the roof: 58 grams.

There is protein in just about everything.

• A cup of cooked pasta (plain)=7 grams
• 1 sweet potato=2 grams.
• 1 tomato=1 gram
• 1 banana=1 gram

You get my point. 

Feeding kids is challenging work, especially when you try to track nutrients.

That's why I advocate focusing on habits instead.  Fill your son up with real foods (like you're doing) and you can be sure you'll be filling him up with protein (and calcium, fiber...) too.  You'll also be teaching your son habits for a liftetime of healthy eating!

~Changing the conversation from nutrition to habits.~

=====================================

Sources: 

Bricklin, M., 1992. Prevention Magazine's Nutrition Advisor: the Ultimate Guide to the Health-Boosting and Health-Harming Factors in Your Diet. Emmaus, Pennsylvania: Rodale Press, Inc.

Nestle, M., 2006. What to Eat. New York: North Point Press. Pp 143-144