Training Kids for the Big Swig: What Bloomberg Knows About Teaching Kids to Eat Right

Whatever you think about New York City Mayor's Michael Bloomberg's plan to ban the sale of any cup or bottle of sweetened drink larger than 16 fluid ounces, I just want to say this: Its heart is in the right place.

I’m going to sidestep the main debate here: Whether it is right, ethical and/or desirable to allow the government to regulate our drink consumption.  

Photo: NY Times. Click on the photo to read article

But this I know: When we make it easier for people to eat right, they eat right. When we make it easier for people to eat wrong, they eat wrong.  

It's time to start making it easier for people to do the right thing.

And if you really need more than 16 ounces of soda there are easy ways to get it. (Buy two drinks, get a refill, go to the grocery store.)

There is incontrovertible empirical evidence that...

1. The bigger the serving size, the more people consume.  Read Size Matters.
2. When portion sizes grow, the amount people consider "normal" to eat grows too.  BIG becomes habitual. Read How Big is That Bag?

And get this: Research shows that people consume more food when it's convenient. Within arms reach convenient.  Have to walk a few feet across the room? Forget about it. Consumption goes down.

What kind of eating environment are you creating at home?

Are you inadvertently imitating the obesogenic eating environment of the world around you? Or are you creating something a little more sensible?

Do the sippy cup check.  Do your children tote around 12 ounce sippy cups?

Filled with apple juice, that cup delivers almost 200 calories and 40 grams of sugar. And it teaches your kids to swig big.

It's pretty good training, too, for needing that 32-ouncer later in life.

Here are some things you can do to shape change what, and how much your kids eat.

• Use small plates and cups.
• Keep fruits and vegetables visible to your toddler, and within easy reach.
• Keep sweets and treats out of sight and hard to reach.
• When you let your kids snack on the go, carry fruits and vegetables. Have your kids sit at the table to eat sweets and treats.
• Use big sippy cups only for water.  Use small sippy cups for everything else (even if you dilute the juice).
• Allow sippy cup refills, but make your kids go to the kitchen to top up. (A little work goes a long way.)
• Read Water vs. Punch and Soda.

All too often parents act as if there is a protected period of time when it doesn't matter what we teach our kids about how to eat.

There is not.

Parents can learn a few things from Bloomberg's plan.  

Make bad eating harder, and good eating easier, even by a fraction, and you'll be setting your kids up for a lifetime of healthier eating.

~Changing the conversation from nutrition to habits.~

Sources:

Privitera, G. J. and H. E. Creary. 2012. “Proximity and Visibility of Fruits and Vegetables Influence Intake in a Kitchen Setting Among College Students.” Environment and Behavior Forthcoming. Published online before print April 17, 2012: http://eab.sagepub.com/content/early/2012/04/10/0013916512442892

Wansink, B., 2006. Mindless Eating: Why We Eat More Than We Think. New York: Bantam Books.

The Portion Size Problem: A Matter of Trust

The problem with portion size is this: Parents don’t trust their kids to get it right.

Think about it, if you thought your children would eat the right amount you wouldn't have to intervene. But you get involved because there's lot of evidence that your kids are kind of crappy about portion control.

Overeating gets all the media attention but most parents of young children are more worried about under-eating. In one study of kindergarteners, 85% of parents tried to get their kids to eat more.  

Rather than control your kids' consumption, consider teaching your kids to self-regulate..accurately. Researchers accomplished this task in 6 weeks.  You can too.  (Read on for details.)

As I see it, the trust problem stems from two sources.

First:

• Parents know kids are born being able to regulate how much to eat. Parents take this to mean their kids won’t overeat. (And this is true unless parents subvert their kid’s natural instincts which we do all the time. Read Two More Bites.)

• Parents also know that kids frequently under-eat. They haven’t yet learned to gauge how much food they need to get from one eating opportunity to another. (And many young kids don’t understand why they can’t eat whenever they want to….like later, after they’re done playing!)  In the short-term, under-eating can be a big problem for parents.

At the same time:

• Either, parents think that young children know when they’re hungry and when they’re full (but they still have to be trained to eat enough food at the right times).
• Or, parents think young kids don’t really know how hungry or full they are and they’re not capable of learning this at such an early age.

The result is a situation where parents are willing to risk teaching their kids to overeat in order to make sure their kids don't under-eat.  It's a high-stakes gamble.

Research shows children vary in their ability to self-regulate how much they eat.

So you might be right to distrust your kids. Some kids naturally eat more than they need. Other kids stop eating way too soon.

Unfortunately, many of the tactics most parents rely on to solve the situation simply make it worse. Kids respond to pressure by eating less or to restriction by eating more.

But even when parental prodding is relatively benign consider this: 

When parents control how much kids eat, children don't learn to self-regulate—they don't learn to do the job on their own.  

You've got to let go.

Teach your kids to self-regulate.

In one study, researchers taught a group of 3-4 year old children to self-regulate. They:

• Talked about the concepts of hunger, satiety and overeating.
• Educated the children on the anatomy of eating: mouth (for chewing), esophagus (for swallowing) and stomach (where the food goes when swallowed).
• Provided playtime with dolls with external stomachs that showed different levels of fullness.
• Encouraged the children to check in with their internal cues of hunger and fullness before, during, and after eating.

You can do all of this at home—even the dolls. The stomachs were made from nylon material (i.e. stockings) and were filled to varying degrees with salt. Make a few and strap them on to a couple of Barbies.

1. Children played with the dolls and were taught to identify the stomachs with different amount of fullness.
2. The children were asked to place their hand over their own stomach and tell whether they were hungry, a little full or very full.
3. The children were asked to choose the doll stomach that was most like the state of their own stomach at various times throughout the day. 

Will your kids make mistakes if you leave the eating up to them?  Sure.  But that’s how they learn.

The  key is to talk to your kids about the underlying issues (hunger and satiation) and to focus less on the food. 

Set appropriate times for meals and snacks—no eating on demand—and then let your kids practice, practice, practice. It won't just solve your short-term problems, it'll teach your kids the habits they need for a lifetime of healthy eating.

Remember, you have to let your children choose not to eat in order for them to choose to eat. (It's a freedom thing.) And you have to allow them to choose not to eat enough in order for them to learn to get it right. If this freaks you out read The Upside of Hunger.

For more on this topic read: 

• Are You Teaching Your Toddler to Overeat?
• How to Serve Seconds Without Hurting Your Kids' Habits

 ~Changing the conversation from nutrition to habits.~

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

Sources:

Orrell-Valente, J. K., L. G. Hill, W. A. Brechwald, K. A. Dodge, G. S. Pettit, and J. E. Bates. 2007. “"Just Three More Bites": an Observational Analysis of Parents' Socialization of Children's Eating At Mealtime.” Appetite48(1): 37-45.

Johnson, S. L. 2000. “Improving Preschoolers' Self-Regulation of Energy Intake.” Pediatrics 106(6): 1429-35.

Kid Eats Q&A: How to Serve Seconds Without Hurting Your Kids’ Habits.

Whenever parents ponder the problem of providing appropriate portion sizes for toddlers and preschoolers, the issue of how to handle seconds inevitably arises.

That’s what happened in response to my last post Are You Teaching Your Toddler to Overeat?  One reader asked:

“I put appropriate sizes on my daughter’s plate, and I don't make her eat or encourage her to eat more. If she eats, she eats, she's the one who knows if she's hungry or not.  Often she will eat all of her fruit or bread or something, not touch anything else, and then want more of the thing she ate. Should I give it to her, or in that instance, tell her ‘no’ because she hasn't eaten anything else, and then encourage her to eat the other stuff on her plate?”

I threw the question back out to parents on my Facebook page, and I agree with a lot of what people had to say.  However… 

The primary solution to the snag of seconds happens long before the battle.  This is definitely a case where an ounce of prevention is worth a pound of cure.  That’s right, you can actually prevent the seconds situation from occurring.  Here's how.

Prevention Part 1: Set aside the goal of getting your toddler to eat a certain amount—or a certain type—of food.  Instead, think about teaching your tot to eat right.

Shifting your goal from worrying about consumption to shaping habits won’t just enable you to keep the highs and lows of any one meal in perspective (though this is certainly a benefit).

It will also help you avoid a common parental pitfall: Relying on a set of strategies that bite you in the butt in the long run.  Read The 2-More-Bites Tango: How YOU Can Take the Lead and Wheelin’ and Dealin’:10 Reasons Why You Shouldn’t Trade Peas for Pie.

And, if these benefits aren’t enough, consider this:

Shifting your goal from consumption to habits will enable you to set up a feeding system that works by transfering your attention to when and how food is served and by altering the parent/child dynamic. It also will drastically reduce the pressure you put on your child to eat.  Read The Pressure-Cooker Problem.

The result:

• You won’t have to monitor what your child eats.
• You’ll be able to encourage vegetable consumption without talking about vegetables.
• You’ll be able to make peace, stop being the enforcer, and start enjoying meals.

Never compromise your long-term goals for the sake of the immediate meal.

Prevention Part 2: Take the pressure off dinner by serving higher quality food through the day.

Here’s a math problem (and possibly a traumatic flashback to fifth grade):  Two children are eating dinner.  One child has eaten 2 bites of vegetable at each of the earlier meals and snacks, for a total of 8 vegetable bites before sitting down to the main meal. The other child hasn’t eaten any vegetables yet today.  Which child’s parent is more likely to crazed about how many carrots her kid consumes at dinner?

Change the dinner dynamic by upgrading the rest of the day. I recommend you serve a fruit and/or a vegetable at every meal and snack.  

Even if you don't achieve this goal every day, you will increase your kid's consumption, thereby resolving most of the seconds dilemma. And let's be honest, vegetables are at the heart of this problem. Would you really care if your toddler asked for seconds after barrelling through the broccoli without so much as checking out the chicken?

The benefits of serving a fruit and/or a vegetable at every meal and snack:

• A net gain of vegetable consumption over the course of the day. Read 10 Ways Improving Your Kids’ Snacking Will Improve YOUR Life.
• When the whole day is healthier you can relax at dinner.
• The more frequently kids are exposed to vegetables, the more familiar vegetables become.  And increasing familiarity is the secret to vegetable-eating success.
• Upgrading snacks will get you out of the Nutrition Zone Mentality since snacks are where the nutrition action really happens. Read Snacking and the Nutrition Zone Mentality. 

Eating is really a matter of math: Kids eat what they're exposed to the most. (And what they eat the most determines the nutritional quality of their day.)

Prevention Part 3: Downsize your expectations and the portions you provide.

Part of the problem with seconds is simply a problem of portion size: You pile on the pasta and the peas (hoping your child will eat at least some of the stack). 

• Even if your toddler eats some of the peas, the part that remains looks untouched, compelling you to ask your tot to do more.
• From your toddler’s perspective, the mountain looks unscalable. Why try?

Put very small portions of food on your child’s plate.  And, make the portions of different foods fairly equal.  In other words, don’t put two bites of broccoli and ½ cup of pasta on the plate.  Put down two bites of broccoli and 2 bites of pasta.

This is definitely a case where less is more, especially if you have a reluctant eater.

Other advantages of serving smaller portions:

• You’ll be giving your child the number of bites you normally negotiate down to, thereby avoiding the need to negotiate.  Read Raising Lawyers.
• You won’t be tempted to pile up the preferred foods and minimize the monsters—thereby inadvertently teaching your tot that some foods are desirable and others are tolerated.  Instead, you’ll be teaching that all foods are created equally.
• You won’t have to worry about your child overeating in order to get to the good stuff.
• You’ll be teaching your child a valuable lifelong lesson about portion size.

Prevention Part 4: Teach your child how to eat.

Think about eating from our kids' perspective: They tuck into their favorites first. Then, after they’re kind of full (or totally stuffed) parents come along and tell them to eat their veggies.

Turn that baby around by teaching your child to eat some of everything before she eats all of anything.  I describe this method of grazing around the plate—which I call One-One—in more detail in the post: My child asks for seconds of pasta before she’s even touched her peas.

Remember, kids don’t know when they are going to be full.  One-One gets a portion of all the goods into their guts before they’re totally goners.  Share this rationale with your toddler: “It’s hard to know when you’ll be full so I would like you to eat a little bit of everything as you go along so you don’t get too full on pasta before you’ve touched your peas.” It might take awhile for the lesson to sink in but don't let that deter you.

Put all the parts of the prevention plan into action.  Then, when your child asks for seconds of the pasta before he's touched his peas...

Say OK. 

Then dawdle.  “I’ll get you some more pasta after I finish a little more of my dinner. Why don’t you work on the rest of your meal while you’re waiting.”

Don't stress about it.

Try again tomorrow.

Then, put your focus back on perfecting all the parts of your prevention plan.  It won't just solve the problem of seconds, it'll change the entire way your child eats.  The prevention plan: It's where you'll find the secret to success.

~Changing the conversation from nutrition to habits.~