Raising a healthy eater

Children continue to grow and develop physically, cognitively, and emotionally from infancy through adolescence. Learning to enjoy new foods and developing feeding skills are important components of any life stage as children aim to gain full independence.

According to Ellyn Satter, a world renowned registered dietitian, who has devoted her life’s practice to feeding families, “the optimal feeding relationship is one in which there is a true division of responsibility. Parents are responsible for the food and environment during meals, while children are responsible for how much or whether they eat." Recognizing this important concept as well as how children develop is important in raising a healthy eater.

Children prefer sweet and salty, reject sour and bitter

Children of all age groups naturally prefer sweet and salty tastes and generally reject sour and bitter tastes. Children eat foods that are familiar to them, which emphasizes the importance environment plays in the development of preferences. Children tend to reject new foods but may learn to accept a new food with repeated (up to 15) exposures to it. Children raised in an environment where all members of the family eat a variety of foods are more likely to eat a variety themselves. The context in which food is offered to a child, influences the child’s food preferences. Foods served on a limited basis but used as a reward become highly desirable. Restricting palatable food may actually promote the intake and desirability of that food.

Children have innate ability to self-regulate food intake

Children have an innate ability to self-regulate food intake to meet their energy needs. If allowed to decide when to eat and when to stop eating without interference, children eat as much as they need. Parents who try to interfere with the child’s ability to self-regulate intake by forcing the child to “clean their plate” or using food as a reward are asking the child to overeat or undereat. Over time, as adults focus children on external cues for eating, children lose their ability to self-regulate.

Although children can self-regulate caloric intake, no inborn mechanisms direct them to select and consume a well-balanced diet. Children learn healthful eating habits mainly by example. Parents, caretakers, teachers, coaches, peers and siblings all influence food preferences.

How can a parent understand each life stage and take action?

For toddlers, it is all about learning and accepting new foods, developing feeding skills, and establishing routines. During this time, a reduction in appetite and food intake is common. Caretakers should establish regular meal and snack times, prepare different types of food at each meal, and allow enough time between meals for the toddler to get hungry.

Preschoolers have increasing autonomy, language skills and are more able to control their behavior. Limits regarding food and meal times need to be firmly set, but within reason. Preschool-aged children also want to be helpful and please their caregivers. This becomes a great time to teach children about foods and preparation by involving them in simple food-related activities.

Preadolescent children continue to grow and develop in preparation for the physical and emotional changes of adolescence. With increasing independence, preadolescents begin to eat more meals and snacks away from home and need to be educated how and why they need to make good food choices. During this time, involve them in simple food preparation, assign chores related to mealtime and discuss why we eat certain foods.

Adolescents have varied nutrition needs with biological maturity. Unhealthy eating behaviors are common and include frequent dieting, meal skipping, and consumption of foods high in fat and sugar. Peers, food availability, convenience, media and body image influence eating behaviors. Abstract reasoning abilities do not fully develop until late adolescence therefore education efforts need to be highly specific and based on concrete principles. Nutrition messages for adolescents need to focus on what is important to their lives, like how good nutrition can positively impact appearance, sports or academic performance rather than focusing on long-term disease prevention.

Other actions you can take at all stages:

• Establish known family routines. Eat meals together to role model good behavior and allow for conversations about food.
• Have meals take place in a secure, happy and positive environment. Do not attempt to control children’s food intake by attaching contingencies and coercive practices. Avoid excessive reprimanding and arguments at meal time.
• Don’t fret about food acceptance – try repeated exposures. Studies show it can take more than 10 tries for a food to be accepted.
• As children age and prepare their own breakfast and afternoon snacks, have a variety of food available to them.
• Look beyond weight and focus on the long-term goal of developing healthy eating patterns.
• Be cautioned not to severely restrict junk foods as that may make these foods even more desirable.
• Use the USDA MyPlate  message as a building block for a healthier diet. Make half your plate fruits and vegetables, half of grains whole, go lean with protein, and avoid added sugar.
• Advocate for nutrition classes as part of the health curriculum as teachers and coaches have increasing influence on children’s attitudes toward food and eating behaviors.

If you have questions, seek advice from a registered dietitian nutritionist (RDN) at your local military treatment facility. Through their education and experience, RDNs are able to help educate families on healthy eating practices.

(About the author: Capt. Kathleen Robins is chief of the Nutrition Care Division at Keller Army Community Hospital, West Point, New York.)