DELAWARE MODERN
PEDIATRICS, P.A.
David M. Epstein, M.D.
300 Biddle Avenue, Suite
206
Springside Plaza, Connor
Building
Newark, Delaware 19702
Phone: (302) 392-2077
Fax: (302) 392 - 0020
www.DelawareModernPediatrics.com
And Prevention of Obesity
In many American families, parents and children struggle over
meals. Often, the children do not want
to eat what is on the table. The
parents, fearing for the children’s health, will try to make the child’s eating
an issue. If the battle escalates, meal
time becomes no fun for anyone at the table.
Much of the struggle is based on the idea that children who do not
eat “properly” are more likely to become ill.
However, this concept turns out to be generally incorrect. I rarely see children in my office who are
ill because they “don’t eat right.”
Poor weight gain is rarely a result of a child choosing not to eat
enough food.
In fact, when a parent says to a child, “I know you are not
hungry, but you need to eat,” then the child may actually hear the parent say,
“my parent says I cannot trust my
appetite.” If the child disagrees,
there is a battle; and if the child agrees with you then the child has learned
not to trust his or her own appetite, and it is possible that eating disorders
and/or obesity may result later in life.
Neither outcome is desirable.
I have several suggestions that can help children develop healthy
eating habits, while at the same time reducing meal time battles:
1.
Never fight over meals.
A child may eat whatever is on the plate. But if he chooses not want to eat, then that is also
acceptable. He may then go play, or stay
at the table and participate in the conversation, depending on the parents’ rules. But never discuss the topic of “how much did
you eat.”
2.
Everyone at the table should eat the
same meal. Please do not try to find something
(other than your meal) that the child “wants” to eat; don’t make separate meals
for each person. This ritual is based
on the erroneous idea that if the child does not eat, he will become sick. (If your child occasionally wants something
special, it should be placed on a platter that everyone can share.)
3.
Allow the children to participate in
weekly meal planning. If the children have had a chance to help
decide what is on the table, then you will know that at each meal there will be
at least one food on the table that the child is willing to eat. Then, if the child decides not to eat at
mealtime, you know it’s not because the child dislikes what’s on the table.
4.
There should be no snacks for 1˝ to 2
hours after the meal,
depending on the age of the child. The
child is not permitted to refuse what’s on the table, but then complain
20 minutes later that he is hungry for cookies or ice cream. It is also a good idea not to permit a snack
for 30 to 60 minutes before the meal.
5.
Limit juice to 6-8 ounces per day. Juice has little nutritional value, and may contribute to a “sweet
tooth.” Milk or water is a better
choice. Limit milk to 24 ounces per
day.
6.
No one in the family should eat when
the television is on. This is a good rule for all the adults
and children in the house. The TV is such a strong stimulus that
for many people it overwhelms the appetite drive. Some people may automatically place food in their mouths and
overeat. Others may stare at the
television, not eating enough to satisfy their appetite; when the TV goes off,
they may still be hungry and continue to snack for the rest of the evening. Either way, obesity is a likely result.
7.
Limit TV watching to 7-10 hours per
week. The inactivity promoted by TV clearly leads
to obesity. Even reading a book burns
more calories than watching TV. And,
advertising for junk food clearly alters peoples’ appetites.
8.
If the parents exercise regularly, the children will see them as role
models, and will be more likely to engage in regular exercise themselves over
time.
You will notice that in
these suggestions, there is no discussion about quantities the child eats, or
the variety of foods consumed. Usually,
if children are permitted to choose,
and if a variety is offered at each meal, over time the diet will be
fairly well balanced. This eliminates
the need for struggle, and makes meal time a pleasurable opportunity to
socialize and enjoy family life.
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Copyright David Epstein, MD 1996, 1999,
2004, 2007