In Summer 2014 I was in a small room in Westminster for a meeting with the then Deputy Chief Medical Officer for England. There weren't many of us, perhaps only 10 or so were at the meeting, but we had a big agenda. Sugar.
As part of the All Party Parliamentary Group on a Fit & Healthy Childhood we were there to discuss our thoughts on the sticky situation our nation was in, and in particular the effect of sugar on the wellbeing of children now and in the future. The title of the meeting was ‘How Can We Reduce Childhood Sugar Consumption?’
The esteemed gentleman all but hung his head in his hands as he told us there was nothing that could be done. He said words to the effect of, "I've been through this with the tobacco industry and its taken a long time. The problem is they have more money than us, more expensive lawyers than us and they'll never give in. We might as well work with them rather than against them." These were crushing words.
Sadly, it wasn’t an answer that should come as a surprise, but it was still a disheartening moment. Like an adult telling a hopeful child they are not prepared to help them. The room had been expectant with great direction and insight from this person in a position of power. But what came instead was the realisation that there are people in authority who have given up before they've even begun. And the knowledge that it’s our children they’re letting down.
The APPG FHC was undeterred and sugar stayed key in subsequent meetings. Leading authorities on the sweet stuff such as Dr Robert Lustig, an American paediatric endocrinologist and author of ‘Fat Chance: The Bitter Truth About Sugar’, met with us and sugar remains as an important topic in recommendations that have been put forward in reports we as a group have subsequently written and which our inspiring, motivating and tenacious Co-Chair, Floella Benjamin, (Baroness Benjamin OBE), has brilliantly communicated to Ministers.
We all know though that one thing will not change it all. Jamie Oliver, whose petition and media attention undoubtedly was crucial in leading the Government to announce a sugary drinks tax, has never claimed a tax would be the solution by itself. But the sugar tax is one thing more than we had before.
I heard Dr Hilary Jones speaking on BBC Radio 2 just after the Government had announced the plans. He said he supported it and said it should have been brought in long ago. That was great to hear. He also mentioned that a sugar tax alone will not solve all health issues. But it is a start. And that is always a good place to begin.
At the All Party Parliamentary Group on a Fit & Healthy Childhood, we'll keep on pushing for what we believe in. A healthy childhood, so that healthy children can grow into healthy adults, and can have healthy children of their own.
If we all do our bit, we can take this 'start' and make it a new beginning.
Let's be under no illusion that those holding influential positions are going to do all that's needed. Sometimes there's another agenda tempting them down a different path. Or they may simply have run out of energy to fight.
But whilst there are big names prepared to stand up and make a noise, let's applaud them, join them and make change.
Three cheers to health and three cheers to our children!
This post is a contribution from Natalia Stasenko, a pediatric dietitian, mom of three and founder of Tribeca Nutrition. Natalia has a Master of Science in Nutrition Education from Columbia University and has years of experience working with families of children with feeding problems both through her private practice and online coaching program at Feeding Bytes.
As a recognized pediatric nutrition expert, Natalia has been featured in Parents Magazine, Pregnancy and Newborn Magazine, Kiwi magazine, Huffington post and other media outlets.
For further information on the latest online coaching program 5 Day Child Feeding Bootcamp, do check out this link. Natalia is also offering 30% to Babycup followers with the code Babycup30.
This 5 day program is for parents who are tired of mealtime battles and need simple and effective solutions to get their children to eat better now and have a healthy relationship with food in the future.
Can we trust our children’s appetites?
• For his dinner, 5 year old Michael ate 1/4 boiled egg, 2 bites of bread and 1 apple slice. After that he said he was full. When his mom said he would get no desert if he did not finish his dinner, Michael took 2 more bites of the egg and ate one piece of broccoli. Mom was upset he did not eat everything but was happy he took a few more bites. To reward him for eating dinner, she gave him a cookie for dessert. • Two year-old Jamie ate all his lunch yesterday but today he just took a few bites. The mom was worried he would not get enough calories and played “here comes the airplane” to make him eat a little more. Jamie finished everything to please his mom and to be able to run to play. • Seven year old Colleen ate all her lunch and then asked for a second helping. Her parents refused to give her more food because their pediatrician told them that Colleen was overweight and they needed to ‘watch her portions’.
What do these stories have in common?
It is obvious that all of the parents featured in them are very worried about their child’s health and wellbeing. It is also probable that they have voiced their concerns to their health care providers at some point. Very often such parents do not receive the support they need to learn about typical eating behaviors in children or the importance of self-regulating the caloric intake.
At some point, often out of legitimate concern and sometimes out of pure fear, they started controlling how much their children ate at every meal. It probably allowed to at least feel ‘proactive’ in sorting out whatever eating issue worried them. But the unfortunate and often unforeseen consequence of a mealtime pressure, apart from the obvious stress and worsened eating, is that children who are told what and how much to eat may gradually lose the ability to self-regulate the amount of food they need on any given day.
Here are a few reasons why trusting children’s appetites is important:
Changes in growth rate. Children grow very fast during the first year of life. In fact, they double their birth weight before they are 12 months old. After that, their growth slows down and so does the appetite. In addition, by the age of 2 children want to assert their independence when it comes to eating. They are more likely to reject previously liked foods or develop fear of new foods. Sometimes the change in appetite and behavior is so dramatic it makes the parents wonder if their child is ok. Feeding struggles often arise when the child is entering this typical fussy eating phase.
Self-regulation rules. Research shows that a vast majority of typically developing children have an innate ability to self-regulate how much they need to eat, even if it looks to us like they eat too much or too little. Unfortunately, the connection with this amazing regulation system starts weakening by 2-3 years of age. At this point, outside factors such as portion sizes may affect how much children choose to eat.
In addition to the naturally diminishing ability to self-regulate, some children are forced to eat more or less than they need by their parents. In response to this, they may eventually stop listening to their bodies and lose the innate ability to eat in response to their energy needs.
Keeping food and emotions apart. Some studies show that little girls often try to please their parents by finishing their meal or some parts of it. This may create a strong link between food and emotions and trigger eating in absence of hunger. Do you often turn to food for comfort or finish everything on your plate even when not hungry any more? It may have started in childhood, when you were praised for eating your meal up or rewarded with a cookie if you ate your carrots.
No broccoli, please. Finally, forcing children to eat certain foods, such as vegetables, may lead to a life-long aversion to them. You probably know someone who cannot bear a sight of boiled cabbage or overcooked cauliflower that they were pressured to eat as kids.
What you can do to help children self-regulate?
• Teach them about it. Discuss with your children what hunger and fullness feel like and help them recognize their signs. During meals, allow your children to stop eating when they are full even when you think they haven’t eaten enough or to ask for more food if they are still hungry. This way you will give them a chance for a healthy weight and a healthy relationship with food for life.
• Implement structure in meals and snacks. Structure is the backbone of healthy eating habits. Having reliable meals and snacks gives children an opportunity to eat again soon if they did not like the previous meal. Schedule meals and snacks every 2-3 hours for toddlers and 3-4 hours for older kids and rest assured that they will not go hungry for a long time. It may take a few days for children to learn that you will not provide snacks on demand any more. But once they understand that, they will learn to focus on eating during the meals and scheduled snacks instead of grazing.
• Follow the Division of Responsibility in feeding. You, as a parent, decide what, when and where to feed your child. Your child decides how much to eat of what is offered. Whenever possible, allow children to serve themselves or ask them what and how much they want before putting food on their plate.When the pressure is gone, their eating may go worse for a few days or even weeks. Children who were forced to eat vegetables may stay away from them for some time while those who were not allowed to eat as much as they wanted may eat bigger portions of food. But, as children realize that they will not be pressured or restricted again, their eating habits improve.
• Relax at mealtimes. Stressful mealtime environment, where children feel judged or pressured to eat (even in a subtle way), may become a big turn-off factor for the little appetites. At the same time, when children are restricted in how much they eat during mealtimes, they may become preoccupied with food and sneak it when parents are not watching. To help them stay attuned to their bodies and eat the right amount of food for them, remove distractions like the TV and shift the focus to the quality of family time during meals, instead of counting bites and spoonfuls.
As a reminder, make sure to get 30% off the online class on feeding toddlers with the code Babycup30 here and start enjoying mealtimes with your child and feel good about feeding him nutritious foods from day one of the program!
References: Johnson SL, Birch LL. Parents’ and children’s adiposity and eating styles. Pediatrics. 1994;94:653-666 Birch LL, Fisher JO, Davison KK. “ Learning to overeat: maternal use of restrictive feeding practices promotes girls’ eating in the absence of hunger.” Am J Clin Nutr. 2003;78:215-220. Webber L, Cooke L, Hill C, Wardle J. Associations between children’s appetitive traits and maternal feeding practices. J Am Diet Assoc. 2010;110(11):1718-1722. Birch LL, Fisher JO, Grimm-Thomas K, Markey CN, Sawyer R, Johnson SL. Confirmatory factor analysis of the Child Feeding Questionnaire: A measure of parental attitudes, beliefs, and practices about child feeding and obesity proneness. Appetite. 2001;36(3):201-210 Orrell-Valente J, Hill L., Brechwald W., Dodge K., Pettit G., Bates J. “Just Three More Bites”: An Observational Analysis of Parents’ Socialization of Children’s Eating at Mealtime. Appetite.2007;48(1):37-45 Fox MK, Devaney B, Reidy K, Razafindrakoto C, Ziegler P. Relationship between portion size and energy intake among infants and toddlers: Evidence of self-regulation. J Am Diet Assoc. 2006;106:S77–S83