Win the food fight with your kids

How to help your kids build a better relationship with food, and be healthier overall

Food Fight

The dinner table is a battlefield. You bribe your daughter to eat her vegetables in exchange for more TV time. You heat up chicken nuggets three nights a week because that’s all your kids will eat. You order take-out pizza because it’s certainly better than fighting at another meal. All of this combat makes a parent want to wave the white flag.

Parents know it’s important to keep their kids healthy. Childhood obesity is a serious problem in the United States, with 18.5% of children between the ages of 2 and 19 considered obese, according to the CDC. And as children get older, the numbers climb. For example, for ages 12 to 19, the obesity rate spikes to more than 20% of the population.

But the guidelines can be confusing and unclear. Here’s how parents can ensure their children are eating the right foods in the right amount, and call a ceasefire at the table.

It starts with the plate

My Plate PnhOne of the simplest ways to visualize a healthy meal starts with your dinner plate. Karen Mountjoy, M.Ed., RD, LD, CLC, a licensed and registered dietitian and owner of Coastal Family Nutrition in Portsmouth, recommends parents follow the “MyPlate” way of eating. The United States Department of Agriculture replaced the familiar Food Pyramid with MyPlate (www.choosemyplate.gov) more than 10 years ago.

It can help your family build healthy meals and eliminate some of the confusion about what to serve at mealtimes, Mountjoy said.

The guidelines to MyPlate are simple: Fill half of your plate with fruits and vegetables, one-quarter of the plate with protein, and the last quarter of your plate with a carbohydrate choice. There is also one serving of dairy included.

“There are flaws for sure. For example, MyPlate doesn’t mention healthy fats, like avocado, fish or olive oil. But I use it with parents as an idea of where to start,” she said.

The MyPlate website does provide some suggested calorie guidelines for children by age and activity level, as well. Along with calorie counts, charts on the site provide a suggested activity level and meal plans. A three-year-old boy, for example, should consume anywhere from 1,000 to 1,400 calories a day depending on his level of activity.

As children get older, it can be more difficult to gauge estimated calorie intake, so other nutritional factors become equally or more important, Mountjoy said.

“Most five-year-olds, for example, are moving targets, and you can make an educated guess about what you think he or she might be burning at that age. For a 13-year-old girl entering puberty, figuring out an estimated calorie intake for her is more about making sure she’s getting her period regularly and that her calories and nutrients reflect that,” Mountjoy said.

“I strongly recommend that parents never say the word ‘diet.’ Parents dieting is the number one indicator or risk factor for a child’s eating disorder. Restricting equals weight gain — the research supports this again and again. If you label foods bad or good, you are setting your kids up to sneak foods later on and overeat them.”

How to be in control at meal times

Jessica O’Connell, registered dietitian and owner of Jessica O’Connell Nutrition, LLC in Epping, started her private practice in 2019 but has served families in hospital settings and as a Hannaford dietitian for more than 15 years.

Dinnertime with children who refuse to eat often erupts into arguments, power struggles, and epic fights. O’Connell suggests that parents avoid expending their energy on forcing their children to eat.

“The more we push, prod, and suggest, the more their resistance goes up,” she said.

She works with families to help their children understand what food is being offered and encourages parents to include at least “one familiar food” on the dinner plate.

Conversely, O’Connell recommends that parents avoid falling into the trap of offering alternate meals or snacks to appease finicky children looking to test their limits.

“They think, they got out of it last time, and they are ready to hear other options,” she said.

Parents may not be able to influence exactly what their kids will eat off of their plates, but they can dictate the “where” and “when” of eating.

They can choose an 8 a.m. breakfast time in the kitchen and offer fruit and waffles. It’s the kid’s job to decide whether to eat, Mountjoy said. It also means parents shouldn’t offer their child endless amounts of waffles. If their child is still hungry during breakfast, they can eat the fruit salad.

“As a parent, it’s your responsibility to make sure you are covering the food groups and introducing as many types of food as you can. If you are offering your child wholesome, nutritious food, 90% of the time you can feel comfortable knowing that you are doing your job and your kid’s body is doing his or her job,” she said.

“If you are concerned about your kid’s Body Mass Index (BMI), and you are concerned they are eating too much, my suggestion would be to look at how often you are feeding your child. Make sure they are not grazing between meals. When breakfast is over, the kitchen is closed. If your child is still hungry at 9 a.m. they can eat a snack at 10:30 a.m.”

Involving your children in meal planning and getting them to take an active role in meal preparation may also inspire them to eat what you are serving, Mountjoy said.

Meals don’t have to be “Pinterest-worthy,” but they should follow the MyPlate model. For example, Monday’s dinner could include homemade pizza, fruit salad, and cut-up vegetables; you could even find a place for macaroni and cheese to fit in the dinner rotation.

While 90% of all the food your children eat should fall into nutritious, healthy food category, there is wiggle room for treats, Mountjoy said.

“Every day, 10% of what they eat can be a fun food…. that translates to a small bag of chips or Goldfish, two Oreos or a half-cup of ice cream,” she said.

O’Connell agrees that involving children in family meal planning can reap positive results. Even if your child wants chicken fingers included on the dinner menu most nights, you can still include them as a “sometimes” food while you also include “always” foods, such as vegetables, as a side.

For parents who need to feed underweight children, O’Connell works with hem to develop healthy meal options their kids will actually eat to avoid creating other snacks at night. But for those who are truly “picky,” she suggests waiting until breakfast before offering new choices.

Special needs

Some children experience eating issues that go beyond picky eating such as having difficulty swallowing, aversions to food textures, or other medical diagnoses. Mountjoy encourages parents of these children to reach out to their medical provider as soon as possible.

The Department of Health and Human Services of New Hampshire offers a Special Medical Services program for children with special medical needs. One of the programs under SMS is Nutrition, Feeding and Swallowing Services. Through NFSS, parents can ask for initial nutrition and feeding and swallowing evaluations to take place at their home or their child’s school.

In collaboration with Early Supports and Services, Head Start, their doctor, and school teams, families can develop safe eating plans and special meal prescription forms for child care and school meal programs.

The sooner you include nutrition as a part of your child’s overall support services, the better your outcomes will be, Montjoy said.

Put less weight on the numbers

At annual well-visits, pediatricians often reveal to parents their child’s Body Mass Index number, or BMI, which can sometimes cause undue alarm. BMI is a diagnostic tool that compares a child’s weight in kilograms divided by the square of height in meters.

A high BMI can be an indicator of high body fatness and it can be used to screen for weight categories that may lead to health problems — but it is not diagnostic of the body fatness or health of an individual, according to CDC.

Mountjoy cautions parents to remember that BMI numbers are relative to the “lane” your child is following in his or her growth pattern.

For example, when BMI is above the 75th percentile, that number is considered out of the normal range of what is considered healthy for weight in relation to height. However, if your child was born with a BMI in the 92nd percentile and stays in that growth patten over the next several years, you may have less to worry about. It’s important to look at your child’s natural genetic pattern, and instead of focus on measures of overall health — like blood pressure, blood sugar, and cholesterol, while at the same time making sure that your child is active, eating, and sleeping well, Mountjoy said.

“I’m more concerned about kids who leave their (BMI) lane. What I see happening is kids who stay in the 30th to 40th percentile for BMI until age 9 or 10, and then their BMI goes upward,” she said.

Tweens and teens

O’Connell works with teen clients who are often surprised at the amount of food she suggests they eat, because she asks them to switch out high-sugar, empty-calorie choices for whole foods that contain more protein, fiber, or healthy fats.

She also works with teens to better understand how their body fits in with their family genetics and talks with them about the lies that the diet culture preaches to young women. Calorie-restricted diets may work in the short-term, but they carry with them real implications, including a heavier weight over one’s lifetime. Instead of dieting, O’Connell recommends that teens instead seek to feed their bodies with nutritious foods first.

“I really work with young girls on body positivity and accepting our body for the powerful, beautiful being it is,” she said. “By instituting calorie restriction, we are setting teens up for a lifetime of disordered eating and potential eating disorders.”

And while the low-carb craze might be an option for adults who want to lose weight and reduce their BMI quickly, it’s not a diet for teens. Instead, they should aim to reduce their intake of simple carbs such as cake, cookies, white bread and pasta; but they should not cut out fruit, vegetables, whole-grains or potatoes, O’Connell said.

“Carbs are a primary fuel for the body and brain. If you deprive your body of carbs it can impact hormone levels. In teenage girls, hormones are in a delicate place as it is and they are not something to mess with,” she said.

When parents should seek help

If you find yourself engaging in food battles with your 6-year-old every night or your teen is experiencing body image concerns, O’Connell suggests reaching out to a dietitian. Depending upon your insurance plan, preventative nutritional counseling might fall under your health benefits and may only require a co-payment.

Children often do not need medical referrals or need to meet specific weight requirements to get seen, she said. But, if you are working with a pediatrician to get your child weighed monthly, and he or she is not gaining any weight, for example, it’s really important to take the next steps to ensure your child is following a healthy path.

The final ingredient: Exercise 

While diet is a critical component to good health, exercise can be overlooked especially if it seems like your child is getting plenty of exercise on the school playground, on weekends or through organized sports. Parents can underestimate how much movement their children need to stay healthy.

Children ages 3 through 5 should be physically active throughout the day for growth and development, according to the Centers for Disease Control. They should be encouraged to be physically active for up to three hours a day. Children and adolescents ages 6 through 17 years should spend 60 minutes or more each day doing moderate-to-vigorous intensity physical activity daily. As part of this activity, the CDC recommends on at least three days during a given week, children and adolescents engage in vigorous activity, such as running or soccer; activity that strengthens muscles, such as climbing or push-ups; and activity that strengthens bones, such as gymnastics or jumping rope.

To help families navigate the balance between healthy eating and exercise, the YMCA offers Prescribe the Y, said Kim Adie, director of Healthy Living at the YMCA of Greater Nashua.

Geared toward ages 6 to 13 and parents, Prescribe the Y meets weekly over 10 weeks and teaches the whole family basic nutrition and exercise guidelines. Divided into two groups, younger children ages 6 to 9 learn how to play games as a way of exercising, while kids ages 10 through 13 work use the club’s cardio and Cybex weight equipment. At the same time, families learn about the 5-2-1-0 method— the idea of eating five or more fruits and vegetables a day; viewing
two hours or less of screen time; getting one or more hours of physical activity; and committing to 0 sugary beverages each day.

The free program, which the Y has run since 2008, continues to gain in popularity, Adie said. The YMCA’s annual campaign, grants and donations help keep the program free-of-charge for members and nonmembers. Families are typically referred to the program by pediatricians, school nurses, psychologists, or other health care providers, according to Adie.

The YMCA also works closely with Hannaford to help families make healthy choices as part of their weekly grocery shopping trips. As part of Prescribe the Y, families visit the store, have questions answered by the store’s nutritionist about shopping and cooking, and often return to take advantage of the store’s free classes held every month.

Krysten Godfrey Maddocks is a frequent contributor to ParentingNH.

Categories: Food, Food news

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