Encouraging healthy eating in children: A report from the front line

Every evening, when I put my daughter’s dinner plate in front of her, I brace myself for an attack. I don’t like tomatoes. I don’t want this green stuff. I want chips. I take a breath and dissemble. Okay, honey. Just eat the bits you like and leave the rest and maybe just have a taste of that avocado. I really want to return fire with I just spent an hour in the kitchen preparing this meal, so just eat it.

Let me explain how we got here.

My kids (son, 8 and daughter, 3) are fussy. I try not to get too cranky about it. I was a fussy kid myself. I spent a lot of time alone at the kitchen bench, long after everyone else had finished dinner. By the time I was a teen I’d developed the strategy of whisking food I didn’t like into a tissue on my lap, hiding the tissue up my sleeve and flushing the parcel down the toilet. I know from experience that forcing a child to eat foods they don’t like doesn’t result in the child developing a better relationship with food. It just makes everyone miserable. I didn’t start trying new foods until I moved out of home (and probably away from the pressure to eat).

Australian nutritional surveys have shown that we, as a population, are not eating enough fruit, vegetables and whole grains and are eating too many added sugars, salt and high fat foods. These behaviours are increasing our risk of developing dietary related chronic diseases such as obesity, cancer and heart disease. Poor diet in childhood often predicts a poor diet in adulthood, so healthy eating must begin in childhood.

My children don’t eat a lot of junk, but they do have limited diets and could benefit from a wider variety of fruits and vegetables. I had recently gotten in the bad habit of making a separate meal for my son when he didn’t like what we were having for dinner. This worked okay until my daughter turned three and food neophobia set in. The farce of preparing three different meals began. Like many parents, I didn’t know that between 2 and 4 is a peak time for food neophobia. This fear of trying new foods is a normal developmental phase, although different children will have it to vastly different degrees. I did know things had to change, but I was unsure how to go about it or even where to source information. Luckily when I started the first subject of my Master of Human Nutrition course I was able to arm myself with knowledge.

Here’s the arsenal of information and strategies I’ve collected for my battle to encourage healthy eating in my children:

Exposure

Children often need at least ten exposures to a new food before they’ll taste it and then numerous tastings may be required before they develop a liking for it. I’ve started to put things like avocado and cucumber on my daughter’s plate, in the hope that one day she’ll start eating them. At the moment she mostly lobs any items she disapproves of, hand-grenade style, onto her Dad’s plate.

Role modelling

Seeing a parent or carer, particularly a mother, eating certain foods influences a child’s acceptance of those foods. My husband and I eat quite well. Although our emphatic cries of These stir fried vegetables are delicious don’t seem to have had much influence yet. I live in hope that one day the images of Mum and Dad enjoying their veggies will  reach a critical enough mass in their young brains to successfully invade and overtake.

Children are also influenced by the eating habits of their peers. So depending on who they’re hanging out with, this can be a good or a bad thing.

Pressure to eat

Pressure can take the form of verbal or physical prompts. In general pressure to eat has been associated with increased neophobia and food avoidance. Pressure to eat, especially prompts to finish everything on your plate, can result in increased food consumption, but may undermine a child’s ability to respond to internal satiety cues and regulate their own consumption.

This is something I need to work on. My kids tend to fill-up on the carbs on their plate (pasta, bread or potatoes) and then are too full to eat the veggies. This results in me saying Just have one more piece of broccoli or a mouthful of corn and then you can leave the table. A more effective strategy would be to reduce the portion size of the carbs  so they have room for the veggies.

Restriction

Overt restriction of foods (for example saying I know there are a dozen donuts in the pantry, but you’re not allowed to have any) has been associated with increased consumption of restricted foods when freely available. Covert restriction (for example not allowing certain food items into your home) does not seem to be related with such effects. Therefore the message is try to keep undesirable foods out of your home and avoid eating in establishments with lots of junk. When undesirable items are available, try not to make a big deal out of it.

We are quite good at not having junk in the house. It’s too much of a temptation for us as parents too. If I purchase a box of cheezels, say in preparation for a party, they usually get eaten (by me hiding in the pantry when everyone else is in bed) long before the day of the party arrives.

Rewards

Rewarding the consumption of one food with another is counterproductive and raises the appreciation of the reward item only. For example telling your child that if they eat all their carrots then they can have ice cream, may result in higher carrot consumption in the short term, but will result in a greater liking for ice cream and no increased enjoyment of carrots.

I am guilty of employing this strategy, but I have now stopped.

My son really likes ice cream.

Combining new foods with favourite flavours

Serving new foods with familiar and liked foods may also help transfer the liking to the new food. I’ve been successful in getting my daughter to eat broccoli and tomatoes by allowing her to dip them in tomato sauce. I am hoping that eventually she’ll eat them without the disgusting high-sugar, high-salt sauce (my eye twitches when I watch her). One victory at a time.

Mealtime environment

Children learn to associate the situation or place where food is eaten (such as the dinner table at 6pm) and are more likely to easily initiate eating when presented with food in that context. Routines around mealtimes are important in establishing healthy and socially acceptable eating patterns.

I have found that my children eat better at the dinner table, rather than in the lounge (where I occasionally serve dinner when I’m feeling lazy and want to slouch on the couch).

Hunger

Children are more likely to be receptive to new foods when they’re hungry. They also come to associate foods eaten when they’re hungry with satisfying that craving, which increases their liking for those foods.

We’re a family of grazers. This often means that my kids aren’t terribly hungry at dinner time. I need to increase my defences against the pleas for a banana or a glass of milk in the late afternoon.

Most effective battle strategies

• Persist with offering healthy, family foods to your kids.
• Don’t pressure kids to eat or offer rewards.
• Allow children to decide what and how much they eat from the food you’ve provided. If they choose not to eat the meal you’ve prepared don’t provide alternatives.
• Encourage kids to taste new things. With the condition that they don’t have to continue eating it if they don’t like it. I’ve found that asking my daughter to simply lick something is the most acceptable method to her.
• And of course, eat well yourself.

Eventually these strategies should translate into a foundation of healthy eating habits.

The struggle continues in my house, but I’m already seeing my children’s interest in trying new foods increasing. I have accepted that I can’t force them to eat and I’m not a bad mum if I don’t ensure they’ve eaten everything on their plate. As a bonus, removing the nagging component from meal times has made life less stressful for all of us.

Check out this cute movie of kids trying new foods.