A new joint policy statement from the American Academy of Pediatrics Council on School Health and Committee on Nutrition puts more emphasis on feeding kids better quality whole foods rather than eliminating sweet and savory processed foods:
A positive emphasis on nutritional value, variety, appropriate portion, and encouragement for a steady improvement in quality will be a more effective approach for improving nutrition and health than simply advocating for the elimination of added sugars.
In a commentary in Pediatrics last week, Drs. Susan and Robert Baker explain the evolutionary appeal to all things sweet and shed light on why childhood obesity is an epidemic:
Taste preferences for sugar and salt are mostly innate. Sugar and salt contribute to the overall pleasure and enjoyment of food. Sweet taste receptors respond to all classes of sweet tastants including natural sugars, artificial sweeteners, d-amino acids, and intensely sweet proteins. Pleasure from sweet taste promotes adequate caloric intake for times when food is scarce. Salty taste supports the proper dietary electrolyte balance. This happy relationship becomes a problem when there is a surfeit of food. Competitive food markets take advantage of these preferences to encourage consumption. Children are an important target because food preferences, eating behaviors, and decisions about pleasurable foods begin early and probably last throughout the life.
Cogswell, et al looked at foods marketed specifically towards infants and young children and concluded in a study published last week in Pediatrics:
Parents can be reassured that commercial foods for infants
(eg, vegetables, dinners, plain fruit [without grains], dry cereals) sold in the United States in 2012 were generally acceptable in sodium and sugar content. However, the majority of snacks, desserts, or juice drinks for infants or toddlers, and many commercial foods meant for toddlers aged 12 months [or more] were either high in sodium content or contained 1 [or more] added sugar. Many types of commercial infant and toddler foods had higher or equivalent levels of sodium and sugars to products sold for older children or adults.
Amy Norton suggests that parents should “do what’s necessary to make nutrient-rich foods palatable”:
If the only milk a young child will drink is flavored milk, for example, the extra sugar might be worth it — as long as the child’s overall diet has limits on sugary foods, according to the academy recommendations.
Similarly, if a dash of brown sugar gets your child to eat oatmeal, or a little salt and fat — such as vegetable oil or cheese — will encourage him to eat his veggies, then parents shouldn’t be afraid to use them, Murray said.
“Think of sweeteners, fat, salt and spices as ways to make nutrient-rich foods more palatable to children,” he said.
Yeah… no.
We’ve discussed this many times before on The PediaBlog. If your child is truly not eating, isn’t gaining weight, or has developed severe behavioral issues related to food and eating, then yes, we need to talk; we have a lot of tricks up our sleeves to make foods more palatable. But these issues are rare. “Picky” toddlers who eat limited quantities and varieties of foods are the norm! You don’t have to chase them around the house to get them to take “one more bite.” You don’t have to make them sit at the table until they “just try it.” And you don’t have to sweeten, fatten, or salt food to make them “more palatable” either. If they don’t want to eat something you serve them, your response should simply be: “Then don’t eat it!”
Also, we do need to specify what we are using to enhance flavors. Instead of putting brown sugar in oatmeal, why not sweeten it with fresh fruit or a tablespoon of 100% juice? (Better yet, sweeten your old fashioned rolled oats or steel cut oats by cooking them with dried fruit like blueberries or raisins.) Roast veggies in healthier and less processed extra virgin olive oil, not vegetable oil, and melt good quality cheeses for dips and sauces instead of using store-bought cheeses, processed with lots of added salts, fats, and sugars, and packaged in cans and jars.
Finally, after their first birthday, children do not need to drink any milk (zero… zilch) to grow well and stay healthy. Yes, milk provides a good source of protein, but there are other good sources of protein, including other dairy products, meats, nuts (and their butters), and beans (legumes). Milk is also a great source of calcium but, again, there are others that can be offered. And milk is a fantastic (in fact, the only reliable) dietary source of vitamin D, an important nutrient for healthy bones and a healthy immune system. But vitamin D can (and should, for most people living in temperate zones) be supplemented easily and effectively. If your child likes chocolate milk, is a good eater, and is normal weight, then let them enjoy it! If your child drinks chocolate milk at the expense of eating good foods or is overweight, then no chocolate milk. Period. End of discussion.
Norton spoke to a dietician with some good ideas:
It’s also a good idea, Delbridge said, to involve kids in grocery shopping and meal preparation, and to give them choices — asking them which fruits or vegetables they want in their lunch, for instance.
Introducing a wide variety of healthful foods from an early age is important, but it also takes patience, Delbridge noted.
“It takes an average of 12 exposures to a new food for a child to accept it,” he said. “Don’t get discouraged if your child doesn’t like something the first time. Try again, try it with different cooking techniques.”
Sitting down to dinner as a family is also key, Delbridge said. It’s a chance for parents to teach kids healthy eating habits, and to “bond” with them, he said.
“Make dinner fun,” he advised. “Those vegetables might end up becoming a ‘comfort food’ for your child, because they’re tied to good memories.”