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THE MD

One sweet a day? It sounded good

November 06, 2006|Valerie Ulene | Special to The Times

For years, I've avoided the role of food cop with my children, in part because they didn't need one -- the overwhelming majority of their food choices were good.

My position changed after a recent school picnic during which they approached me no less than 20 times, pleading for cookies, doughnuts, candy and cake. Because they were unable to exercise restraint, I decided I'd do it for them. On the way home, I laid down a new law: We'd be operating under a "one-sweet-per-day" rule.

That was easier said than done.

Ironically, most children start out life with a natural ability to self-regulate what they eat. "Given the opportunity to balance their intake of energy and foods, infants and toddlers will do it," says Pat Crawford, co-director for the Center for Weight and Health at UC Berkeley. Though every meal may not be ideal, their overall intake tends to be on target.

As children get older, however, their ability to self-regulate often goes awry. "They can become susceptible to the temptations of the environment," says Myles Faith, an assistant professor at the Center for Weight and Eating Disorders at the University of Pennsylvania School of Medicine. "Over time, their ability to self-regulate is overpowered."

Not only do kids begin to spend more time outside their homes, gaining access to a wider variety of foods, but they also learn to eat in response to environmental cues. Cake and soda beckon at birthday parties, parents dole out snacks at the briefest sporting events and a constant stream of school celebrations offer a parade of sugary goods.

Commercial pressures take a toll too. Powerful advertising messages promote unhealthful food choices, such as candy and fast food, via children's television shows and billboards. In Los Angeles, buses have even been painted to look like candy bars.

Of course, parents can help counteract these influences. "If you want children to learn to make healthy choices, you have to make healthy choices accessible," Faith says.

For starters, the availability of high-calorie, nutrient-poor foods and beverages should be limited at home. That does not mean that junk food must be totally banned, but choices should be made thoughtfully. The occasional purchase of a six-pack of soda or a gallon of ice cream will cause little harm -- as long as it's not immediately replaced.

It is far more challenging for parents to control what goes on outside of a child's immediate environment. Parents cannot dictate what snacks are served when their children are at a friend's house or determine what is sold at a school bake sale.

But both inside and outside the home, children should be allowed to assume some choice over what -- and how much -- they eat. Food restrictions can backfire and should be used cautiously. Research has shown that children whose parents limit their food choices tend to continue eating when they are no longer hungry and are more likely to become overweight than children without food restrictions.

In my experience, restrictions resulted in my children wanting the banned foods even more. (As my son put it shortly after our one-a-day rule was implemented, "Now I dream about candy.")

Some limits are appropriate. "It's all right to have family rules," says Crawford. "It's OK, for example, to say, 'We don't eat sweets before lunchtime' or 'We only have one serving of dessert.' "

Parents should recognize, however, that foods high in sugar, fat and salt are simply hard for most children to pass up, and family rules are bound to be broken. Parents shouldn't be too critical when this happens. "There is little to be gained from criticism and, for some families, it can have a negative effect," Faith says. Teasing children about their weight is particularly damaging to a child's self-esteem and self-image.

Conversations about food should always be about making healthful choices. "Children should be praised for good decision making," says Faith. "It's about reinforcing children, instead of being critical about their weight or putting them down."

The most important thing a parent can do is model good eating behaviors. What parents eat and how they behave trickles down to their children.

I stand behind my one-a-day rule -- but only in theory. After just a few weeks, I grew tired of the constant nagging ("Does this count as my treat?" became my children's mantra) and laid it aside. The response I got was mixed. My 5-year-old son dug immediately into his stash of candy. My 12-year-old daughter actually expressed some regret. Despite all of her complaints about the rule, she clearly looked to me for guidance about how to eat well.

Dr. Valerie Ulene is a board-certified specialist in preventive medicine practicing in Los Angeles. She can be reached at themd@att.net. The MD appears the first Monday of the month.

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