What to do about your child's diet

Feeding your child in today's obesoginic environment is a difficult thing. Children having a natural preference for the high sugar, high fat, high calorie foods that now surround us and childhood is well established to be the time when eating patterns are set for life.
Unfortunately, many strategies used by parents out of concern for their child's weight in fact are likely to lead to increased desire for unhealthy foods, troublesome eating patterns and ultimately becoming overweight or obese.

What not to do
These strategies are generally considered to result in a higher preference for high fat, high calorie food, limit the range of food eaten and overall disrupt self-regulation of energy intake by altering their responsiveness to cues on hunger and fullness, all of which are known risk factors for poor diet in adulthood.

1. Pressure to eat (in general and healthy foods): This practice has been shown to reduce the child's ability to self regulate and result in less consumption of the desired foods (1)
2. Engage in restriction of foods: Preventing children from eating foods that are available or limiting how much of it they can eat has been linked to continued eating when full (2), eating in the absence of hunger (3) and greater weight gain (5). By restricting the desired food, the child then pays more attention to it and their preference for it develops. When the food is available the child will then eat more of it, regardless of hunger levels, this will lead s to the loss of ability to self regulate and greater weight gain (5).
3. Use excessive control in determining what, when and how much the child can eat: Excessive control includes being 'firm' with them about what and how much they should eat and not  providing the child the ability to sometimes make these decisions.This prevents children from exercising self control and is associated with increased overall food consumption and lower levels of healthy food consumption (6)
4. Use rewards for eating healthy food: This strategy is counterproductive in the long run as it has been shown to decrease desire for the healthy food and increase desire for the reward (7)
5. Use food to control child's behavior: This includes using food as as a reward for good behavior, as a distraction or for mood regulation and is linked to increased consumption of unhealthy food (4)
6. Be inconsistent with food: Being erratic with when and what food is available, results in the child being unable to predict when food will be available and what it will be. Ultimately they overeat or eat when are not hungry as they are unsure of when food will next be available (8).
7. Allow meals in front of the television: This has been associated with higher BMIs in children (9)

What to do
1. Leave them alone: From the age of 1  to 3 children can largely regulate their own energy intake if a wide offer of plain food is available. This is a skill that is only lost through others interference. If your child's BMI is in the healthy weight range, provide them with adequate food in an adequate portion size and then allow them to regulate how much they eat (including getting more if desired). (10)
2. Be a good role model: Parent's who have poor dietary habits have repeatedly been shown to also have children who have a poor diet quality  (1112)
3. Have healthy food readily available: Studies have shown a strong association between fruit and vegetable availability and its consumption (13) They can't eat it if its not there!
4. Provide your child with broad experiences with food: The evidence indicates that broader early food exposure results in a healthier diet overall (14). It is normal for children to not like certain tastes initially but this can be reduced or reversed by modeling and repeated taste exposures. Mixing familiar flavors with these foods has also been shown to help in their acceptance
5. Eat dinner as a family: Children who have at least one parent eat with them have been shown to have higher fruit, vegetable and dairy consumption and are less likely to skip meals (15)
6. Be sensitive as to your child's weight status: Studies have shown that the majority of parents underrate their child's weight category 16, , 18) and this contributes to the child's risk of being overweight or obese at school age (1719).


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