• E-mail
• Print
• Comment
• Font Size
• Digg
• del.icio.us
• Discuss article

LET's EAT -- Dietitians Say Best Approach to Children's Weight is Not to Limit Any Foods, Set Structure to Eating

Posted on: Tuesday, 17 January 2006, 09:00 CST

By Jennifer Biggs / biggs@commercialappealcom

Ellyn Satter believes that the key to controlling your children's weight doesn't depend so much on what you feed them as how you feed them.

She believes no food should be withheld.

Not soda.

Not candy.

Not chips.

Before your head starts spinning, take a breath: She's not saying that Coke, candy and potato chips should be your child's sole diet.

What she believes is that you've got to offer your kids a full diet - no food restriction - in order to have them grow to their healthful weight and to learn how to eat.

Not that she always believed that.

"I used to put children on food restriction diets when I was a young dietitian," she said. "I knew the exchange system and I thought I was hot stuff."

But she saw children becoming miserable, sneaking food and getting tattled on by siblings.

And she noticed that the children would get fatter, not thinner.

In "Your Child's Weight: Helping Without Harming" (Kelcy Press, $19.95), she writes about counseling a frustrated mother and son one day, when she blurted out that the mother's job was not to control how much food her children ate, but instead to get it on the table. It was the child's job to decide how much to eat.

It started to click.

Eventually, she returned to school to become a family therapist.

Today Satter, a registered dietitian, licensed clinical social worker, author of several books and the president and CEO of Ellyn Satter Associates in Madison, Wis., has a loyal following.

Dr. Marion Hare, an assistant professor of

pediatrics with the University of Tennessee, is one of them.

"I pretty much agree with what Ellyn says, for the most part," Hare said.

In fact, Hare is part of a group that was recently awarded a $1.8 million grant from the National Institutes of Health to teach similar principles to families with overweight children.

She's read Satter's books for years and attended a seminar she held in Memphis late last year.

"Ellyn's made me a believer that food restriction can lead to overweight," Hare said.

Satter teaches that a successful feeding relationship depends on trust, a nurturing parent, and structure. It comes down to a division of responsibility: The parent is responsible for the what , when and where , and the child is responsible for deciding whether and how much to eat.

Ideally this relationship will begin in infancy, but often it's not until later years, when a child is overweight, that a parent seeks help.

The first thing Satter does is review the child's growth chart.

"If a child's weight is stable, heavy but not accelerating, I'd congratulate the parent," Satter said. "Parents can overreact, and understandably so, because parents are being set up to overreact."

And no wonder - obesity and attendant disease is a huge health problem for today's youth. But in the fervor to protect children from obesity, Satter believes that healthcare providers forget that some children are genetically predisposed to be larger than others.

Protect yourself from well-meaning interference if your child is growing at a consistent rate, Satter says, and resist the urge to withhold food.

"Restricting your child's intake is highly likely to fail," she said. "Restricting leads to a preoccupation with food."

Instead, establish a healthy feeding dynamic with your child by starting with the where and when .

That means start with structure.

"Providing structure is the most nurturing thing you can do for your child," she said.

Let food selection come later.

"Even if you're eating fast food, you sit down and you have a pleasant family dinner," Satter said.

Go inside the restaurant, or take the food home and serve it around the table instead of letting everyone grab their burger and eat it wherever they choose.

Eventually, she says, parent and child will begin to make better choices.

"If we try to get there too fast, then we're just going to be defeated," she said.

She tells parents to have a wide variety of foods available at meal time, and no skimping on the good stuff.

That means full-fat salad dressing, butter and margarine on the table. Kids who might not eat plain broccoli will eat it if they have something to dress it with.

Foods like candy, cookies and soft drinks should also be offered, but as a choice. For instance, if a child wants to drink a soda with dinner, then that's their sugar option for the meal. At the next meal he might want a cookie instead - what's important is that the options are there and that food is served in a loving family environment.

Hare and others will emphasize the behavioral aspects of feeding at the program they plan to start in conjunction with the Health Loop Clinics in the spring.

Selected families of children ages 4 to 7 who are above the 85th percentile for weight will learn about the importance of the family meal, positive reinforcement and physical exercise. The parents will also receive basic dietary training so they'll know how to put nutritious food on the table.

"We'll suggest limited certain foods, but we won't say you can't eat something," Hare said.

Satter's approach is not "throw open the refrigerator door," she stressed.

It requires diligence by the parent, who must make sure there are abundant food choices available at meal times and that meals and snacks (which are mini-meals, not treats) are reliably scheduled.

"The parent is the gatekeeper," she said.

She believes her system works because it teaches self-regulation in a loving environment - and it's natural.

"Children want to be nurtured, they need to be nurtured," she said. "And parents want to nurture."

- Jennifer Biggs: 529-5223

Source: Commercial Appeal, The

More News in this Category