Thursday, May 26, 2011

Eating Disorder Denial. Missing the Big Picture Isn't Pretty.

Professional conferences don't tend to bring me to tears. But the opening session for this year's MEDA conference (Multi-service Eating Disorder Association ) broke with convention.

Doris, now a therapist, was simply a mom, a seemingly fine and quite likeable mom at that. She had a lovely husband (or so he appeared from the video clip displayed), provided a nurturing home (from what I could casually assess from her words and images) and had two lovely daughters. And now she has only one. Her younger daughter, Andrea, died 12 years ago from bulimia.

I am not new to this field of eating disorders, nor am I naive about the risks of having an eating disorder. In fact, not infrequently I am the treatment team member reality checking about the need for a higher level of care, pointing out the writing on the wall, so to speak.

Yet Doris caught me off guard. Even for me, her story about Andrea was alarming. Andrea became bulimic toward the end of her first year of college. Perhaps not atypical. But Andrea got help reportedly after only 2 weeks of eating disorder behavior, of purging. A therapist, MD, and dietitian were all a part of her recovery team, seeing her weekly.

Andrea reportedly looked healthy, by her mother's account. She was a normal weight—also not unusual. Bulimics are often normal or average weight, but restricting bulimics may present underweight. The danger, of course, is that being a healthy weight in many ways increases your risk. Strange? Here's why. At a healthy weight your risk may be minimized—by your own distorted thoughts, by your family and loved ones who see you as visibly healthy, and by the medical community which may not be triggered to ask the necessary questions about your eating disorder behaviors. Yes, we could all be in denial.

Just last week I had a rather unpleasant situation arise following a new patient session. Abby presented for her first visit along with her mother. Here's the summary: Her weight was below a healthy BMI and less than 90% of her healthy and usual body weight. She had lost significant weight, about 20% of her weight from the past year. Abby was restricting her food intake, eating close to nothing all day. Abby planned a binge, and subsequently purged once daily. She also was active, playing a team sport and exercising on her own. Admittedly the exercise wasn't compulsive, just frequent.

Oh, I forgot to mention that one month prior she presented to her pediatrician because her mom was concerned about Abby's hair loss, a common occurrence in eating disorders and with malnutrition, which can certainly also be caused by other conditions. At that time, her weight was just as low, and she had been in her disordered pattern for close to a year and a half.

Well, how would you assess the situation?

Toward the end of our lengthy initial session, it was clear that Abby was struggling to accept much if any change. I think a glass of skim milk was about all she would agree to increase—certainly not enough to keep her safe. So I made it clear that all exercise needed to cease. I urged a higher level of care—given how little change she was prepared to make—and a follow up with the MD (sooner that the 3 month visit that was planned).  And what was the end result? I was fired by Abby's family, and not thought  favorably of by the MD;  my direct acknowledgement of the need to be addressing this case differently was not well received.

Why share all this?

Because even I can get sucked into denying the reality of a situation. Because all of us are far too accustomed to measuring health and risk, based largely on body weight. And often that misses the boat. Because while I like to focus on the positive changes, the improvements patients are making over time, sometimes just heading in the right direction is not enough protection from the risk of maintaining an eating disorder. Because the health impact of eating disorders, both physical and psychological, are major, and shouldn't be minimized—not by the dietitian, the therapist, the physician, your family or community. 

And certainly not by you. Because eating disorders can result in death. And Doris can attest to the fact that this is no exaggeration.
Thank you, Doris, for sharing your wisdom with all of us at the conference and for allowing me to reference Andrea’s story on this blog. 

If this blog motivates even one eating disordered individual to change, or one health practitioner or family member to shift her thinking, it will be a great achievement. And please check out Doris’s website at

Thanks for taking this post seriously, and for passing it along to all those who need to read it.

Tuesday, May 24, 2011

Out of Into the Mouths of Babes. Weight management without the rules. 

Ok, so my baby is 20 (years, not months) but as a parent I can still appreciate it when kids say the darndest things, especially when it relates to food regulation.

This past weekend we visited our son at school and indulged him with a lovely Japanese meal out. To be fair, he would have felt more indulged by a home cooked meal, but logistically that just wasn't happening, so dining out it was. Together with my husband, we ordered an assortment of appetizers including delectable sushi. And then it came to ordering our entrees. Now in the past, even the somewhat recent past, I vividly recall the eye rolling and comments when I would place my order. I would feel my sons cringe as I'd politely inquire about the food preparation, frequently requesting a meal "light on the oil", with less ghee at an Indian restaurant or easy on a rich and creamy sauce.

It's what makes me comfortable--I prefer the taste, and it allows me to dine out and feel physically comfortable afterwards. I'd prefer to have it my way than to simply avoid delicious tasting entrees and fine cuisine. So I bit my tongue and stifled my chuckles when my son ordered his noodle-based dish, requesting of the waiter "can you make that light on the oil?"

And there was no prompting from me, I might add; my terriaki salmon order with white rice and vegetables was rather straight forward, necessitating no modifications for my satisfaction. 

The way my son described it, he was so tired of the richness of the frequent meals out that he wanted to eat something that felt better.

Later, he described his recent experience dining at the local burger joint in his college town. He ordered a burger and fries meal at lunch. Sooo, you're thinking? Well, my 6'1" slim and fit son ordered the kids' meal as opposed to the regular portion, and, he added, it was more than adequate. He knew that with restaurant portions tending to be quite excessive, that a kids' size would better meet his needs. Okay, perhaps the fact that he had only $20 left in his campus bank account may also have been an influence. Nonetheless, I was struck by this awareness and ability to self regulate even in restaurants, even after leaving the world of his nutritionist mom behind. And from what I've observed of restaurant portions, his selection was quite wise.

Yes, this is a child raised with chocolates, cookies, ice cream and home baked goods. He was never limited by others regarding how much he ate or what choices he was allowed. The only deprivation he might have experienced is a lack of fast food, as that has never been part of our family repertoire.

Remember those bagels described in a previous post? (  With no knowledge of their 7.5 oz weight (he rarely reads these posts and this knowledge would not have been a deterrent) nor of their calorie content, my other son found them impossible to comfortably consume, at least topped with cream cheese.  And last summer, I remember him (also 6'1" healthy and fit, I might add) ordering a kiddie size ice cream at our local, full fat dairy ice cream stand. Yes, he knew that the small serving (measuring approximately 2 full cups) was beyond his need.
No, not my son, but a happy cupcake maker
in NYC, who enjoys his cupcakes!

Let me clarify that these are healthy young men without disorders. They eat all kinds of foods and enjoy great desserts. One stays active through the year with recreational sports, one only seasonally when he trains for a bike event, and both use their legs for local transportation around their campuses.

Neither sets rules about calorie limits, nor restricts his intake to 

certain hours of the day. There is nothing unique about them, other than that they were raised perhaps without nutrition rules. 

In fact, in some ways, at some points, I felt I had failed to educate them, to teach them nutrition basics; we talked little of nutrition and dietary requirements, and I often felt that their classmates were more well-versed in diet basics. Until I realized that in fact I had taught them--by example, through what was served, through watching me enjoy my chocolate snack or my rugelach(, and by modeling balance both in and out of the home. And, by providing an atmosphere devoid of negative messages about my body and of theirs. 

"That's just fine," you may be thinking, "but I wasn't so fortunate to be raised in such a household! Now what am I supposed to do?"
 Well, let me confess-- neither was I. There were plenty of messages about weight and weight loss needs in my childhood home, and food was pushed for the sake of avoiding wrapping up leftovers. Stating that I was full was generally followed by encouragement for dessert, although in the next breath the command to "hold your stomach in" was frequently stated. I never really understood how one is supposed to hold their stomach in while still breathing…
A Picasso at MOMA, NYC
My patients, also, are rarely so fortunate. They present feeling hopeless and out of control with their eating. Or, so rigidly controlled by their disorder, fearing that acknowledgment of their body's signals will open the flood gates and cause a non-stop food frenzy. But over time, with guidance, they begin to trust the process, and their bodies. They are shocked that they can keep a 1/2 gallon (actually, they're 1.75 quarts now, unfortunately) of their favorite ice cream around and it will last more than the night! They learn that after the initial leap of faith where they break the rules, and choose foods that satisfy, that they can begin to trust their bodies. But at the start, no one believes it. They all believe they are different, that their bodies don't follow these same laws of nature.
Managing your eating is in part intuitive and involves listening to your body and its signals. But that assumes that the signals are present. If you've been severely restricting, you will require more structure to get this system working. If your hunger is not present, if you struggle with anxiety or depression, or are on meds which may impact appetite, then you too will need more structure to start. 
A Matisse at MOMA, NYC. A print hangs in my main office.

But besides the intuitive part, there are strategies like those mentioned above that help with comfort around eating and weight regulation, regardless of the direction your weight needs to go. 

To summarize:
  • Ask for what you need. When dining out, choose restaurants that will accommodate your preferences, without rolling their eyes! Feel free to request sauces on the lighter side or on the side.
  • Request a second plate. For those simply overwhelmed by the quantities of food, the second plate allows you to take control of your portions. For those struggling to lose weight (who actually need to), this separation can help you reorient to what a reasonable portion is.
  • Give yourself permission to eat again later, if you need to--if it's in your meal plan, or simply if you're hungry--regardless of time of day.
  • Work on tasting your food and enjoying it with all your senses. Sometimes with eating disorder recovery, there's a focus on simply getting through the meal. But ultimately, wouldn't it be great to enjoy the food?
  • How many years have you been struggling with your eating? Your thoughts and behaviors will not change overnight, even if these guidelines seem so sensible. So be kind to your self and be patient, and appreciate any changes you experience, rather than just focusing on weight changes. Appreciate the change in energy level, strength, weight preoccupation, mood and sense of hope you may now have.

Hoping this post doesn't trigger anyone.  And, that my sons are not reading this and rolling their eyes!

Thursday, May 19, 2011

The Halo Effect. Your Thoughts About Healthy Foods Can Make or Break Your Weight Struggle.

Convinced of the health merits of such calorie-dense items as almonds, peanut butter and olive oil? You may feel more relaxed, more permissive about eating them as they’re nutrient rich and heart-healthy. After all, they’re good for you, right? So what’s the harm of eating them freely?

But then there’s the frustrated cry I hear most days, by seemingly educated dieters.
"But I eat so well, so healthily, I don't understand why I'm not able to lose weight”.

Thank you Jenny Wan-Chen Lee, a graduate student at Cornell University and her mentor Dr. Wansink for clarifying what’s going on here, confirming and quantifying what I’ve long experienced with my patients the past 25 years in practice. It’s called the halo effect.

What’s the Halo Effect?

Beautiful people are often attributed other positive features, simply because of their beauty. Their beauty radiates a sort of halo, influencing us to see them as smarter, more competent, and more likely to make a better president, for instance.

I enjoyed every morsel of this lavender flavored chocolate, and no,
it was not organic!
Growing evidence suggests that this halo effect may also apply to foods, ultimately influencing our eating. Research has shown that people tend to eat more calories at fast-food establishments claiming to serve "healthier" foods, versus the amount they’d have at a standard fast-food restaurant. Perceiving a food to be more nutritious, they’re less cautious and tend to overindulge. New research by Lee explored the halo effect around organic food, to see if people’s positive notions of organic items would lead them to perceive them as tastier or lower calorie.

“She tested this question by conducting a double-blind, controlled trial in which she asked 144 subjects at the local mall to compare what they thought were conventionally and organically produced chocolate sandwich cookies, plain yogurt, and potato chips. All of the products, however, were actually of the organic variety -- they were just labeled as being "regular" or "organic." Participants were then asked to rate each food for 10 different attributes (e.g., overall taste, perception of fat content) using a scale from 1 to 9. She also asked them to estimate the number of calories in each food item and how much they would be willing to pay.”

“Confirming Lee's health halo hypothesis, the subjects reported preferring almost all of the taste characteristics of the organically-labeled foods, even though they were actually identical to their conventionally-labeled counterparts. The foods labeled "organic" were also perceived to be significantly lower in calories and evoked a higher price tag. In addition, foods with the "organic" label were perceived as being lower in fat and higher in fiber. Overall, organically-labeled chips and cookies were considered to be more nutritious than their "non-organic" counterparts.”

From my experience, this halo effect can have a positive or a negative impact on eating, depending on your eating issue.

For those struggling with overeating, the halo effect contributes to eating in
excess. Here's how it happens. If you perceive a food as healthy or good for you, and therefore acceptable to eat, you tend to be less mindful of portions of these foods. So consider that cry I hear frequently from new patients presenting for weight management. Assessing their intake makes it crystal clear—they are simply eating too much of a good thing!

And the Atkins and Zone Diets have made the situation worse, as I see it. If you were indoctrinated with the false information that protein at any cost is the answer and that carbohydrate is the culprit for your weight problems, it’s not so easy to let it go.

 And so excessive portions of protein rich foods are eaten, leading to excessive calories and therefore worsening weight struggles.
It may look attractive in the display, but... 

Trainers at the gym, are also frequently at fault, for propagating nutrition bubbe meises, or old wive’s tales. “Eat more protein to lose weight”, they convince their clients, who return to my office frustrated by their escalating weight (not, I might add, the result of increasing muscle mass).

When I started practice in the 1980s, I remember patients proudly sharing their progress. They'd declare that they had moved from Oreos to Snackwell's fat free cookies, consuming 6 or 8 at a time because they were fat free. But they missed the part that they were not calorie free. These patients were sold on the merits of Snackwells having no fat, which in that era was considered a good thing.

This very same halo effect has its benefits for those dealing with
restrictive eating disorders. It is often easier to include foods seen as healthy, even if only because of their organic label. Yes, for some people, certified organic chocolate feels safer as a means to increase calories than many other items might be. Similarly, a food attribute such as fiber content often allows people to select that food even if it is higher in calories. It's an effect I encourage taking advantage of, as it allows clients to become more comfortable with a wider range of foods.

What does this halo effect mean for you?

If you struggle with restrictive eating, you may find it easier to incorporate foods with some perceived health benefit, something you can justify as good for you. This often makes change easier. This will also lead to greater variety with less deprivation. It can then lead to transference of trust—allowing you to change items, to swap them—recognizing they are equivalent in nutritional value for weight and energy balance. Ultimately, you’ll be more likely to manage your nutritional needs, expanding your food selection and increasing your intake.

For those who believe that simply eating healthy foods without regard to physical need shouldn't result in weight gain, think again. Excessive calories relative to need is what impacts weight. Organic, high fiber, whole grain, omega 3-containing foods may all have their merits. But weight management comes down to calories in versus calories out.

Tuesday, May 10, 2011

My Selfish Post

A Picasso from the MOMA, NYC
One whole year, 80 separate posts, and numerous responses to comments and I’m still blogging.  Since entering this unfamiliar world I’ve acquired 163 followers (including Twitter and on site “Followers”), many virtual friends, and no doubt, many enemies, as not everyone agrees with my perspectives. I’ve learned as much from my readers and fellow bloggers as I have shared—of that I’m sure.

I’ve come to appreciate the blog community as a support group for readers, writers and my patients. And the blog (both mine and others I revere) has become a valuable resource to refer clients to, to help reinforce a point, to share a recipe, or a perspective, or mindfulness activities. 

Blogging began for selfish reasons. As I mentioned in an early post, I wanted to add support for a book proposal.  Through the twice-weekly posts, give or take, you’ve given me a lot of feedback. Now I’m revisiting the book idea—but with a different focus. 

And now I turn back to you. I’d love to hear more from you—my target readers—about what you value from these writings. 

No, I'm not writing a cookbook! 
But here's a view of part of my collection.
Do you have a favorite post or posts? Is there a message that sticks with you, that motivates you as you set out to meet your goals? Has this blog and its perspective shifted your perspective or your relationship with food at all?

If you could change anything about the blog, what would it be? I would so appreciate your guidance as I embark on my next stab at a book proposal. There, I’ve said it. Now I’ve got to work toward making it happen!

Thanks in advance for your help. Thanks for reading, for commenting, and for making me feel that it is worth the time and mental energy to pull off two posts a week, simply because it has moved a few souls to change and feel better. And thanks to my fellow bloggers and Twitter followers for their guidance, their promotion, their tweets and encouragement.

Friday, May 6, 2011

Weighing your Actions. More Guidance on Feeding Children and Managing Weight.

I write this in response to the wonderful comments I received on my Frosted Flakes For Healthy Kids post ( And in honor of all the mothers who blame themselves for their children’s weight and eating issues, whether compulsive overeaters or anorexics, or simply obese without the components to label it a disorder. It is, after all, Mother’s Day this Sunday!
"Grandma the clown" in the Big Apple Circus
On behalf of the mothers reading this, let me confess, we don’t always do or say the right things. We, too, are works in progress. We may not have had the best role models for parenting. Or we may be working on juggling too much—working at a job, parenting, running a household, and lastly attempting to meet our own needs (although that one rarely seems to take much of our time!) Or we may not know what’s the best way to parent, or feed our children, or ourselves. We sometimes know all the right things to say, and inadvertently say the stupidest things. (Yes, I’ll be the first to admit it, boys!)

I’d like to highlight a few points that may have gotten buried in the last post:

I believe in balance.

Yes, there's a place for low nutritional value foods, but in a balanced diet. What is a balanced diet? One that contains a variety of foods and nutrients. It contains generous amounts of fruits and vegetables, as well as dairy sources (or milk alternatives for the vegetarians among you). And yes, it could even be chocolate milk and sweetened yogurts. That, too, is balance.
It includes grains and starches of all types. Sure, higher fiber and whole grain choices have great merit. But white pasta or rice and low-fiber French bread has not caused any health risk as part of the Mediterranean diet. And it includes protein sources from animals or plants as well.

I believe that how we eat matters perhaps more than what we eat, when it comes to weight management.

Eating mindfully, at the table, without distraction truly makes a difference. Yes, I know you and your kids are talented at multitasking, but it just has no place when we are eating. Eating mindfully allows you to acknowledge what you are eating. That may be why my anorexic patients struggle with this task; they often prefer not to know what they eating, not to acknowledge it. Limiting eating to the kitchen or dining room also helps us contain things, to give some order to our eating behaviors. It also elevates our eating, to something special.

Parents are responsible for setting appropriate limits with their kids.

This is as true about eating as all other activities. You can say, “you can buy school lunch, but only once per week”. That is your right. And you can say “instead of Lunchables, I’ll make you Lunchable style meals that you’ll enjoy, while limiting the number of highly processed, high sodium and saturated fat items in this convenience boxed lunch.

We need to educate our children and ourselves that immediate gratification in the name of fullness, comfortable fullness, is a fantasy.

We generally do not observe fullness in the 10-15 minutes it takes us to finish our meal. Rather, there may be stomach fullness, the first stage of fullness around that time, which is more volume dependent and can mislead us. For instance, have a bottle of Diet soda with no calories and you’ll feel full. But that fullness won’t last—and it certainly won’t fuel your body! It can take an hour or so for the our brains to sense fullness. The exceptions to this occur in those with slowed gastric emptying from chronic eating disorder behavior, or with gastroparesis, a delay in stomach emptying from conditions such as diabetes and neurological changes.

Acknowledge that it’s normal to feel hungry immediately after their short meal. But reassure them that they can eat again later (in perhaps an hour) when their body really can tell if it needs more. Then honor it! Allow them to eat again, regardless of the time of night!
Isn't this great? Taken at Chateau Chevernay in the Loire, France

Use your resources!

These days, if you don't know how or what to cook or serve your family, there are plenty of resources to assist you. See an RD for individualized guidance or check out to learn balance and portions. Explore the wealth of cook books, websites, and cooking classes in stores, schools and towns.

Physical activity is key.

 Well actually, balance of intake and activity is what’s essential to consider. If you are restricting your intake, I do not support exercise (unless you can fuel it with enough food!). There have been plenty of studies correlating BMI with the numbers of hours of what is now termed “screen time”.

Preventing “now or never” thinking is critical.

Now or never thoughts about foods can happen because you set restrictions on what foods are acceptable to keep around see Jane’s story in last post). But it can also happen, as Quincy Carole pointed out in her comment on that post, when shopping is limited to one day a week. Knowledge that “when it’s gone, it’s gone” may drive us to overeat around the shopping days. The solution, be sure to reassure that there will always be more. If you can, keep additional packages of favorite snacks, so kids realize that they don’t have to get it all in today!
Thanks you readers for inspiring this post with your honest and most valuable comments!

Happy Mother’s Day!

Wednesday, May 4, 2011

Healthier Kids With Frosted Flakes. Balancing Sugar And BMI.

Tony the Tiger of Kellogg's Frosted Flakes fame

Ban Aunt Jemima? That’s just fine. Her image is not politically correct (and I’ve always preferred homemade pancakes and real maple syrup anyway). Joe Camel, as cigarette promoter, I am glad became extinct. But must we bury Betty Crocker before her time, just because her baked goods are high sugar? And Tony the Tiger, who I grew up believing was GREAAAAT, in spite of the sugar coating on his Frosted Flakes? And Toucan Sam of Fruit Loop fame? Must we part with them all, desperate to halt the obesity epidemic, to take control of our kids’ climbing BMIs?

I’m reacting to the recent NY Times article on the government’s plan for voluntary principles for food manufacturers, regarding advertising products to children. ( Make foods healthier or stop advertising them to kids, is the message. “The guidelines call for foods that are advertised to children to meet two basic requirements. They would have to include certain healthful ingredients, like whole grains, fresh fruits and vegetables, or low-fat milk. And they could not contain unhealthful amounts of sugar, saturated fat, trans fat and salt.”

Is a sugar limit really the best way to control our kids' obesity?
Scott Faber, representing food makers, said that “…ads for packaged foods on television shows aimed at children 2 to 11 had dropped significantly since 2004, and that the ads more often showed healthier types of foods.” Yet based on CDC data, obesity rates among kids nearly tripled since 1980, and continues to climb .

Hmmm, something just doesn’t add up. Maybe it’s not the ads that are the problem, but the number of hours sitting around watching TV and playing video games that’s an issue!

Guess how much sugar is in 1 Tbsp?
But what if we did limit these useless foods being fed to our kids? Seems harmless enough. I mean, what harm is there in not having these items around, of omitting them from our kids’ diets?

Not so fast. Before we ban all things deemed unhealthy and we start setting criteria for labeling foods as healthy enough to be advertised to kids, consider the consequences. Here’s what I fear will happen: 
Inadvertently, we will stigmatize foods as good versus bad. And the last thing we need is more black and white rules. They make no sense, and they certainly don’t resolve the issues for a culture struggling with making peace with food and an inability to manage weight.
1 gram more sugar than in a serving of Frosted Flakes, and figs are
first ingredient. Should we restrict exposure to kids?
Let's think twice before we set absurd guidelines!

Take Jane, an adolescent who came to see me 2 weeks ago for weight management. Referred by her pediatrician, accompanied by her mother, I learned some interesting things in our one-hour session. This articulate 15 year old described the “perfect” home environment. Mom cooks nightly, providing the healthiest of meals. Full of vegetables and whole grains, containing lean protein, her dinners were nothing short of wholesome. Second portions were never an issue, as Jane didn’t care much for the foods that were served. But she made the most of it.

When asked if she liked baked goods and ice cream Jane replied shyly that she did—but that she never had them at home. These were banned as unhealthy. The result is that Jane eats more than her share of these items whenever she has the opportunity—when she is out with friends, or at a party— regardless of how hungry she is. It is “now or never” thinking.

It’s like the Halloween candy phenomena ( Restricting these items fails to achieve the intended goal and as I’ve seen, makes for an unhealthy relationship with food.

Now I’m a parent, too. And while my kids are way past the age where I can control their food choices, I do recall that time. So what did I do when confronted with their request to eat what their peers were eating (and what was being advertised to them on TV and at eye level at the supermarket)? How did I balance my need to provide a healthy diet, while minimizing conflict around food? And, maintain a healthy relationship with eating?

The only one allowed to snack in the living room.
I didn’t restrict their ad exposure, although I limited TV time so that they would use their bodies to be active and their minds to create through reading and play. There were no TVs in their bedrooms, and all meals and snacks were eaten at the kitchen or dining room table. The only one in our home who could eat his snack in his den was my dog, Mica, who would grab his biscuit and eat it in his bed. No such luck for the kids, though.

But when they did view television ads, I’d make a point of educating them to be critical thinkers. I would share with them that high sugar cereal may be called a healthy breakfast, but it’s like eating candy for breakfast. We’d discuss how perhaps that cereal would make a good sweet snack to have with a glass of milk, instead of eating cookies, if they preferred. Or I would point out how they were being tricked by the ad’s information, teaching them to be more critical viewers of the media and to not be manipulated by savvy messages and messengers.
When they were young, I’d offer the high sugar cereal as a mix in with a healthier, lower sugar cereal choice. For instance, Frosted Flakes mixed in with corn flakes, or a small serving of Fruit Loops mixed in with Cheerios. This achieved many goals. It minimized conflict and prevented categorizing foods as acceptable and forbidden. And, it kept their intake rather healthy, despite inclusion of small amounts of sweetened items. And now as adults, I see them choosing lower sugar, healthier selections. And stopping when they’ve had enough to eat, even of such favorites as white flour, fiber-less bagels.
1/4 c. has more than twice the sugar than 3/4 c of
Frosted Flakes. Should we ban them? 

What about the idea of allowing food manufacturers to target kids if their product were healthier? Specifically, if it had 8 grams or less of sugar, or contained a certain level of whole grains or capped the sodium content? Good intentions, but here’s what I fear. If it were limited to 8 grams of sugar as proposed, that eliminates much added fruit (including raisins) in the cereal. Yes, fruit is naturally high in sugar (24 grams in ¼ cup of raisins), and there’s nothing wrong with including it generously in your diet! And I can imagine that foods will be filled with diet sweeteners, as a means to lower the evil sugar content. I suspect most parents may not want to be pumping their kids with diet products throughout the day.

Chocolate chip cookies would hardly fit, based on the planned guidelines. But should they be eliminated from our diet? If you’ve read enough of the posts on this blog you certainly know where I stand on this.

Yes, this is from the raisin container. 100% natural raisins.
Kids, like adults, need to learn balance. They need to appreciate it as they get older and become independent. They need to learn that while a food itself may not be nutritionally rich, it’s important to have enjoyment from what we eat, regardless of where you are on the BMI chart! A food may not be so balanced by itself (for instance, it may be relatively high in sodium), but as part of a meal it may fit just fine. Perhaps what can change is that kids (and their parents) will consider their portion of pizza, but won’t eliminate it because of its high salt and low fiber content. Rather, they’ll include a glass of low fat milk at the meal and serve some veggies with it.

I write this post as both a mother, and as an RD—one who sees obese kids, and eating disordered children and adults. Let’s be careful to not replace one health epidemic, obesity, with disordered eating.

What was your experience as a child? And how do you approach this issue with your kids? Comments welcome!