Nutrition education in schools worries me. My sentiments have been echoed
on the Academy for Eating Disorders list serve and among peers from SCAN--the Academy for Nutrition and Dietetics (AND) subgroup populated by progressive thinkers.
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| A very different path. |
To change the direction of how kids are being taught, I've written this piece. Share this locally, in your schools, and virtually. Use it, and use it fully, including my name, please. Thanks for spreading the word and working for change.
Good food, bad food and calorie counting? What kids really need to learn.
By Lori Lieberman, RD, MPH, CDE, LDN
In an attempt to tackle the
“obesity epidemic” kids, educators and parents often receive well-intentioned
but potentially harmful messages to manage eating. (1)Calorie-counting apps and
black and white messages about what’s healthy to eat can be problematic. Kids,
parents and educators need practical, realistic strategies to add to their
toolbox. Help kids learn to self-regulate their food intake utilizing current
knowledge on eating behaviors and the food environment and know the damage of
deprivation-based diet approaches.
One size does not fit all!
We are educating the masses—kids
of all sizes and weights, including those who are sedentary and those with very
high needs given their size, needs for growth and for sports—and kids with
personality traits who tend to be very literal, anxious or perfectionistic. Consequentially,
food messages should be presented to serve all without harm.
Good food/bad food
Nutrition messages need to
shift from the ineffective ‘good’ versus ‘bad’ nutrients and foods, to factors that
impact the ability to self-regulate intake. Directing individuals to restrict
their fat intake can backfire. (2) Labeling sugar as ‘bad’ and setting calorie
budgets fails to control weight in long term. (3) Evidence shows that
perceiving a scarcity of food and deprivation from restrained eating creates
greater problems (4) and contributes to eating disorder development. (5)
Calorie counting
Calorie counting is ineffective in the long run and conflicts with utilizing hunger and
fullness—essential for managing energy balance. It fails to teach kids about major
obstacles to changing eating—eating behaviors and environment. Counting
calories has little positive impact on improving eating habits and weight. (3,6,7)In
one study kids who began dieting had a significantly higher likelihood of
developing a serious eating disorder. (5)
Portions
Portions are
also not one-size fits all. Current materials (1) refer to appropriate snack
sizes but for underweight kids, competitive athletes, and those simply with
higher needs, these may be inadequate. Many teens require more than the current
campaign’s recommended single serving of most snacks and greater than the 100
calories encouraged as ‘moderate’.
Sit, structure, separate, sense.
Let’s shift the focus to what works—a mindfulness approach addressing simple, achievable eating behaviors. (8,9)
Address these key behaviors
to improve intake and portioning of food, applicable to all children and
adults.
- Sit in the kitchen or designated eating space, at a table
or counter when eating.
- Structure the day to include 3 balanced meals and snacks.
Include an early breakfast and be prepared—keep snacks available and give kids
a chance to eat when they need to. Encourage delaying not forbidding ‘seconds’,
allowing time to sense fullness. Allow eating later when hunger is present.
- Separate eating from distractions, like TV, phone, homework,
computer; distracted eating increases intake. Separate food from sight; keep
food off the counters to prevent triggering eating.
- Separate food from its package!
- Plate it.
- Use your senses.
- See,
smell, feel, hear and taste your food—whether it’s a cookie or cantaloupe. You’ll
be more satisfied when you really pay attention to and enjoy what you’re
eating.
Encourage
positive additions and messages to support a healthy diet.
- Include 3 or more cups of
milk, yogurt or milk alternative (such as soy milk) for protein, calcium and
vitamin D.
- Choose fruit frequently.
- Select
from fresh, frozen, canned in juice. Don’t forget dried fruit—a convenient,
satisfying, nutrient and fiber rich snack.
- Vary the Vegetables: shred
them, steam them, sauté them, dip them, puree them into soups or smoothies.
- Get
them in all colors. Include more than a cup a day.
- Get real! Choose more foods
that are processed less, including nuts and seeds, beans, whole grains and
fresh fish/meats.
Let’s spread a sensible, more
sensitive message to promote health among school age kids of various sizes and
needs. Advocate for diversity of foods to normalize intake for a diet rich in
nutrients and adequate in calories. Let’s focus on learning to encourage portions
that fit the individual’s needs by integrating both mindfulness and
environmental strategies. And let’s accept that normal eating includes having
foods at times simply because they taste good.
Citations
2. Wansink,
Brian, and Pierre Chandon. Can “low-fat” nutrition labels lead to obesity? .Journal
of marketing research 43.4
(2006): 605-617.
3. Lowe MR,
Doshi SD, Katterman SN, Feig EH. Dieting and restrained eating as prospective
predictors of weight gain. Frontiers
in Psychology 2013;4:577.
4. Mullainathan,
S, Shafir, E. Scarcity.New York::Times Books, 20135. Lowe, M. R.,
Thomas, J. G., Safer, D. L. and Butryn, M. L. (2007), The relationship of
weight suppression and dietary restraint to binge eating in bulimia nervosa. Int. J. Eat. Disord.,
40: 640–644. doi: 10.1002/eat.204056.
6. Downs, Julie S., et al. "Supplementing menu labeling
with calorie recommendations to test for facilitation effects." American journal of public health 103.9 (2013): 1604-1609.
7. Ely, Alice
V., et al. "Differential reward response to palatable food cues in past
and current dieters: A fMRI study." Obesity 22.5 (2014): E38-E45.
8. Beshara, Monica,
Amanda D.Hutchinson, and Carlene Wilson. "Does mindfulness matter?
Everyday mindfulness, mindful eating and self-reported serving size of energy
dense foods among a sample of South Australian adults." Appetite 67 (2013): 25-29
