How To Get Kids To Eat Healthy

Some kids are happy to snack on carrots, raw peppers and hummus, while other kids would be happy to follow a carb-based "white" diet of pasta, rice and bread.

Why are some kids so fussy about food? It turns out there a dizzying number of reasons your child may turn up his nose at mealtimes. A 2015 review of dozens of studies that date back to the 1990s that looked at kids' eating patterns found that fussy, picky or choosy eating habits were linked to and affected by everything from personality traits to parental control at mealtime to social influences to maternal eating patterns. Or it could just be your kid being, well, a kid.

An important point to remember is that fussy or picky eating is normal in young kids, says Lee Gibson, PhD, a reader in biopsychology and director of the Clinical and Health Psychology Research Centre at University of Roehampton in London. And in general, overreacting or trying to apply strict dietary regimes to discourage picky eating tends to be counterproductive.

"Parental anxiety won't help," Gibson says. "It's better to learn by example, always be positive when offering food and show children how much you like a food when you're asking them to eat it."

And while the evidence of long-term health outcomes of picking eating following children into adulthood is somewhat scant, the evidence that does exist suggests picky eating tendencies don't appear to be related to increased risk of becoming overweight or obese (that's on the population level, looking trends of how picky eating affects most kids), according to a review of several previous studies on the topic that Gibson and his colleagues published earlier this year in the journal Current Obesity Reports.

But pediatrician Tanya Altmann, MD, adds that if a picky eater isn't getting enough good nutrition because of being too selective, in individual cases, picky eating (especially extreme picky eating) can lead to both short- and long-term nutrient deficiencies and other problems.

It's better to learn by example, always be positive when offering food and show children how much you like a food when you're asking them to eat it.

"It is important for kids to develop a healthy relationship with food at a young age," says Altmann, a Calabasas, California-based private practitioner, spokesperson for the American Academy of Pediatrics, author of What to Feed Your Baby, and mother of three. "When this doesn't happen, [kids] can have weight problems and disordered eating later on in life."

To help your kids develop that healthy relationship with what they're eating (and avoid daily dinnertime rows), here's what you should know.

Most of the time, it's probably not about those last two bites of green beans

The battle may start because of the green beans, but most of the time for the picky eaters, it's not the green beans, the peas or even the elusive dessert, that's upsetting them, explains Dina Rose, PhD, a sociologist and author of It's Not About the Broccoli. A lot of the time it's a control struggle, she says.

Of course there are times when kids have a reaction to a specific taste or the way a food looks, Rose points out. "But even in these instances, the refusal to try that food is an expression of fear or other feelings. Control and being able to control their own food environment is the primary problem."

As toddlers, it becomes a kid's job to learn control — how to move and control their body and all of its functions. Choosing what foods to put on their plate and choosing whether or not to swallow that food is another ripe area they can control, Rose says.

But parents want control when it comes to kids' eating, too (deciding what kids eat, when, and, often, limits), Rose says. There is enormous pressure on parents to feed children adequately and nutritiously, Rose says. "Parents walk into the feeding dynamic already nervous."

Kids sense the pressure and get that mealtime is something parents really care about, Rose adds. The power struggle begins.

The green beans are the chore that needs to get done, and the gooey brownie is the reward. Even though the kid might learn he or she needs to eat the vegetable, we're not teaching the kid to prefer it.

Often at the dinner table, good intentions backfire

Power struggles can teach kids the wrong messages about food. When a kid rejects a certain food and we put pressure on the kid to eat that food, it becomes a negative experience, Rose explains. How many of us have been told or told our kids: "Two more bites and you can have dessert"?

"That makes the dessert valuable and the vegetable not valuable," Rose says. The green beans are the chore that needs to get done, and the gooey brownie is the reward. Even though the kid might learn he or she needs to eat the vegetable, we're not teaching the kid to prefer it.

Problem two: we give kids the wrong vocabulary when it comes to food, Rose says. Maybe they don't want to eat a food because they're cranky, they're not hungry, they had their hearts set on something else for dinner — whatever the reason — but they say "I don't like it" so that they don't have to eat it. "We systematically teach children that the only 'legal' way to get out of eating a food is to say, 'I don't like it,'" Rose says.

Kids are still learning and developing taste preferences until about age 5, when they become more stable. Kids' thoughts and evaluations of those foods also start more fluid and become stabilized, she says. "But 'I don't like it' gets reinforced in their own minds and the parents' minds."

Tips for defusing the power struggle:

One well-cited theory on discouraging picky eating encourages parents to share responsibility with their kids when it comes to eating. Parents control what food is available and when and where meals and snacks are eaten; kids determine how much they eat and whether to eat. Registered dietitian Ellyn Satter developed the theory — coined the "Division of Responsibility in feeding" model — in the 1980s and 1990s.

Versions of the model are part of nutrition guidelines for children and adolescents that come from The Academy of Nutrition and Dietetics and The American Academy of Pediatrics. And it's influenced a lot of healthy eating strategies for kids that are taught, advocated and followed today, Rose says.

Here are some tips for what to do at mealtime:

1. Set realistic expectations.

More often, if you're giving a kid a food for the first time, they're probably going to be a little bit unsure at first. That's okay, Rose says. Nutrition science research suggests that it takes kids up to 12 exposures to any given food to put it in the category of food they "like," Rose adds. "Exposure" literally means any time a kid is exposed to the food. (It doesn't mean they have to eat 12 servings, she explains.)

An exposure might be looking at a food in the serving dish, listening to a parent talk about eating it, helping prepare the food, feeling the food or trying a nibble of the food.

Put too much pressure on a kid to like the food right away and if there's any reason a kid doesn't want to eat that food, it gets put into the "don't like it box" — and it becomes tougher for the next exposure to go well, Rose says.

An exposure might be looking at a food in the serving dish, listening to a parent talk about eating it, helping prepare the food, feeling the food or trying a nibble of the food.

2. Change up the menu.

Variety — meaning trying new foods and rotating the foods and meals you are eating — is a key component of healthy eating. If you eat the same meals every single day (even if those meals are composed of healthy foods), you're not going to be eating a healthy diet, Rose says. Lots of parents fall into the "peas is the only vegetable my kid eats" trap — and then that parents serves peas every night, she adds. "This teaches children the mindset that monotony is normal."

Kids need to learn this early and they need to learn not to expect to get the same meal served to them every day. And — when appropriate — give kids options when it comes to eating, Rose says. This helps teach decision-making when it comes to feeding.

3. But don't make separate meals.

Catering to kids' picky preferences drives the pickiness and never gives them a reason to try new foods, explains Sally Sampson, co-author of The Picky Eater Project and founder of ChopChop, a non-profit that teaches families about cooking together.

When Sampson raised her two kids (now both in their 20s and not picky eaters), if they didn't like the meal being served, they had the option to get up from the table and get themselves plain yogurt, cottage cheese, or plain Cheerios for that meal instead, she says. They hardly ever chose the alternatives, she says. "My daughter said: 'It was never worth it to not try what you were serving. You were offering the most boring foods as substitutes.'"

It can be an attention struggle: Mom needing to get up and make a separate dish means more attention on the child, making them feel doted on or special, Sampson adds. What incentive is there then to be the kid who doesn't require that extra attention?

"[Don't] give the picky eater a lot of 'air time,'" Sampson says.

4. Give kids options you want them to eat.

If you don't want kids to pick macaroni and cheese, don't make that one of the options, Sampson says. That doesn't mean you need to have a kitchen full of wheat germ and kale, but it's important to surround kids with good options — when it comes to what's being served, what foods you're talking about, and what kids are eating when they're outside your kitchen — so they can make good decisions.

For after-school snack, put out raw vegetables, hummus and fruit, Sampson says. Even if they skip the carrots and hummus, and devour the grapes, they're still making a healthy choice. And don't make a big deal about what the snack is or how much they need to eat, she adds. "If they're hungry, they'll eat it."

(And just because they don't eat it one night, don't stop serving it. It goes back to the exposure theory — eventually after seeing everyone else eat it, they'll try it, maybe they'll like it, and eventually it won't be a problem.)

5. Separate behavior issues from picky eating.

If a child is screaming or throwing a tantrum at the dinner table, that's a behavior issue, not a picky eating issue, Rose says. And behavior issues need to be dealt with appropriately.

If behavior problems get treated as picky eating problems, they make that entire feeding experience negative — and that negative environment won't allow kids to give any new foods a chance.

6. Involve kids in meal prep.

Involving kids in meal prep makes them active participants and gives them a sense of control from the very get-go, Sampson explains. Have kids help pick out groceries, prep food and set the table. It keeps kids' curiosities peeked, so they want to be part of the end result: eating the dinner.

7. Don't ban sweets, help kids manage when and how they eat them.

Kids should have access to sweets and treats, but parents still need to teach kids how to eat it sparingly, Rose says. Give kids guidelines about what that means — one dessert per day, three meals a day, one afterschool snack, or whatever the eating schedule is, Rose says. "Kids don't come out of the chute understanding that."

Forbidding sweets entirely can backfire, potentially leading kids to overindulge or abuse them when those foods are available, she adds.

Give kids a candy drawer that they can reach and talk to your kids about what amount of sweets is appropriate for them to be eating, Rose suggests. Maybe that's one treat a day. If Johnny decides to eat a piece of candy after lunch as his sweet for the day, he may need to skip having a cookie after dinner (even if his sister decided to have her sweet for the day then). That's a learning opportunity, Rose says.

"If a parent feels like his or her kid cannot be trusted, that's a trust issue not a food issue," Rose adds.

8. Relax, enjoy it and make mealtimes the positive experience they should be.

Not every meal is going to turn out perfect — and even the healthiest eater is going to have a day of eating that's not as balanced as it could be, Sampson says. "Part of that is relaxing and [as parents] stopping trying to control kids so much."

Making mealtimes a struggle or battleground sets up both the parent and kids for failure when it comes to trying new foods and eating well. In general, kids want to eat what's in front of them and eat what everyone else is eating, Rose says. "Nobody chooses to be a picky eater."

For a lot of kids, becoming a picky eater is a mechanism that solves some sort of unrelated problem for them — it eliminates pressure or gives them control, Rose says. It's not about what's actually on the plate.

It's important to remember that healthy eating is about happiness, too, Rose says. "Happiness at home matters," she says. "And when children enjoy meals they tend to eat better."

NEXT: How Your Brain Changes After Baby

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