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.

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 (http://bit.ly/j0kwS1). 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 mypyramid.org 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!

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. (http://nyti.ms/lxO60F) 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 http://1.usa.gov/kmdWbN .

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 (http://bit.ly/bjTtFT). 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!