Patience, my dear

When I am trying to help parents deal with their picky eaters, the most frustrating challenge is getting the parents to sit back and silently watch their child not eating. Despite their claims that they want their child to eat a healthy and varied diet, many parents can’t muster up either the patience or the fortitude to watch their child ignore a plate of healthy but unpreferred food. Going to bed “hungry” just doesn’t seem to happen. Before the pajamas are even out of the bottom drawer, the child is offered an alternative serving of something on the child’s short list of nutritionally sketchy “will eats.”

Parents will dredge up any excuse they can find, including the eco-conscious claim that throwing the uneaten food will swamp the town landfill. Neither the reality that the amount thrown out is minuscule nor the concept of composting seems to convince them not to worry. The more prevalent excuse is that if their child doesn’t eat something he will become malnourished or lose weight – a strange claim in a country plagued by obesity. Or heaven forbid, the child will be sentenced to suffer the pangs of “hunger” until morning.

As part of an epidemic loss of common sense, North American parents seem to also have lost their ability to be patient. It takes time to break old habits and develop new ones. They fail to appreciate that the process of change will grind to a halt if they continue to offer alternatives that enable an old habit to persist.

The challenge facing the parent of a 3-year-old picky eater is no different than the one facing our nation’s school lunch program. It is just a matter of scale. In an attempt to stop our epidemic of child obesity, the Congress passed the Healthy, Hunger-Free Kids Act in 2010. The nutritional standards it mandated were finalized by the Department of Agriculture in 2012 and put into effect in the 2012-2013 school year.

Before the first tray of healthier alternatives could slide down the polished stainless steel of a cafeteria line, there were complaints from the “lunch ladies,” aka the School Nutrition Association, a group with support from some food industry giants. Like the parent of a picky eater, the “lunch ladies” predicted that kids wouldn’t eat that healthy stuff and food would be wasted. Healthy less processed food would be more expensive (and of course less profitable for industries that process). And surprise, surprise, they were correct. Some grade school kids even organized their own protests.

However, common sense suggests that with time behavior would change if the standards were maintained. A recently released study by the Rudd Center for Food Policy and Obesity at the University of Connecticut, Hartford, “New School Meal Regulations Increase Fruit Consumption and Do Not Increase Total Plate Waste” (Child Obesity 2015 [doi:10.1089/chi.2015.0019]), has found that in the three urban school districts sampled that the percentage of students choosing fruit for lunch rose from 54% in 2012 to 66% 2014. There also was less wasted because 84% of the students ate their entrées, including fruit, in 2014. This was up from 71% at the beginning of the 3-year survey. There was a significant increase in vegetable consumption, from 45.6% in 2012 to 63.6% in 2014.

The study was far from robust in that it compared data from only 1 day in each school year over the study period. The authors noted that each year fewer children in the cohort were eating school lunches, a phenomenon they suspect may be due to the tendency of older children to take less advantage of school lunches.

Regardless of its deficiencies, the study seems to support the basic principle that giving children better choices and waiting patiently will result in more nutritionally sound eating patterns. There is no question that in the short term that providing healthier school meals is more costly. However, this gap should narrow as the lunch ladies learn more cost-effective strategies for food procurement and preparation. The Department of Agriculture is already providing funds for the school departments who are struggling financially to comply with the new standards.

Unfortunately, some impatient members of Congress are like many parents of picky eaters and are trying to roll back the nutritional standards rather than wait for the inevitable change. None of us likes the thought of wasting food or money. But when managing unhealthy eating behaviors, sometimes waste has to happen.

Dr. Wilkoff practiced primary care pediatrics in Brunswick, Maine, for nearly 40 years. He has authored several books on behavioral pediatrics, including “Coping With a Picky Eater.” E-mail him at [email protected].

When I am trying to help parents deal with their picky eaters, the most frustrating challenge is getting the parents to sit back and silently watch their child not eating. Despite their claims that they want their child to eat a healthy and varied diet, many parents can’t muster up either the patience or the fortitude to watch their child ignore a plate of healthy but unpreferred food. Going to bed “hungry” just doesn’t seem to happen. Before the pajamas are even out of the bottom drawer, the child is offered an alternative serving of something on the child’s short list of nutritionally sketchy “will eats.”

Parents will dredge up any excuse they can find, including the eco-conscious claim that throwing the uneaten food will swamp the town landfill. Neither the reality that the amount thrown out is minuscule nor the concept of composting seems to convince them not to worry. The more prevalent excuse is that if their child doesn’t eat something he will become malnourished or lose weight – a strange claim in a country plagued by obesity. Or heaven forbid, the child will be sentenced to suffer the pangs of “hunger” until morning.

As part of an epidemic loss of common sense, North American parents seem to also have lost their ability to be patient. It takes time to break old habits and develop new ones. They fail to appreciate that the process of change will grind to a halt if they continue to offer alternatives that enable an old habit to persist.

The challenge facing the parent of a 3-year-old picky eater is no different than the one facing our nation’s school lunch program. It is just a matter of scale. In an attempt to stop our epidemic of child obesity, the Congress passed the Healthy, Hunger-Free Kids Act in 2010. The nutritional standards it mandated were finalized by the Department of Agriculture in 2012 and put into effect in the 2012-2013 school year.

Before the first tray of healthier alternatives could slide down the polished stainless steel of a cafeteria line, there were complaints from the “lunch ladies,” aka the School Nutrition Association, a group with support from some food industry giants. Like the parent of a picky eater, the “lunch ladies” predicted that kids wouldn’t eat that healthy stuff and food would be wasted. Healthy less processed food would be more expensive (and of course less profitable for industries that process). And surprise, surprise, they were correct. Some grade school kids even organized their own protests.

However, common sense suggests that with time behavior would change if the standards were maintained. A recently released study by the Rudd Center for Food Policy and Obesity at the University of Connecticut, Hartford, “New School Meal Regulations Increase Fruit Consumption and Do Not Increase Total Plate Waste” (Child Obesity 2015 [doi:10.1089/chi.2015.0019]), has found that in the three urban school districts sampled that the percentage of students choosing fruit for lunch rose from 54% in 2012 to 66% 2014. There also was less wasted because 84% of the students ate their entrées, including fruit, in 2014. This was up from 71% at the beginning of the 3-year survey. There was a significant increase in vegetable consumption, from 45.6% in 2012 to 63.6% in 2014.

The study was far from robust in that it compared data from only 1 day in each school year over the study period. The authors noted that each year fewer children in the cohort were eating school lunches, a phenomenon they suspect may be due to the tendency of older children to take less advantage of school lunches.

Regardless of its deficiencies, the study seems to support the basic principle that giving children better choices and waiting patiently will result in more nutritionally sound eating patterns. There is no question that in the short term that providing healthier school meals is more costly. However, this gap should narrow as the lunch ladies learn more cost-effective strategies for food procurement and preparation. The Department of Agriculture is already providing funds for the school departments who are struggling financially to comply with the new standards.

Unfortunately, some impatient members of Congress are like many parents of picky eaters and are trying to roll back the nutritional standards rather than wait for the inevitable change. None of us likes the thought of wasting food or money. But when managing unhealthy eating behaviors, sometimes waste has to happen.

Dr. Wilkoff practiced primary care pediatrics in Brunswick, Maine, for nearly 40 years. He has authored several books on behavioral pediatrics, including “Coping With a Picky Eater.” E-mail him at [email protected].

When I am trying to help parents deal with their picky eaters, the most frustrating challenge is getting the parents to sit back and silently watch their child not eating. Despite their claims that they want their child to eat a healthy and varied diet, many parents can’t muster up either the patience or the fortitude to watch their child ignore a plate of healthy but unpreferred food. Going to bed “hungry” just doesn’t seem to happen. Before the pajamas are even out of the bottom drawer, the child is offered an alternative serving of something on the child’s short list of nutritionally sketchy “will eats.”

Parents will dredge up any excuse they can find, including the eco-conscious claim that throwing the uneaten food will swamp the town landfill. Neither the reality that the amount thrown out is minuscule nor the concept of composting seems to convince them not to worry. The more prevalent excuse is that if their child doesn’t eat something he will become malnourished or lose weight – a strange claim in a country plagued by obesity. Or heaven forbid, the child will be sentenced to suffer the pangs of “hunger” until morning.

As part of an epidemic loss of common sense, North American parents seem to also have lost their ability to be patient. It takes time to break old habits and develop new ones. They fail to appreciate that the process of change will grind to a halt if they continue to offer alternatives that enable an old habit to persist.

The challenge facing the parent of a 3-year-old picky eater is no different than the one facing our nation’s school lunch program. It is just a matter of scale. In an attempt to stop our epidemic of child obesity, the Congress passed the Healthy, Hunger-Free Kids Act in 2010. The nutritional standards it mandated were finalized by the Department of Agriculture in 2012 and put into effect in the 2012-2013 school year.

Before the first tray of healthier alternatives could slide down the polished stainless steel of a cafeteria line, there were complaints from the “lunch ladies,” aka the School Nutrition Association, a group with support from some food industry giants. Like the parent of a picky eater, the “lunch ladies” predicted that kids wouldn’t eat that healthy stuff and food would be wasted. Healthy less processed food would be more expensive (and of course less profitable for industries that process). And surprise, surprise, they were correct. Some grade school kids even organized their own protests.

However, common sense suggests that with time behavior would change if the standards were maintained. A recently released study by the Rudd Center for Food Policy and Obesity at the University of Connecticut, Hartford, “New School Meal Regulations Increase Fruit Consumption and Do Not Increase Total Plate Waste” (Child Obesity 2015 [doi:10.1089/chi.2015.0019]), has found that in the three urban school districts sampled that the percentage of students choosing fruit for lunch rose from 54% in 2012 to 66% 2014. There also was less wasted because 84% of the students ate their entrées, including fruit, in 2014. This was up from 71% at the beginning of the 3-year survey. There was a significant increase in vegetable consumption, from 45.6% in 2012 to 63.6% in 2014.

The study was far from robust in that it compared data from only 1 day in each school year over the study period. The authors noted that each year fewer children in the cohort were eating school lunches, a phenomenon they suspect may be due to the tendency of older children to take less advantage of school lunches.

Regardless of its deficiencies, the study seems to support the basic principle that giving children better choices and waiting patiently will result in more nutritionally sound eating patterns. There is no question that in the short term that providing healthier school meals is more costly. However, this gap should narrow as the lunch ladies learn more cost-effective strategies for food procurement and preparation. The Department of Agriculture is already providing funds for the school departments who are struggling financially to comply with the new standards.

Unfortunately, some impatient members of Congress are like many parents of picky eaters and are trying to roll back the nutritional standards rather than wait for the inevitable change. None of us likes the thought of wasting food or money. But when managing unhealthy eating behaviors, sometimes waste has to happen.

Dr. Wilkoff practiced primary care pediatrics in Brunswick, Maine, for nearly 40 years. He has authored several books on behavioral pediatrics, including “Coping With a Picky Eater.” E-mail him at [email protected].