Let’s talk about: How to get our children to eat and be interested in healthy food?

Early childhood is a critical time for establishing food preferences and dietary habits. The food and drinks children eat should provide them with the nutrients needed for growth and brain development as well as feeling good in their bodies on a daily basis.

An important aspect of developing healthy eating habits with your child is to be a healthy eating role model yourself. This way you show how to eat healthily, without having to bribe, threaten, scream, beg or plead.  In general, the parent’s role is to offer a variety of healthful food, plan and assemble the meals and snacks, and set the schedule for them. The child’s responsibility is to decide what, how much, and even whether he/she wants to eat a particular item/s on their plate, even though it means that they eat little to none of that particular ingredient [1].
So firstly, the best thing is to offer it and then let it be their choice. You may just find that they begin to explore these foods when they don’t gain power from not eating them, like what happens when we start bribing or begging. Secondly, research shows that children often need to try novel food at least 10 times before accepting it [2, 3, 4]. Meaning, more exposure = good thing. So just keep on offering as long as possible.
Another thing to keep in mind is that it seems as though introducing vegetables into a child’s diet before 5 months seems to be protective against fussy eating [5]. Infants can discriminate the flavors of different food items, and both tasting specific food and experiencing a variety of flavors will promote the willingness to eat varied food [6]. There seems to be a flavor window from 4-18 months, where children are more acceptable for trying new food. However, studies support the idea that at any age, children’s preference and intake patterns are largely a reflection of the food that becomes familiar to them. Results indicate that the extent of fruits and vegetables that are present, readily available and accessible in the home correlates positively with the level of consumption of those foods in young children [7]. They also show that even just holding an unfamiliar fruit and/or vegetable can enhance children’s willingness to taste these foods [4].
Thus, the more fruits and vegetable are available to a child in early childhood (from as early as 4 months to 12 years of age) the more interest they have in them, the more they are going to eat of them, and the more they are going to like it.
Additionally, studies show that when mothers are and see themselves as having healthy eating habits, their toddlers (2-5 years of age) ate more healthily. Especially when it came to higher fruit and vegetable intake as well as having less added sugars in their diet [8, 9]. Research also shows, that eating habits of fathers were related to what their primary school-aged children ate. When the dads improved their lifestyle habits and became better role models for their children, it was associated with a reduction in the intakes of total sugars, salt and energy-dense, nutrient-poor junk foods and higher intakes of nutrient-dense (healthy) foods [10]. It has furthermore been shown that better dietary patterns are associated with better school performance, especially among children who regularly ate healthy breakfast, had lower intakes of junk foods and whose eating patterns were of a higher nutritional quality [11].

What can parents do to increase healthy eating habits and increase their child’s/children’s interest in healthy food?

Offer 3 meals as well as at least 2 snacks every day. Have set meals (especially for breakfast and dinner) and a plan for snacks. A good idea is to have prepared and cut down fruits and vegetables in the fridge for the children to grab as a snack. It can be anything from orange slices, kiwis, blueberries or pineapple bites, to broccoli, avocado, cauliflower or celery stalks (like ants on a log, and other fun ideas here). And when it comes to drinks, water is pretty much always the best choice.
Eat meals together as a family as often as possible. Having family meals often enhances child and adolescent health and wellbeing [12]. Children who share family meals three or more times per week, are more likely to be in the healthy weight range, and to have healthier dietary and eating patterns [13]. On a busy day, quality time can sometimes be hard to come by, so this is the perfect moment in the day to be together; talk about the day and eat a delicious and nutritious meal in the best company.
Prepare a healthy breakfast every morning. Having breakfast has been associated with e.g. better school performance [11], while skipping breakfast has shown e.g. to increase risk of childhood overweight and/or obesity [14]. It is very good to establish a good morning routine. Of course, some mornings are more hectic than others, but we all know that eating a nutritious breakfast is the healthy way to go. And there you can squeeze in those fruits or veggies for your children. A good rule of thumb is to have one piece of fruit every morning, berries or a few pieces of vegetables, along with one serving of either whole grain and/or a protein source. Nuts and seeds, like almonds and ground flaxseed, can also be a part of the morning diet and if you choose yoghurt as a protein source, remember to pick one that is low in added sugar (like Greek yoghurt, skyr, kefir or something along those lines). Sugar-heavy cereals and granolas should be avoided, and preferably substituted with porridge, muesli or granola with little to no added sugar. Smoothies and smoothie bowls can also be a good option. Try adding cauliflower, squash, cucumber, kale, spinach, avocado or even celery as well as nuts and seeds into the smoothie. This will both decrease the sugar content, increase the fibers and boost up the nutrients – and often the kids won’t even notice this sneaky vegetable add-in. Win-win!
Plating! It turns out that children have different preferences for how food should be arranged on the plate to make them want to eat it, depending on gender and age. It seems as though a separated serving style is the best solution, especially to children younger than 12 years of age. The child can then mix the food when the various elements are separated on the plate, while the reverse is not possible [15].
Teach your kids about where the food comes from. Take them with you to the grocery store or let them help out in the kitchen. Children are often likely to eat foods that they helped prepare. Having their own kitchen knife or an apron will make it even more fun helping out. You can also visit a farm where they e.g. produce milk or grow potatoes and kale and even meet the people who grow the food themselves. Another fun option is to go berry or apple picking. And even growing your own garden, so the child can see how the whole process works, from planting the seeds to harvesting the herbs, fruits and vegetables. If you do not have the option of having your own small garden, a herb or even a plant in the windowsill will also go a long way.
Talk about nutrients and how they fuel and help the body. Everything from the macronutrients (carbohydrates, protein and fats) to the micronutrients including vitamin(s) A, B, C, D, E and K and minerals like magnesium, calcium and iron. When we know how to nourish our body and what types of food actually helps us nourish it, then we might get even more interested in eating those types of foods. You could explain to them that you are cooking healthier food to help make their bodies feel both good and strong and their brains work even better.
Get as much fruit and vegetable exposure as possible. During the early part of the weaning process concentrate on making vegetable purées and choose store-bought baby food that have a vegetable listed as the first ingredient on the back. All humans are naturally drawn to sweet flavors, so fruit can therefore be introduced a bit later in your child’s palate development [16]. The key to practicing early flavor-learning is variety in (consistent) rotation: introducing flavors from different flavor categories and reintroducing them again 3-4 days later. Good starting vegetables are carrots, green beans, spinach, and broccoli and it is good to put the purées in their (e.g. oat or quinoa) cereal (approx. 50/50). And for the older children, adding both veggies and fruits to smoothies or smoothie bowls, making thick puréed vegetable based soups, flavorful stews, squeezing them finely chopped or minced into lasagna and the marinara sauce for their pasta, or make pizza crusts made from vegetable like spinach, cauliflower, broccoli and/or kale. It sometimes also works wonders making fun with a face-plate or an animal toast. Even offering the older ones their favorite dip with fresh vegetables, like hummus or even ketchup (if that is their favorite). Studies show that children who were given unfamiliar vegetable and offered either familiar vs. unfamiliar dip with it, those children who were offered the familiar dip were more likely to try tasting the new food [17]. If it gets them to dip and eat fresh veggies, awesome. And remember, the more exposure, the better. Even though your child doesn’t know he is getting a taste for these veggies or fruits just yet, their taste for them is on to being formed.

So the bottom of line is; be a good role model yourself and eat those fruits and veggies. Prepare vegetables at dinner and have them around the house so the kids get familiar with them. It’s all about slow and steady progress here, so keep at it, keep offering healthy food choices and don’t give up. And above all, remember to be in the now and enjoy the little things and the small victories as much as possible.


 

 

References:
  1. Evers, C. Empower children to develop healthful eating habits. 1997. J Am Diet Sddoc., 97(2): 116.
  2. Pelchat, M.L. “Try it. You’ll like it.” Effects of information on willingness to try novel foods. 1995. Appetite, 24: 153-166.
  3. Paroche, M.M., Caton, S.J., Vereijken, H.W., Houston-Price, C. How Infants and Young Children Learn About Food: A Systematic Review. 2017. Front Psychol., 8: 1046.
  4. Dazeley, P., Houston-Price, C. Exposure to foods’ non-taste sensory properties. A nursery intervention to increase children’s willingness to try fruit and vegetables. 2015. Appetite, 84: 1-6.
  5. de Barse, L.M., Jansen, P.W., Edelson-Fries, L.R., Jaddoe, V.W.V., Franco, O.H., Tiemeier, H., Steenweg-de Graff, J. Infant feeding and child fussy eating: The Generation R Study. 2017. Appetite, 114: 374-381.
  6. Mennella, J.A., Trabulsi, J.C. Complementary Foods and Flavor Experiences: Setting the Foundation. 2012. Ann Nutr Metab., 60:2, 40-50.
  7. Smith, E., Wells, K., Stluka, S., McCormack, L.A. The Impact of a Fruit and Vegetable Intervention on Children and Caregivers. 2015. American Journal of Health Education, 46:6, 316-322.
  8. Kueppers, J., Stein, K.F., Groth, S., Fernandez, I.D. Maternal and child dietary intake: The role of maternal healthy-eater self-schema. 2018. Appetite, 1:125, 527-536.
  9. Ashman, A.M., Collins, C.E., Hure, A.J., Jensen, M., Oldmeadow, C. Maternal diet during early childhood, but not pregnancy, predicts diet quality and fruit and vegetable acceptance in offspring. 2016. Matern Child Nutr., 12:3, 579-90.
  10. Williams, A., de Vlieger, N., Young, M., Jensen, M.E., Burrows, T.L., Morgan, P.J., Collins, C.E. Dietary outcomes of overweight fathers and their children in the Healthy Dads, Healthy Kids community randomized controlled trial. 2018. J Hum Nutr Diet. 
  11. Burrows, T., Goldman, S., Pursey, K., Lim, R. 2017. Is there an association between dietary intake and academic achievement: a systematic review. J Hum Nutr Diet, 30:2, 117-140.
  12. Eisenberg, M.E., Olson, R.E., Neumark-Sztainer, D., al. Correlations Between Family Meals and Psychosocial Well-being Among Adolescents. 2004. Arch Pediatr Adolesc Med, 158:8, 792-796.
  13. Hammons, A.J., Fiese, B.H. Is Frequency of Shared Family Meals Related to the Nutritional Health of Children and Adolescents? 2011. Pediatrics, 127:6.
  14. Okada, C., Tabuchi, T., Iso, H. Association between skipping breakfast in parents and children and childhood overweight/obesity among children: a nationwide 10.5-year prospective study in Japan. 2018. International Journal of Obesity
  15. Nielson, S.E., Skouw, S., Olsen, A. Serving style preferences for various meal arrangements among children. 2018. Journal of Sensory Studies.
  16. Drewnowski, A., Mennella, J.A., Johnson, S.L., Bellisle, F. Sweetness and Food Preference. 2012. J Nutr.,142:6, 1142S–1148S.
  17. Pliner, P. & Stallberg-White, C. “Pass the ketchup, please”: familiar flavors increase children’s willingness to taste novel food. 2000. Appetite, 34: 1, 95-103.

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