To Prevent Obesity, How Kids Eat Matters As Much As What They Eat, Article Says

Parents can teach kids to recognize when they’re full and develop healthy eating behaviors that help prevent childhood obesity, according to a new scientific statement from the American Heart Association.

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Any parent who has ever tried and failed to feed broccoli to a toddler knows all too well how hard it can be to get children to eat what’s good for them. Now, new guidelines from the American Heart Association (AHA) suggest that helping kids recognize when they’re hungry and when they’re full may be just as important as encouraging them to eat their veggies in the effort to prevent childhood obesity.

“Parents and caregivers should consider building a positive food environment centered on healthy eating habits, rather than focusing on rigid rules,” says Alexis Wood, PhD, an assistant professor in pediatrics and nutrition at Baylor College of Medicine in Houston and the lead author of the AHA scientific statement published in May 2020 in the Journal of the American Heart Association.

This doesn’t mean abandoning broccoli altogether. But it does mean many parents may need to change their approach to meals, offer broccoli as one of several healthy options kids can choose, and avoid any mention of the clean plate club.

Setting a Good Example for Your Kids Can Go a Long Way

Parents who want kids to eat broccoli need to eat it themselves.

“Children's eating behaviors are influenced by a lot of people in their lives, so ideally, we want the whole family to demonstrate healthy eating habits,” Dr. Wood says.

More than one in five toddlers and preschoolers in the United States are overweight or obese, putting them at increased risk for developing heart disease and other chronic health problems later in life, according to the AHA.

Even parents of newborns can help minimize this risk. One reason breast-feeding is linked to a lower obesity risk for kids than formula is that many parents who use bottles continue feedings until the baby has finished every last drop, the AHA notes.

This doesn’t have to happen. A study published in April 2015 in Appetite tested the use of opaque, weighted bottles and found this resulted in babies consuming less formula than with traditional, clear bottles. This suggests that parents who don’t see how much remains in bottles may be better at stopping when babies are full, which is what usually happens with breast-feeding.

Pressuring Picky Eaters May Do More Harm Than Good

Toddlers and preschoolers, meanwhile, may assert their autonomy during meals by resisting new foods or becoming increasingly picky about what they eat.

Parents who respond by pressuring kids to eat what's in front of them may not only fail to get children to try more foods, they may also inadvertently prevent children from learning to recognize and respond to their own hunger cues.

“Overly restrictive parenting approaches — if they are not responsive to the child — can contribute to a shift in the child’s eating behaviors where they start and stop eating in response to external cues, not to their internal sensations of hunger and fullness,” Wood says.

On the other hand, parents who cave to kids’ every whim at mealtimes may prevent children from developing an ability to resist cravings for junk food and empty calories.

Finding a Balance Between Children’s Wants and Their Needs

“Allowing children total autonomy over their eating behavior may result in some children not choosing to eat healthy foods,” Wood says. “Therefore, it is currently recommended that children are given some freedom and autonomy within an environment that fosters, or supports, a healthful approach to eating.”

There are several ways that parents can strike a balance between these two extremes and support the development of healthier eating habits, according to the AHA. These include:

• Setting consistent mealtimes
• Eating with kids so they see parents enjoying a variety of healthy foods
• Letting kids choose foods they want from a selection of healthy options
• Serving healthy new foods alongside foods that kids already enjoy
• Paying attention to kids’ verbal or nonverbal hunger and fullness cues
• Not forcing kids to eat more than they want to eat

Making meals fun, and even a little messy, may not hurt either. A study published in July 2015 in the Journal of the Academy of Nutrition and Dietetics, for example, found that toddlers who dug through food with their hands to uncover buried toys were less likely to become picky eaters. In this study, children also ate more fruits and vegetables when their parents consumed more of these foods.

Prioritizing Exercise

The AHA focused only on young children in these recommendations, which are limited to how caregivers can influence kids’ eating behaviors and not on dietary quality or variety.

“Since family is so important in children’s and teens development, some of the guidance for younger kids will still apply, such as not having junk food or overly sugary food available in the house, and having structured family mealtimes as much as possible,” says Anne McTiernan, MD, PhD, a professor at Fred Hutchinson Cancer Research and author of Starved: A Nutrition Doctor’s Journey From Empty to Full.

While the AHA scientific statement does not focus on physical activity, exercise is important for obesity prevention for people of all ages, Dr. McTiernan says.

“For children, sports and other opportunities for activity are critically important,” McTiernan says.

If children have obesity, parents should work with their pediatrician to find ways to help kids get more exercise and change their eating habits, especially if they have health problems related to obesity like diabetes or elevated blood pressure, McTiernan says.

Avoiding Diet Messaging Is Critical for Helping Youngsters Lose Weight Healthfully

One thing parents should generally avoid — especially with young children — is talking about dieting or cutting calories, according to guidelines from the American Academy of Pediatrics (AAP). Some strategies the AAP does recommend, in addition to offering kids a wide variety of healthy foods, include:

• Limit consumption of sodas and sugary drinks.
• Eat meals at home instead of in restaurants.
• Have breakfast every day.
• Enjoy meals as a family.
• Allow three hours a day of physical activity for kids 3 to 5 years old.
• Encourage at least one hour a day of physical activity for older kids and teens, with three days a week of vigorous exercise.
• Allow no screen time for kids younger than 2.
• Limit screen time to an hour a day for kids 2–5 years old, and watch with them.

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