Health: Here's a new way to feed toddlers that takes the biscuit (for `biscuit', read `broccoli')
Tuesday 02 December 1997
Natasha Chamberlain, a teacher and the mother of two-and-a-half- year-old Thomas is a normal, sane, rational human being. But when it comes to getting her son to eat a proper meal she becomes, as she herself admits, "a headless chicken".
"Mealtime gradually degenerates into farce," she says. "We start off quite sensibly enough, but at his first refusal of food, I bring out a selection of books which I start reading to him to try and distract him. That works for a few more bites and then he decides to get down and I end up chasing him round the kitchen with spoonfuls of food. He finds this quite amusing and stops to take a bite every so often. After a bit he refuses even this and I end up bribing him with the promise of chocolate buttons."
Michaela Hallworthy, mother of Enrico, also two, lines up a menagerie of plastic farm and zoo animals, which all have to be fed before Enrico accepts a bite. "If this doesn't work I have to threaten to eat his supper myself and sometimes I end up eating most of his meal, which he finds very funny and no doubt very satisfying," she says.
It may sound bizarre, especially to those who have not tried to feed a toddler recently. But it is all too common and rather disturbing. There is growing concern about the amount of junk food children eat today and the knowledge that establishing healthy eating habits early can prevent heart disease and other ailments in later life. And the converse is, of course, that it is parents who are failing to establish these habits.
But help is at hand. Over the past five years a team of psychologists from the University of Wales at Bangor has been at work on the project and the results, to be published next spring, have been nothing short of spectacular. They have managed to get young children so enthusiastic about fruit and vegetables that not only at mealtimes do the children eat all their greens, but when offered healthy snacks alongside chocolate and crisps, the children now choose the healthy snacks. What's more, on supermarket shopping expeditions, 75 per cent of parents reported that their converted children asked them specifically to buy fruits and vegetables they had never requested before including oranges, apricots, kiwi fruit, beans, broccoli, cucumber and even the dreaded spinach.
"We started from the rather optimistic assumption that almost any child can learn to eat almost any food," says Professor Fergus Lowe, head of the school of Psychology at Bangor. "That is, although there are some biological constraints - children do have a predisposition to favour sweet and salty foods - eating is a fundamentally learned behaviour." He uses as an example the fact that children of South American Indians are perfectly happy eating monkeys, grubs, bees and headlice because that is what they have learned to eat alongside their parents.
The average British school child's diet has long given cause for concern. Surveys regularly report that children eat too much junk food and saturated fats and not enough fresh fruit and vegetables. British children are getting heavier and fatter and are carrying this extra weight into adulthood, leading to an increasing propensity for people to suffer from cardiovascular disease and cancer. The latest National Diet and Nutrition Survey for pre-schoolers, published in 1994, revealed that many toddlers suffer from vitamin deficiencies because of the lack of fresh greens in their diets. The survey revealed that the foods eaten by 70 per cent of the children surveyed were biscuits, white bread, soft drinks, savoury snacks, chips and confectionery. Less than a quarter of the children ate raw vegetables and salad. In addition, the survey revealed that in the 30 years since the last comparable survey children have become heavier.
"Even the most responsible and careful parent has trouble persuading their child to eat the right sort of food," says Professor Lowe. "The trouble is that junk foods, sweets and salty snacks are so widely available that it is impossible to keep one's toddler away from them."
Professor Jane Wardle, a psychologist at University College London's Health Behaviour Unit, is also working on the toddler-feeding problem and whether the parent's attitude towards the child's eating has an effect on how the child approaches the meal.
"We have conducted studies to show that the offer of rewards for eating vegetables has a detrimental effect on the child's perception of the food," she says. "Children who were offered a sticker for eating their vegetables up would eat the food but when the offer of a reward was withdrawn, the consumption of the vegetables immediately declined. It was as if the offer of the reward somehow sent a message to the child that the vegetable was not worth eating for its own sake."
She also says that distraction - reading books, singing, feeding cuddly toys and other animals - is also counter-productive: it devalues the action of eating the food.
"Parents complain about the vicious circle they get into - a child refuses lunch, containing a good balance of vegetables, fruit, carbohydrates and protein. The child then gets hungry and ratty in the afternoon so the parent gives them a biscuit or a cake, thus ruining their appetite for a healthy meal in the evening."
She says that after about the age of two, a reasonably growing child should have very little fat on them, and should remain skinny until the age of about seven, when they start to accumulate fat again. "The later a child starts to put fat on again, the more chance they have of becoming a slim adult." She added that because children are fatter than 30 years ago, parents worry that their four-year-old is skinny, if his friends are all on the chubby side. But a skinny four-year-old should be the norm she says.
So, how can we get our toddlers to eat their greens? Enter the Food Dudes, a creation of the team at Bangor. These super heroes, cartoon children led by the fearless Jasper, are depicted in videos fighting the forces of evil in the form of the Junk Food Junta. Children in the Bangor study, whose uptake of fruit and vegetables was sometimes as low as 1 per cent, were asked to watch the videos before mealtime, then offered some of the food used in the video. The Food Dudes enthusiastically ate a variety of vegetables and fruit including kiwi fruit, celery and blackeye beans and exhorted the viewer to do likewise in their struggle against the Junk Food Junta. In return, the children were offered rewards, such as Food Dude caps, lunch boxes and T-shirts if they ate 75 per cent of the target food.
"The results were astonishing," says Professor Lowe. "In each case, the consumption of the target food, often refused before, rose to 100 per cent. One child, for example, who before watching the video had claimed: `I don't like kiwi, I hate kiwi', and pushed the plate away, after watching the video not only ate all the fruit up, but was caught trying to steal an extra kiwi fruit from her mother's fruit store." More importantly, six months after the trial, consumption of kiwi fruit was at 80 per cent, and even consumption of celery and beans was at about 33 per cent - far higher than before the trial.
The team operated a control mechanism where the rewards were offered without the child watching the video, and where the child watched the video without being offered a reward. In each case, the results were far less satisfactory than when the video and rewards were used in combination. "We have seen that offering rewards, or bribes in isolation, do not work. But if they are offered as part of an entire system, using these peer models to whom the children relate to, then they do work," says Professor Lowe.
One child involved in the study, six-year-old Marec Kennett, now actually asks his mother Janina to buy spinach for him at the supermarket.
"Before we got involved, Marec was only really enthusiastic about a narrow range of fruit such as satsumas and bananas. He didn't really want to try new vegetables, which meant I was limited in what I gave him," says Janina, who admits she was sceptical about the Food Dudes. "The change was almost overnight. And because Marec was asking for a wider variety of fruit and vegetables such as apricots, prunes, green beans and mango, the whole family has benefited. I thought he would get bored with the video, but no. Every night he would chant the song: "If I eat my fruit tonight, General Junk will get a fright."
The Bangor team are now working with schools and the Government to see how the Food Dudes can be made available nationwide.
Toddler feeding dos and don'ts
l Do not offer rewards or bribes for eating food, unless as part of a system such as the Food Dudes.
l Do not try to distract the child by singing songs or reading books.
l Never force a child to eat something he or she doesn't want. Calmly remove the plate and try again at a later time.
l Do not offer a toddler who has refused lunch a biscuit in the middle of the afternoon. Try again with the refused lunch or a healthy snack such as an apple.
l Do not take "I hate broccoli" as written in stone. What a toddler hates one day he may love the next.
l If a toddler is really difficult about vegetables try with the sweeter ones such as peas, carrots and parsnips first.
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