O.K. I have a beef (more than one really.) I was chatting with a lovely client the other morning. They had seen a dietitian for weight concerns for their two-year-old son. This child eats a phenomenal variety of wholesome foods but has become increasingly food preoccupied (as they have tried to control his intake.) The mom was rightly concerned when they were told that diet soda and Crystal Light were on the “preferred” beverage list at a University pediatric weight management center. Really? Does a two-year-old need diet soda? I just had this vision of the idea that these are “free drinks!” (zero points, “green-light” drinks…) so go ahead and fill up that Big-Gulp Sippy Cup and have at it! The family was also recommended a calorie reduction diet (remember, the failure rate in adults is 85-95%) which was worsening the child’s preoccupation with food and tendency to eat quickly and large amounts at every opportunity. (He would hang around the buffet at parties instead of wanting to play.)
What would I recommend a two-year-old drink? (regardless of weight, BTW.) 2% or whole milk, water, or watered down fruit juice. I like the nectars or cloudy apple-juice. Aim for roughly 4 ounces of juice a day, don’t sweat it if it’s more some days and less others. You can get juice boxes with watered down juice now too. (I told my husband years ago that someone would make a lot of money someday watering down juice and charging more for it because it’s low sugar and fewer calories Milk or water or juice with sit-down meals and snacks, only water in between.
This chat reminded me of my one or two (really, that’s all we get folks) nutrition lectures in a top ten medical school. The panacea? “Fat-free cheese! Fat-free mayo! Low-sodium cans of soup! Sugar substitutes!” All artificial, probably not so tasty, all WHAT answers with no thought to HOW we eat. (Don’t get me wrong, these products may have their place with certain medical conditions, but for the general public, not really necessary, not really tasty, but hey, tasty doesn’t matter, right?)
It had me wondering, do any of these experts like food? Know how to cook, or how to eat? Have a big picture mentality? When experts at a therapeutic-feeding training I recently attended went on and on about their Weight Watchers issues, I wondered if they themselves were eating competent and how ironic it would be that the people teaching kids to eat, don’t know how to do it themselves. Is there ANY evidence that diet drinks help adults lose weight, much less children? (Also, is there any evidence that giving a 2-year-old skim milk will make him leaner? Read this post for a discussion on that topic…)
Another mother wrote in to complain that her small son who was on prednisone (notorious for increasing appetite) was scolded for letting her son have 2% milk and told to “cut out the juice” (the child didn’t drink juice.) No one had addressed his asthma properly (which limited his play) or done any kind of intake analysis, or felt that her concerns about his frequent prednisone bursts had anything to do with his weight. She was basically just told, “cut down on the calories.” Even if he was drinking 6 ounces of juice a day, that would not be why he was gaining weight.
Well, there is so much more to it than calories, and the answer is not Aspartame or Olestra, or Diet Doctor Pepper, or eating by a point-system.
Have you been to a nutrition expert around your child’s feeding? What were you told? Dietitians, what do you think of this post. Fair? Not fair? Regional? Your hands are tied by protocol? (I think I should tag this under “ranting” rather than “musings”
(Tip: we had a water bubbler in our home since M could walk and she has loved getting her little cup and filling it with water between meals and snacks.)
UPDATE ADDED LATER: from the mom of the 2 1/2 year old boy put on the diet. We worked together by phone, and 6 weeks after we started, here is what she said, “The last few weeks have been MUCH easier! He is like a different child, occasionally finishing his meals but not always. We went to the bagel store for lunch today and he only ate 1/4 of the bagel. This a totally different boy than the one who consumed 2 1/2 bagels in a sitting only a month ago.”