September 12, 2018

Today we talk to David Fisher again.  He is a dietician and helps plan nutritious meals for LifeFuel in Grand Rapids.  We asked him to give us some pointers specifically related to children and getting them to eat healthily.  You can listen to this complete podcast episode on iTunes or SoundCloud.

 

Alyssa:  Hello.  Welcome to Ask the Doulas.  I am Alyssa Veneklase, your host, and today we’re talking to David Fisher again, who is a registered dietician.  So last time you were here, you mentioned you have two little boys.  They’re one and three?

David:  That’s right.

Alyssa:  So as a dietician, what do meals look like in your home?  Are they even allowed to eat cereal?

David:  So I will add the caveat that I’m a very busy dietician, and for that reason, cereal does make an appearance at times in our home, yes.

Alyssa:  I’m glad.  I’m glad, so this will be realistic.  You have a realistic expectation of a busy parent with kids, who you want them to eat healthy, but — you know, there’s always a “but…” So how do we as parents — because I’m busy, as well, and my daughter loves cereal.  She would eat cereal for breakfast, lunch, and dinner if I would let her.  But I try for 80% of the time.  I have an 80/20 rule.  We’re try 80% of the time, we try to be really, really, really good, knowing that there’s going to be times where she’s going to have a cupcake or at school something will come up.  But how do you manage that?

David:  Yeah, I mean, your approach sounds appropriate.  The most important thing for people to understand is that you control what you offer and when you offer it.  And the kid controls whether or not he or she eats it.  You have no control whether a child eats a food or doesn’t.  You control whether it’s presented to the kid or not.  So it’s very important to start right away, like when you are introducing foods to a kid.

Alyssa:  Like at six months?

David:  Yes.  Just set the precedent that the family eats together most of the time; not every single day, but almost every single day, and the kids get the food, the same food that Mom and Dad eat.  And if they eat it, good.  If they don’t, they’re going to be hungry.  Kids do not starve themselves, as long as you’re offering appropriate foods.  You can’t expect a two-year-old to eat a kale salad; that’s unreasonable, but you can expect them to eat healthy foods.  Now, the first time you say, “Oh, you don’t want to eat that?  What do you want to eat?” or “How about this thing that’s much yummier?”  That was a big mistake because that kid knows now that there’s another option.  And so if I take him over to Grandma’s house or something like that, they’re going to know right away if that’s something they can get away with there.  And that’s fine, but at our house, we eat together, and these are the foods we’re eating.  Feel free to eat them, and if you don’t, that’s okay.  So with our three-year-old, he is a very good eater.  But he will sometimes get up because he wants to go play or something, and if we say, “Are you full?” he says, “Yeah, I’m full,” — which he might not be.  So okay, you can go play.  And he’ll go play, and an hour or so later, “I’m hungry.”

Alyssa:  Story of my life!

David:  Right.  So what we do is we pull out the plate of food, the exact same plate he had before, and say, “Here’s your food.”  And I don’t know that we’ve ever once offered some different food later at night, because if we did that, then he would never eat his dinner and he would always eat the other thing later.  And he almost always will eat that dinner later, and I will remind him, “You’re hungry because you didn’t eat earlier.”  And so I think we have, with that approach, with not offering something else, we’ve been pretty successful with that.

Alyssa:  What about with your one-year-old?  What is he eating?

David:  So he’s the same.  Texture becomes important for them because obviously I can’t serve him a whole grape or something like that; it would be dangerous for him.  But he always ate with the family, even before he was able to eat.  He would sit up there with us, and then as he starts to eat really soft things, he’ll be there with us.  And at very first, when they’re six months or seven months and they’re first eating, you may not be able to serve them exactly what you’re eating.  Sometimes you can because you can puree it up or use a baby blender with the food that you’re eating, which is a great way to do it.  Other times, we would, for us personally, we might use some baby food jars or some pureed-up food that we had made the weekend before or something like that, and he would sit at the table with us, and we would kind of feed him and eat.  And that slowly transitioned into him eating what the family’s eating.  But a one-year-old appropriate version of it, so maybe the carrots that we had, for him, are pureed up.   And then eventually he needs less and less modification, and now maybe I just have to cut it up in little pieces or something like that, and he can feed himself.  So he’s always been integrated into the family dinner, and he’s transitioning to just being able to eat like we are.

Alyssa:  What about food allergies?  We found out at around two that our daughter had some — not severe allergies, but she got really bad eczema and tummy aches, and it was the majors: gluten, dairy, eggs.  It’s really hard to find foods for her.  If I just make a mound of meat and veggies — she can eat meat and veggies, basically.  But I feel like I was making two different meals often, and then it got to the point where I was like, “Oh, you can just have this.  You can just have the chicken nuggets or something,” which I know are bad, but she couldn’t eat what we were eating.  I don’t know; what do you tell parents?  Or even if the adult has a food allergy, and they’re the only one in the home: how do you deal with that?

David:  It can be difficult.  I think I would try your best to get everyone eating the same foods when possible.  You can make it clear; oh, so-and-so can’t have this food because she has a food allergy, and kids will understand that eventually.  But I would try not to have separate meals for different people when possible.  And food allergies are kind of difficult, though, because it can be difficult to say, does this person have one and will they outgrow it?  A lot of times, they’ll outgrow it.  That happens, too.  You just try to get the family eating the same thing when possible.

Alyssa: I probably need to do a better job of that.

David:  It sounds like you’re working hard at it.

Alyssa: Trying!

David:  Give yourself credit.

Alyssa:  Trying!  So if you could give parents one piece of advice, besides, you know, eating together at the table, which I think is just good for family in general, and then eating the same thing, is there any piece of advice with nutrition?  What are, in general, kids lacking right now?  What are they missing out on?

David:  So the important thing with kids is just offering them healthy foods, and kids will typically choose to eat the amounts that they need over the course of a week or so.  In any given day, they might eat a lot or a little, and that’s okay.  If they’re offered healthy foods, they will eat what they should be eating.  I don’t worry about kids who are offered a variety of pretty healthy foods.  If kids are starting to be limited — and I see this with parents who are limiting them.  “Oh, he won’t eat that.”  Well, he’s never tried that, right?  So try not to be the one who’s causing your child’s limited diet.  Encourage those healthy eating habits, and the kid will be fine.  If you start introducing a lot of processed and sugary foods, and the kid starts to eat a lot those, that’s when I would start to worry about missing some nutrients.  But outside of that scenario, I don’t really worry about malnutrition in children in the United States.

Alyssa: Good.  So, obviously, it’s best to get our nutrients from fresh veggies and fruits, but what about supplements?  I know that these gummy vitamins for kids are just loaded with sugar, too, and are they even getting the nutrients that they need?  Do you have any thoughts or recommendations on these supplemental vitamins for kids?  And even adults, I suppose?

David:  Yeah, so I’m not aware of research with children and vitamins.  I would have to look into that topic.  From a theoretical point of view, I don’t see why a child would need that if, you know, with the caveat of what I said previously.

Alyssa:  If they’re eating healthy?

David:  If they’re eating a relatively healthy diet, there’s not any reason why a kid would need that.  So I wouldn’t choose to do that.  If there was some circumstance where you were having trouble getting enough healthy food into a child, or maybe a disease state like cystic fibrosis or something where you have difficulty absorbing foods, then maybe we would talk about targeted nutrition supplements, but I wouldn’t head that direction outside of that, personally.

Alyssa:  So as long as your kid is eating pretty healthily, you probably don’t need to try to force a vitamin down them, too?

David:  That’s my opinion, yeah.  And in adults, we do have research that says that taking multivitamins don’t really help your health.  But the interesting thing is that there’s kind of confounding variables, so people who tend to take multivitamins are healthier than people who don’t.  So what you want to be is the kind of person who takes a multivitamin — but you actually need to take the multivitamin.

Alyssa:  Right, it’s kind of like a placebo effect.  We don’t really need it.  I take one every day, but yeah, I don’t notice a difference in my health.  But I’m already a pretty healthy person.

David:  Yeah, exactly.  And it’s not unreasonable to take one.  It’s just that we don’t have data proving that it’s helpful, and we have some pretty large-scale studies.  But it may be helpful for you to feel like you have your bases covered, or even for someone to take one a couple times a week or something is not unreasonable.  It won’t harm you.

Alyssa:  Is this another market to just make money?  Is this, like, this whole multivitamin thing just to make us spend more money, to make us feel like we’re going to get healthier?

David:  Largely, yes.  But sometimes it can even be a distraction, and so I discussed before about eating food that’s close to the way it came out of the earth, and that’s where I start with every single person that I would talk to about nutrition.  Because they’ll come to me and say, “I’m taking my folic acid; I’m taking this; and I’m using my protein shake, and I’m still not meeting my goals of muscle gain or weight loss or whatever it is.”  And it’s like, hold on.  You’re getting distracted.  What’s your food intake?  How close is your food to how it comes from the earth?  If we answer that question, then we’ll come back to this stuff.  Don’t get distracted.

Alyssa: T hat’s interesting.  It is a distraction, because I know my doctor would tell me I don’t get enough protein, so I’m taking a protein shake, but why am I not eating more protein, right?  The look — if you could see the look he just gave me!

David:  I am almost a physician’s assistant, so I will be prescribing things like this, and it is tempting for someone to say, well, take this targeted protein supplement or vitamin or medicine.  But we can address those problems a lot of times with food itself, but it takes a little more work on the part of the doctor and the patient, too.  Now, I do sometimes use protein supplements.  Just to be clear, there can be a time and space for some things like that.  I don’t want to say that they’re never useful, but they’re not the basis.  I want to add one more thing, if I may, about involving kids in eating.  If you involve a kid in the process of food, you’re much more likely to get their buy-in on eating a food.  And so this can go as far back into the food process as you can get them involved.  So I have a garden, and I helped my son pick out some seeds that we were going to plant.  So he was involved from the earlier possible step of picking which peas we were going to plant and helping us plant them.  Then he sees them grow; he can pick them, and usually he eats them while he’s standing right there in the garden, but then when he’s in the kitchen, he can help us cook, and now that he’s three, he old enough to actually help a little bit.  He’s definitely going to eat that food when it comes to the table.  He cuts the asparagus out of our garden, and he will definitely eat it, whereas if he just sits at the table and I just throw some asparagus on his plate, he might be like, what’s that?  I’m not going to eat that.  But he’s invested, so it’s important to get that process started.  Get kids in the kitchen.  In fact, I was at the farmer’s market, and they were giving out little kid knives.  I don’t know if you’ve seen these, but it’s a knife that a kid can use to cut vegetables or anything, and it really works, but it won’t come them.  And so now he loves to come in with me and help prepare dinner.

Alyssa:  That’s a really good point.  We had Katie from Kitchen Stewardship on our show.  She’s all about getting kids cooking in the kitchen because when they cook their own meals, they’re more likely to eat it.  But I’m glad you mentioned the garden, too, because I did the same thing with my daughter.  She helped me plant the seeds, watched them grow, and she’ll literally pluck a carrot out and go rinse it off in the house and just eat it like Bugs Bunny.  And I told her that we can eat beet greens and lettuce, so she’ll walk up and say, “Mommy, can I have a beet green?”  And my friends will look at me, like, did she just ask if she could eat a beet green?  I’m like, girl, you eat all the beet greens you want!  Yes, go!  So it’s true; if they’re in it from the beginning of the process, they’re much more invested.  “I grew these, Mommy, they’re mine!”

David:  And conversely, you mentioned having sweets or something sometimes.  We certainly have them sometimes, too, and so they have their place, and they’re kind of special.  Sometimes we’ll walk down to the ice cream shop.  We’ve discussed that it’s not somewhere we go every day, but sometimes we do, and we enjoy the heck out of it.  And then maybe sometime in the future, we’ll go again.  So those things are fine in their place.

Alyssa:  Right.  Okay, I’ve got some thinking to do with how I get my daughter to eat some meals with me.  But actually, some of the LifeFuel ones, she’s been eating.  Like those pancakes, she loved.  They were gluten-free vegan pancakes, and then she loves meat, so she just devoured the meat, too, so yeah, I probably need to order more specific ones like those that she will eat.  Well, thanks for coming in again.  It’s been fun.  And Genevieve, will we have you back on sometimes?

Genevieve:  Absolutely!

Alyssa: Okay.  You didn’t talk on this one.  Probably no one knew you were here!

Genevieve:  I’m just hanging out in the background.

Alyssa: Genevieve from LifeFuel.  Since you are here, why don’t you tell us your website and how to find LifeFuel if they’re interested in ordering?

Genevieve:  Yes, the website is lifefuelbyvault.com.  You can order meals weekly.  We will deliver them to your house, and they’re healthy and delicious.

Alyssa: I can vouch for that.  You can always find us at goldcoastdoulas.com, Instagram, and Facebook.  And you can listen on iTunes and SoundCloud.  Thanks!