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Dr. Katja Rowell: Obesity fear-mongering

Love Me, Feed Me!This is the second entry of a 5-part interview series with Dr. Katja Rowell whose consulting service, The Feeding Doctor, focuses on helping families learn about healthy, happy eating. Finding non-alarmist nutrition information for kids is a challenge and her commonsense, respectful approach has been a huge boon to me. Be sure to become a The Feeding Doctor fan on facebook and check out her new book, Love Me, Feed Me! now available at Amazon.

Can you talk some about kids and the emphasis on obesity in nutrition education? The good and the bad of it?

This is so tough. We know there is a problem with how we feed our kids as a society. Many kids are getting bigger than is healthy for them, and many are also not getting enough food (food insecurity) many are malnourished, many teens are practicing dangerous dieting behaviors, are gaining weight and bingeing as well and eating disorders are being diagnosed in more and younger children. I see it more as a crisis in feeding all our kids. A crisis in our relationship with food. I really have a problem with nutrition education that is aimed at fat kids, or aimed at “preventing fat kids.” There are many normal or healthy weight kids who have terrible nutrition and we are ignoring them. If you know that most fat adults were not fat kids, then we have to help all children. There are many larger kids who are healthy and we are misdiagnosing them. Our emphasis on weight and weight loss is not healthy for anyone. We know that teens who diet, even “healthy” dieting like “watching what you eat,” or trying to eat more fruits and veggies are heavier than their peers who do not diet. I think we have to be really careful with nutrition education, not to scare kids or focus on avoidance or restriction. Nutrition education should be age-appropriate (meaning we should NOT have six year olds reading labels for fat grams) and should focus on joy, structure, providing, good taste and permission. There are no “bad” foods. There is room in a healthy diet for all foods.

I also get particularly angry that the language of addiction is used in nutrition education with kids. We need to get the “crazy” out of our relationship with food and not introduce kids to the idea that food is somehow forbidden, or that you have a “snack attack” or “can’t stop” or that you have a “craving” for a food. Commercials for kids use this language really well as they are trying to pique a child’s interest in a food and make it desirable- to tap in to that formidable “pester power” so the kid begs for Cocoa Puffs or Cheetos. And why does every movie or TV show (Disney too) show tweens and women eating ice-cream out of the carton when they are upset? What are we teaching girls by showing them that cliched coping model? We need to reframe how we talk about food. The fact that nutrition education co-opts this language and reinforces the message of desire, lack of control and pathology is harmful. Nutrition education should normalize food as a delicious, joyful part of life, not something that controls us.

Is the “healthy at any size” credo something that makes sense for children? Why or why not?

sodasip-insideI do think it makes sense. I think we need to focus on behaviors. Is the kid eating breakfast, are they given the opportunity to move their bodies in enjoyable ways? I think of my brother who is tall and lean now but had a puffy phase right before his pubertal growth spurt. (This is a very common pattern.) If he had been told to worry about that, or put on a diet, he would have been robbed of the opportunity to grow into the body he was meant to have. I cannot tell you how many women share that history of being started on a diet around that time and starting a lifetime of dieting, shame and consequently weight gain. Again, if we as parents can provide a variety of foods in a structured setting and avoid the notion that all kids have to grow at the 50th % we would all be better off. Now, I want to be clear that if someone is gaining weight rapidly in a way that is not consistent with their healthy growth curve (big or small) that person needs help. Rather than ask “what is that kid eating?” we need to ask “What is happening in that child’s life that is messing up their normal growth?” Are they getting enough food? Structure? Sleep? Is there chaos or stress in the home? Are they getting a variety of foods? It is more about behaviors and taking care of yourself than the number on the scale.

How can parents promote healthy eating and exercise without focusing too much on body shape or losing weight?

I remember being at the park with my daughter on the swings and a little girl ran up and started swinging. Her dad, a lean man, came jogging over and yelled, “Sally! Get off the swings! That’s lazy exercise! We didn’t come here to sit around, get off and run around.” Her smile faded pretty quick. I can tell you that’s NOT the way to instill in her a life-long love of movement and her body. We can’t be food cops or personal trainers.

Ignore weight. Focus on behaviors that you can control. Be a good role model. When I do intake analyses with my clients, they are shocked when I usually start with “feed your child more” and stop restricting. The urge again to do “something” and follow the advice in magazines might mean you give your child a piece of fruit for snack and that’s it. The reality is kids need substantial meals and snacks so they can have energy and then not be allowed to graze in between. Be a good role model. Enjoy eating a variety of foods yourself. Swing by the park on the way home from day-care for half an hour. Play some Wii Games (watch out for wii fit!) FInd a community pool, provide opportunities to be active. I saw something from the pediatrician’s office the other day that exemplified to me how out of touch and ridiculous current public health initiatives can be. It said, “Outside of school, have your child participate in sixty minutes of vigorous aerobic activity for an uninterrupted sixty minutes.” and, “Don’t let your child be sedentary for more than thirty minutes at a time.” Really? Then you turn into that personal trainer dad. Do you have a timer when your kid plays Legos or draws and make them do laps around the house if they’re doing homework for thirty minutes? How can your kids do an hour of uninterrupted activity? It’s too much and sets every one up to feel like a failure which leads to apathy and a lost opportunity to encourage small, real changes that are intrinsically rewarding. So much of the advice is also not backed by any scientific evidence that the recommendation will improve health or outcomes.

(Stay Tuned for Part 3 next week!)

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