Welcome to Health Talks.
Brought to you by the Permanente Medical Group
Hi, I'm Anne Feder, and I'd like to introduce
our guest today, Dr. Kim Newell, who's gonna talk to us today
about healthy eating for your family.
Dr. Newell attended medical school at the
University of Pennsylvania and did her pediatric residency
in the University of California in San Francisco.
She joined Kaiser Permanente in December of 2005
as a pediatrician in San Francisco.
Dr. Newell's also an assistant clinical professor of pediatrics
at the University of California, San Francisco
and supervises pediatricians in training in the
Residence Continuity Clinic at Kaiser Permanente.
Dr. Newell, thanks for joining us today.
Thanks so much, Anne.
I'm excited to be here to talk about how we keep
our kids healthy.
Well, that's a topic that's near and dear to my heart
as I have two young children at home,
and it seems every time I turn around there's something else
in the news about what they should be eating,
what we shouldn't be eating, what to avoid, what to eat.
What do we really need to know?
That's a great question.
And it's actually really tricky to be a parent these days
and consumer of foods in general.
You know, there's so much out there in the media
and in the supermarkets telling us what is and isn't healthy.
And it just turns out that when you see something marketed
as healthy or as a health food,
it often is less likely to be healthy.
Things that are low fat, often the companies have
added something to make up for the taste,
and so they added more sugar or more salt.
If they're low sugar, they've added chemicals that we may not
need in our body and aren't that healthy,
especially for kids.
So in order to navigate this, I like to tell my patients
something that makes it more simple for them,
and from that I take the words from Michael Pollen,
a local Bay Area food writer.
And what he says is, he says three things:
eat real food, mostly plants, and not too much.
If you eat mostly food that your great-great-grandmother
would recognize, then you'll be fine.
That's real food.
Your great-great-grandmother wouldn't know what Cheetos or
Gummy Fruits are; she wouldn't know what a lot of the
low fat snack bars are.
And basically, what this does it cuts out processed food.
So let's talk about that a little bit.
What do you mean by processed foods?
Does that mean that we should all be baking our own breads
at home and churning our own butter?
How do we make that part of the something that we're all
looking for as convenience in providing healthy meals
and snacks for our families?
Well, that's tricky.
But the real things that you want to think about are
eating real foods, so lots of fruits and vegetables
are a key portion of the diet.
And then when you're looking at foods that have been pre-made,
you want to look for foods that have fewer ingredients
and real ingredients.
Foods with more than five ingredients on them
often have chemicals and processed ingredients,
and if you look at a label and it reads like a chemistry class,
then you probably shouldn't be eating that food.
Okay. And you said mostly plants,
so we're talking fruits and vegetables.
And you and I are both moms, and so you probably know as
well as I do that getting kids to eat vegetables can be
a real challenge.
What advice do you have for us?
Well, that is a tough one and I feel it in my own family as
well as from the patients that I give advice to every day.
So, you know, a lot of kids at certain ages
will really decrease the amount of vegetables they eat.
A lot of kids around the age of 18 to 24 months
close their palate.
They were great eaters up until then.
My kid would eat anything until she was about two,
two and a half years old.
And now, just the other day she said to me,
"Mommy, I don't like vegetables."
Now this was as she was chewing a stalk of asparagus,
so I think that's a definition thing.
But in any case, there are a couple things
that I tell families.
First of all, you really can get sneaky and put vegetables
in places where the kids don't notice them,
and that's a greet way to get them in.
So patties are a really great way to get kids
to eat vegetables.
You can puree a bunch of onions and zucchini and spinach and
other vegetables, and you can make a hamburger patty
or a turkey burger that is literally half vegetables,
taste delicious, and the kids don't even notice they're there.
Smoothies are another really great way to get vegetables
into kids.
You can add so many things.
So take a bunch of frozen bananas, some frozen fruits,
and then add some spinach or a cucumber.
You can add carrots to smoothies.
I even say to put canned beets or cooked beets into them
because then all of a sudden they take on this great
purple hue.
And pumpkins are another great vegetable,
and you can get canned pumpkin and put that into a smoothie,
and those are great ways to sneak foods into kids.
Oh, very nice; getting at 'em where they don't recognize it
certainly gets it done.
And what about that not too much part?
How do we know how much we should be feeding our kids?
Well, that's a really good question.
You know, a lot of parents get so nervous that their kids
aren't eating enough.
That's one of the biggest things that parents say to me
when they come into the clinic.
And the kid's growing beautifully
or they're actually gaining too much weight.
So how do you know?
It turns out that what you have to do is trust your kid.
Kids, when not given any pressure,
they will eat until they're full and then they'll stop.
But unfortunately, we give them a lot of early signaling that
teaches them the opposite.
We teach them to eat until they're full,
and then to keep eating.
And that happens because we do things like make them
clean their plates.
So I'm not a believer in the clean plate club.
We just need to allow them to eat what they need
and really trust them to do it.
The thing is that portion sizes have skyrocketed.
We eat three times more in our restaurants and in our homes
than we did 20, 40, 60 years ago.
So we need to give kids smaller portions than we think,
and then if they say they're hungry after we finish eating,
and it's healthy food, then they can have some more.
But we don't want to push them to finish.
Our job as parents is to offer foods,
a healthy variety at regular meals of the day,
and then let them choose how much they want to eat.
And you said healthy variety.
How do we decide how much protein,
how much carbohydrate, how much of the different kinds of food
they should be eating?
That's a question that a lot of families have trouble with and,
you know, we used to --
we used to be taught about the food pyramid,
which is a funny thing because nobody eats food
in the shape of a pyramid.
So luckily, we now have something we call
the plate method.
And in the plate method, the goal is that each plate that you
look at should be half --
50 percent of the plate should be fruits and vegetables;
another quarter of that plate should be protein,
ideally a lean protein most of the time;
and the other quarter of the plate should be carbohydrates,
some kind of grain, and better whole grains than
processed grains.
Keep in mind, though, that balance in one meal is not
necessary because kids will eat certain things at one time,
and then eat another thing at another time.
So really, for your kids, instead of stressing exactly
what they eat in one meal, keep in mind that their balance of
what they eat over a week can really keep them healthful.
Good news!
Good news for those kids who have refused a meal or two.
So I want to also ask you about snacking.
I've been hearing a lot about small meals spread out
across the day, so perhaps five small meals a day
rather than what our great-great-grandmother
might have recommended as three big meals a day.
What do you think about that?
Well, I think there are two tricky things about snacking.
The first thing is that in our world,
snacks typically are less healthy foods.
They're quick foods and they're convenience foods,
and so they tend to be more likely to be processed,
more likely to be high sugar, high fat and high calorie,
and so you've just got to be careful about that.
So even my three year old --
and I'm really careful about what snacks she gets --
I told her the other day, "It's lunch time, Lucy."
And she said, "No, Mommy, it's snack time!"
Because she realizes that snacks are special.
So I think the tricky thing about snacking is
if you're gonna have your kids snack,
then you need to keep them healthy.
So maybe it's a difference in the vocabulary.
We're talking about when you eat versus
what kinds of foods you eat at certain times of the day.
Absolutely. Absolutely.
The other thing though is that I think that a lot of the
healthy foods that are eaten at the main meals of the day,
kids might refuse those and say, "Oh, no, I'm not hungry,"
and then wait for the time when they later say,
"I'm hungry, Mommy," and then you give them the
foods that they are more likely to want.
And so what I tell parents is you offer them the food,
and if they don't eat it, then even if they say they're hungry
until the next regular eating time --
and maybe that's three meals and two small snacks in a day --
they just don't need food in between those times.
So a lot of times, kids'll use those times to manipulate you.
"I'm hungry, Mommy!"
And then you'll give them some food that's not so good
for their bodies.
But just don't worry.
They will be okay until the next regular eating time.
And particularly if you start that as a new rule in the house,
they might fight and argue for the first few days,
but they'll get it that you're serious, and they'll be okay.
So we've talked a lot about younger kids who are sort of
waiting for us to feed them.
Let's talk a little bit about tweens and teenagers,
those kids that have their opportunity to purchase their
own food, eat food away from home.
And you don't have any control over what they're eating.
So a few things I tell parents as kids grow up.
One is that those kids who were really particular about the food
they ate and they sort of closed down their palate,
those palates open up over time.
So there are a couple of big times in kids' lives where they
start to eat -- typically, they start to eat broader foods,
may introduce vegetables again.
And that's typically between five and seven years of age,
and then again at ten to twelve years of age.
So first of all, the thing to do is really be open with your kids
offering them new, healthy flavors along the way.
And then the second thing, as kids get a little bit older is
I think it's really important to engage kids in the making
of the food, the creating of the food,
and then in the eating of the food all together as a family.
And so that's where both cooking and then eating together
as a part of a family meal can be a really important way
to keep modeling the kind of eating that you want your kids
to do for the whole rest of their lives.
And I understand that family dinners have a lot of benefits
beyond just the --
the healthy foods that you put in front of them.
Absolutely.
Family dinners are so important for a million reasons,
but they're really a great way to connect with your kids
and your family.
And it's an important time in everybody's day.
It's tricky to find the right time to do that.
You know, so many of our kids are involved in activities
after school.
Many of us are working parents who come home and are
trying to whip things together.
And so, you know, I think of a family dinner as a really
broader concept.
Maybe family dinner happens on three nights a week
to designate as family dinner night.
In some families, the mornings are easy,
so you make it family breakfast.
Or it's family brunch on the weekend.
But as many times a week as you can really commit to that,
I think that's a great way to be a part of a meal that's both
socialized healthy eating, and it's also a connection
for you and your family.
Great. Well this has been very helpful for my own family
and for our listeners.
And I certainly will take eating real food, mostly plants,
and not too much to heart as I'm planning out meals for --
meals and snacks for our family going forward.
So, Dr. Newell, thank you very much for your time today.
It was my pleasure, Anne.
And for those of you interested in more of Dr. Newell's thoughts
and advice, you can follow her on Twitter at KPBabyDoctor.
Thank you for tuning in.
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