Health: Pick but no mix

Published on Friday 19 June 2009 13:55

MEET Joshua. His daily diet consists of chicken nuggets, chips and white bread. He has occasionally nibbled on a Findus Crispy Pancake, but has never knowingly eaten a vegetable in all of his ten years.

His mother Laura despairs. "I really can't understand it," she says. "His older brother Kyle will eat anything I put in front of him – always did – but Josh has always been a picky eater. I've tried persuasion, coercion; I've tried shouting at him; we've even sat at the table for hours after everyone else has finished, refusing to budge until he's eaten what's on his plate, but it just ends in tears. Usually mine.

"Now I'm just trying to relax about it a bit more. And I give him a daily vitamin supplement to make sure he doesn't miss out nutritionally."

Joshua is part of a growing army of fussy eaters. Message boards abound with tales from parents at the end of their tether. "I have a 13-year-old son whose diet consists of chips," says one. "He only drinks lemonade and will also eat muesli bars (choc-chip) or ice-cream. He has been like this since the age of four. I have had him to dietitians, psychologists and GPs with no luck. They tell me that he will eat when he's hungry.

"I am worried he's going to have a heart attack and die. I try to make food fun and offer him things other kids would eat but he just gags, swears and refuses. I am at my wits' end."

In April this year it was announced that a quarter of Scots schoolchildren had rejected free schools meals because they were too picky.

While our parents' generation delights in informing us that, when they were young, they had to eat what was put in front of them or go hungry, that's easier said than done in these days of ready meals and convenience foods. So what has happened to the children of the Noughties? Is their picky eating really just a symptom of our increased affluence?

"Certainly, we are a more affluent society, we waste more products and go for more convenience foods," says Dr Richard Woolfson, a child psychologist working in Glasgow. "But in this case I think it's about the child being manipulative of the parent.

"What happens is, let's say a three-year-old sits down one day and genuinely doesn't like what's in front of him. What's the parent's reaction? They start to flap about. 'Oh honey, please try it, let's play a game.' Very soon the child learns this is a great way of getting a big song and dance. That's why, very often, the answer to what to do about fussy eaters is to do nothing."

He says most parents cotton on to this behaviour fairly quickly and the issue rarely goes beyond toddlerhood. But, he says, a nine or ten-year-old who is still turning their nose up at the dinner table is another matter entirely. "You can do anything with a child," he says. "You can scream at them, you can bawl at them, but you can't make them eat. Therefore the child has total control.

"So it's very much about negotiation, trying to say, 'You eat that and take a little bit of this,' trying to extend the child's range of foods very gradually; not expecting to go from eating a pizza a day to eating ten different vegetables. Don't put down 500 green peas on the child's plate; put down a couple and start to build up that way."

Another useful tool is to get the youngster involved in the food preparation, says Woolfson, so that the connection with the experience doesn't begin at the point where the plate arrives at the table, when they have no ownership of it at all. "Get them involved in chopping the vegetables or whatever and they're far more likely to eat what's in front of them."

The most important tactic, he advises, is to stay calm. "I've seen parents who are crying their eyes out because their three-year-old isn't eating properly. My answer is always the same. Have you had him weighed? Is there a medical problem? And the parents say, 'His weight's fine, he might be a bit light but there are no health problems.' So I say OK, if he's thriving and growing, what is the problem? What are they worrying about?

"If you ask a parent that, there's usually a stunned silence. Because the problem is the child isn't conforming to the way you want him to eat, but he's eating enough to nourish and thrive and develop so let's all calm down, relax and take the pressure off the meals."

However, a highly restrictive diet can have serious health consequences. According to Edinburgh nutritionist Emma Conroy: "Chicken nuggets and chips will provide some essential protein, vitamins, minerals and fibre, but contain few antioxidants and very little if any essential fatty acids. Lack of these types of nutrients is associated with a wide range of health problems, including cancer, heart disease and premature ageing.

"Essential fatty acids are crucial for a healthy brain and nervous system, and signs of deficiency include dry skin, dry eyes, fatigue, poor memory or concentration, various allergies, premenstrual syndrome and infertility."

Those who eat only bread, cereal or biscuits are in even more trouble, she says. "These foods are far less nutritious than animal products. Furthermore, the vitamins, minerals and essential fats that do occur in plant-based foods are harder to absorb, and in less effective forms. So, for example, someone living solely on grains (even whole grains) is very much at risk of serious deficiencies, including proteins, vitamin B12, vitamin C, zinc, vitamin A and iron. This would be particularly serious in a child, as nutrients are so important for growth and development."

Initially, the change to a more varied, healthy diet might not even seem as though it is doing you any good. "Switching from a high-sugar diet to one that contains more foods that release energy slowly (low GI foods) can sometimes cause mood changes or feelings of discomfort as the body adjusts," says Conroy. But it is worth it in the end.

"Food is so powerfully bound up with emotions, our earliest experiences and family dynamics that the right or wrong food, the right or wrong way to cook or serve it, can take on a monstrous significance and rouse the strongest feelings of fear or revulsion," she adds. "Every case is different, but it is helpful to be challenged with new foods, and to be made to face up to the health consequences of abnormal eating patterns."

For advice on nutritional issues, see www.edinburghnutrition.com

HOW TO HELP FUSSY EATERS

• Stay calm, but don't give up.

• Introduce new foods slowly – say, just a couple of peas, one carrot baton or a slice of tomato at a time.

• Don't be fooled into thinking children are programmed into liking sweet, bland foods. On the contrary, breast milk is flavoured with whatever the mother has been eating or drinking.

• Sit down with a child as they eat, so they don't have to use the food as a way of getting attention.

• Negotiate.

• As long as the child is still growing and is healthy, don't panic.

• Get the child involved in the food preparation process.

• Don't confuse healthy food with processed "healthy" food such as low-fat sausages or cheese etc, which is invariably flavourless and not terribly good for us.

• Give the tastebuds time to adjust to more natural flavours instead of additives.