Monday, November 30, 2009

Division of Responsibility for physical activity

I want to raise a daughter that is happy and healthy, who enjoys moving her body and has a good level of fitness. There are ample studies that confirm that fitness is a better marker of health than BMI (which the American Heart Association has outright said is not a good clinical marker for health.) So, how do we get our kids to be more active without turning into a drill sargaent who will turn our kids off of physical activity? (See recent post about parents pressuring kids to be more active.)
Basically, follow the
Division of Responsibility. Regular readers know that with feeding this means your job as a parent is to provide what, when and where the child eats, the child then decides if and how much.
The same should be true for activity. The parent's job is to provide the opportunity for physical activity, the structure and support and then leave it up to the child. The more you push, the more they will resist.
It's been fascinating for me to watch my own case study, now almost 4. Her innate level of activity has jumped recently. She seems to go through cycles– very active as a crawler and toddler, a little less so around 2-3, now more active again. We went to the sculpture garden recently and she ran the whole time (photo top.) She had endless interest in hide-and-seek, ran across the bridge to Loring Park to the playground. A few months ago she would have been riding in the stroller. She runs around the house in angel wings, starts spontaneous games of bowling with cups and materials scavenged from the recycling bin, jumps on our second-hand
jogging trampoline, launches herself into piles of beanbags etc... I sometime wish she could sit still for all of Finding Nemo, but I can't force her to watch TV either, no matter how much I could use the break!

Tips for supporting activity:
1) Don't push it, allow them to find their natural rhythm.
2) NO TVs in the bedroom, limit TV watching to what feels right for you, but no more than 2 hours (for some folks it might be none, or 20 minutes...)
2) Make a point of being active in a fun way, ride bikes to the park, set up indoor obstacle courses (we actually had no furniture in half our living room when she was little so she could run and jump on couch cushions) indoor bowling, velcro darts...
3) Find something they like to do and sign up for a class. Rec centers are great for this. Be careful not to over-program your kids to the point that you miss out on Family Dinners regularly.
4) Go for Winter lights walks. Bundle up after dark, bring a flashlight or glowstick ($1 for a bunch at Michaels) Even if you have to bring them in the stroller or wagon for awhile, get in the habit of moving your bodies in a fun way together.
5) Make a list of scavenger items for a walk, Snelling State Park is full of deer and wild turkey. We almost always see them! (Ask them to collect pine-cones, a tiny rock, a feather...)
6) Make your own fitness about having fun and feeling good, if weight loss is your goal, you are less likely to enjoy yourself and continue with the activity.
7) Play music with a great beat, and dance with them
8) Be positive, telling a child they are fat or need to lose weight is the best way to get them to be LESS active. Don't talk about weight at all.
Have fun!

Tuesday, November 24, 2009

kids in the kitchen

Studies show that kids who are involved in food prep are more likely to enjoy and try a variety of foods. I found this stalk of brussels sprouts at the local market. It was fun for M to see how they grow and taste the difference between the bigger ones at the bottom and the smaller ones at the top. As usual, when she helps me make dinner, she nibbles on the veggies, a sort of appetizer/pick-me-up while we still have 30-45 minutes to wait.
I had some Thousand Island Dressing which she had never had, so she poured some into a little bowl and ate about 4 sprouts raw. (See my post about eating raw sprouts and how to prep and cook them.)
She pulled them off the stalk with a satisfying "snap" and then I cut off part of the stalk and outer leaves. I cut them in half and she dipped and nibbled. She again chose not to eat any of the cooked sprouts.
  • Don't get into battles. I did not ask or force her to try any cooked sprouts. Her attitude about eating is more important than what she eats any given day.
  • Involve kids in food prep when you can.
  • Include dips as a way to introduce new foods. Small children need fat for brain development and proper nutrition, don't be too stingy with fats. (Infants and toddlers need 30-40% of their calories from fat...)

Friday, November 20, 2009

BMI as false clinical marker

I read a nice post by a medical student that is a great illustration of how BMI is being misused as a clinical marker. The sad thing is this is a lecture going on today. Lots of misinformation abounds and our future docs are being trained this way. (Please see the photo of the man with the "obese" BMI of 32...)
It reminds me of my friend who mentioned that every time she took her healthy, athletic son to the doctor, from birth to 6 years, she was told he is "obese." He is healthy, active, normal, eats well and is in no way at increased risk of illness. In fact, labeling him, or trying to change what they are doing is likely to cause more harm than good.
I wish I had known more about the Health at Every Size paradigm when I was in practice. I always felt something was off in how we dealt with weight concerns and wellness. Focusing on BMI and not behaviors means we misdiagnose some healthy people (with higher BMIs) as having problems, and we miss folks with "normal" BMIs who may be at greater risk for illness. It is a false marker in the vast majority of cases. Food for thought...

Tuesday, November 17, 2009

trust is not always easy

It happened again today. Another one of those moments when I said aloud, "Thank God for Ellyn Satter."
Let me explain. I found Ellyn Satter and the Division or Responsibility in feeding first as a concerned mother and second as a professional. I have made it my job to spread the word about the beauty and importance of a healthy feeding relationship– and I still get tested at home.
Milk. Calcium. It's that important. M always drank enough milk to cover her calcium needs until about 8 weeks ago. Abruptly and matter of factly she refused milk and always opted for water at meals and snacks. Without milk, she was not getting the recommended amount of calcium. She ate small amounts of yogurt, ice-cream and cream cheese, but not "enough." I did better about drinking milk at meals to provide an example, but I stuck to my job, and let her do hers. That is, I offered milk and if she refused, I did not lecture, pressure, bribe, praise or cajole her to try to get her to drink milk. I trusted that it would work out.
What would I tell my clients? "Trust that if you drink milk as a family, that she too will return to it." I gave myself the same pep talks and advice that I share with clients. "It will take time, be patient. Her attitude about eating and meals is more important than what she eats on any given day." (As Ellyn puts it.) Then weeks went by and no milk. I offered home-made hot chocolate which she drank happily for awhile, made oatmeal with milk, cooked with condensed milk, bought rice pudding again, which she refuses to try so far. (See addendum on Calcium in Child of Mine for more great ideas...) I supported her calcium intake with my cooking while I waited for her to come back to milk.
But why was it taking so long! My resolve was wearing away. This morning I woke up and thought about milk. Do I start only offering milk? I know she likes it... No. I will trust that this will work out and stop worrying about it.
Then, at breakfast, she had a banana and dry cereal and an apple (bread and butter was on offer, but she didn't want it.) I was drinking milk with my toast and she asked for some milk in her cereal (first time in months.) Then she proceeded to have several small servings of cereal and milk (she likes her Kix crunchy...) She certainly got an adequate serving this morning.
It was such a powerful reminder and example of how kids will do well with feeding if we support them and don't bring pressure into the equation. What would our lives be like if I had pressured and pushed milk a few weeks ago? Would we be in battles every day over milk? Would it turn her off milk for years, possibly forever (like my relative who literally gagged down a glass of warm milk every morning and now won't drink it...)
It reminds me of the anxiety and worry my clients have over fruits, vegetables, quantities, calcium, protein etc. These experiences with my daughter are amazing first-hand affirmations of the model of feeding I teach. I face challenges with feeding, but I have the tools and skills to handle them and I want to pass those skills along.
"Hang in there," I told myself, and I tell my clients. If you can stick with it, truly and honestly, and get the pressure out of feeding, chances are very good that your child will eat better and your family will be a lot happier.

Wednesday, November 11, 2009


I recently read some books about "locavores," people who only eat what can be produced locally, and I came away feeling a mix of inspiration and guilt for not doing more. As you know, my mantra is "taking anxiety and conflict off the menu," so in an effort to reduce my anxiety I decided to look into it a little further.

Living in Minnesota, eating only local seems like an impossible task. Also, with a small child still developing her tastes, I want to expose her to a wide variety of produce, and buying local or seasonal-only is hard to do. (In my fantasy world, I would buy all local and organic and can them for use in the winter, but that's not happening!)

Since I choose to eat "out of season" foods, I face a further dilemma:

Do I buy organic from Mexico or California, or a local conventionally grown product?

Now that the farm-fresh tomatoes are over, what to do!? Bushel Boy brands- a Minnesota company- sells tomatoes and lettuce at co-ops, Whole Foods and Target. Cherry tomatoes are a favorite for my daughter, and we just had delicious large tomato slices on BLT's. Their "live" lettuce mix which comes with the roots and dirt are great and stay fresh a long time which helps with meal planning.

I wrote to Bushel Boy to ask more about what they do. Aside from supporting a Minnesota company, they seem to be really dedicated to making a tasty, safe, local product, which employs Minnesotans, and importantly reduces shipping. Trucking a tomato from California is a heavy carbon load. In addition to reusing water at the facility, here is an excerpt of other practices at Bushel Boy:

"We really do not want to use chemicals on our plants. We pollinate with live bees and if we spray we risk killing off all our hives which is very expensive. Also, chemicals weaken our plants and make them less resistant to stress. We have 3 full-time people that we call "scouts." They monitor our plants constantly for insects and signs of stress and disease. If they find an insect problem, we monitor it. If necessary we will bring in "predator" insects to take care of the problems ones. Once the problem is taken care of, the predator insects die out. There have been times when we've had to spray. All chemicals we use are FDA approved for use on tomato plants. We have, and follow, strict guidelines for the use of ANYTHING that goes on our plants for the protection of our employees, our plants, and of course, our customers!"

In addition, Zoie, a local food producer from Lucille's Kitchen Garden had the following to say on the topic:

" I generally prioritize local over organic with a preference for local sustainable. I do this for a couple of reasons. First of all I believe there is a huge flavor difference. I have my daughter pick out our produce by smell which gets her really excited about preparing our food. I have found that when I simply ask her which smells better, it is always the freshest. Secondly, food miles are currently my number one "green concern." Since we don't have a ton of large vegetable farmers with the exception of Bushel Boy, most of our local produce is grown in a sustainable manner. I should say that I am very thankful for Bushel Boy for offering us tomatoes that taste like tomatoes earlier in the season! Controls in other countries vary as far as organic goes and one must factor in general pollution as well. Thirdly, I like to keep money in our area. I think it is important to keep a good variety of industry in MN, so I try to keep as much money in the local economy to encourage that. "

Kristin Hamaker, personal chef and owner of Farm to Fork agrees, "I worked as a farm hand for an entire year for a farm that operated under the strictest organic practices. I mean we did so much the old-fashioned way, without any sprays or toxins. And yet our farmer, Charlie, could still not call his farm organic because he could not afford the certification. But he did talk to people about his methods and that satisfied them. Organic is important for our health, but local is too, particularly for the health of the community. Local foods, especially organic ones, just usually taste better and are more nutritious, because they haven't been sitting on a truck across country for any number of days. Fresh is flavor and nutritionally better."

Hope that helps and doesn't just add to the confusion!

Sunday, November 8, 2009

non-food birthday rituals

My daughter celebrated her fourth birthday at school recently. It's a Montessori school with kids from ages 3-6 in one classroom. The school has a "low sugar" policy, and I'm not exactly sure what that means, but part of that is there are no sweets and treats for birthdays or special occasions. I also don't have to deal with bags of candy for each holiday from her little classmates. (M certainly gets "sugar" in the lunches I pack, with a home-made cookie or rice-krispie treat or jello about half the days along with her cherry tomatoes or cucumber salad and left-overs...)
The parents are invited to celebrate the birthday with the child, and I don't think anyone missed sweets at all. In fact, it was a lovely celebration of M's life. The children all sit on the floor while the birthday child walks around a candle once for each year of her life. The parents are invited to share a special story about that year and the children sing a lovely song. It was all very special and more of a celebration than a tray of quickly consumed cupcakes might have been. M had cupcakes at her party and cake for the family celebration in case any of you worry that she is being deprived! :)
We incorporate sweets and treats in our menu planning, and I guess I am thankful that the school doesn't have a constant parade at all hours of sweet treats. I know that their snacks offer protein, fat and carb and I get to pack her lunch. (We offer sweets during certain snack or meal times with a protein if possible like a glass of milk so it lasts longer and doesn't spoil her appetite.)
You might find out what your school or childcare does. I would worry if the policy on food is too strict. If the school tries to limit portions of foods (in the name of health or "obesity prevention") or serves snacks with only carbs (graham crackers and juice or water) with no fat or protein, I would be concerned. Also ask that the adults feeding your children don't enforce "growing food" before dessert rules, or make kids feel bad about the foods they eat. The adult's job should be to provide a pleasant atmosphere, limit distractions, help the children set out the food, and if possible model enjoying a variety of foods. They also need to adhere to the division of responsibility and not push your child to eat more or less than he wants to. (See and scroll down to resources under child care policy where you can download a PDF and bring it to your school or daycare if you have concerns...)

per request, another post about rituals with kids...

Sunday, November 1, 2009

training with Ellyn Satter

I will be off to Madison to train with my mentor, Ellyn Satter this week. I'm super excited to go down again this year and see the person who has been so influential in my personal and professional life. I'll be training in her Eating Competence Model (ecSatter) and learning more about working with adults.
Lots of the moms I meet tell me that they themselves struggle with eating or a history of an eating disorder. A great resource is "Secrets to Feeding a Healthy Family." As we try to teach our children to be competent eaters, sometime we moms need to learn it for ourselves.
I'll be back on the blogs after the 9th, or sooner if I can catch some downtime in Madison!