Joey Wahler (Host): It's a common parental challenge. So, we're discussing meal planning for picky eaters. Our guest, Mikie Rangel, she's a clinical dietician in the Nutrition Clinic at Children's Health. This is Children's Health Checkup where we answer parents' most common questions about raising healthy and happy kids. Thanks so much for joining us. I'm Joey Wahler. Hi there, Mikie. Welcome.

Mikie Rangel, RD: Well, hi, and thank you so much for having me.

Host: Thank you so much for doing this. This is one that's close to my heart, the subject that is, because my wife and I have a three-year-old daughter who is already showing some finicky habits with eating—more on that in a moment. But, first, generally speaking, why do so many kids tend to be picky about food?

Mikie Rangel, RD: Well, it's such a good question to start with, because as you've just said, it's important for frustrated parents to remember that so many kids are picky about foods. It's a fairly common part of childhood. It does happen for a variety of reasons. At the most basic level, there are biological factors at play. Young kids tend to be naturally cautious about foods. And historically, this helped protect them from eating something harmful. It makes sense when we think about kids developing these tendencies, you know, around age two or so, when they might be starting to toddle off and explore the world on their own.

There's a natural fear of the unfamiliar, which is very protective. Some kids are certainly more cautious in life and some are more adventurous, and those cautious kids are often the pickier eaters. And developmentally speaking, kids have more sensitive taste buds than adults. Strong flavors, mixed textures, things like that can feel really overwhelming, especially to a child experiencing the world for the first-time.

You know, when we think of those foods accepted by most kids, they tend to be pretty basic and bland things, like pasta and chicken nuggets and fries—very basic, unthreatening foods. And finally, a desire for control often comes into play. Eating is one of the few areas where kids can assert some independence. Saying no to eating a food is an easy way for them to feel in control of their experiences.

Host: Interesting. Very interesting indeed, because you're pointing out some things there, Mikie, that don't necessarily have to do with the food as well as just the emotional development of the kids. So, let me ask you this. How can parents of picky eaters plan meals accordingly without cooking separate ones once they get to the point where everyone is, in theory, going to be eating the same meal?

Mikie Rangel, RD: Yeah. And this comes up all the time. Parents of picky eaters do not have to and should not become short order cooks. This just allows the child to get stuck in that comfort zone and keeps the picky eating really locked in long-term. The key is planning meals that are unified but flexible. We want to be considerate, of course, without enabling the picky eater.

I cannot overstate the importance of planning when it comes to family meals. It may seem like it takes too much time to sit and plan for the week, but I promise taking those 30 minutes or so to plan the week out and shop for everything that's needed just one time saves so much time and money over the course of the week ahead. It is nearly impossible to plan and prepare a balanced meal that can please the whole family starting at 5:30 PM. So with that planning, keep in mind that it's important to serve, like you said, just one meal for the whole family. We want to try to plan for at least three food groups at a meal. If we can increase to four, that's better. And gosh, getting all five food groups is a real A+ win. That would be a fruit, a vegetable, a protein, a grain, and a serving of dairy.

With those food groups in mind, consider that each person in the family should feel comfortable with at least one of those food served. If dinner consists of, say, chicken, rice, broccoli, maybe apples, and the option of milk to drink, one child might only want the chicken and rice, while the other one only wants the apples, but no one will go away completely hungry. We must remember that the division of responsibility when it comes to feeding is important. Parents decide what, when and where. Children though decide how much and whether or not to eat something. Once parents have prepared the meal and served it at the table, their job is done. They can focus on their own delicious meal, while the kid makes decisions for themselves. And if that decision is to not eat any of it, that's okay too. They can also choose to be hungry until the next planned meal or snack. And parents can rest assured that a child that chose not to eat will not perish from that one missed meal. And better yet, they'll be even more ready to eat the next time food is offered.

Host: And that's a great point you made there at the end, because we go through that quite a bit with our daughter. My wife is always leery of having her completely pass on a meal or not eat enough. And I try to kind of go with what you just mentioned, hey, you know, one meal that isn't a hundred percent is not going to do irreversible harm. So, what should parents do, Mikie, if their child refuses to eat something in particular like, say, vegetables?

Mikie Rangel, RD: Hot topic. Well, first, let me take the stress off of vegetables. Now, they are fabulous and everyone should eat as much as possible. However, they are but one tiny part of a person's overall health. The most important thing to think about is the big picture. When it comes to their health and development, kids can get the same important nutrients from fruit, the fiber, the vitamins, the minerals, the antioxidants. And the more stress we put on them eating, for example, vegetables, the more resistance they will likely have. We must think about that big picture. We must play the long game. Our goal should not be to force them to try broccoli one time or take just one bite, that really won't have much impact on their health and ends up creating negativity and a battle around food.

More importantly, we want them to feel comfortable sitting in a meal with all types of foods. Those they like, those they don't like, and have confidence to try new foods on their own terms. Now, in more practical terms, parents should continue serving vegetables regularly, even if they go untouched, because, of course, a child can never try what they aren't served.

Serve vegetables in different ways. We all know raw carrots and cooked carrots are totally different. Don't be shy about adding a little salt, maybe a different seasoning, maybe a little bit of cheese. If a child has only ever been offered plain boiled vegetables, they don't even know what they're missing from something roasted or grilled. Just keep serving that variety of vegetables with no pressure, no drama around them, and just let kids figure it out.

Host: How about practical or fun ways to introduce new foods to picky eaters?

Mikie Rangel, RD: Well, the first step is getting kids involved. Let them choose the new foods to try. Seek out recipes maybe on some kid friendly websites or books. Let them help with the preparation. Let them use like a fun and unique serving utensil to serve even you, if it's not them. Let them be the leaders and the teachers.

Ask kids to give you some ideas that would help other kids try new foods. They might come up with ideas for dips or sauces or adding cheese or cutting them into fun shapes. Ask them if there's any foods they've seen their friends eating that they're curious about, even if they aren't really sure they want to actually eat them. The goal isn't really about intake. It's about lowering resistance, reducing stress around foods.

And another practical strategy is to use a deconstructed approach when you're planning that one meal to satisfy everyone. Serve, say, chicken and rice and vegetables separately, instead of putting them all together in a stir fry. Have sauces on the side that each person can add as they like. Have some DIY options like taco night or pasta bar where everyone can add in the elements that they choose for themselves individually. And you might be surprised when randomly one day your kid does put lettuce in her taco, because it's just kind of what everybody's doing.

Host: How about knowing what's " normal" picky eating, and when it's something more than that? Where's the line would you say?

Mikie Rangel, RD: Yeah. Picky eating does exist on a wide spectrum. And most of it, of course, is completely normal. So, normal picky eating will start around age two to four. It may come and go in phases. Kids may only want the same thing for several days, and then completely reject that and move on to something else. They may eat really well one day and hardly anything the next. It's pretty normal for kids to prefer fruits over vegetables. They usually don't like a lot of meat. They might dislike foods mixed together like soups or casseroles.

With typical picky eating, kids will accept at least two to three foods from each food group. And now, here, I'll count fruits and vegetables as one group. They eat enough foods over the course of the days and the weeks to grow and have energy. With typical picky eating, kids can sit at the table and find something they like from the variety that's offered and confidently pass on the foods they don't want just then. They might also eat better away from home. This is about social norms. When they're at school or at a friend's house, they might eat things to fit in that they wouldn't normally eat at home, and that's just a compliment to parents. That just means that they feel confident in your love and acceptance, and they can be their most authentic selves at home.

Now, some signs that might be more concerning, so kids that eat fewer than, say, 10 to 15 total foods altogether. Kids that reject entire food groups; again, considering fruits and vegetables as one group in this case. Kids that cannot even sit at the table with unaccepted foods or have intense reactions like gagging or vomiting or real emotional panic around food. Kids that will only eat one brand of a certain food. Like they'll eat chicken nuggets, but only that brand and that package cooked in that way and that shape, or maybe certain colors or textures. And ultimately, when kids lose weight or are having poor growth due to their intake, that's a concern.

Host: Now, our daughter's food tastes are what I would call a moving target, oftentimes. You sort of alluded to this, right? What she loves today, she may not the next day or the next week, and vice versa. So, it seems like one thing you're saying here, am I right, is your reaction should not be, "Well, you liked it the last time I gave it to you." So, what should you do if all of a sudden the kids' tastes change regarding a certain item?

Mikie Rangel, RD: Yeah, great question. So, rolling with it is exactly what you should be doing. This is where we're getting away from catering to the child. Once you've served chicken and rice and broccoli and apples, because you think maybe apples were that one thing that she was going to eat because she's been eating them, and all of a sudden she doesn't even want that, just ignore the behavior. Just say, "Gosh, I still love apples. These are great. Love how crunchy they are," and mind your own business with your food and let her figure it out. The more attention it gets, the more likely they are to think, "Huh, this behavior is interesting. Maybe I should keep this up." Once you've served the food, your job is done. Let the kids figure it out.

Host: Gotcha. How about negotiating with your child? "If you eat this, we'll let you have that."

Mikie Rangel, RD: Yes. Things like that. Like, the negotiations or the one bite rule, yeah, definitely something we want to avoid. This seems like it's working in the short term, because they ate the food. However, it's not building any trust or any autonomy for the child. They're just doing that to get the thing. And now, all of a sudden, the broccoli or the chicken or whatever it was seems like this negative thing they had to get through to get to the reward.

Kids need to be able to take the food on their own terms. Again, parents serve, kids eat. That's how they develop trust and curiosity and confidence. A child that has been bribed into eating something certainly isn't eating it for the joy of food, and that's what we're trying to foster.

Host: How about the best way to explain to a child, especially if they're younger and may not completely understand that sweets or other junk food aren't good for them, and that it's in their best interest? Not necessarily to never have it, but to not have too much of it.

Mikie Rangel, RD: Yeah. So, the first-line of defense is just not having it around all the time. When we stock our house with cookies and candy and ice cream and chips, we should not be surprised when our child asks for them and wants them. And, you know, if you offer a kid carrot sticks or Cheetos, inevitably, they're going to go for the Cheetos. Those are those, you know, tasty, salty, sweet, crunchy things that are just pleasing on the taste palette.

What we want to do is present our kids with those healthy foods day in and day out. Stock the fridge and the pantry with only healthy options, but introduce those treats in moderation. Maybe Friday nights, we go out and everybody gets an ice cream cone. And we talk about how tasty it is and how sweet and delicious. Certainly when we're at a birthday party and we have a piece of cake or we have chips at the barbecue. It is just a normal part of intake. We don't have that battle every day because it's stocked in the house. And when they come around, it doesn't feel as much of a this or that. It's just part of the intake that we're all eating. Focus when you're eating food also on how tasty it is, how delicious, how much you love that milk helps your bones, and fruits and vegetables help keep you healthy and those messages will get through.

Host: That's great advice indeed. Couple of other things for you. How about one mistake from your expertise that parents commonly make with picky eating kids and how they should address it?

Mikie Rangel, RD: Well, thankfully, we've covered a couple of good ones, which is the short order cooking, and the one bite or the bribing. But another big mistake is just excessive snacking. Kids that graze all day long will never develop true hunger. And without hunger, there's very little motivation for a picky eater to try new foods.

Now, of course, it's appropriate for kids to have snacks, but these should be planned. They should be intentional. They should be served at the table at a predictable time, and never within about an hour and a half to two hours of the next meal, depending on their age, of course. Younger kids eat smaller portions and they might need to eat more frequently. But we want to give kids time to get hungry before food is served. So, we need to limit any intake leading up to the meal. A hungry kid is much more likely to try a new food than a kid that's not hungry at all, because they just finished a handful of crackers.

Host: It certainly makes sense there. And finally, in summary here, Mikie, for those joining us that are wondering, "Okay. This all sounds great. I think there are some issues here that I haven't been able to nip in the bud," what should parents do? Where can they turn for help?

Mikie Rangel, RD: Yeah. If parents have some true concerns, the first step would be to bring it up with the pediatrician. They see lots of kids every day with lots of different eating habits, and they have a pretty good handle on what's typical and what may be more serious. Remember, growth patterns are going to matter more than food lists, especially in the short term. Their intake is generally going to change over time, and it's overall intake that's going to matter to their health. If there are deeper concerns, ask about seeing a registered dietician or even for a referral to feeding therapy.

Host: Well, folks, we trust you are now more familiar with meal planning for a picky eating child. Mikie, valuable information indeed, stuff that all parents for their kids can certainly take advantage of. Keep up all your great work. And thanks so much again.

Mikie Rangel, RD: Well, thank you so much for having me for this very important and timely topic.

Host: Yes. Important indeed. And to learn more about how to build healthy habits and make lifestyle changes as a family, please visit childrens.com/healthyweight, W-E-I-G-H-T. Now, if you found this podcast helpful, we ask that you please rate and review it or share the episode. And please follow Children's Health on your social channels as well. And thanks again for being part of Children's Health Checkup.