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Amanda Wilde (Host): Healthy eating can be a challenge and feeding kids can be stressful, especially if you have a picky eater. Dietician, Lisa Olson is here to share recipes for nourishing good eating habits. This is Lemonade, the Family Medicine podcast from Mitchell County Regional Health Center. I'm Amanda Wilde. Lisa, so many questions about how to make mealtimes pleasant and nutritious. Let's start with the basics. How should we think about what goes into making a good or healthy meal?

Lisa Olson, RD, LDN, CDCES (Guest): So, when we consider healthy, we typically just think about exactly what you just said, what. However, food is more than just calories in calories out. It's more than just what we eat. Food is emotional, it's cultural and it's relational. And when we take this wider angle approach and consider more than just what we eat, but the how and the when of we eat, we eat better.

Host: So, we should approach mealtime in a very holistic way, it sounds like. And is that about what makes us feel good emotionally? What we're sharing culturally and relationship wise?

Lisa: It's about all of that. Often we reach for food because it's a cold winter night and we're wanting to warm ourselves up. It's not about the calories. It's not even really, exactly about the what. It's about the emotional response we want out of that food. And when we understand that and we approach our food and our eating, honoring that, it allows us to eat in a way that feels good; that allows us to eat in a way where we are joyful about eating. We are relaxed about eating. And what research tells me is that when we approach food that way, we actually eat better. We have less health issues. We have less issues with overeating and undereating and wild eating. We have more strength in our eating because we're eating in a way that honors our whole self and not just our physical bodies and our calories in calories out.

Now with that, we still want to be structured with our eating. I don't recommend eating anything you feel like all the time. That definitely doesn't lead to healthy food relationships. So, we still want to be structured with our eating, but within the context of that structure, giving permission to be joyful about our eating and eat foods that taste good to us, that are culturally, you know, we're in the Midwest. A lot of people love their meat and potatoes. And I hear people these days feeling really guilty about eating meat or eating potatoes, and yet we still reach for them over and over and over again, because those are the foods we grew up with and those are the foods we really want. And when we honor that instead of try and condemn that we actually do better with our eating.

Host: So, how do I honor that? I'm going to make dinner tonight with three kids. I want meat and potatoes, like you said. How do I approach meal time with all that in mind?

Lisa: You make meals that sound good to you. My general rule of thumb for a good meal is you want to include at least three things. You want to include some kind of protein. Meat falls really well into that. Some kind of starch, at least one, sometimes two, especially for kiddos. The starchy foods tend to be what they feel most safe and comfortable with.

So sometimes you need more than just one starch, but at least one starch. So potatoes, and then I recommend including a fruit or vegetable with every meal. Potatoes kind of double up because they are a vegetable, they're a starchy vegetable, but they are a vegetable. So you know, a meat, a potato and apple sauce, or canned peaches can make a real easy, real, simple, real enjoyable meal.

Host: And so we would call that a well-balanced meal?

Lisa: Yes.

Host: Great. And what are the most important things to know when we're considering feeding our kids?

Lisa: So, when we look at feeding kids, it's really tempting to treat them as little eating machines. And if we can just get the right foods in the right amounts into them at the right time, then they will have the right bodies and the right minds and the right attitudes, because we all know kids get hangry. And it'll just, everything will go great. The problem is, kids aren't eating machines. They're people, they're human beings with all kinds of emotions and opinions, and they don't want to eat the right foods in the right amounts based on what we think. And so instead, what I recommend is using, it's called Satter's Division of Responsibility in Feeding. It's a framework that helps us create an environment that supports our kids in being successful with their eating and developing a healthy relationship with food, with their bodies and with us in a way that is positive and joyful and really relaxed. It's a model that's recommended by the Academy of Nutrition and Dietetics. It's recommended by the American Academy of Pediatrics. And it takes a lot of the guesswork out of feeding kids.

Host: So how do we create an environment that supports kids that way?

Lisa: So the concept is there are certain things you, as a parent are responsible for and there are certain things your kids are responsible for. And when we followed this division of responsibility, everything goes better. You as the parent need to take the leadership and you are responsible for what. You decide what's for dinner, what's for snack. What is coming into the house? What is for the meal? You're also responsible for when. Being considerate of making sure most kids need to eat at least five to six times a day. So, making sure the when of our meals is working out well. And then you're also responsible for where is food going to be eaten?

Is it at the table, on the couch, in the car? You, as the parent decide what's for dinner, when we're going to eat it and where we're going to eat it. And then your kid is responsible or kids are responsible for deciding from what's on the table or from what's available to them, what they're going to eat and how much they're going to eat. So, parents don't ask, what do you want for dinner, and then tell their kids, you need to eat more, or you need to eat less. Parents are deciding this is what's for dinner. And the kid is deciding, this is how much I want to eat.

Host: And the kid sometimes says, you know, I don't really like anything here. And I guess that leads into me, like how do we avoid mealtime drama? We've all experienced it. Or is that just baked in so to speak?

Lisa: There's certain elements that are baked in because we're people, but the best way to avoid that mealtime drama is being considerate without catering. This is especially challenging if you've got a picky eater who maybe only likes a handful of foods. You as the parent, then need to take this into consideration. Take a moment to say, okay, I know they really only like maybe mac and cheese and chicken nuggets, but they also eat bread. So, all of a sudden bread becomes a part of pretty much every meal. And you have this happy out where you can say, you don't have to eat anything. It's your job. I know there's something here that you can eat if you want.

And if not, there's a snack coming up in a couple hours and they can eat then and it takes that pressure out from them. And so they have an out. They can look and decide, you know, I want to try what the family is eating or no, I don't, but I'm not going to starve because there is something here that I can eat and fill up on.

Host: Now a lot of parents, and in my era, my mom always told us, take three bites, which meant three, not just bites, but three green beans or three, whatever it was. How do you feel about that kind of encouragement?

Lisa: I really caution parents against the bite rules. It can very quickly backfire, especially if you have a kid that's got a strong personality or that, that stubborn personality. Yes for a kid that's maybe a little bit more compliant, you'll get them to eat, but they may not actually like the food. And often they end up associating that food in a negative way. Nobody wants to be pressured. As an adult, if I told you, you had to try brain, would you want to do that?

Host: I can definitely say no to that one.

Lisa: And so for our kids, they look at these foods, these vegetables, these things that mom or dad made and they go, eh, it probably looks a little bit like brain to them, or feels really scary to them and being forced to eat it puts you as a parent in a position that's, it's really a hard position because unless you're willing to actually forcibly feed your kid, which is not a good idea, we don't recommend that; you end up in this power struggle, potentially.

And so instead I encourage don't say anything, not a single thing. Serve it, eat it yourself. Enjoy it. And let them just be a part, let them watch you. In their own time, kids want to grow up and be like their parents, especially little kids. They want to grow up and be like their parents. They want to grow and be able to eat and they will push themselves along when given that opportunity day in and day out and observing and seeing how much you enjoy your green beans. Now you've got to enjoy them. Not in a pretend way, but in an honest way. When you enjoy that, they're going to see that. And they're going to want to experience that and different kids will want to experience it at a different rate. Some kids are real adventurous and will be like, yeah, let me try that, and other kids may not for years, even. But in the long run, they're going to maintain that healthy relationship with you and that positive memory of that food. And when they're ready, they'll explore it on their own.

Host: So, when we talk about how to raise good eaters, it sounds like it's pretty important for us to lead by example, rather than get in that war of the wills. We have to shift our thinking for positive outcomes. And as you said, eat what we enjoy and show that we enjoy it.

Lisa: Yes. That's one of the biggest things I encourage people and parents to do is make food that you like. Make meals that are enjoyable for you because when you have a healthy relationship with food, when you're enjoying your food, when you want to eat, it shows. Kids pick up on that. And even if they don't, you're at least enjoying yourself. You didn't go to all this bother of making this fancy meal that you don't really like, and that then nobody eats because that is super frustrating. And kids pick up on that too.

Host: Yeah. And I'm thinking of a mom friend of mine now. How many would you recommend dealing with this? She herself doesn't like vegetables at all. She wasn't, you know, a lot of us don't have great eating habits as adults. So, how do we finesse that at meal times?

Lisa: So, you start with deciding what is important to you and not putting an expectation on your kids that you're not willing to take on yourself. So, if you look and you go, I don't like vegetables and I have no desire to like vegetables, then don't expect your kids to develop that. If you're looking and go, I want better for my kids. I want my kids to be able to eat and enjoy vegetables, even though I don't. Then you, again, you start with yourself and you start to learn how to make vegetables enjoyable. I didn't grow up eating vegetables. I thought they were gross. We had a garden and I loved growing them. And then they would get to the table and I'd be like nope. No, thank you. And then I became a dietician and I was like, I'm going to be a bad dietician. I don't like vegetables. I need to figure this out. And I taught myself to like vegetables. I explored different preparation methods. I started including them in things that I already liked. I started playing around and finding things I honestly liked. And from there, I grew for a love of vegetables where if we don't have vegetables, once, twice, three times a day, it's a rare day in our house because we honestly enjoy them. And that joy is what drives our eating of those vegetables. And we know from research people who enjoy their food do I eat better and you can have an agenda with yourself and teach yourself to like those things.

I also didn't grow up drinking milk and I taught myself to drink milk with cookies. I sat down with a big stack of cookies and like half an ounce of milk. And that's how I bribed myself into drinking milk. And now I love milk. And I honestly love it because I taught myself to love it because I wanted to. And so that's the best place to start as a parent. If you look and you go, I want better for my kids. I want them to eat better than I do. Then start teaching yourself to eat better and do that in front of your kids. Let them see you try things and allow them to try it and grow alongside you.

Host: What a great way to approach it. I mean, I love that story about your own family and how you came to like vegetables. Maybe it was in the preparation cause it obviously was there for you to choose from, but trying different preparations. Putting the things you may not like, but do want your kids to eat into things that you already like, are really good examples of how we can sort of start incorporating those foods into our own diet.

But then we have what we love. The kids love and adults love sugar. What about those kinds of foods? I mean, do we limit them? Do we ban them all together for ourselves and our kids? What's the best way to approach those kinds of foods that are really pretty junky?

Lisa: Yeah, I hear people call them junk all the time and they, I like to come back with, well, are you digging it out of the garbage can? And I always get the strange look because unless you're literally digging it out of the garbage, I really caution people against calling any food garbage or junk. Personally, I love sweets. My daughter is two and a half. And when you ask her what her favorite food is, she'll say sugar. She loves sweets too. We really enjoy them. And when we attempt to ban them altogether, we actually set our kids and ourselves up for failure. You can't avoid sugar in our world, unless you've locked yourself up at home, which I guess is now kind of an option. But, you can't avoid sugar.

And so instead, learning how to develop a healthy relationship with sugar is really the key to this. What we recommend for that is and again, I default to parent taste preference here. As often as you, as a parent, want to have sweets, you need to have sweets in your house. If it's meal time, we recommend serving one serving of dessert with the meal. Everybody gets just one serving. So, we are limiting our portion there. We serve it at the beginning of the meal for everyone. I've really enjoyed watching my daughter explore this because she's two and she knows nothing different. And I always eat dessert at the end of the meal. That's how I grew up. That's the right way to do it.

You eat dessert at the end, but we serve dessert right with everything else. And she sometimes eats it at the beginning. She sometimes eats it in the middle. Sometimes she doesn't even touch it. Even though sugar is her favorite food. She just doesn't want it that night. She'll sometimes dip her brownie in her ketchup, which I think is gross, but I let her do it.

And it's just another part of the meal. Sugar isn't something extra special. It's just a part of the meal. And when we shift our focus to sugar is just a part, it loses some of that power over us. And then on occasion, we serve something sweet as a snack all by itself, and we allow it in unlimited amounts. So, it often looks like a plate of cookies with a glass of milk. It ends up being pretty balanced. Milk's a great, it's my favorite go-to. It's got carbs. It's got fat, it's got protein. It's perfectly balanced. It kind of makes an easy fill in the gaps. And typically it's a day where it's a cold day and we wanted to make cookies.

So, we make up cookies and I make up a whole pan of cookies and we sit down with a plate and sometimes, she'll eat a cookie and be done and want to go play. And one time, I will never forget she ate nine cookies. And my dietician mom heart just about stopped. Cause I was like, you're going to have a stomachache. How in the world are you doing this? They weren't very big cookies, but like she ate nine of them and I was counting and I just didn't know what to do. And she was fine and she was perfectly and completely and totally fine. She didn't have a stomachache. She was just apparently really hungry. And so she ate a lot that time. And like I said, the next time she ate not even a whole cookie and she was done.

Sugar doesn't have this special place. It's just another food. And that is one of the most powerful things we can give our kids or even ourselves where sugar no longer has that power over us. That dry, gross donut sitting in the office that nobody's eaten, doesn't call to you because it's sweet because it's not good.

And so you don't need it. It's not good. And when it's. You eat it and you enjoy it. And then you move on with your life and it doesn't hold this magical power over you anymore.

Host: But isn't sugar one of those things that the more we eat it, the more we crave it?

Lisa: It actually isn't. It's one of the big myths out there. I hear a lot of people talk about sugar addiction, or if you just cut it out, then you will lose your taste for it. We do know that if we have a lot of concentrated sweets, our taste buds kind of adjust and it takes those concentrated sweets to really taste sweet.

People who do a lot of concentrated sweets will tell me, well, fruit isn't really that sweet. Well, actually fruit is really sweet. You're just used to really high, high, high sweet taste so you can't taste that flavor anymore. But sugar doesn't actually have addictive properties. Often, it's the restriction or the attempted restriction of sugar that causes that. It's that old adage of, if I tell you don't think about elephants, what pops into your mind?

Elephants. And the more we restrict it, the more it creates this desire for it. The less big deal we make about it, the more we just include it comfortably, the less power it holds over us. I did a personal experiment when I was first learning about this with chocolate. I love chocolate. And I had always restricted my access to chocolate for fear that I would just go crazy.

And so I got a big old bag of chocolate and I stuck it in my desk drawer. And every time I wanted chocolate, I just had chocolate. I don't generally recommend doing that, but I was doing an experiment with myself and over the course of a couple months, I started to lose my taste for chocolate. I just stopped wanting it because I had access to it all the time and it wasn't a big deal anymore.

And I was a little sad because I enjoyed a piece of chocolate as a stress reliever and it just stopped being something special for me. And so, again, especially with kids, if we can keep the food neutral. In our family, we don't talk about treats. Treats are for dogs. We have dessert, but it's not a treat, it's just dessert.

It just is. And we take that power out of it by how we talk about it. And so again, sometimes the dessert sits on the plate and doesn't even get eaten because we're just not in the mood for it. And it's okay. And psychologically is where we fight that battle, not in a restrictive food manner.

Host: Oh, that's so interesting. I'm thinking about though, like when I take the kids out to a carnival or something, and there's all kinds of rotten food there like, we won't call it junk or garbage, but there's all kinds of sugared, you know, food there that I don't want them to have like cotton candy that just somehow it's so fascinating. It looks great. Are you suggesting, you know, that we allow that to demystify it? Or how do you deal with those sort of forbidden food situations when you're out with kids or with your kids are at someone else's house?

Lisa: So, it starts in your own home and it starts with yourself. So, you made the comment of, that's not something I want my kids eating. You can have that conversation, real honest with your kids, if they're old enough of, you know, what that food is straight sugar and I don't want you eating that. It's not a bad food. But straight sugar really doesn't strengthen our bodies and I'm just not comfortable buying that for you. That is a conversation you can have. In general, I encourage parents work through of allowing their kids to have those sorts of things on occasion, but planning accordingly. So, you know, cotton candy, funnel cakes, those sorts of things, they are just pretty much straight sugar.

And if that's your snack, your kids are going to crash and be crabby pretty quick. And so planning ahead. And having more of a balanced snack, something that includes some protein as a combination with it, a compliment to it or beforehand, and then saying, yeah, you know what let's do this as kind of piece of our snack or to give them the option of we're at a carnival, you can have this many tokens, you can spend it on whatever you want, either on the food or on the games and let them make that decision. Trust them with that, you know, depending on their age either explore that or not. It's hard when they're at other people's houses. You're trusting other people to care for your kids, but also now one meal of sugar isn't going to kill them.

Host: Well, with quarantine, I think it's been particularly hard not to develop more bad eating habits when we're home all the time. Can you talk a little bit about feeding a family while on quarantine having its own sort of set of challenges?

Lisa: It is, most of us don't have access to food all day, whether you're on quarantine or maybe you're working from home, there's been a lot of snickering about COVID 19 pounds that people are putting on. And we have seen a lot of people gain a lot of weight because all of a sudden we have all this access to food.

And a lot of my recommendation goes back to really that division of responsibility and looking at are we being structured with our eating? Do we have planned meals and snacks? When you're stuck at home, you have to create it yourself. It's not being imposed on you by the school or by your work environment.

But create that. Have a time when you get up. Have breakfast, get dressed, have breakfast, have a snack, have lunch, have a snack, have supper, have a bedtime snack. Stick with that structure and that schedule, you may have to set the alarm on your phone to remind you or something, but stick with that structure for your eating.

And then when you sit down and eat, honor your appetite, eat the foods that you really want. Often when we're feeling stressed, we're reaching for different foods. That's okay. Go ahead and do that. Quarantine is a great time to do some food play, especially if you're not feeling sick. It's a great time to try that new recipe, to do that thing that you've always wanted to try, but it takes like four hours for it cook. And you're never home to do that. While you're home, so use that opportunity have fun in the kitchen, to stick with that structure, to honor and explore what do I really want and to tune out distractions. Typically we eat distracted. We're watching TV, we're on the go.

Well, quarantine is a great time to practice paying attention and to truly slow down. There's nowhere to go. There's nothing you have to do. Make that plate of cookies. Appreciate how it makes a whole house smell fantastic. Take a moment to look at the cookie before you eat it. To know that is the cookie the same all the way through, is it a chocolate chip cookie where there's a little more chocolate chips over here than over here?

Are you eating it when it's warm and still melty or has it set up completely? And those chocolate chips are providing a crunch factor. Take the time to notice, to enjoy and to stick with that structure. So, you don't have the temptation to graze all day long. And that takes a lot of, again, that power out of the forbidden foods or those danger foods that we're always afraid of because you only have certain times to eat them.

And then you eat them in the amount that you want without distractions. You're going to get bored eating before you get to a point where you eat through, you know, your whole stash of chips or your whole batch of cookies because you're not doing anything else. And your body's going to naturally help you maintain a healthy amount of food because you're not going to want to eat until you're uncomfortable. And that, structure really helps with it.

Host: Yeah, the structure, but the play within the structure and finding that joy in food and really enjoying our meals sounds like a good recipe for a successful family mealtime.

Lisa: That's exactly what we're after.

Host: These are great practical tips. You've given us plenty of food for thought, a lot to chew over. Thank you, Lisa.

Lisa: Thank you.

Host: For more information, check out our website at www.mcrhc.com. Thanks for listening to Lemonade, the Family Medicine Podcast from Mitchell County Regional Health Center. If you found this podcast helpful, be sure to tell a friend, subscribe, rate, and review this podcast and check the entire podcast library for additional topics of interest. Mitchell County Regional Health Center, your trusted health care partner for life. I'm Amanda Wilde. Be well.