FMF #11 addressed a Centers for Disease Control study¹ reporting the 2003-2004 overweight incidence to be 17.1% among US children and 66% among adults. How can we take such data seriously without being sent off on a witch-hunt? As emphasized in FMF # 6, standard early-intervention approaches�perceiving a child as overweight, being concerned about it, and restricting a child�s food intake,make children fatter, not thinner.^2,3

To help without harming with child overweight, attend to the how, not the what of feeding.

Emphasize providing, not depriving The first order of nutritional business for children is getting enough to eat so they can grow and develop. When children, either at home or at school, aren't sure of getting enough to eat at dependable times they are preoccupied with food and overeat when they can. In all the frenzy around stripping schools of calories, we mustn't forget to compensate with nourishing, enjoyable and well-timed school meals that fill children up.

Emphasize structure The structure of meals and sit-down snacks reassures children of all ages that adults will look out for them. (See FMF #4) Current patterns harm more through loss of structure and support than through poor food selection. A deliberate sit-down family meal at a fast food franchise is great. Off-handedly whipping through the drive-through and tossing a bag in the back seat is not. It's simply good parenting to structure food availability so children save their appetites for meals and not spoil their appetites by letting them have unlimited access to drinks or snacks�of any kind.

Avoid food restriction in all its forms Food restriction makes children fatter, not thinner.^2,3 Current ''indirect'' approaches to child overweight represent food restriction: Encouraging increased intake of low-caloric-density foods (fruits and vegetables, whole grains), decreased intake of high-calorie foods (high-fat, high sugar) and restriction of portion size. (See FMF #3) The alternative: Offer a variety of food at structured times and let children serve themselves. (see FMF #5)

Encourage judicious use of high-sugar, high-fat food Children who are forbidden to have sweets and high-fat snacks eat more of them and are fatter than children given regular access.⁴ Good parenting with treats gives regular access by including snack-type food at regular, sit-down meals and snacks, but doesn't let children graze,on those or any other food or drinks.

For more information for parents about optimum feeding to help children grow up to get bodies that are right for them, see Your Child's Weight: Helping Without Harming.

Reference List

1. Ogden CL, Carroll MD, Curtin LR, McDowell MA, Tabak CJ, Flegal KM. Prevalence of Overweight and Obesity in the United States, 1999-2004. JAMA. 2006;295:1549-1555.

2. Faith MS, Berkowitz RI, Stallings VA, Kerns J, Storey M, Stunkard AJ. Parental Feeding Attitudes and Styles and Child Body Mass Index: Prospective Analysis of a Gene-Environment Interaction. Pediatrics. 2004;114:e429-436.

3. Faith MS, Scanlon KS, Birch LL, Francis LA, Sherry B. Parent-Child Feeding Strategies and Their Relationships to Child Eating and Weight Status. Obes Res. 2004;12:1711-1722.

4. Fisher JO, Birch LL. Eating in the absence of hunger and overweight in girls from 5 to 7 y of age . American Journal of Clinical Nutrition. 2002;76:226-231.

Family Meals Focus by Ellyn Satter, MS, RD, LCSW, BCD. discusses trends, research and clinical issues in eating and feeding and interprets other research from a feeding-dynamics, eating-competence perspective. For past issues of Family Meals Focus, click here.

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