Each day in clinic, as I meet patients and parents to discuss their child's ear, nose, and/or throat problems, I try to consistently ask if their child eats "pretty healthy." I keep the conversation light by asking if they are picky or not, if they eat vegetables and fresh fruits or not, and what they drink most of the time throughout the day. A 30 second to 1 minute conversation on this topic quickly tell me what I need to know: Is there an opportunity for this family and this patient to work on a healthier diet and dietary habits?
This blog is specifically focused on our preteen and teenage children. I have found through years of talking about eating habits with families that as parents, very few will allow young preschoolers and elementary school kids to skip breakfast. But once our children are in their teens, it's another story. This often comes up as I have conversation with parents and patients especially when the adolescent is severely overweight. I very frequently hear from teenagers and their parents that the teenager "skips" breakfast. When I ask why, there are no compelling reasons. Sometimes I am told they are simply not hungry in the morning, sometimes it's a matter of not making time or having time especially if they like to hit the snooze button. Other times even thought the teen can have breakfast at school, they don't want to because the food is "gross." In fact, what is really concerning to me are teenagers who tell me they skip both breakfast AND lunch!
One patient I met in December told me that she never eats lunch at school because the food is the same as what they feed prisoners! I said to her, "wow, how did you know this?" I have in fact read that here in the U.S. there are in fact same food suppliers that supply both our children's school and our prison system. What I never expected, was for this teenager to tell me, "The prison is connected to our school!" She meant it literally!
Here is the obvious. These patients, who are often obese, regularly skip breakfast and/or lunch, and then immediately after school are famished and will binge eat. Parents will tell me how hungry they are when the teens get home, and then late afternoon/evening and throughout the night the eating may not stop. I share with them concerns from a medical health standpoint as well as a eating behavior standpoint. I explain to them that of course, by not eating, blood sugar is low and many research studies have shown association between school performance and eating breakfast. We have all seen those commercials that show how eating breakfast leads to better weight control, this is because by eating regularly we avoid drastic fluctuations in blood sugar and our insulin releases. Bottom line, I know first hand how I am when I skip breakfast and lunch and then binge in the evening. I fully admit to my own hypocrisy when it comes to to eating regular meals. By sharing with families and patients who are old enough to understand me when I explain things, I try to emphasize how much better they will feel and function simply by eating. We then discuss options which are relatively easy and nutritional, based on their personal preferences. I share with them that 2 PopTarts are not what I have mind, that "eating something is better than nothing" may or may not be true since highly refined sugar in the morning does not exactly lead to the boost in brain function that I was envisioning.
In my experience speaking with parents and patients, I have continue to try and make positive impact and believe that every conversation about how and what we eat matters because usually I find our teens and their families are very interested in this topic and parents do want their child to eat breakfast and not skip meals. Through open lighthearted discussions, I have acknowledged with them that if the school lunch is really not good, nutritious, and/or preferable for the patient, then they need to commit to packing their own lunch. I discuss this in front of the parent and of course get parent engagement that they will help ensure a conscious discussion about what are the lunches the teenagers can pack for themselves so it's not one more thankless task for mom! There is no recipe that fits every teenager or every family, but hey, it's worth talking about at least and changing their habits.
Here is one recipe for a sandwich for lunch to try:
- 2 slices whole grain bread
- 3 - 4 tablespoons of hummus
- loose spinach leaves
- half of an avocado, sliced
Smear hummus on one slice of bread, place avocado slices in one layer on top of the hummus, top with loose spinach leaves. Wrap sandwich in aluminum foil, that may decrease it from getting completely "smooshed."
- Strawberry/banana/low fat yogurt smoothies
- Bob's Red Mill 10 grain hot cereal, with some milk/soy milk/tiny bit of maple syrup
- Whole grain or wheat toast with a hard boiled egg, or scrambled egg with some shredded cheese.
Of course, those ground flaxseed/whole wheat flour/oat bran muffins that I feature in A Healthier Wei. I try to give Claire fresh fruit with every meal, so hopefully there are fruits your child will want to eat some of the time.