The picky eater guide: Part 1. What’s the problem?

The Pediatric Insider

© 2012 Roy Benaroch, MD

Melissa, and many other parents, want to know what to do with kids who don’t eat what we want them to eat: “I was wondering your thoughts on ‘picky eaters’? I spend all day questioning whether I’m doing the right thing for my child (he’s almost 17 months). I’ve heard not to push them to eat because they will eat when they’re hungry. I’ve heard to make them sit there until they eat what you want them to. I’ve heard don’t offer them alternatives to what you’ve prepared. I’m really just confused and so flustered at meal times!”

Some perspective: for thousands of years, there was no such thing as a picky eater. When food is scarce, people ate what they could, and ate when they could. In fact, vestiges of that kind of primal urge to eat still lurk in our cravings for high fat at high sugar foods. We’re programmed to really want food of high energy density—that is, the stuff that gets us the most bang for our chewing buck. When faced with a meal of chewing some kind of celery precursor for 20 minutes, versus chowing down on fire-roasted meat, guess which one gets you more food energy for the effort?

The idea that we ought to eat a variety of things every day is also a relatively new concept. Until a few hundred years ago, people ate what they could grow or kill in their own backyards. Since then, food storage (yay refrigerators!) and food transport (yay roads!) has made it possible for us to have oranges from Chile in June.

In the developed world, we are swimming in food. Thousands of choices, easy availability, and it’s cheaper than ever. The good news: nutrition has never been better. The bad news: nutrition has never been worse.

The “better” aspect of nutrition in the developed world: we’ve got plenty of food, and people are getting plenty of calories. Those with economic disadvantages get free meals in schools and food stamps, and the cheapness of prepared foods makes it possible for just about everyone to afford to eat something. Also, vitamin deficiencies are pretty much a thing of the past. With a few exceptions, our food is so fortified with vitamins and minerals that it’s difficult to find people who aren’t getting the micronutrients they need.

But there’s bad news, too. The over-availability of food has led to a new health problem. About 1 in 3 school age children are overweight, and most of these kids will become overweight adults. Obesity contributes to diabetes and hypertension, and in many cases to short and unhappy lives.

In other words: the problem isn’t that Junior doesn’t eat enough vegetables or enough quinoa. The problem is that Junior is developing lifetime habits that are causing him to eat too much of everything else.

Next time, we’ll talk about those life habits, and how some misguided efforts to “fix” picky eating might make it more likely that obesity will become a problem.

For more perspective on how people used to eat, read Little House in the Big Woods by Laura Ingalls Wilder (featuring the “Pig Bladder” scene!) For a comprehensive and fascinating account of the history of human nutrition, try Terrors of the Table by Walter Gratzer.

 

The picky eater guide: The whole enchilada:

Part 1. What’s the problem?

Part 2. The “Don’ts”

Part 3. The Rule

Part 4. The jobs of parents and kids

Part 5. Special circumstances, vitamins, and a muffin bonus

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