by Charles Stuart Platkin

I was in the supermarket the other day with my 4-year-old daughter. As we were walking down the dairy aisle, she saw a yogurt with a cartoon character on the container, and she wanted it bad. No big deal, right? Yogurt is healthy. Well, this particular yogurt was filled with added sugar and loaded with calories. Raising nutritionally intelligent children is no easy task, but you have to start them young. How young? I reached out to a few experts to find out.

How young do you start teaching your children about healthy and unhealthy foods?
You have to start early. "Nutrition begins with the parents. Some studies indicate that a child's taste starts to be established based on what a pregnant woman eats," says Shari Barkin, M.D., M.S.H.S., professor of pediatrics at Children's Hospital at Vanderbilt University.

"I believe that we teach by what we model, and this occurs from the day our children are born. For instance, breast-feeding mothers who eat a variety of foods such as fruits and vegetables have breast milk that changes in flavor. Research suggests that this variety in flavor leads to greater acceptance of foods when solids are introduced," Joanne Sorte, M.S., director of the Oregon State University Child Development Center.

Try to "make your baby's first foods real foods, such as fresh fruits and vegetables.  Select the foods you most want them to eat as older children and begin these foods early on.  This helps children acquire a taste for real, wholesome foods.  When children grow up with the taste of real food, this starts them off on the right nutritional track.  Then, when they get into preschool and the real world of junk food, their tastes have already been shaped.  These children learn to associate good food with good gut feelings and junk food with junky gut feelings," says William Sears, M.D., pediatrician and co-author of The Healthiest Kid in the Neighborhood: Ten Ways to Get Your Family on the Right Nutritional Track (Little Brown, 2006).

What else can parents do?
"You can teach your children about good nutrition by what you decide to prepare and serve. They learn to eat the same foods that you eat," says Sorte. 

You can also stock up on books and DVDs to reinforce the health message. For instance, Sesame Workshop has created some great DVDs and a book series called Healthy Habits for Life, including Get Moving with Grover, My Healthy Body, Healthy Foods and Happy Healthy Monsters Head to Toe! They're all part of the Healthy Monsters series - and they're great.  (visit: www.sesameworkshop.org/healthyhabits). Another book is Treasure Hunt with the Munch Crunch Bunch by Jan Wolterman, Melinda Hemmelgarn, M.S., R.D. and J.W. Wolterman.

Plant a garden. Researchers report that if you plant a garden it will increase your kids' desire for vegetables and fruit.

How do you encourage preschoolers to try new and healthy foods?
Aside from leading by example, it's important to try and try again. Research has demonstrated that a child may have to try a new and healthy food up to 15 times before liking it.  "It helps to offer new food items relatively frequently. This makes the concept of new food seem routine and commonplace. It also helps if the new item is introduced alongside familiar and comfortable foods," suggests Sorte. You should also try preparing the food using different flavors and different cooking methods. Children respond to food texture, smell and the social surroundings. Sorte also recommends sampling new foods together as a family with planned taste tests.

Should you forbid certain "sin" foods (cookies, cakes, ice cream, candy, etc.)?
"There is no need to focus on healthy vs. unhealthy or good vs. bad foods if you are modeling healthy eating, because your actions speak more loudly than words.  To tell a child a food is forbidden when we all know it tastes good sends a confusing message," says Sorte.  In fact, she believes that forbidding particular foods is often an invitation for undue desire. "A better approach is to seek a reasonable balance. Any food can have a place in a healthy diet - when, how much, how often are the decisions of the adult," she adds.

Patti Scott, R.N., M.S.N., a pediatric nurse practitioner from the Vanderbilt School of Nursing, doesn't believe in forbidding any foods unless there is a medical reason. "If there is a birthday party or special occasion, let them eat cake! What I teach parents and what worked for me, is to just simply not have junk food in the house. They can't ask for something that isn't there. However, we had a balanced and rational approach so we could enjoy treats without making a huge deal out of them."

She recommends that instead of saying that a food is "bad," to tell the child about what good foods can do for his or her body. "All children want to be strong and healthy. Candies and other treats taste good but don't do anything good for their bodies. You can tell them that sugary treats can cause cavities if they don't brush right away, and that too many treats can cause a tummy ache. That is why we don't eat them every day." Another option is to find healthy alternatives that are still natural and tasty.  For instance, the Vitalicious Apple BerryBran VitaMuffins are great.  My daughter loves them, and occasionally has them as a snack. They are 100 calories, have 5 grams of fiber, plus vitamins and minerals

What about those times when you want to indulge?
Candy and other goodies like ice cream and cake should be treated matter-of-factly. If you rub your own tummy and say "yum" when you eat ice cream and not when you eat green beans, your children will think ice cream is best. If they see you eating a brownie instead of a granola bar when you're hungry and "on the run" they'll think that sugary treats are best, says Scott. You can also show them how you prepare your own healthy treats, such as making and baking some Whole Wheat Rocky Road VitaMuffins (see recipe).

What can you do when children go to day care or preschool?
Parents need to voice their opinions, explain their concerns and offer ideas to administrators to help identify healthy alternatives. Building good relationships with the care providers and discussing the foods the children eat will help support your food-family values.

What about using candy and sweet foods for rewards? 
"By using sweet rewards as motivators, adults are pretty much acknowledging that they are out of control of the situation," says Sorte.  Parents need to come up with other options and not fall into the food-reward trap - which is no easy task.

Scott offers the following alternatives: Playing at the park, fishing (real or imagined, with a bucket, stick and paper fish), play dates to the playground with just Mom or with a friends, story time at the library, making Play-Doh animals, making melon ball "people" (or snowmen or animals), then eating the melon. Stickers or even a nice big hug work, too.

Should I limit my child's television viewing? What if there are no commercials?  All the research shows that the more your kids watch TV, the more likely they are going to be overweight. "Commercials add to the hard sell of high-sugar and high-fat foods that put the big ouch into the diet. At the same time, watching lots of television means children are not being active, so it's a double whammy," says Sorte.  In fact, even if they watch educational programs and/or TV without commercials, they're still more likely to over-consume food and be less active.

When I take my child to the supermarket and he/she wants me to buy unhealthy foods, what should I do?
Learn the art of saying no - no matter what the consequences. But you should offer alternatives, and make sure not to take your children to the supermarket hungry.

"Parents can build positive habits during shopping trips by involving children in making the shopping list, asking them to keep on the lookout for needed items as they travel through the store, teaching them how to choose healthy foods like carrots, apples, oranges and potatoes.  If parents start right from the beginning to engage with children around food selection in a matter-of-fact, we-eat-healthy way, children will practice that kind of behavior in the grocery setting," says Sorte.

If my preschooler is heavy, should I put him/her on a diet?  What do I do? When should I be concerned?
According to Sorte, "Every eating pattern is essentially a 'diet,' but what you're asking is if and when should we make adjustments in food offerings to accomplish weight reduction. In some ways the jury is still out on this issue. Investigators suggest that we don't have enough information to make specific judgments related to the weight issues of individual children: How much do individual and familial (genetic) growth patterns affect the child's rate and pace of growth and development, including weight gain? However, the coast-to-coast opinion is that overweight and obesity in very young children is present in all of our communities and has increased from 5 percent of the preschool population in the 1970s to 10 percent in the year 2000.

"Consider the balance of food vs. activity in your child's life. If food is predominant, make adjustments in the family lifestyle: Serve food in smaller amounts overall (keep from cooking more than the family needs for a meal so the idea of second helpings is reduced); offer treats like ice cream in tiny dishes; choreograph slow-paced mealtimes so children have time to feel food working; create a plan for after-dinner time that does not include TV (host family pingpong time, go for a moonlight stroll, play games) and use these fun events to distract children from food and inactivity."


Encouraging Healthy Eating in Preschoolers – Tips for Parents
From Nutritionist Kati Chevaux, M.S. of preschoolrock.com

1. Eat healthy yourself. Setting a good example is the best way to help a preschooler develop healthy eating habits.

2. Stock the house with nutrient-dense foods. Leave the treats and candy for special occasions. Preschoolers have a way of wearing you down to get the goods if they know cookies and candy are hiding in the cupboard.

3. Provide a few items, including at least one nutrient-dense choice, at meals and snacks instead of one highly palatable food. For instance, setting out a snack plate with a few apple slices, some nuts and a couple of whole-grain crackers is better than offering a whole bag of snack crackers.

4. Turn dessert into a family event. Instead of always having a gallon of ice cream in the freezer or cookies in the cupboard, pick a night each week to go out for ice cream or a smoothie. And if you can walk there, it's a great way to get out of the house for some exercise.

5. Take advantage of snack time. Instead of the standard crackers and juice, offer fruit, edamame (boiled soybeans), nuts or veggies with dips like guacamole, bean dip, hummus or nut butter. Nutrient-dense snacks like these can go a long way toward your child's nutrient goals, so it's OK if they make a meal out of the snack. And it can help take the pressure off finishing the vegetables at dinner.

6. Add nutritious goodies to their favorite foods. Cheese tortilla a favorite? Replace some of the cheese with black or refried beans or add diced tomatoes. Do they like a certain soup or stew? Lots of vegetables can be added without drastically changing the flavor. Pancakes might be a hit. Add berries or make whole-grain pancakes by substituting oatmeal for part of the flour.

7. Be flexible. Make an effort to eat healthy most of the time. If you do, you can feel good on those special occasions when your preschooler enjoys food just because it's yummy.

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CHARLES STUART PLATKIN is a nutrition and public health advocate, author of The Diet Detective's Count Down (Simon & Schuster, 2007) and founder of DietDetective.com, the health and fitness network. Copyright 2007 by Charles Stuart Platkin.