“The Well” blog at the New York Times has posted a new interview with pediatric endocrinologist Dr. Robert Lustig about his new book, the Fat Chance Cookbook, and about the possibilities for treating obesity in children with a better, less processed diet.
Two or three takeaways from the interview surprised me by echoing things I’ve either thought or written about here since my daughter became a Type I diabetic four years ago.
Almost always, we see an obese kid come in with an obese parent. And when the kid loses weight, the parent loses weight, because the parent actually changed what’s going on in the home.
We do something called “the teaching breakfast.” Every kid comes in fasting because we’re drawing blood. So they’re all hungry. They go to the teaching breakfast with their parents – it’s six families all at a communal table – and our dietitian spends an hour with them. The dietitian narrates exactly what’s on the table and teaches the parent and the kid at the same time….We make sure four things happen. No. 1, we show the parent the kid will eat the food. No. 2, we show the parent that they will eat the food. No. 3, we show the parent that other kids will eat the food, because they have other kids at home and they have to be able to buy stuff that they know other kids will eat. And No. 4, we show them the grocery bill, so they see that they can afford the food. If you don’t do all four of those, they won’t change.
Also, and I think this is my favorite:
…my wife is Norwegian… When she’s mad at me, she bakes…My wife has learned by experimenting that she can take any cookie recipe, any cake recipe, and reduce the amount of sugar by one third, and it actually tastes better…. And you can taste the chocolate, the nuts, the oatmeal, the macadamia – whatever is in it.
Back to the top, though, I’ve got to say I love the idea of the teaching breakfast. My one concern is the reality of time cost for families with school-aged children, because eggs and vegetables, two of the (sometimes) inexpensive staples of the UCSF clinic’s teaching breakfast, take more time to prepare than a bowl of cereal, and require more cleanup. On weekdays, that might be a real challenge, especially for families with two working parents and/or long drives to school. A lot of the families I know in this situation (long drives and no school buses being a common problem in Southern California) are used to tossing their kids in the car with some kind of makeshift breakfast to eat on the way–often resorting to bagels, pop tarts, or bananas, none of which are great choices.
Perhaps if the dietician showed some simple microwaveable 5-minute meals like oatmeal or an easy vegetable-filled frittata (with some of the yolks left out) that can be made the night before and refrigerated? The plain yogurt with fresh fruit idea is also quick and simple but not especially cheap–these days a quart of plain non-Greek yogurt goes for $2.50 at Trader Joe’s, almost the same as a gallon of milk, and costs even more at the local Ralph’s (west coast Kroger affiliate), but it serves only 4 if each serving is a whole cup. Cereal with milk is a lot cheaper–but it could certainly be better cereal, high in fiber and low in sugar and salt, and measured by the cup or on a scale before pouring it into the bowl to make sure you don’t get more than you think you’re getting.
Cutting up fruit and vegetables takes time that parents usually feel they don’t have. And berries, which don’t need cutting up, are relatively expensive fruits, even when frozen. So showing parents a couple of “instantly grabbable” ways to serve the less expensive fresh (or fresh-frozen) fruits and vegetables instead of Froot Loops might be key.
A simple “just wash and nosh” approach would probably be a good start. I know I generally rail against buying precut, expensive little baggies of manicured (and dried out) vegetables in the supermarket, but the big bags of “baby carrots” that don’t require peeling and are finger-food size would be an okay starting point to get kids and parents to think about vegetables as a good snack or even breakfast choice. My daughter lived on them for lunches (along with a PBJ on whole wheat and an apple) for most of her grade school years, and even though she has (and will probably always have) a mean sweet tooth, she still seeks out raw green beans, wedges of red cabbage, roma tomatoes and broccoli or cauliflower branches to break off, rinse under the tap and nosh on after school.
Filed under: books, breakfast, cooking, Dairy, DASH Diet, Diabetes, frugality, kid food, nutrition, shopping, Vegetabalia | Tagged: breakfast, childhood diabetes, childhood obesity, dietetics, Dr. Robert Lustig, healthy kids, nutrition, pediatric endocrinology, UCSF, vegetables |