Positive Interactions: How Friends Affect Our Health

Positive Interactions: How Friends Affect Our Health
By Laura Cipullo, RD CDE CEDRD CDN and Mom

I needed to keep my two boys as active as possible during their spring break from school. My intent was to safeguard their physical health—and my own personal mental health as well! We shared a fun-filled week. Although we did engage in some “brainy” activities like touring the Math Museum, we truly stretched our bodies and minds rock climbing.

 

Yup, thanks to my wonderful clients (they teach me things too!), I was introduced to indoor rock climbing. I have rock climbed in Colorado but never thought it would become an afternoon activity I could replicate here in NYC. Well…we did it…and will definitely be doing it again.

 

My “mommy” friend and I rounded up our children, and literally, up they all went! My older son Bobby has always been a little timid about rock climbing. He was about five years old the first time I introduced him to the sport…and he was positively terrified. As you might easily imagine, I was so very disappointed. I had paid for a full semester of mommy and son rock climbing! But now with some extra age plus the addition of his younger brother and his two peers, he just had to become highly self-motivated. Upon our arrival at the rock-climbing venue however, Bobby told me he wasn’t going to climb. Before I could say anything, my friend Abby said: “That’s okay. You can just watch.” Thank goodness she had responded to him first; it influenced me in a very positive way. I casually chimed in: “Yeah, don’t worry, you can just watch.” So, because the pressure had been removed, he decided to do it on his own. He saw the other three kids—including his younger brother Billy—happily putting on their harnesses and clipping in. I think he decided against letting his fears be the cause of his missing out on all of the fun. I also wonder if the fact that his friends were girls, and they were excited to rock climb, had any bearing on his decision. He even told the instructor he wasn’t sure if he was climbing. But, as soon as he saw the girls and Billy go up, he clearly said: “I’m next!” And he truly had the best time!

Wow! What a confidence booster for Bobby and real assurance for me about not pressuring my kids into doing anything they may not immediately embrace. Abby’s (the other mom) demeanor was great. When I thanked her for unknowingly helping me through the difficult earlier moment, she just laughed. And then she told me that if it had been her kids, she too would have been urging them to try and just do it.  So while I was supported by my peer, my older son also was supported by his peers. All four kids were climbing “rock stars”! I was so jealous. Now I’m planning to go back to climb there myself.

 

After two hours of rock climbing, the kids were famished and the moms were exhausted just from watching. When we all headed out to share dinner, Billy had this wonderfully positive interaction. His little friend was dipping her bread in olive oil with salt and pepper. He simply adores her…and surely was influenced to follow her lead. Playing it very cool, he poured himself some olive oil and sprinkled salt and pepper on it. He dipped his bread with real pride. We moms laughed knowing how the kids had all been such great role models for each other that afternoon and evening. And what a great day the moms had too. My belly laughs, the delight of watching all four kids summit the climbs, plus having another mom to share the experiences with. Easily the best dose of good health ever!

 

Did you catch Laura on The Daily Meal yesterday? Click on the photo below to hear Laura’s tips and to learn more about her book Healthy Habits!

Q: Can I teach my child with attention difficulties to be a mindful eater?

A Westchester Mom asks the question:

I have children with attention difficulties and because of this, I feel that their ability to detect hunger and fullness cues are dulled. Can this be taught?

Moms, Laura and Elyse respond:

All children, whether they have attention difficulties or not, can benefit from a quiet, calm and soothing environment that’s free of distractions, but it’s just as important to time all meals and snacks too. Here are a few tricks of the trade that can help teach your child how to recognize internal satiation cues over time.

Set the mood. Give your child a 5-minute warning that their meal will be served. Take this time to turn off any screens that may be on, and maybe turn on a little light, relaxing music in the background. The atmosphere can be a critical element as you begin to create a calming environment.

Take control. Because a hyperactive child may be impulsive, I recommend keeping the food on the counter or stovetop to prevent impulsive behaviors during the meal. Once your child is ready to eat, you can then go ahead and plate their food. It’s okay if your child requests seconds, but it’s a good idea to ask what their stomach feels like before going ahead and serving more. In other words, ask what their hunger or fullness level is before dishing out a second portion.

Hungry vs. Full. One good way to determine whether your child truly wants a second portion is to have them create a unique scale that allows them to express their hunger or fullness. Keep in mind that even adults may have difficulty determining the difference between hungry and full based on biological factors. A deficiency or resistance to the hormone leptin, for example, can impede on the ability to determine fullness. More research is needed to identify whether this holds true for children too, and if so, what the exact trigger is [1].

Create your scale. Try designing a child-friendly chart that ranges from 0 to 10—0 meaning starving and 10 being extremely full.

Let your child think up their own descriptions for the numbers 0, 3, 5, 7, and 10, but begin by asking them to describe what 0 and 10, or starving and stuffed—the most extreme sensations—feel like first, as these are most obvious. What does “extreme hunger,” or a 0, feel like? Is it dizzy? Is it crying? Is it sleepy? Is it a meltdown? Does your belly hurt? Are you nauseous or queasy? Then ask them to identify the opposite extreme. This would be overfull or stuffed and equal to a 10 on the scale. Does this mean belly pain? Belly sticking out? Nauseous? Want mommy to rub belly? Pants may be uncomfortable around their tummy? Not interested in eating more food? Can’t sit at table any longer? Can’t eat your favorite food if offered?

Each of these descriptions will differ slightly from one child to the next, but ultimately, it will help to jump-start this identification process, allowing them to both feel and recognize internal satiation cues. If it’s difficult for your child to verbalize their feelings, try using faces (happy, sad, etc.), stickers or pictures of children who appear happy, sad, angry, etc. to allow them to relate to the emotion.

Once extreme feelings are identified, then narrow it down by establishing what it means to be neutral, or not hungry and not full. This would be a 5 on their scale.

If your child is at a 5, but claims to still be hungry, then it’s appropriate to serve enough food to get them to a 7 on the scale. At that point, you probably wouldn’t need to serve an entire portion. (Of course, the amount will differ for each child, and individual parents can estimate and then let their child determine the rest.)

If your child responds that they are at a 7, explain to them that their body received all of the nutrition it needs for now, and they can have something to eat at the next meal or snack when their body is hungry again. (Remember, this all depends on your child’s personal scale. This may be a 3 for them.)

If your child asks for food in between meals or snacks, explain that food is only necessary when they are truly hungry, which may be when they feel like a 3 or higher (again, this may vary). The point is to teach them the difference between hunger and fullness, and while they should trust that you’ll serve them more when they are truly hungry, the scale will also allow them to identify whether they need more or not on their own.

Example of a H/F scale

10 = Belly Pain

7 = Comfortable fullness

5 = Neutral, can eat a little more

3 = Stomach growling, stomach empty, need to eat

0 = Starving

Institute a reward system. You can also consider offering a reward for positive behavior, for example, when your child sits nicely at the dinner table. The reward should be age specific, and consistency is key. This reward should not be food. The reward is not for eating but for sitting at the table. Never reward for eating or use food as a reward.

Photo Credit: bogenfreund via Compfight cc

One way to facilitate a reward system is to utilize tangible measurements of time, such as an hourglass. This can be placed before your child so they can monitor their behavior too. Start small, and work up to greater accomplishments. For the first week, if your child sits at the kitchen table for more than 10 minutes, regardless of what they did or did not eat, they would get a reward. At week 2, if the child sits at the table for 12 minutes, regardless of what they eat or how much, they would get a reward. Helpful Hint: The sand timer from Lakeshore Learning Center offers different time ranges from one minute to ten minutes.

Of course, all children—not just those with ADD or ADHD—have limited attention spans when it comes to sitting at the table. These strategic tactics are simply inspired by behavioral techniques utilized for children with special needs, though the goal is a common one: to ensure that your children get the nutrition they need.

  1. Aronne, LJ, Bowman A. The Skinny: On Losing Weight Without Being Hungry-The Ultimate Guide to Weight Loss Success. New York, NY: Crown Publishing Group; 2009.

Guest Blog: Elyse Falk

Hi, I’m Elyse Falk and I am a registered dietitian in Westchester, NY and a mom of 3 wonderful, energetic boys, ages 11, 8, and 4. I initially decided to become an RD because I love good food—you know, the kind that makes your body healthy and strong—and immediately knew I wanted to raise a family that would grow up appreciating good, wholesome food as much as I do.

Through my education as well as my professional and personal experiences, I have learned that both parents and their children must play active roles in cultivating a healthy relationship with food.
As a parent, I am responsible for determining the types of food that are in the home and preparing these ingredients in a way that my family will actually eat and enjoy. In order to do this, I am always planning a day ahead and thinking about how to serve meals that include at least 3 to 4 food groups. Looking at my childrens’ diets as a whole, I ask myself: Did they get their fruits and vegetables for the day? What about lean proteins and low-fat dairy?

But it’s not just about what they eat; I am also in charge of structuring their meals and snacks throughout the day, deciphering how they eat too. My ultimate parental role is to educate my children so that they understand the difference between when to eat foods that “do good things” for the body versus when to eat “sometimes foods,” otherwise defined as those products or ingredients that don’t offer much nutrition for the body.   
Something I’ve discovered is that “sometimes foods,” like cookies (my boys love chocolate chip cookies), don’t necessarily need their own place and time. Instead, I find that they should be neutralized in order to eliminate the notion of treats. If they ask for cookies, for example, I allow my boys to eat them with their dinner, a decision which neutralizes dessert so that it is not necessarily the highlight of their evening intake. When I first started combining dinner and dessert, I was fascinated that my son actually went back and forth between eating his veggie burger and cookie at the same time, finishing both without an issue. This also proves how insignificant dessert really is to children; all they’re really hoping for is a “sometimes food” at some point during their meal.

All parents, myself included, need to serve as a role model for healthy eating. One way I accomplish this is by sitting down for meals with my children and showing them how I enjoy consuming delicious, wholesome food. As for the kids, at the end of the day, they are the ones who are in charge of how much food to eat and whether they want to eat certain kinds or not. While I encourage them to try new foods, I won’t ever push them to the point where it becomes an issue. (I do expect them to say, “no thank you” and “please,” though. Manners are important too.)

Photo Credit: ….Tim via Compfight cc

As my boys get older, they seem to be developing more adventurous tendencies. If one tries a new food, the others seem to want a taste too. (This is incredibly funny to watch as an outsider.) As they’ve grown, I’ve also learned a thing or two about their eating habits. For instance, I don’t celebrate if one of them tries a new food, because as soon as they see my contentment, they’ll stop eating it (it has to do with control). I’ve also discovered that some days they can eat me under the table whereas other days they’re just not as hungry.

Being an RD and working with clients with disordered eating habits has made me particularly sensitive to the way my boys experience food at home. As a mother of 3, I know that food can be both necessary and fun, and yet I’m also aware that it can cause stress and concern at times too.
Laura, my friend and colleague for 10 years, has asked me to join her efforts on Mom Dishes It Out and to contribute my experiences and expertise to give her readers yet another perspective on finding joy and balance in moderate parenting and feeding. I am happy to be a part of this project and hope all the feeders and eaters out there know that it is a constant balancing act, but it is one that is worth every minute.

Raising Children With Different Nutrition Needs

By Laura Cipullo, RD, CDE with Elyse Falk, MS, RD

Photo Credit: Marina K Caprara via Compfight cc

A Real Mom’s Question

How should a parent handle instances when one child has a HUGE sweet tooth, and is underweight but the other kids in the same family are a normal weight or overweight?  For example, at dessert time, all the kids want ice cream – maybe one child shouldn’t have a ton and the other really could use it.  How does a parent deal with this situation in a way that doesn’t create food issues?

Two Real Moms’ Answers

Focus on Equality

First and foremost, everyone should be treated equally at the dinner table. In order to prevent any type of discord between the kids, you’re far better off teaching them the importance of nutrition and their health in a more neutral setting.

Regardless of weight, children need to focus on eating balanced meals and snacks. Sweets, like cake, cookies, and candy, are what we like to call “sometimes foods,” because they are foods that are okay to eat some of the time.

The child with the huge sweet tooth has to learn to eat an array of flavors – not just those made mostly of sugar – otherwise they may develop nutrient deficiencies or simply close their mind to the idea of fruits, vegetables, lean meats, nuts, eggs and low-fat dairy. Even an underweight child should not make sweets his or her primary source of nourishment. Instead, teach them to focus on increasing the amount of nutrient-dense foods they consume throughout the day. Young children need to learn to eat the kind of food that’s necessary for their bodies, and observe healthy role models who guide them, so that they can grow into confident eaters.

Reassess

Did your family’s pediatrician recommend that your child gain weight, or are you assuming this? Do your children’s height and weight fall into in the same percentiles on the growth chart? If so, it is probably safe to assume that both of your children are at appropriate weights. In general, the focus should not necessarily be on gaining weight. Instead, it should be on eating enough nutritious food on a daily basis. Consider seeking counseling with a registered dietitian.

If your child’s weight is truly beneath their height on the growth curve, your child has not grown in a year, or if a physician prescribed weight gain, then you’ll need to focus on increasing the quantity of food your child is consuming while simultaneously looking for ways to add nutrient-dense foods to their intake (this refers to a small serving of food that is high in calories). As Mommy Faulk reminds, children have smaller stomachs than adults and often can’t consume large amounts of food at a time. Because of this, they may need to eat smaller, nutrient-dense meals more often.

You may also want to ask yourself: Is my child a picky eater? Don’t forget that, just because school sets aside time for lunch doesn’t mean your child is eating. Perhaps something happened at school that is causing them not to eat, or maybe they don’t have enough time to eat. This may be the problem, especially if your child has lost a significant amount of weight in the past 2 months (>/= 2%) and could possibly put them at risk of developing an eating disorder. In other words, in order to remedy the situation, it’s essential to first determine why your child is not meeting their nutrition needs.

Quick Tips to Increase Intake Without Increasing Quantity

  • Add 1-2 tbsp of wheat germ to yogurt, meatloaf, cereal, muffins, etc.
  • Add an extra slice of cheese to their sandwich.
    • Add granola to low fat yogurt or allow them to eat it plain.
    • Put peanut butter on their muffin.
    • Make smoothies with protein powder and lots of berries.
    • Add a morning snack of raisins or nuts at around 10 a.m.
    • Provide a snack of crackers and a spread like hummus before bed.
    • Encourage healthy fats such as avocado, olives, olive oil, nuts, and nut butters.
    • Have all-natural nutrition bars and packaged low-fat milk available on the go.
    • Let them have a mini-meal when they get home from school, like a sandwich, grapes, low-fat cheese, hearty soup, homemade English muffin pizza, etc.
    • Add olive oil to whole-grain pasta and veggies; let child dip whole-grain bread into olive oil with their meal.

Behaviors to Implement

  • Talk to the school to help your child to remember to eat.
  • Help your child relax before meals and decrease anxiety to prevent emotional fullness.
  • Encourage your child to help choose the menu.
  • Do not discuss food issues and/or weight at the table.
  • Focus on your child’s behaviors around food and commend them for trying new foods or practicing self-care.
  • Make meals an enjoyable time so they are not rushing to finish and leave the table.
  • If the pediatrician is concerned, have them talk to the child with a parent in the room and explain why they need to get more nutrition.

This Mom's Early Path to Nutrition

Many of my clients often wonder what attracted me to the field of nutrition. In truth, there’s no single response, and the reason can be traced back to a progression of events throughout my life that affected the way I view health and wellness today. Here is my honest answer.

My journey began with the family in which I was raised. I come from an Italian and German household. I have one sister. My mother, who is 100% German, was fantastic about providing balanced, home-cooked meals. She made us oatmeal and pancakes, packed our lunches, and prepared dinner menus that included stuffed peppers, roasted chicken, veggies and grains. Our lunches typically had 2 cookies as a side (I distinctly remember envying my friends with bags and bags of snacks.), and we ate dessert nightly.

I remember observing my father’s eating habits along with those of my extended family, including aunts, uncles and cousins. My family is not on the lighter side; rather, many relatives weigh on the upside of 300. Holidays and celebrations were centered on food. If we had 30 people, then we had 30 pounds of mashed potatoes. Portions were without limits. However, my sister and I ate intuitively. I never thought about portions or my health until 8th grade, when I was diagnosed with high cholesterol.

The doctors told me that I had “inherited” high cholesterol, but before they would consider medication, I was instructed to change my diet. Physically, I was still very petite, and though I ran track and stayed in shape, I also consumed a ton of high-fat dairy products like cheese and drank whole milk like it was going out of style.

The doctor’s prognosis made me much more aware of my diet, and so my mother and I began to educate ourselves. I eventually learned to lower my consumption of high saturated fat foods, eating less cheese and switching to skim milk. I ate plain pasta. Within a month, my cholesterol dropped from 236 to 180. Wow! If observing my family’s eating habits signified the first time I’d recognize differences in dietary behaviors, then this was the first time I realized the power of those behaviors and what we put into our bodies.

When I hit middle school and high school, specifically between 7th and 10th grade, my habits changed significantly, mainly because I started eating outside of my home on a regular basis. I ate a lot more pizza, Chinese take–out, and tons of muffins while working at DePiero’s Farm, which had a bakery I absolutely loved.

I specifically remember people telling me I would gain weight if I kept eating those foods—especially the muffins. Well, they were right. The next time I’d have a revelation of this magnitude was when I couldn’t fit into my clothes—the result of eating endless baked goods daily for lunch while working one summer. Puberty and growth may have been partially to blame too, but the weight gain was largely caused by an increase in calories.

Another piece to the puzzle was when I quickly lost weight as a freshman in high school—the result of playing sports all 3 seasons. The weight loss was unintentional, and when my friends and family noticed, they brought it to my attention. In an effort to re-gain the weight, I began to eat even when I wasn’t hungry. This helped me put the weight back on, but this routine of eating for no reason and at any time stuck around.

Sophomore year was challenging for me. I could no longer run due to an injury and I was eating for behavioral reasons, as mentioned above. Fortunately, I began to learn about health and nutrition in biology class. I became fascinated, and before long, I was hooked.

It was also around that time that my uncle Gene was diagnosed with diabetes and started seeing a registered dietitian. Kindly, he was open to me joining his sessions.

Inspired by what I was learning, I knew I waned to become an RD and began apprenticing for my uncle’s nutritionist, Nancy. Just like that, my career path was set.

So like I said, my decision to become an RD can’t be pinpointed to any single moment in time. In the same way many others discover their passions in life, my desire to learn about nutrition and to teach others about its importance is the result of a confluence of experiences—from my childhood on. It was through all of these lessons that I personally found empowerment, balance and my ideal health. Today, as an RD and a mother, I can only hope to pass on my knowledge and enthusiasm for the field to others.

A Moment of Momzilla!

Photo Credit: tyczka1 via Compfight cc

Last winter I took my eldest son, Bobby, and my nephew skiing for their very first time. When Bobby did great on his first run, I decided to take my nephew down the mountain too. Of course, it was ridiculous to think I could handle 2 beginners. Bobby ended up falling.

I was convinced I had ruined skiing for Bobby forever; he was resistant to sports to begin with. I had already scheduled private lessons for the boys 2 days later, so I sent them anyway.

Bobby was not exactly excited to get back on skis after his initial spill. He resisted. He acted out. It was ultimately a failed attempt.

Hoping he’d maybe forgotten about his first experience, I tried to get him back on skis on another weekend at a different mountain. This time, he was like a limp noodle, refusing to as much as stand upright let alone listen to his instructor. Bobby only wanted to ski with me, but that was impossible since I had unfortunately been in a ski accident the week before and was forced to sit on the sidelines for the rest of the season. I was so distraught.

Maybe it was the concussion speaking, but I just couldn’t understand how my son—my own flesh and blood—didn’t love skiing as much as I did. I was looking into buying a ski house. What would I do with Bobby if he hated skiing? To add insult to injury, my nephew, whose parents don’t ski, was having the time of his life. I couldn’t stop thinking how reversed the situation was.

To me, this was a catastrophe. Sad to admit, but I even cried about this to my therapist. It wasn’t so much that Bobby hated skiing or that my dream house was quickly becoming a nightmare. No, it’s because I was suddenly becoming this mother that I didn’t want to be—a momzilla of sorts.

Refusing to accept Bobby’s athletic distaste (how can a dietitian’s son be physically inactive?), I gave the whole sports thing one more shot (he refused to play soccer too)—this time with mother-son rock climbing. The result? Bobby thought that scaling the smaller wall was fun, but when faced with the full rock wall, he went running for the hills. (Well, really, he hid under the mat as though he were a small animal.) I, of course, said all the wrong things—and hated myself as each word escaped my mouth. I offered rewards. I made threats. I knew I was completely out of line.

Both my therapist and husband said I was overreacting. They said when my son was ready, he would participate in whatever physical activities he wanted. So, heeding their advice, I dropped it. No more sports classes, no more private instructors, no more pushing or comparing or dreaming. I needed to let Bobby be himself and grow into someone different than who I may have thought he’d be, at least at that age.

Well, guess what? This fall, I enrolled Bobby in a school soccer program. I know you’re thinking, “Here she goes again.” But my husband and I send our children to progressive schools that encourage self-exploration, teamwork and learning through activity, and I hoped he would react differently in a more supportive environment, especially now that Bobby was older. I sent him to a soccer program that focuses on having fun—not on drills—and it worked. He loved the class and never complained.

Since turning five, Bobby has taken to a few other sports too. He smiles through swim lessons (my husband initially taught him to swim since he hated the classes), has started skateboarding (and is doing well) and has even attended a 2-week sports camp with a classmate over winter break.

Apart from giving him enough time to acclimate to new athletic endeavors, I think that Bobby’s peers have positively influenced him as well. As a colleague of mine, a pediatric development specialist, taught me, when kids try new activities, they don’t have to do them well. It’s more important to offer encouragement and praise for trying. So this is what I have been doing and I think it is effective in building self- esteem and acceptance.  After his first swim lesson, Bobby said to me, “I know why you are proud of me. Because I was scared, but I tried it and I had fun.”

As parents, we need to focus on building our children’s self-worth as they learn to cope with their environment. Give your child time to be who they are, not who you want them to be. I caught myself being a momzilla and changed my ways. It’s a delicate issue, but as parents we have a responsibility to handle it with care.

Have you ever found yourself facing your inner momzilla?

 

A note to my readers:

Photo Credit: J. Paxon Reyes via Compfight cc

A note to my readers

 

As I continue to share my stories, experiences and other “food for thought,” I am realizing that at times my entries extend beyond the experiences of my personal family. Each lesson is, however, always relevant to my family, since I am constantly applying what I learn toward raising my children.

 

I see my blog as an opportunity for all moms, dads, and caregivers to unite, bond, and learn to become moderate in our parenting and the feeding of our children. The goal is to raise happy, healthy, moderate children who eat all food in moderation, respect their bodies no matter what shape they may be, and enjoy life. Health promotion and disease prevention are of course at the core of what I do too.

 

So, instead of limiting our children’s perspectives on food and life to that of a black and white way of thinking (i.e. good and bad, skinny and fat, right and wrong), we should be pioneering this mindset of moderate parenting and feeding.

 

Thank you for your support over the past few months. I look forward to sharing more entries, and I hope you too will contribute your experiences, lessons, and “food for thought” on the trials and tribulations of raising “moderate” children. I would love to have at least one guest blogger a month. Please email me if you are interested: cipulloRD@gmail.com.