Rare are the parents who have not experienced some pangs of guilt over what their children do or don't eat. Have there been too many trips to fast-food restaurants recently? Have they been putting enough vegetables alongside all that pasta, or should they be packing more fresh fruit in the lunch boxes instead of those chocolate pudding cups? Is it a mistake to cater to their toddler's desire for nothing but cheese at lunch time?
All of these concerns are addressed in "The Yale Guide to Children's Nutrition," a book by a team of experts from the School of Medicine and Yale-New Haven Children's Hospital, published this spring by Yale University Press. And for many parents, the information provided in the book is reassuring.
For example, it is best to take a relaxed approach toward a toddler who insists on eating only certain foods, according to the authors of "The Yale Guide," as the book has come to be known. Forcing children of any age to eat particular foods can set the stage for unhealthy eating habits, they note, whereas creating a relaxed atmosphere at meals and allowing a toddler to make some choices is more likely to result in good eating habits later on. As for sweets or the occasional trip to McDonald's, the authors say: "Sweets, fast foods, and snacks that are high in sugar and fat need not be forbidden ... It is best not to offer these foods daily, but there is little harm in a treat a few times a week. An excursion to a fast food restaurant is fun for the family, and an occasional dessert or chips with a sandwich are tasty."
In fact, in the preface to the book, Dr. William V. Tamborlane, editor- in-chief of "The Yale Guide," sets forth one of the book's underlying principles: "There is no such thing as a bad food." For instance, high- fat foods, which the public is repeatedly warned to avoid, "provide a dense source of energy that may be especially useful during periods of rapid growth or intense physical activity," notes Dr. Tamborlane, who is professor and chief of pediatric endocrinology at the School of Medicine and director of its Children's Clinical Research Center.
Like many things in life, the key to a healthy, nutritious diet for children is moderation, according to the authors. "It is the balance of different kinds of food that determines the quality of the diet," says Dr. Tamborlane, who has devoted his career to the study of childhood metabolism and the care of children with diabetes. He has also written extensively on both the importance of diet in managing certain diseases as well as on the diets of healthy children.
The Yale team began writing the book at the suggestion of the Friends of the Children's Hospital at Yale-New Haven, a group of lay people committed to improving the health and well-being of children through advocacy and educational and community outreach. At first, the authors planned a cookbook of recipes for children; however, they changed their focus when they realized that there was no up- to-date, comprehensive resource for parents with questions about how to provide good nutrition to their children. Still, the authors included more than 60 nutritional recipes from world-class chefs in the book.
The recipes make up the final part of "The Yale Guide to Children's Nutrition," which includes five other sections: "From Infancy to Adolescence: Developmental Nutrition," "Common Concerns," "Beyond the Basics: Special Challenges in Nutrition," "Building Blocks for Good Nutrition" and "Eating In, Eating Out." In these, the authors cover such topics as feeding problems in infants; vegetarian diets; strategies for feeding sick children or those with conditions such as cystic fibrosis, diabetes or other metabolic disorders; eating disorders; food allergies; and childhood obesity. In the chapter on the latter topic, the Yale experts note that up to 25 percent of children in North America are estimated to be overweight -- which the authors partially attribute to the growing numbers of children who are inactive while watching television for long periods of time, often while they are eating.
The authors repeatedly remind their readers that children will most likely eat healthy foods if their parents do; conversely, parents who have poor eating habits are more likely to have children with the same problem. Parents can establish a "positive food culture" at home by stocking up on healthy foods at the supermarket (thereby limiting unhealthy choices at home) and by creating an environment conducive to healthy eating during meal and snack times, say Dr. Tamborlane and his collaborators. The most important element of healthy eating, they emphasize, is to make it fun.
"The family table should be a place for communication and comfort, a place for socialization as well as enjoyment of tastes," says the team of authors. "A happy table is often indicative of a happy family."
Food facts vs. food myths
In addition to offering practical advice and suggestions, the Yale team also dispels common myths about foods in "The Yale Guide to Children's Nutrition." Here are some examples:
-- Chocolate and fried foods cause acne. No connection has ever been found, say the authors.
-- Starting infants on solids early helps babies sleep through the night. No connection in better sleeping has been found. Furthermore, infants younger than 4-6 months are not physiologically ready for solid foods.
-- Children should be taught to eat everything on their plates. On the contrary, forcing children to eat everything on their plates may promote obesity, the authors stress. Children should be allowed to determine their own intake of food, they say.
-- Drinking milk makes a child produce more mucous. Again, research has not shown a connection between milk intake and mucous production, according to the book's authors.
-- Sugar causes hyperactivity. Another unproved claim, say writers of "The Yale Guide." They claim that a "modest intake of sugar is acceptable in the context of a balanced, nutritious diet."