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Family Meals Focus

The Ellyn Satter Institute Newsletter

Managing “junk” food, AKA sweets, chips, sodas 

by Ellyn Satter, Family Therapist and Registered Dietitian

Kids who regularly get to eat as much as they want of high-calorie, low-nutrient foods become as relaxed and casual about eating them as they do other food. They don’t go off the deep end and consume a lot of sweets, chips, and sodas when they become older school-age children and adolescents and can get it on their own. Instead, they continue to be relaxed, positive, and competent with eating junk food the same as other food. 

Restriction is the norm

Outpatient dietitian: I diligently teach Satter’s Division of Responsibility in Feeding (sDOR) to the parents of all my childhood obesity and metabolic syndrome referrals. A pediatrician called today, concerned that one of her patients’ mothers had said, “the dietitian told us to offer unlimited sweets.” Based on your article, Using “forbidden” food, and your discussion about “controlled substances” in Secrets of Feeding a Healthy Family,1 I explained that I follow sDOR, which stipulates regular family meals and structured, sit-down snacks, and that those unlimited sweets are to be offered at the occasional sit-down snack. She disagreed and wanted me to incorporate portion control. I stood my ground, but I need the research! 

The doctor assumes, as do a lot of people, that her small patient will go out of control and eat way too many sweets. In contrast, your strategy is to change sweets from being treats (that she overeats) into being ordinary food (that she evolves into eating moderately). 

sDOR: the practical, realistic,  junk food strategy

  • Include high-calorie/low nutrient foods in scheduled meal- and snack-times.
  • Within that context, children and other people may eat as much as they want.
  • This is with the exception of the mealtime dessert strategy, which recommends giving only one serving.
  • Once the food is included in the meal or snack, parents do not restrict in any way: not by managing portions, not by running out of food, not by giving the child the look.
  • Have soda occasionally, with a meal or snack where it tastes especially good. 

Children become relaxed about eating junk food

“My teens walk by chips and treats and leave half a dessert because they are full. Their body weight is normal.” In contrast, sixty percent of parents wait-listed for  obesity management say “I have to be careful that my child does not eat too much.”

The junk food strategy is not just for today – it is for a child’s lifetime. Kids who regularly get to eat as much as they want of high-calorie, low-nutrient foods become as relaxed and casual about eating them as they do other food. They don’t go off the deep end and eat a lot of junk food when they become older school-age children and adolescents and can get it on their own. Instead, they continue to be relaxed, positive, and competent with eating junk food the same as as they are with other food. 

Research supports the sDOR based junk food strategy

The control perspective appears to be that children have a tendency to eat too much, particularly of high calorie food, and that that tendency has to be managed by food restriction, portion control, and/or strict limits on access to the junk foods in today’s “obesogenic” food environment. This is despite the fact that there is considerable evidence showing that restriction and avoidance don’t work and even do more harm than good. Consider the evidence: restriction backfires. 

  • Clinical observation indicates that unsupervised restricted children tend to overeat when forbidden foods are available, a tendency that leaves them ill-equipped to cope with the broader food environment.  
  • Restriction increases children’s enthusiasm for and intake of restricted food.2
  • Such enthusiasm and intake is exacerbated when children show tendencies for high approach (positive anticipation) and low inhibitory control (ability to resist or delay gratification).2  That is, when children especially enjoy eating and have no patience with restricting themselves. [And what is the matter with that?]
  • According to the Eating in the Absence of Hunger (EAH) research protocol, which monitors children’s after-a-filling-lunch intake of freely available snack foods, restricted children eat more and feel worse about their eating.3 That is, they are ashamed of eating what their parents don’t want them to eat. 
  • Girls deprived of palatable snack foods show relatively high EAH as well as increasing EAH from age 5 to 9 years, a tendency that is higher in “overweight.” girls.4 
  • In contrast, even girls who are given no structure at all, in that they are allowed unlimited access to all kinds of snacks, have moderate BMIs and lower EAH than those whose parents restrict. Restrictive parents control the what and when of eating and, in contrast to sDOR, also how much.
  • Girls whose parents restrict high-fat, high-sugar snacks have relatively high BMI; those whose parents restrict all snacks show relatively high EAH.5

The sDOR junk food strategy works

The sDOR “forbidden food” strategy works: that is, matter-of-factly including high-calorie, low-nutrient foods in structured meals and snacks and letting children eat as much as they want of them at those times. In the words of a parent on Facebook, “My teens walk by cupboards of chips and treats. They leave half a dessert unfinished because they are full. Their body weight is normal for them.” In contrast, sixty percent of parents enrolled and wait-listed in an obesity management intervention say “I have to be careful that my child does not eat too much.”6 

References

  1. Satter EM. The feeding relationship: problems and interventions. J Pediatr. 1990;117:S181-S189.
  2. Rollins BY, Loken E, Savage JS, Birch LL. Effects of restriction on children’s intake differ by child temperament, food reinforcement, and parent’s chronic use of restriction. Appetite. Feb 2014;73:31-39.
  3. Fisher JO, Birch LL. Parents’ restrictive feeding practices are associated with young girls’ negative self-evaluation of eating. Journal of the American Dietetic Association. 2000;100:1341-1346.
  4. Birch LL, Fisher JO, Davison KK. Learning to overeat: maternal use of restrictive feeding practices promotes girls’ eating in the absence of hunger. Am J Clin Nutr. 2003;78:215-220.
  5. Rollins BY, Loken E, Savage JS, Birch LL. Maternal controlling feeding practices and girls’ inhibitory control interact to predict changes in BMI and eating in the absence of hunger from 5 to 7 y1,3. Am J Clin Nutr. Feb 2014;99:249-257.
  6. Sonneville KR, Rifas-Shiman SL, Haines J, et al. Associations of parental control of feeding with eating in the absence of hunger and food sneaking, hiding, and hoarding. Child Obes. Aug 2013;9(4):346-349.
 

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