Kids and Nutrition
An interview with Keith-Thomas Ayoob

The start of the school year means kids are on the go with new studies and activities. This presents an even bigger challenge for parents seeking healthy solutions for their children's diets. FoodFit asked pediatric nutrition expert Dr. Keith-Thomas Ayoob what parents can do to ensure their kids are eating nutritiously. He offers great ideas for improving your child's diet without driving yourself crazy.

Fuel for Learning

A well-nourished child can concentrate better and has better memory skills. Dr. Ayoob says evidence that nutrition makes a big difference for kids is most obvious with breakfast. Kids "seem to do better on memory tests...math tests...and they seem to be much more focused on their school work."

Ayoob actually sees kids walk into his office at 9:30 a.m. drinking soda because "their parents say they didn't have time for breakfast." That excuse doesn't work for him. Ayoob emphasizes that eating nutritiously doesn't have to be time consuming and suggests that a quick breakfast can be as simple as a glass of milk with a piece of fruit and half a bagel. This can be grabbed as your kids are walking out the door and takes less time than a soda stop at the corner store.

Picky Eaters

Many parents complain that their children either won't eat or will only eat the same foods day after day. These parents are concerned that their children won't gain enough weight or aren't consuming important nutrients. On picky eaters, Ayoob has this advice: "...the worst thing to do is to force-feed kids. That's just going to create a negative association with food and eating." He suggests offering food to kids in a very matter-of-fact manner and avoiding associating stress with mealtime. Parents shouldn't be short order cooks. A parent's job "is over once they present a good, balanced, nutritious diet."

While it's sometimes fine to offer an alternative (like chicken with or without sauce), Ayoob cautions against offering too many options. Providing one or two alternatives at a meal allows kids to feel like they have choices, but too much freedom can be problematic. And what if they refuse everything? Ayoob's advice is reassuring, "If the child chooses not to have anything that's OK, kids will skip a meal occasionally but it's not something to worry about." If your child does skip a meal, don't let him snack on less nutritious items; always steer him back to a well-balanced meal when they're ready.

Dr. Ayoob suggests keeping kids on a regular meal and snack schedule—three meals and two to three snacks per day is appropriate. Though grazing may work for you, he advises against letting your kids do it, because what they're eating may not be nutritionally complete and it may interfere with their appetite for meals. Another factor that plays a role in decreasing appetite for meals is the intake of high-sugar drinks. This includes fruit-flavored drinks and punch, soda and even 100% fruit juice. Ayoob suggests minimizing your child's consumption of these sweet drinks. For more on new fruit juice recommendations, see our Foods in the News article.

Ayoob admits that parents need to do a certain amount of planning to make sure that kids get nutritious meals and snacks. He understands that "kids and families have a lot of things going on these days, but good nutrition and good health need to be a lifestyle priority." Ayoob stresses that good eating habits are learned and that parents are the most important role models for kids.

The Right Balance

Parents often make the mistake of offering a wide variety of packaged snack items, but only a few types of healthy snacks like fresh fruits. Ayoob stresses that even if your kids complain that they don't like fruit, you should continue offering different varieties instead of giving up. He acknowledges that "Kids are inevitably going to eat a few sweets, a few savory snacks—that doesn't bother me and they'll get that when they go out of the house anyway." Problems start when there are more unhealthy snacks like chips and candy in the house than more nutritious items like low fat yogurt, whole-grain crackers and fresh produce.

Ayoob suggests bringing your kids to the grocery store with you to help choose the food for the week. They'll enjoy picking out brightly colored fruits and vegetables just as much as their favorite cookies. Once you're back in the kitchen, "Get them involved even if it's something so simple as tearing up green beans—so they'll all be irregular, who cares—but, they are going to be more likely to eat these green beans because they had a hand in preparing them."

Kid-Sized

Just as new foods can be intimidating to children, large, complicated foods can as well. Ayoob suggests that by giving your kids smaller versions of foods, they may be more willing to try them. For example, kids may be turned off by big beefsteak tomatoes, but would happily try a bite-sized, easy-to-hold, cherry tomato. The same concept can be applied to fruits: clementines instead of oranges and finger bananas instead of regular.

How Much is Enough?

A combination of five servings of fruits and vegetables each day is what the USDA recommends adults eat, but how does this translate to children? For kids ages four-to-six, cup of fruit or vegetables is recommended, while cup is appropriate for two-to-three-year-olds. If parents made sure that their kids got their daily intake, "they'd be going a long way in getting kids a more balanced diet and also in helping start them towards a more balanced lifestyle."

—Frances Largeman, RD
Managing Editor

About Keith-Thomas Ayoob, EdD, RD, FADA

Keith-Thomas Ayoob is associate clinical professor of pediatrics at Albert Einstein College of Medicine. A pediatric nutritionist, Ayoob counsels children and caregivers on nutrition issues including obesity, nutritional deficiencies and eating behavior problems. His current research involves obesity in inner-city children.

Ayoob speaks frequently to consumer groups on nutrition and health. He serves on the editorial board of the Journal of the American Dietetic Association, is a member of several ADA dietetic practice groups and is a past winner of the Greater New York Dietetic Association's Distinguished Dietitian of the Year Award. A Fellow of the American Dietetic Association, Ayoob holds a doctoral degree and two master's degrees in nutrition from Columbia University. He received his bachelor's degree in nutrition science from the University of California at Davis.