Dr. Ayala's Blog

The latest science of healthy food and healthy living

Dr. Ayala

Dr. Ayala
Location
Philadelphia, Pennsylvania, USA
Title
V.P. Product Development
Company
Herbal Water
Bio
I’m a physician (Pediatrics and Medical Genetics), artist, and mother of 3 school age active kids. I recently co-founded Herbal Water Inc. (www.herbalwater.com) with my husband, Albert. I am a serious home cook, and love to entertain. My expertise is vegetarian food (I have been a vegetarian all my life). I strongly believe that eating healthy and enjoying good food go hand in hand. My main interests are science, nutrition and art, and I am overall a very curious person that tries to learn something new every day. Dr. Ayala (Ayala Laufer-Cahana M.D.)

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Editor’s Pick
MAY 4, 2011 9:05AM

The Forbidden Food Debate

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We want what’s best for our kids, therefore we want them to eat well, but what's the best way to influence our kids’ eating habits?

I believe in the importance of good parental role-modeling regarding food choices; We have to watch what and how we eat not only for our own well-being, but because our kids are watching!

I also believe that we as parents have the right and the duty to decide what goes into our pantry and on our table.

But when it comes to the issue of control over kids’ food intake it gets a little more complicated. Well-meaning parents, consciously or not, often participate in some form of pressure or restriction to further reinforce what they see as good eating habits.

I devoted a previous post to the issue of pressuring kids to eat healthy — pressure includes common practices, such as prizes and coercion tactics — not cruel torture. I concluded that pressure is counterproductive, and is more likely to lead to decreased consumption of the target food (aside from fostering an overall unpleasant experience).

But what about restricting foods you perceive as unhealthy? Could prohibiting certain unhealthy foods from kids benefit their diet?

I’m sure most of you already have an opinion about the wisdom and fairness of such tactics, but I pulled out a few studies to see if we can look at this topic in a more evidence-based way before we get to that.

There are several studies showing a correlation between parents’ restrictions on food and overweight and obesity; the more restrictions on food intake the higher the body-weight. In these studies one can argue that parents restricted food because the kid was getting chubby, and not the other way round. That’s why I’ll discuss two studies that actually perform an experiment, and don’t just look at associated findings. Both studies were lead by Esther Jansen, a clinical psychology researcher and both were published in the research journal Appetite.

In the first study, 74 kids aged 5-6 years were recruited from six elementary schools in the Netherlands, Germany and Belgium. The researchers set out to test whether prohibiting snack foods elevates their desirability and consumption. The snack food was M&M’s of the red and yellow variety, and crisps (chips in American), also in red and yellow. The snacks did not differ in taste, only in color (yeah, that red doesn’t come from strawberries or cherries; it’s just color).

The kids were randomly assigned to either a prohibition group, or a no-prohibition (control) group. Each kid was tested individually and answered questions about taste, satiety and desirability of the snacks. 

Four bowls were filled with measured amounts of the snacks.In the first phase of the experiment, the kids were left alone with the four bowls for five minutes, in which the prohibition group was instructed not to eat red snacks, and the control group kids could eat whatever they wanted. The bowls were then taken away and measured. The level of desire for the snacks was assessed between the two phases of the tasting experience. In the second phase, both groups of kids had five minutes in privacy in which they could eat whatever they wanted from the four replaced and measured bowls of snacks.

The desire to eat the forbidden red snack increased after the prohibition even though this prohibition lasted only five minutes. Kids that were forbidden the red snack also ate relatively more of it in the second phase once they could.

This raised an interesting possibility: If restriction creates desirability, can restriction be used for positive purposes? Can we make healthy foods more attractive by forbidding them?

That’s exactly what the researchers set out to test in the second experiment. Seventy kids, aged 5-7 years were divided into three groups. This experiment followed much the same protocol of the previous one, but the four foods tested this time were pineapple pieces, banana slices, M&Ms and fruitgums. In the first phase, one group was prohibited to eat from the two fruit bowls, the second group was prohibited to eat from the two candy bowls, and the control group could eat whatever they wanted. In the second phase, all kids could eat whatever they pleased.

And the results? Kids in both the fruit-banned group and the candy-banned group ate more of the forbidden food during the second phase of the experiment. What’s more, total food intake (and total calorie intake) was higher in the two prohibition groups compared to the controls, proving that prohibition indeed results in higher intake, not only of tempting unhealthy food, but also of food kids usually don’t crave and fight over.

These studies support previous research showing that strict restrictions of foods lead to unintended consequences (many argue that The Prohibition in the twenties and early thirties increased drinking—or at least binge drinking—proving the same point).

What’s a parent to do? As with many other issues of effective parenting, I think what we’re all looking for is the middle ground between too much freedom, which isn’t a good thing for a kid, and to much control, which usually backfires, leads to rebellion, and I personally feel isn’t really fair!

A few suggestions I follow (none too strictly):

• Strive to make your home a sanctuary of nothing but healthy wholesome foods (by my definition that does include quality desserts in moderation).

• Try to provide as many of the meals your family eats.

• Don’t worry about imposing your rules out of home. I don’t dwell too much on what my kids eat at other people’s home or about the snacks they’re served at parties and sports events. Kids should know what their parents think, but then use their own judgment. I see with satisfaction that my kids often dismiss the typical after-soccer snacks and choose healthier options out of home, too.

• Provide an explanation for your objection to foods you think aren’t good to eat.

• Make healthy eating so pleasurable and tasty that it would be self-evident that anyone would prefer it over fast food and junk food. It actually isn’t that hard to do. If kids get accustomed to the great taste of quality real food, junk food will look more and more like the cheap imitation it really is.

And no, I definitely don’t think we should prohibit healthy foods so that kids will desire them more: I’m against tricking kids.

Kids will need to eventually build up their own self-control. Empowering them with the knowledge and tools to do so isn’t easy, but providing the control from the outside isn’t the solution either.

Please share your experience, opinion and advice.

Dr. Ayala

Read more from Dr. Ayala at  http://herbalwater.typepad.com/ 

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Comments

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Your good taste in food is delicious to read.
Doc. Ayala...
Here, here. I always enjoy your posts - a firm believer in real food, not too much, mostly vegetables (-- with thanks to Michael Pollan)
I agree, and when I read the title, I came here to tell you the things you already sited. Forcing and restriction are fruitless (no pun intended). Explanation of why, what it does, the calorie and fat content and how it affects the body are what will eventually cause kids and teens to go to good food. Also, having plenty of good food in the house and not going to fast food places yourself. At least this is what worked in my household. Both my adult children eat healthy, are aware when they don't ( how lousy they feel) and work out regularly. They craved fast food and once a year or so we went out for it, pizza was a treat occasionally. Arming them with facts and letting them choose was the way that won out. Good post.
This is so difficult for me because I'm dealing with an eight-year/old who would eat too much junk food if left to her own devices. I've been aware of the prohibition issue for some time however and have therefore tried to balance her restrictions. It's true that the best teaching is done by example and she does have some good habits from watching me, but she seems to be obsessed with sweets any time they're around. My husband and step-daughter are always baking. They insist on having a cake or batch of cookies on the table way too often in my view. "Everything in moderation" they say, but I have a lot of obesity in my family so my instinct is to restrict sweets.

This child-rearing business is highly complex :)
@ Algis
Thank you!
@Vivian: "real food, not too much, mostly vegetables" -- words to live by!
@Rita
I love how you put it: “Arming them with facts and letting them choose was the way that won out.”
If you are not a compulsive overeater you really don't know what it is like to be in the addiction. Whenever I see someone giving advice about what to eat I just want to yell at them that it is much deeper than they can ever realize. I have tried to put it into words but it is beyond language. It is about control and fear. It is about primitive reactions to emotional damage. It is not about good nutrition or exercise. It is a journey that has everything to do with spirit and very little to do with medicine or science.
Kids early on eat what their folks eat. Left to their own devices is another story. (my brother lived on baloney and pickles) When my two year old grandson went to Ghana, he ate lots meat and rice--apples and bananas. The boy doesn't like bread. And will drink rivers of milk if you let him. Go figure. We only break out the Cheetos during long shopping trips at Walmart.
Zanelle,

I agree. As an OTR truck driver I eat every meal from a food establishment for weeks on end. I will order a menu item based on the fact it comes with a salad or a salad bar because that is what I really want and will fill up on.

However, as a stress eater I can tell you that what is eaten during periods of stress has nothing to do with how good it is for you. Yesterday for example my driving snack was a bag of carrots. Not a few, but the whole bag. While I guess it's better than M&Ms it was still the whole bag.

The study I want to see is the difference in weight loss between two groups, one lead by a skinny person and one who has some weight issues and knows what is going on. To me this is like the pre marriage classes we took from a priest, who was a virgin, talking about having sex...........
Dr., I waded through the entire post to find your 5 very sensible rules that most "common-sensed" parents seem to know intuitively. Since the parents control the purse-strings and determine what is bought and brought into the home and what is purchased away from home for consumption then the simple thing is to just not buy it and serve it. However, this presumes that parents have and use common sense and don't horde and consume their own "guilty pleasures" which the little urchins will, one way or another, find out about. Thanks.
Great post as always. Did you see the latest article on salt intake that was published in JAMA. This is not the first time a study suggests that low salt diets are a bunch of BS. I believe that people are better off flavoring their food with salt than with sugar- if they need to have something for taste.
Great post as always. Did you see the latest article on salt intake that was published in JAMA. This is not the first time a study suggests that low salt diets are a bunch of BS. I believe that people are better off flavoring their food with salt than with sugar- if they need to have something for taste.
To follow from Dr. Levine - I find the recent press coverage on both salt AND sugar to be fascinating. The science is lagging, and the press really wants a clear-cut answer to report. I, for one, am simply staying tuned... thanks for another great post, Dr. Ayala
@Dr. Evan Levine
With sugar, as with salt, I believe that “The dose makes the poison”, and my feeling is that salt is more of an issue for just some of us – not everyone is as susceptible.
@aliquot
As you say: “The science is lagging” – almost always.
Another reason to keep humble, moderate, and not too strict on any conviction :)