C

Aelce

VaWsomtfhdvsbf“pdbpoitMfr

TTapppaa■

■

■

■

■

PTy

T

M

J

PracticeBEYOND THE HEADLINES

hildhood eating patterns: The roles parents play

ccording to a new study in the Octo-ber issue of Pediatrics, dieting inchildhood may have the unintended

ffect of promoting weight gain later inife. But what part do families play in a

child’s life. Kovach says that householdswhere fruits and vegetables are providedin abundance in the preschool years isassociated with a greater intake of thesefoods during the school years. Strategiespie“i

ECpwvcmoiiiibbwamctpufOlal

RFissccdhbmwsae

AB

have, parents have the responsibility tobe advocate for their children’s health,especially in the school setting. Manyparents don’t want physical educationclasses or recess taken away. To helppnitw

PMaireemwst

ptnangtwftfmmphIpommvcisffftscf

hild’s weight gain? Is the familial influ-nce more hereditary or environmental?Karen Miller-Kovach, MBA, MS, RD,

ice President of Program Developmentnd Chief Scientific Officer at Weightatchers International, Inc and speaker

ays, “The vulnerability or propensity toverweight is inherited and the environ-ent allows it to be expressed.” She con-

inues, “If we did not have an abundance ofood and were forced to move, we wouldn’tave the prevalence of overweight that weo—regardless of genetics.” Kovach ofteniews genetic factors such as body compo-ition and shape and satiety signals likerain neurotransmitters and a preferenceor sweets of fatty foods as what we donaturally,” or if we’re not thinking. “Thisoint of view recognizes that biology is notestiny, but biology defines the inheritedehaviors that need effort to change.” Torove her point, she cites the Pima Indiansf Arizona and Mexico, with one group liv-

ng the American lifestyle in Arizona andhe other “scraping out an existence” inexico. “The degree of obesity in the

ormer is astronomical and in the latter,are.”

HE ROLES PARENTS PLAYhe environment of the family can affectchild’s weight through the family’s foodreferences as well as eating and activityatterns. In this regard, Kovach says,arents play five roles when it comes tochild’s weight, eating, and physical

ctivity:provider;enforcer;protector;role model; andadvocate.

roviderhe food served at home in the earlyears sets a pattern for the rest of the

his article was written by Jim

cCaffree, an Editor with the

ournal, in Chicago, IL.

adoi: 10.1016/j.jada.2003.10.031

arents as providers can take are stock-ng the cupboard with healthful foodsveryone in the family can enjoy, not justnormal” weight children; and encourag-ng and supporting physical activity.

nforcerommon knowledge would have manyarents believe that when a child is over-eight, they should be “enforcers.” Ko-ach asserts that the more a parent isoncerned about a child’s weight, theore controlling a parent becomes. The

nly problem with this practice, she says,s that restricting or overmanaging theirnfant’s food intake may affect their abil-ty to self-regulate their food intake latern life. “The influence may begin atirth,” she says. “It is theorized that ba-ies are born with the internal where-ithal to self-regulate food intake in suchway as to optimize growth and develop-ent.” She continues, “External cues

an override these signals. This theory,herefore, argues against such commonarental practices as feeding on a sched-le and encouraging that last ounce oformula or two more bites of rice cereal.”verplaying the enforcer role can also

ead to a dieting mentality and black-nd-white thinking that is detrimental toong-term weight management, she says.

ole Modelsor Kovach, “Enforcement is about talk-

ng and modeling is about doing. In a nut-hell, it’s walking the talk and the lessaid the better.” For example, “it’s beenlearly demonstrated that women whohronically diet—having high scores forietary restraint and food inhibition—ave daughters that diet as well.” Theest thing that parents can do when roleodeling is to demonstrate that “healthyeight management is a reflection of

elf-care that includes positive food andctivity behaviors that come from and re-nforce a positive self-image.”

dvocatesecause children rarely have the voice to

dvocate for themselves that parents r

Journal of THE A

revent this from happening, parentseed to be active at school board meet-

ngs, participate in curriculum commit-ees, and elect school board membersho are like-minded.

rotectorsedia coverage on the topic of childhood

nd adolescent obesity has risen dramat-cally in the past two years. How a childesponds to this heightened awareness,specially overweight children is influ-nced by parents. Sadly, even though theajority of the US population is over-eight or obese, weight discrimination

till exists, and adults are not the onlyargets.

In her experience, Kovach finds thatarents “play the role that they thinkhey should, as well as what the childeeds. It varies a lot by the child, thege of the child, and the parents’ incli-ations. The key is matching the de-ree that each role is played to achievehe desired outcome.” For instance,hen a child is overweight, the en-

orcer role should be minimalized andhe provider role should be broughtorth. “It is my experience that theost concerned parents often do theost harm because they become ‘foodolice’ enforcers in a sincere effort toelp their children. In these situations,recommend that the parents take thatositive energy and redirect it intother roles.” Whether one role is playedore than the others isn’t as harmful asuch as how they are played: “The pro-

ider parent who provides food that en-ourages overweight in the households harmful; the provider parent whotocks a home with food that is health-ul for everyone is helpful. The en-orcer parent who counts every gram ofood that goes into the child is harmful;he enforcer parent who decides thatoda pop cannot be the beverage ofhoice at meal times for anyone in theamily is helpful. The same is true for

ole modeling.”

MERICAN DIETETIC ASSOCIATION / 1587