It's Not Easy Eating Green

A reader sent me a recent article about methods used throughout history to get children to take their medicines.  While the piece focused on sweet talk and sweeteners, the biogeek in me was drawn to a comment about a new compound, GIV3616, that blocks the bitter taste receptors on the tongue.  A scientist from Givaudan Flavors, developer of this chemical, noted that for veggie-phobic children, "We’d like to be able to make their diets more enjoyable by masking the off-putting flavors of bitterness. Blocking these flavors we call off-notes could help consumers eat healthier and more varied diets."  I was dying to get a hold of this bitter blocker to sprinkle on my picky daughter's kale, but that would probably alienate those of you who eschew genetically modified, irradiated, non-organic, non-sustainable, non-locally produced Frankenfoods.  Besides, when I did a Google Scholar search on this compound, nothing has been published -- not even animal safety studies.  (I'm sure it's proprietary.)

It turns out there's a cheaper, low tech solution to increasing vegetable consumption in kids.  This week in JAMA, a psychologist, an economist, a marketing professor and two nutritionists walk into a bar published a study in which they placed photographs of vegetables in elementary school lunch tray compartments.  They measured vegetable consumption on a day when the trays had the photographs and compared it to a day when they didn't have the photographs.  These valiant researchers (or more likely, their undergraduate assistant in charge of "data acquisition") went so far as to scrape off and weigh uneaten vegetables left on the trays, tables and floors.

Does your kid's lunch tray look like this....

...or this?

So what did they find?  On the positive side, the percentage of children scooping green beans and carrots into those compartments went up from 6-12% to 15-37%, and overall consumption increased modestly.  On the downside, a lot of the kids left their veggies uneaten (in fact, more carrots were wasted in the photograph group), and even with the overall increase, consumption still did not meet government recommendations.  The study was also performed over a mere two days.  Kids will figure out in no time that no one's going to punish them if they scoop pudding into a green bean compartment.

As for me, I'll keep waiting for that magic bullet.  To the marketing geniuses at Givaudan:  hurry up, rechristen your license-plate chemical "Flavia," and release it to the general public. And  one more favor, if you please: Publish a study showing your bitter blocker won't make my daughter grow a third eyeball.*

*What's more likely is that she would grow more bitter taste receptors in response to chronic blockade.  (That's the mechanism by which people become tolerant to narcotics or alcohol).  If she were to suddenly stop using the chemical, she would be more sensitive to bitterness than ever before.

Cuckoo for Cocoa Puffs?

A visit to Jelly Belly heaven....

will I be paying for this later?

One of the enduring myths of Christmas (aside from the man with the bag) is that eating all those candy canes will make your kids go bonkers.  There are certainly observational studies showing that sugar ingestion leads to inattention and impulsivity.  But if you look at only the well-designed, double-blind, placebo-controlled studies (there have been at least a dozen), not one has found that sugar has a deleterious effect on behavior in kids, even in those with attention deficit-hyperactivity disorder (ADHD).

The definitive study was performed in normal preschoolers, as well as 6- to 10-year olds whose parents had identified as being "sugar sensitive."  The care involved in the design of this trial was remarkable.  A dietician supervised the removal of all the food from the home, except for coffee and alcohol "as long as they were not consumed by the children."  The families were then provided with meals for the next 9 weeks.  The experimental diets, which rotated every three weeks, included one that used sucrose (sugar) as a sweetener, one that used aspartame (Nutrasweet), and one that used saccharin.  The families were not told the hypothesis, or what substitutions were made.  In fact, the investigators created sham diets that changed every week, to throw the parents off the scent.  One sham diet, for instance, consisted mainly of red and orange foods (although no artificial food coloring or additives were allowed).  Every three weeks, children underwent tests of their memory, attention, motor skills, reading and math performance.  Interviewers also surveyed parents and teachers about their kids' behavior.

The blinding was near perfect; only one parent correctly identified the sequence of diets.  Even though 48 tests and surveys were conducted per child, almost none found a difference in cognition or behavior among the three diets.  The one exception? Children on the sugar diet scored significantly better on the cognition portion of the Pediatric Behavior Scale.  I'm tempted to use this as a post hoc justification for letting my kids eat Cap'n Crunch, but it's probably just a chance finding.

Nonetheless, some parents continue to insist that sweets make their kids hyper.  Once you believe something, you're more likely to see it.  In one study, thirty-five 5- to 7-year-old boys who were reported to be sensitive to sugar were randomized to two groups.  In one group, the mothers were told their sons would receive a sugary drink; in the other group, they were told that they would receive a Nutrasweet drink.  They then videotaped the boys playing by themselves and with their mom.  The boys also wore an "actometer" on their wrists and ankles as an objective measure of their activity level.

Here's the twist:  Both groups actually received Nutrasweet.  As expected, there was no significant difference in the boys' activity levels by videotape review or actometer readings.  But the mothers who thought their sons consumed sugar reported significantly more hyperactivity during the play session than those who knew they were drinking Nutrasweet.  The videotape reviewers (who were blinded to the intervention) also found that the mothers who thought their boys drank sugar were more likely to hover around them, yet they scored lower in warmth and friendliness.  It was kind of a mean study, if you think about it.  First, they lied to the moms, then they slammed them for being more vigilant.

So why, despite the plethora of data to the contrary, has the sugar myth persisted?  It's possible that something else in the sweets, such as food coloring or caffeine, causes hyperactivity.  And think about it: When do we do let our kids consume copious amounts of sugar?  On birthdays, Halloween, and Christmas -- all recipes for going a little nuts.

Now With More Protein!

My kids' favorite cereal is Cap'n Crunch Crunch Berries.  Hey, I'm a health-minded mom; I  make certain that they get a serving of fruit every morning.  Sure, Crunch Berries might not have the same anti-oxidant, cancer-fighting properties of acai berries.  (Amazonian natives don't get cancer, so it must be true!)  But I sure ain't gonna feed 'em the fruitless stuff.

They were rooting around in the pantry for their fix when they came across this old cereal container:

I tried to pass off the larvae* as a science experiment/proof of spontaneous generation/Christmas surprise, but my kids would have none of it.  I was tempted to call the Captain himself to complain about the inaccurate nutrition labelling, when my husband discovered another little squirmer in a half-opened box of Cinnamon Life.  Somehow finding one larva in your cereal is way more disturbing than finding a colony of them.

No doubt some of you are more disgusted that I let my kids eat sugary cereal than by the fact that my pantry is an insect zoo.  And indeed, you would be in the right.  There are no studies examining the larval content of sugary cereals, but there is a study showing that there is (brace yourself) sugar in sugary cereal. 

The Environmental Working Group released a report this week on the sugar content of 84 popular breakfast cereals.  Only one in four met the U.S. government's guideline of having less than 26% added sugar by weight.  The worst was Kellogg's Honey Smacks, followed closely by Post Golden Crisps (formerly known as Sugar Smacks; there used to be truth in advertising).  Cap'n Crunch Crunch Berries came in 9th, with 42% added sugar.  A cup has 11 grams of sugar, which is less than a Twinkie but more than two Oreos.  You can imagine how upset I was when I read that.  I've since reformed my ways, and this is what I now serve my kids in the morning:

Chocolate's an anti-oxidant, isn't it?

*They weren't maggots; maggots eat meat, not fake berries.  I have no idea what these larvae would have metamorphed into.  (Any entomologists among my readers?)  We sprayed them with Raid, squished them, burned them, and scattered their ashes in a lovely forest glen.

The Picky Eater

My parents are preparing a traditional Thanksgiving dinner for the extended family this year.  They're excited to have all their grandkids at the table, but also a bit nervous, as they're venturing far outside their Chinese food comfort zone.  I've warned them, though, not to feel hurt if my 6-year-old daughter eats nothing but mashed potatoes.

That's right, despite our vibrant heritage of Chinese-American gluttony dating back to the Ching dynasty, my family has been cursed with a picky eater.  

In-n-Out started her down the road to perdition.

There is no universally accepted definition of what makes a fussy eater, but most parents say they know it when they see it.  Nutritionists and psychologists distinguish between two related conditions.  Food neophobia is defined as the fear of trying new foods.  It's thought to be an evolutionary vestige from our Neanderthal days, when eating something new, particularly a plant, carried a risk of poisoning or illness. Food neophobes will often reject a new food based on sight or odor alone, refusing to even taste it.  Neophobia starts at age 2, when the child becomes more mobile and hence, less supervised, and usually ends at around 6 years of age.  Picky eating, on the other hand, is the refusal to eat even familiar foods.  Picky eaters may be more willing to taste new foods, but will regularly eat only a narrow range of items.  Picky eaters gravitate towards carbohydrates and away from vegetables and protein sources.  Unlike food neophobia, many picky eaters do not outgrow this tendency.  In reality, there is a great deal of overlap between food neophobia and picky eating, and many kids have both.

Up to half of parents claim to have a picky eater in their family.  The health consequences of picky eating aren't clear.  Some studies have shown a lower body mass index in picky eaters, while others have found the opposite.  Picky eaters tend to take in fewer nutrients and vitamins, though frank deficiency is rare.  And one study, which followed children over an average of 11 years, found that picky eaters have more symptoms of anorexia in later adolescence. 

Scientists aren't even sure of what causes some kids to be picky eaters.  Twin studies suggest that about two-thirds of picky eating is genetic, rather than environmental.  Part of this may be due to a known inherited variation in the ability to taste bitterness in vegetables; those with higher sensitivity may be more likely to avoid veggies.  Picky eating may also associated with higher rates of anxiety.  Regardless of the underlying cause, meal times can often deteriorate into a battle for control, further exacerbating the pickiness.

My daughter Sarah's all-time record was being forced to sit two hours at the dinner table with an unwanted pork chop in her mouth.  I finally gave up when she started nodding off.  If she was going to choke on something in her sleep, I wanted it to at least be a vegetable.  Otherwise, what would the neighbors say?
 
There are studies examining ways to diversify the picky eater's diet.  The French, naturally, are on the cutting edge of gastronomical research.*  In schools in Dijon, half of 9-year-olds were assigned to a weekly 90-minute program to train their tender young palates.  The sessions included lectures, cooking workshops, and a field trip to a restaurant (though contrary to stereotype, no wine tastings).  The children were surveyed before and after the program, and presented with unusual items, such as leek sprouts and dried anchovies, to taste.  Kids enrolled in the program were slightly more likely to sample the offerings.  Tant pis, ten months after the program ended, the reduction in food neophobia disappeared and returned to baseline.


Of course, this study is unlikely to be of much help to those of us in the States, where schools are dealing with budget crunches by dropping frivolous subjects, like long division.  So what's a beleaguered parent to do?  Here are some tips:


Munch on a carrot while breastfeeding your baby.  (Or better yet, drink a Bloody Mary -- read my post on drinking while nursing.)  Breastfeeding is associated with lower rates of picky eating.  It's been well-established that many flavors from a mother's diet are transferred to her breast milk -- which may explain, for instance, why Indian babies have no problems tolerating curry.  There's weak evidence that consuming carrot juice while nursing increases an infant's acceptance of carrot puree.**  Although there are few studies on this topic, there are plenty of other good reasons to nurse.

Don't reward your children for eating healthy food.  Multiple studies have found that if you reward a child for eating something, she will eat more of it in the short term, but she'll end up disliking and eating less of it in the future -- the thought being, "If Mom has to give me a prize to eat this green bean, it must taste terrible."  Even verbal praise for consuming a particular food reduces a child's liking for it.  


Present healthy food as a reward.  Rewarding behavior with food increases the desirability of that food.  Note that this trick works best with the very young.  One researcher who tried the old "eat your dessert, then you may eat your vegetables" ruse was unable to fool a single 4-year-old.

Expose your child to the food you want him to eat.  Then do it again.  And again.  And again.  In fact, studies show you must present new food to a child a minimum of 10 times for him to finally accept it.  One randomized trial had parents in the experimental arm present an unpopular vegetable (most often a bell pepper) to their child every day for 14 days.  The parents were to encourage their child to taste it, but not to offer any reward for eating it.  At the end of the two weeks, kids in the exposure group increased their liking and consumption of the vegetable, compared to no change in the control group.  The problem?  Many of the parents weren't able to stick it out for the full 14 days, and when they included these kids in the analysis, there was no benefit.


Set a good example for your kids, and eat your veggies.  This won't be a surprise to anyone, but several studies have found that vegetable consumption in kids closely mirrors that of their parents.  Hard to know if this is genetic or environmental, or if there's a cause and effect relationship, but it can't hurt.


If all else fails, talk to your pediatrician -- preferably someone as non-judgmental as my kids' doctor.  I became really concerned when Sarah weighed one pound less at her 4-year-old visit than she did at her 3-year-old one.  I bemoaned her tuber-based diet, and asked for suggestions on how I could get her to eat her veggies.  Her pediatrician's answer?  "Does she eat ketchup with her French fries?  Ketchup counts."


Ketchup counts?  I've got Thanksgiving covered.


*Public schools in France serve a five-course meal to their students, and no, it's not like in America, where the hors d'oeurves consist primarily of pomme frites.

**OK, I realize that you could use the same logic to argue that drinking while nursing could give your baby a taste for Jack Daniels.  If you're a breastfeeding mom, just pretend that you never read this footnote.