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Dianne Fagan, RD, CDN

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Dianne Fagan, RD, CDN

We caught up with nutrition expert Dianne Fagan, RD, CDN, who practices in New York focusing on children, teens and the issues they face when confronted with food choices and changing nutritional needs. She shared some tips with us on kids eating habits, peer pressure with food choices, motivation to make healthier choices and talking to your overweight child based on her 20 years of experience.

What do you think about the statement “children will eat when they are hungry”? Is it okay to let your child skip a meal?

Kids eat when they are hungry but if given the choice between play and food, they will choose play. Kids, like adults, need to take time or get reminders it is time to eat.

Set up regular times for meals and snacks to break up their day. Even if your child says they are not hungry, they still need to sit at the table with the rest of the family, at least 10-15 minutes. It is okay for them to skip a meal occasionally, but that doesn’t mean they should spend that time playing. Don’t force your children to eat, but give them the opportunity. Sitting at the table may whet their appetite. You can use this time to share their day’s events. Once mealtime is over they can go back to their activity. Making time to plan meals early in the day will help with meal time success.

Teens can be challenging to motivate. What are helpful ways to approach teens on healthy eating? How can parents get involved?

Ask them what they want or what’s important to them. Ask for their permission to discuss their eating habits and make suggestions, always asking what they think about them.

Parents are food providers and menu planners. They are co-pilots but they may need to take a step back and observe versus trying to take on the diet with their child. Like saying, “we’ll do it together.” Most teens I meet with hate this because it is their thing, not mom or dad’s. Parents are often focused on health, whereas the teen may be more focused on social goals like skateboarding with friends, making a sports team, or being accepted by their peers.

By the time parents bring their kids to see me they are often negative because they have reached their limits. They come in with an “I can’t do this anymore” attitude. They disconnect because they are frustrated. They need outside help. This is when kids need their parents the most to be there for them emotionally. Parents need to be persistent and at the same time know how to be helpful.

Instead of doing it for them, they can ask their tween or teen “what do you think will be helpful?”

It is often challenging to get the parents out of the consultation room. They want to hear what I say to validate what they have been telling their kids. They want to be able to say “I told you so.” This is not helpful because the kids then think I am on their parents “side”.

What are 3 steps you’ve found to be effective in getting kids to eat more vegetables?

First I have the child list the vegetables that they are currently eating.  I like to start out on a positive point. I ask them about vegetables that they have eaten and/or tried. Then I ask them follow up questions like “what they liked and didn’t like about the vegetable(s)”. One challenge I run into is that they often don’t know names of different vegetables because they have not been exposed to them.  Pictures of vegetables are helpful in my dialog with a child. If they have tried a vegetable before and didn’t like it, I ask them if they would be willing to try it again for me.

I tell parents not to dwell on kids not eating a variety of vegetables. There are plenty of adults who don’t like lots of vegetables and they are perfectly fine.  Parents don’t need to put that much energy into it. Instead I have them focus on what the child will eat. Parents seem relieved when I tell them this because they are getting permission from a professional that they don’t have to worry so much about their children’s vegetable intake.

Your role as the parent is to prep and serve the vegetables to your children. As they get braver, they will try them.  Keep in mind eating a variety of fruits and vegetables in your diet and exposing children to a variety of fruits and vegetables in early childhood will help with acceptance later in life.

What suggestions can parents provide their children to help respond to peer pressure that teens often face with food?

Have a conversation with your child about strategy. You can’t tell them not to go to a restaurant with their friends, so you should help them make healthier choices. Your role is to provide them with information. Help them make a plan before they go, like at a party choose 2 slices of pizza, diet soda or water and no chips.

Teens can’t say no to their friends, especially when they start to drive. One strategy would be to limit their allowance. “I can’t eat out because I don’t have any money” is a way out for your teen. And if their friend says they will treat, then you need to help your kid develop a Plan B. “I’m not really that hungry” or choose a healthier alternative at the restaurant.

Sleepovers are “eatfests”, lots of pizza, chips, take-out, candy, etc. Help your teen set up a strategy. Ask them what they normally eat at a sleepover.  Then help them map out/plan a realistic strategy.

Empower your kids so they can make good choices when with their peers.

How do you encourage parents to talk to their child who is overweight?

I suggest that parents be up front and do not beat around the bush. Parents can often dismiss or shut the conversation down by saying “your fine” or “you’ll grow out of it.” Parents try so hard to protect their children’s self esteem but weight issues and weight talk arises in peer groups, so by not talking about it at home, what their peers think and say becomes more important. Kids often do not respond positively to parents’ discussion on the topic because the kids feel criticized, so overall listen and ask them “how can I help?”

When your child brings the topic up, don’t dismiss them, it may become a missed opportunity to talk about their weight. Be straight up and to the point. Ask them “Why do you think that is happening. Did someone say something to you?”

Most 4th and 5th graders recognize they are changing and think “I’m huge”. You may want to talk to them about their genetics and about how their bodies resemble yours and their relatives. Let your child do most of the talking and speak to them in a constructive way. If you have teens, ask them if this is something they want to change.

Parents who are over-weight often have overweight children, how do you help make eating right a family affair?

Parents are the gatekeepers and they need to “walk the walk” and “talk the talk“. Often dads are more challenging to work with than the moms. Dads tend to do their own thing and are often on a different schedule from the rest of the family. Dads may also “treat” their kids and then tell them not to tell their moms.

One parent has to step up and be the leader. Usually this parent is mom. She shops for groceries and plans and organizes meals. Nowadays, dads are starting to take more responsibility for shopping and cooking. It is good to share the responsibility, but one person needs to take the lead.

Do you find it harder to get parents to change their eating habits than their children? If so how do you address this?

Parents are usually motivated to change. I find it is the kids that are often resisting the imposed and often may have unhealthy dietary restrictions.

Yes, it can be hard to get parents to change but I appeal to their desire to be healthy. The biggest challenge is the lack of physical activity. How do parents expect their kids to be active when they are not? Lots of families have workout equipment in their homes, but find it difficult to find 20 minutes to exercise. Parents need to live a healthy lifestyle and their kids will too.

What kind of fitness activities do you encourage for your clients?

Move it! Any physical movement requires energy so anything is better than nothing. It takes energy to move your body. Even when “picking up a pen”, my muscle needs energy. Anything above and beyond what you are doing is using energy. When children are overweight, they often are not comfortable to move.  Encourage your kids to participate in physical activities in a less structured manner, like picking up toys, vacuuming, shoveling snow, and cleaning out the garage. Make a game out of cleaning up. Parents should have an expectation of what kids should do around the house. This also means parents need to have consequences when those expectations are not met.

Plan family outings that are fun for everyone. Adopt an active lifestyle like taking a walk, sleigh riding, taking your dog for a walk, or snow-shoeing. In colder areas, people use the cold as an excuse. Just put on extra layers and go outside – you will survive.

Dianne Fagan, RD, CDN is a Registered Dietitian and a Certified Dietitian Nutritionist, who practices in Niskayuna, New York. Her practice focuses on children, teens and the issues they face when confronted with food choices and changing nutritional needs. She help kids and those who care for them to solve nutrition related problems and dietary concerns.

You can view all of our expert interviews Here.

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