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column of knowledge: pediatrics

Nutritional Fitness in Children

The following are just a few of the questions I get every day regarding the way kids eat:

Q: My toddler is soooo picky! How can I make him a better eater?
A: Your toddler's pickiness is typical. Most young children enjoy a limited array of foods because the first few years of erupting teeth make anything that is not easy to chew a bit painful. Also, foods that older children and adults like are too challenging for the toddler tongue.

Toddler breakfasts typically consist of something sweet and soft like cereal, pancakes, waffles and fruit. Most kids are hungry in the morning after (hopefully) sleeping all night, and most parents are happy with the amount of breakfast their kids eat. The mid-morning snack is very important and should be simple and healthy: whole grain crackers or cereal, fruit, low-fat yogurt, a cup of 100% juice, low-fat milk (after age two) or water.

Lunch should consist of two or three favorites that kids can depend on: peanut butter and jelly, macaroni and cheese, grilled cheese, hot dogs and chicken nuggets. However, soups, salads and meat sandwiches generally are too complex in tastes and textures. A mid-afternoon snack should also be offered.

By dinnertime, most children won’t sit for long at the table and eat what the rest of the family is eating. One reason is that after four meals, they are likely not very hungry; and another is that they really don’t like your food — it looks complicated, smells strong and is hard to chew. Nevertheless, I recommend serving toddlers and older children the dinner you have prepared for everyone. Give them a small portion, so if they don’t eat it you won’t waste much. If they get hungry later, offer something healthful that takes less than 30 seconds to prepare. Finally, don’t fight with your children about food. If they’re hungry they’ll eat; if not, they won’t.

Q: All my kid eats is junk! What’s up with that?
A: Your child eats junk because he likes it. If you don’t buy junk, then he won’t eat junk! Then, as he gets older, he is less likely to choose junk when he is away from home. You are the parent. It really is okay to say “no” to your child; and you can say “yes” at special times, too.

Q: What are the fundamentals of nutritional fitness?
A: Okay, I admit I’ve never been asked that particular question. But I do believe that the triad of nutritional fitness, physical fitness and psychological fitness are the cornerstones of good health. The three are interconnected and supportive of each other. When one breaks down, the others are left weaker.

Nutritional fitness requires a diet that is high in fiber, low in fat and low in sugar. Without question, the amount of sugar in the American diet is largely responsible for the obesity epidemic in the United States today. Sugary beverages play a huge role, but so do staples like refined flour, potatoes and corn, all of which have high glycemic (sugar) indexes.

Remember when your mother used to say: “Eat your vegetables!” and “Go outside and play!” and “Turn that frown upside down!” She was referring to the triad of good health. •


Pediatrician Edward Ketyer has been in private practice in the South Hills for 16 years. The Chartiers/McMurray division of Pediatric Alliance has two locations in Bridgeville and McMurray. For more information, call 412-221-0160 or 724-941-2747 or visit www.pediatricalliance.com.

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