The Empathic Family Meal

In the last post, I’ve pointed out that a family meal is a good idea.  At least by current research, there seems to be solid evidence that family meals are good things for your kids.  When read critically, the research leaves many questions unanswered.  Research shows that kids who eat regular family meals have lower rates of obesity.  And lower rates of other problems.  It could be that kids are less likely to have eating issues if they come from these cartoonishly-structured families. You know, the families where mom is in an apron most of the day at home and dad comes home from work about 5:30.  It could also be that families that make an effort to get together and keep in touch with the lives of each family member are more supportive, and this is a key factor in prevention of obesity.  Maybe just the fact of having a dependable dinner every night prevents that fast-food or pizza stop on the way home from school. 

Since I’m writing this to encourage you to make a family meal part of your daily routine, or part of your weekly routine if you can’t do it daily, you should have an idea what an Empathic Family Meal might look like.

Those that follow my general take on parenting see that I encourage an empathic approach.  The authoritarian, Top-Down Management model of parenting—as would be practiced by the family I described above with mom at home wearing an apron and so looking forward to the time her husband will give her permission to leave the bunker and freshen up their survivalist hoard—is not going to get a lot of support here.  But because these families don’t move much (it’s just so inconvenient to pack up all the firearms), have stable family structures and menus that are easy to keep track of, they are heavily followed by researchers.  That alone might skew some of the conclusions.

It’s both funny and foolish to look back on those family meals from our own childhoods or those we have witnessed.  Sometimes they were opportunities for bitter parents to enforce conformity, where having an elbow on the table was an offense deserving of discipline.  Children were there to be interrogated about their school or personal lives, and their attempts to keep certain parts of their lives private were never respected.  Occasionally, parents who were either sadistic or indifferent would bring up the most humiliating issues at the dinner table.  You know this is possible.  It has happened to you or your friends.  (These parents are the ones who in 30 years will have adult children that don’t talk to them.)  So there’s a danger in the power structure of the family meal that I think has been ignored.  Absolute power, corrupting as it does, has a nasty tendency to make the people sitting at the head of the table really believe that they are in charge.  Like a president-for-life in a small ex-colonial country, they really believe that if they are happy, the family is happy.

Family meals do more than somehow help reduce the chances of obesity and eating disorders.  They are a great way of reducing picky eating in younger kids, and getting children to try new--occasionally even green--things.  This can be accomplished with an empathic family meal. 

Here is the best way I know to get a preschooler to eat vegetables.  Give them some guidelines, take them to the market, and leave them in charge.  Start with a plan.  Maybe your plan is that on Wednesday night, Eric is making dinner.  Why would he?  Is this just another unrewarded chore that Eric, 5, is supposed to do while you catch up on your emails?  Of course not.  Eric’s true reward is the one-on-one time he will spend with you.  First, you and he will plan a menu.  Make the menu suitable for a weeknight family dinner.  There are many fine cookbooks with short recipes, if you don’t know some off the top of your head.  This dinner, however, does not consist of a phone number and stained paper menu of the ethnic restaurant that delivers.  From the menu, make a shopping list.  From the shopping list, make a trip to the market.  With Eric.  This last part is crucial for success.  When you call your partner to pick up some broccoli on the way home, you have rescinded Eric’s ownership of the event.  He needs to pick it out.  However ridiculous it may appear, he makes an important step when he’s at the market with you and picks out one bunch of broccoli over another.  In his mind, he has been given authority over what his family will eat.  You have trusted him with your sustenance and he has taken up that challenge. 

I often encourage new parents to put aside one bottle a day for dad to feed the baby.  A baby bottle, I mean.  Whatever bottle dad was hoping for is his own business.  However sleep-deprived he might be, that intimate time with the baby, giving her what she needs, is profoundly meaningful to new dads.  Even though newborns may not smile or laugh, the dads have no problem sensing their baby’s gratitude.  It’s a moving and wonderful thing that every mother knows.

I think this wonderful generosity of supporting another’s life through food stars with feeding a baby.  It continues through life.  There’s a reason humans of all cultures socialize over food.

So picture the parent I saw today with an 18-month old.  She complained that he’s “starting to get picky about eating.”  She said that she fed him in the kitchen before she and his dad sat down to eat.  I asked why they didn’t have him at the table with them.  She said that it was just too much trouble because he would keep grabbing their food if they held him, and if he was in his high chair, he would complain about not getting stuff off their plates.  Do you see the empathic parenting lesson here?  When they give him baby food he’s not interested in, he won’t eat it unless he’s very hungry or it’s one of his favorite foods.  We’ve all had this experience.  We look in the full refrigerator, the bursting pantry and complain that there’s nothing to eat.  That’s us.  We’re picky, too. 

But we usually will eat if the company is good, and even if the food isn’t just to our taste, we’ll be polite about it because we see how happy it makes others.  Babies know this and they feel it.  This 18-month-old was telling his mother this in the clearest way he could.  Isolating the child isn’t what he wants.  If he had a place at the table, it would indeed be a lot messier.  But he would love to taste the broccoli off mom’s plate and maybe some of the clam chowder dad was eating.  They don’t want to try healthy foods, and they don’t want to try new foods.  They want to try your foods.  Let them.

The Problem with Picky Eaters

Should we intervene with picky eaters?

This is both a medical and philosophical question. The medical question is easier, so I’ll deal with that first.

If the child’s picky eating has left them without enough vitamin intake (if they ate zero vegetables, for example), they probably should take a vitamin. Luckily, there’s a lot of good-tasting vitamin choices available. For iron deficiency, it’s a little more difficult, because the iron supplements often taste bad. But there’s now orange juice with iron, and vitamins with iron which might help. For kids who don’t have any dairy, there are many calcium-fortified foods and drinks. If the child has a problem with creamy-textured foods, that’s sometimes a problem with fat-soluble vitamins A, E, and D, which are usually found in milk. Most soy milk and rice milk is also fortified with these vitamins. But supplements are available for these too. In short, if there's a medical problem, we'll deal with it medically.

The philosophical question is related to the saying, ‘if it ain’t broke, don’t fix it.’ By the time they’re 2, half of all children are considered picky eaters by their parents. So if this is a pretty typical part of child development, do we need to change it? Should we even try?

Research has suggested some of the answers. It turns out that preschoolers who are very picky eaters were often picky toddlers, and these were picky babies who had difficulty nursing and were often fussy. When they became older children, better able to say what they didn’t like, they often had difficulty describing the hesitation they had with certain foods. But many of these very picky eaters remain very sensitive to certain flavors, textures, and smells. Some also were sensitive to other sensory inputs, such as noises, clothing textures, and temperature of the environment.

When I was in medical school, I had the great good fortune to work in a laboratory that studied taste and smell, run by a brilliant scientist named Linda Bartoshuk. Though I personally focused on some of the curious effects of hot peppers in the mouth, the lab studied many interesting phenomena. When I was there, I learned that what I had been taught about the sense of taste was mostly wrong. Bitter taste, in particular, seemed to be genetically determined. It was often more intense in women of childbearing age, and less intense in girls and older women. It was usually less intense in men. Some people simply could not taste one of the test chemicals, while for others it was intolerably intense. Researchers in the lab photographed tongues (including mine) with a microscope, and meticulously counted the taste buds. It turns out that there’s a wide variation in the number and kinds of taste buds people have. Both this and the variations in what we can taste and how intense that taste is can be related to how certain foods taste to us. Professor Bartoshuk and her former student Valerie Duffy, now a professor at the University of Connecticut, collaborated on a great research study that's important to the way we should probably look at this issue. These scientists looked at how intensely adults experienced bitter taste. Then they tested how much these same adults liked asparagus, kale, and brussels sprouts; they also asked about how many servings of vegetables these people ate. Maybe it's not a surprise that those who had the most unpleasant and intense bitter taste perception ate the fewest vegetables. So it's not because their parents were inept about teaching good eating habits. And not because their parents didn't find the right bribe to use to get them to have one more bite of vegetables. It's because the vegetables just didn't taste good.

I have always been interested in doing this kind of experiment in children, which nobody's done. But there are complex issues when experimenting on kids, and that's why it hasn't happened.

Knowing this influences my approach to this common question. The child may not, in fact, be perceiving as delicious what we perceive as delicious. To them, it might be too intensely flavored, even bitter enough to make them gag or vomit. This might be built into their tongues and brains, and won’t improve with nagging or bribing. In other words, it's not necessarily behavioral—which is why behavioral approaches may not work, and could return unwanted consequences.

We could end up causing lasting harm, leaving them with serious food and eating issues that might result in eating disorders and self-esteem issues when they are older.

It’s an unfortunate coincidence that this issue seems to coincide developmentally with the time that most kids are naturally learning to exert control on their environment and their parents. It will take an intelligent parent to figure out when these typical eating issues leave off and the child’s quest for independence and control take over.

So what is the perceptive parent to do? That's the next post.