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| By Dr. Ronald Hoffman
Poor childhood nutrition is one of the most critical problems that threatens the health, productivity, and even national security of America.
Time was, during the mobilization of young men that accompanied World Wars I and II, a high percentage of recruits were underweight and undernourished; they had to be fattened up on military fare to meet the basic physical requirements of combat-readiness.
Now, the armed forces face the opposite problem: too many volunteers are overweight and can’t pass increasingly lenient tests of endurance and stamina. The term “hunger” has been supplanted by “food insecurity”, which means that too many impoverished American families aren’t starving, but don’t have consistent access to good quality food.
The result: “Rates of new diagnosed cases of type 1 and type 2 diabetes are increasing among youth in the United States, according to a report in the New England Journal of Medicine (Incidence Trends of Type 1 and Type 2 Diabetes among Youths, 2002-2012). Type 2 diabetes increased at the rate of 7% annually, and the rate was especially high among non-white Hispanics, Blacks and Native Americans.
Nor is the problem restricted to less affluent or minority precincts. Junk food consumption abounds across all demographics. Even if it doesn’t produce overweight, it sets the stage for a myriad of inflammatory, allergic, and cardiovascular diseases, even childhood cancers. And it may impair the cognitive development of kids, resulting in an unprecedented rise in behavioral and developmental conditions like autism, ADHD, bipolar disorder, and childhood depression and anxiety. One study reveals that higher fruit and vegetable intake is linked to better mental health in secondary schoolchildren.
While some surveys suggest that Americans’ embrace of junk food peaked in the early 2000s and is now declining, a review in the American Journal of Clinical Nutrition finds the opposite. While, indeed, there were significant decreases in particular junk food categories (e.g. candy, cakes, and pies), they were offset by increases in other categories, especially snack and meal bars. This parallels a trend toward supplanting sugary soda with “energy drinks”, juice beverages, and diet soda.
Cereal bars and nutrition bars marketed as replacements for real food are endowed with a false “health halo” when labeled as “natural”, “organic”, “keto” or “high-protein”. I eat bars maybe 2 or 3 times a year when I need muscle glycogen for an endurance event like a triathlon. They are ill-suited to “tiding you over” when you’re too busy to sit down to eat real food.
An editorial that accompanies the article in AJCN notes: “Marketing has also been on the rise—between 2010 and 2014 there was a 25% increase in total advertising spending by leading brands of snack bars, which corresponded to children aged 6–11 y being exposed to 65% more television advertisements for these products in 2014 than in 2010.”
The opinion piece calls for consideration of taxes on junk food, which have been somewhat successful in countries like Mexico, curtailing consumption by about 5-10%. I’m not a fan of “nanny-statism”, and taxes on things like cigarettes hit the poor hardest; I think education is the answer. Schools, media, and parents should pound the message that junk foods are deleterious.
To this end, junk food should be plastered with labels as lurid as those on cigarette packs. Warnings should appear for calories, sugar, fat, and salt content. Many countries, including Israel, Finland, Thailand, and Chile are pioneering this strategy. That won’t deter unbridled hedonists, but it’ll educate the receptive majority of the public to the perils of these pseudo-foods and drive consumption down.
And there should be an absolute ban on marketing these harmful substances to kids. The AJCN reports: In 2014, the last year for which we have statistics, “greater than 40% of all food and beverage advertisements viewed by children and adolescents were for snack foods.” And that doesn’t even account for enormous product placement on social media with paid “influencers” whose behaviors kids increasingly emulate.
Another problem is “picky eating” by kids. Research shows that many picky eaters are deficient in critical nutrients, impairing optimal growth and development.
There is no “gold standard” for defining picky eating. And it’s considered by many as developmentally normal, so it’s important to distinguish between problematic and non-problematic picky eating.
According to a recent review, the prevalence of picky eating is 22% in the first two years of life ( ≤ 30 months of age) . It reaches its peak between ages 2 and 6 years. Estimates also vary widely from 6% to 50% amongst young children aged 2–5 years of age and 19% to 59% among older school-aged children (aged 6–12 years).
The predilection for sweets is hard-wired in babies and toddlers as a survival mechanism favored by natural selection. That’s been verified in studies demonstrating infants’ preference for breast milks of higher sugar composition.
Moreover, a certain percentage of the population is genetically sensitive to bitter taste and have built-in aversions to cruciferous vegetables. Taste aversions are more pronounced in pregnant women and small children as a hedge against consuming toxic vegetation. Often kids grow out of it.
Picky eating may result in a vicious cycle of refusal, caregiver pressure, and mounting resistance. Kids are headstrong, and with few other outlets for their developing individuation, food offers an arena for asserting their choices.
Forcing the issue is likely to backfire. Authoritarian parenting, rewards for eating, and pressuring the child to eat have been found to be strategies least likely to help modify picky eating.
What does work? The study authors recommend these proven measures:
Sometimes it may seem like an incessant battle, but educating our kids about good eating habits is an “infrastructure investment” that will yield long-term dividends. And it’s a crucial starting point for health.
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