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How do you get kids to eat right — and like it? 

When November rolls around, we begin thinking about food, families and giving thanks —three front-burner topics for parents. Lewis First, chief of pediatrics at Vermont Children's Hospital at Fletcher Allen and editor-in-chief of Pediatrics, discusses palates and clean plates.

KIDS VT: Everybody says that sugar makes kids hyper. Is that true?

LEWIS FIRST: It's not true. The only health issues that have been linked to high sugar intake are tooth decay and obesity. There have been at least 12 studies that I know of that have tried to link sugar intake to hyperactivity, and not one of them could show any linkage, comparing children who got lots of sugar to those who didn't. Whether this was done studying natural sugars, sugar in sweets such as chocolate candy or even in kids whose parents said they were very sensitive to sugar, no studies proved it.

KVT: How does food insecurity relate to sugar intake and childhood obesity?

LF: Often when families cannot afford the healthiest food, they tend to buy food that is high in quantity but low in nutritional value — foods that are going to lead to kids having an increased risk of becoming overweight or obese. Thanksgiving is a great time for people to think about families who may not be as secure with their foods and think about ways to help them by volunteering at food shelves, donating foods or even making a contribution to one of the food charity organizations here in our area.

KVT: Is it true that exposing kids to different foods can shape their tastes?

LF: The American Academy of Pediatrics recommends solid foods being introduced between the ages of 4 and 6 months. Ideally it's recommended that parents breast-feed exclusively to as close to 6 months as possible and then introduce solids. The reason we go so long before we introduce solids is because solids don't contain enough calories and nutrients to help your child grow in that first year of life. Solids are purely for taste and texture, believe it or not. If you go a lot further past 6 months before you introduce the solids, your child may be less excited about trying different tastes and textures. One suggestion that some health care providers make is that you begin with cereal, which is very easily digested, move on to vegetables and eventually get to fruits. Because the fruits are the sweetest, children will like them. If they've been eating fruits, and then they get introduced to the spinach or the broccoli, they're not going to be as enthused.

KVT: What happened to the old "food pyramid"?

LF: This year, the U.S. Department of Agriculture switched from the pyramid to this colorful food plate, which is called MyPlate. It helps families eat healthy in as simple a manner as possible. Instead of six sections of the pyramid, the plate has four: vegetables, fruits, grains and proteins — plus a side spot for dairy. Fruits and vegetables make up more than half the plate, which is what a child or an adult's diet really should consist of. Hopefully, how you set your child's plate up will mimic the proportions on the new MyPlate. In addition, there's a website (choosemyplate.gov) where you can enter your child's age, height and weight. Then it offers you and your child choices of different food groups and proportions.

KVT: Any ideas for picky eaters?

LF: Offer some choices with each meal. Not 25 choices, but "do you want eggs or pancakes with your breakfast?" That way, children begin to understand that they have some control over the meal but not the entire kitchen. With an ability to choose, they may be more apt to eat what is in front of them rather than be picky. Also, kids respond better to small portions on bigger plates than they do to overwhelming their plate with lots of food on a small plate. Parents need to realize that between one and two years of life, a child averages about two and a half pounds of weight gain. Often, because there's been such an emphasis on helping our babies grow in the first year of life, they forget that they don't have to cram food into their toddlers.

KVT: There's an old saying that breakfast is the most important meal of the day. Is that true?

LF: Absolutely. There have been lots of studies that children perform better with the right healthy protein, grains, fruits and vegetables in their digestive system before they focus on using their brains to do some good schoolwork. Kids should strive to eat a healthy breakfast, either with their family or, if families can't make that happen, many of the schools in our area really focus on making sure that kids have a good breakfast at school before they start class.

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