When prompted to describe his favorite food, Jennifer Fitzgerald's 8-year-old son paused thoughtfully before delivering an answer.
"Quiche," said Keenan, of Concord, Calif., before elaborating. "Broccoli quiche."
At pizza joints, he and his 9-year-old sister Samantha will often opt for the salad bar over a slice. Recently, a friend offered her kids a Pop-Tart. They didn't know what one was.
The Fitzgerald kids' affinity for greens and other foods often thought of as anathema to children isn't some small miracle bestowed upon Fitzgerald and her husband, John. Both children were at one time picky eaters, shunning many of the healthy foods that are staples at the family dinner table.
But their parents didn't give in. Picky eating was never rewarded. The rule was to eat what's for dinner, or have a bowl of granola with milk — in other words, no trading up broccoli for mac and cheese.
Much research has backed up what the Fitzgeralds have learned in practice: Grown-ups and kids eat the same foods, sit-down family meals are standard and picky eating simply isn't tolerated. Parents need not resort to trickery to get their kids to eat their veggies.
"Research shows that you have to offer a child a food an average 10 to 12 times before they like it," said Dr. Scott Gee, a pediatrician specializing in obesity at Kaiser Permanente's Walnut Creek (Calif.) Medical Center. "I think a lot of parents give up."
The Fitzgeralds did not.
"People say, 'Well, kids don't eat this,' " said Jennifer Fitzgerald. "Kids ate regular food before we had all this convenience food. They will eat healthy."
The effort takes time
Most nights Jennifer makes dinner from scratch — recent meals included vegetarian lasagna with salad and chicken with sautéed kale. Keenan and Samantha usually gobble it up, Fitzgerald said. When they were toddlers, she said, it was often a struggle to get the kids to enjoy — or even eat — what was on their plates.
Take grapefruit: "I recognize it's kind of a weird taste for a kid," Fitzgerald said. When her kids didn't want it, she said, she didn't push the issue. Every so often, curious, they would ask for a bite of hers. Soon they were requesting their own. Grapefruit drizzled with honey is now a mainstay of the lunches Fitzgerald packs for the kids to take to school.
For Keenan, the more finicky of the two kids when it comes to food, salad was a particular hurdle. The Fitzgeralds never attempted to force their kids to eat whole meals of foods they didn't like, but with each meal, Fitzgerald would request that Keenan try just a bite of her salad. Eventually, he realized it was the concept he'd disdained and not the taste. Now he chooses salad over pizza.
Although Fitzgerald didn't realize it, she was relying on so-called "modeling," a strategy that many studies — the most recent published in June in the International Journal of Obesity — have shown as among the most effective in helping children develop healthy eating patterns. The basic concept is that parents should eat what they would like their kids to eat. After all, there is no injustice like being served up a plate of Brussels sprouts while Mom and Dad dine on burgers.
"Having the parents model good eating habits is a big part of it," said Gail Seche, a nurse and the clinical nutrition manager at Children's Hospital Oakland in Oakland, Calif.
Could do better
A new federal report found that the diet quality of children and adolescents nationwide fell woefully short of federal recommendations, pointing to a need for better strategies in teaching kids about nutrition. The report, by the Federal Interagency Forum on Child and Family Statistics, found that from 2003 to 2008, the diets of American children ages 2 to 17 scored 50 percent or less on a Healthy Eating Index.
Recent emphasis on the unhealthy dangers lurking in school cafeterias has prompted revisions to school standards. Next year, more changes will be rolled out as part of the 2010 Healthy Hunger-Free Kids Act, including limiting fatty, salty and high-calorie snacks in vending machines and making drinking water more easily accessible.
The role parents play in teaching kids about nutrition, though, is key in kids' developing healthy habits, especially at a younger age. "If you can establish good eating habits early on, they will carry through," Gee said. "The younger the child, the more important the parent."
Make it a habit
The Fitzgeralds have stressed healthy eating since their kids were old enough to eat solid foods. By the time Keenan and Samantha were old enough to make decisions about food on their own, they had already established eating healthy as a habit.
The kids sometimes help with grocery shopping, as well as tending to the family's chickens and small vegetable garden, involving them in the production of their own food. Cooking or gardening with kids, according to research, often increases their propensity for healthy eating. A carrot is all the more interesting when you've watched it grow.
The family is careful to eat grass-fed meats, whole grains and foods without tons of preservatives, chemicals or food coloring. The point, though, is not to be overly restrictive. On special occasions, even the junkiest of junk food is permissible.
Seche said forbidding certain foods isn't the answer. The whole point is to launch the child into being a healthy eater on his or her own, she said, so that when faced with the temptations of, say, a vending machine, the child can still make good choices.
Explaining to kids why healthy food is good for you is also important.
"I try to explain the difference between something that's good for them and something that's not healthy but OK as a treat," Fitzgerald said.
A recent Stanford University study found that taking the nutrition lesson even further is effective. The study, published in the journal Psychological Science, capitalized on young children's natural curiosity, using storybooks to emphasize important concepts of food and nutrition.
Preschoolers were introduced to conceptual details of the food-body relationship generally dismissed as too complex for kids, such as what nutrients are and how blood moves them through the body.
"From their point of view, digestion is a mystery," said Ellen Markman, a study co-author and Stanford psychologist. She said the children in the study were fascinated by their own biology.
"When we're teaching them about blood, you see them inspecting veins," she said.
Explaining the science of why vegetables are important proved persuasive. Co-author Sarah Gripshover said that after the study she even noticed some children "evangelizing" other children on the values of a diverse diet.
Seche said the concept makes sense. "I've seen 4-year-olds talking about protein," she said.