Home Plate

Like most new moms, I had only the best of intentions for how I would feed my baby girl. Exclusive breast-feeding, for a year, would be followed by her first solids – organic sweet potatoes, lovingly mashed by hand. Capping it off would be her first birthday cake: carrot, no nuts, naturally sweetened. Fast-forward to year two, however, and my standards have slipped – considerably. My toddler subsists on nuggets and noodles now, grazes on glazed Munchkins and crunches on Goldfish crackers. And she’s not alone.

Only 2 percent of kids today meet the government’s food pyramid guidelines for a balanced diet, with fewer than one in five getting enough fruits and vegetables. It’s no wonder obesity rates among children in the United States have doubled in the past 20 years. According to the American Dietetic Association, at least 10 percent of preschoolers and 15 percent of children 6 to 11 are overweight, putting them at risk of health and self-esteem problems – not to mention what could be a lifelong battle with weight. "One of the biggest risk factors of being overweight as an adult is being overweight as a child," says Christina Economous, an assistant professor at Tufts University’s Friedman School of Nutrition Science and Policy. "It’s very difficult to reverse."

By now, the reasons are well-worn: time-crunched families resorting to packaged processed fast foods (guilty), kids spending fewer hours playing outside and more time staring at a computer or TV screen (guilty again).

Concerned, the private, nonprofit Institute of Medicine (IOM) has produced two new reports on the epidemic, and in 2004, Congress passed the Child Nutrition Reauthorization Act, requiring every school district to put in place a "wellness policy" by the start of the 2006-2007 school year. Locally, the Boston Public Schools have sponsored "vegetable festivals" and yanked out sodas and high-fat snacks from vending machines, despite raising the ire of students and suffering a financial hit. "We’re not going to bring them back at the expense of students’ heath," says nutrition education coordinator Debra Korzec-Ramirez.

Slowly, the message is trickling through. Tune in to PBS these days, and you’re likely to see singing vegetables alongside Cookie Monster, brought to you by new sponsors like Earth’s Best organic baby food in addition to McDonald’s. At Disney theme parks, kids’ meals now include a choice of carrots or grapes instead of fries.

Some parents, especially those with teenage girls, fear that too much of a "thin is in" mantra may inadvertently send a pro-anorexia message. Authorities say the key is to avoid insulting – or excessively complimenting – young girls’ appearance. Instead, focus on achieving a healthy weight and emphasize that a "healthy" number on the scale may be different for everyone. Alison Field, an assistant professor of adolescent medicine at Children’s Hospital Boston, says no study, to her knowledge, has ever found a spike in eating disorders from school-based interventions – and one she coauthored found that encouraging healthy eating behaviors actually reduced risky practices such as purging.

Karrie Welborn, a Somerville mom who has struggled with her own weight, is determined to lead her son in a healthier direction. "To some parents, I’m sure I seem like the ‘food police,’ " says Welborn, whose blog, One Weird Mother, relates life with Max, 3. "My strategy is to offer a wide range of healthy foods, and to only allow junk in very limited amounts, outside our home." On her forbidden list? Soda and processed foods, particularly those with high-fructose corn syrup or partially hydrogenated oils. "I sometimes judge feeding choices, like giving toddlers Lunchables or fast-food meals," Welborn admits to me. "But I think most parents are just doing the best that they can." Others are less forgiving. "Too many parents are in too much of a hurry," says Jennifer Dacey, a Boston mom of a 9-month-old boy. "They are just feeding them stuff that will teach their children that fast food is OK."

Still, even among parents who strive for healthier choices, the decisions can be daunting - and, at play groups and playgrounds, divisive. Breast milk or formula? Organic or soy? Whole grain or multi? Which is worse: trans fats or high-fructose corn syrup? And are juice boxes really evil? Dr. W. Allan Walker, director of nutrition at Harvard Medical School and the author of Eat, Play and Be Healthy, says the choices parents make in the first few years really are critical (including breast-feeding, which has been found to reduce the risk of obesity, according to one of the IOM reports). "The tendency to have a taste for something occurs early on," Walker explains. "If children acquire a taste for salty and sweet, when they get older, that’s what they eat."

"It all goes back to what you do from the start," agrees Jessica Grosman, a Boston dietitian and mother of a 15-month-old. "My daughter got plain nonfat yogurt from the start – not YoBaby [an organic but sugar-added yogurt]. In her little mind, that’s what yogurt is, that’s what she learned to like. She begs for more. How can I complain about that?"

Even if your children snub healthy foods at first, authorities say you should keep presenting them with healthy choices. They might not eat peas the first nine times, but on the 10th, they just might. "Parents decide what, when, and where – kids decide which and how much," explains Julie Rackliffe Lucey, an Arlington mother and nutritional consultant. "Kids have small stomachs, and if they get filled up with Goldfish from someone’s snack bag or ice cream from the ice cream truck – it’s done. They simply aren’t hungry when the healthful options come around, and frankly, that’s not their fault."

The juice-is-evil crowd may have a point, too. Many juice "cocktails" are essentially sugar water, with only a little real juice and without the fiber and nutrients of fresh fruit. The American Academy of Pediatrics advises sticking to 100 percent juice and only serving around a half a cup daily for children younger than 6 and one cupful for older kids.

Perhaps hardest to swallow is the fact that for any of this to work, you, too, are going to have to throw away the Cheez-Its and the Twinkies. Studies have shown that kids are more likely to eat their vegetables and drink their milk if they see their parents doing so, rather than being pressured to.

One sure way to engage older children is to take them on a visit to the grocery store and teach them how to spot desirable (whole-wheat flour) and undesirable (high-fructose corn syrup) ingredients on labels. Or try planting some tomatoes or zucchini in your own garden, to spark your child’s interest in eating whole foods like vegetables. Just as crucial, avoid creating food-related hang-ups. What about the traditional refrain to "clean your plate"? Wrong. Instead, teach your children to tune in to their internal hunger cues and eat the amount their body needs, not necessarily the amount that’s doled out. And don’t make those portions supersized, either. Allow your children to serve themselves, or hand out smaller portions if the child has a tendency to overeat. Another bad idea: bribes. As tempting as it may be, try to resist offering a cookie in return for good behavior. "Using food that way is not in the child’s best interest," says Walker. "What happens is, when a child becomes older, and they don’t feel good and want to reward themselves, they eat."

But don’t make treats off-limits, either, which risks turning them into desirable forbidden fruit. Jennifer Thompson, a Watertown mom, showed a picture of her son’s first birthday to some friends. "One mom was absolutely shocked that I allowed my son to have frosting on his birthday cake. I thought she was concerned about the mess – but it turns out she was concerned about the sugar."

Stories like this make some parents wonder if the pendulum has swung too far toward the so-called sanctimommies. "Diet is very important, but should not be stressful," says Rosalind Kabrhel, a Belmont mother of two daughters – and many authorities agree. "Kids should not have to wonder whether they will need to go jog to burn off the extra calories from eating an ice cream cone," Kabrhel says. (Correction: Because of an editing error, the name of Christina Economos, an assistant professor at the Tufts University Friedman School of Nutrition Science, is misspelled in the story "Home Plate" in today's Globe magazine.)