What Should I Eat, Coach?
By Lisa Poisso
First appeared at Dallas Child Magazine
One
year ago, the Wellborn family from Plano needed help. Eleven-year-old
Brecken was growing broader faster
than he was growing taller
and some of the kids at school were beginning to tease. Additionally,
the Wellborns suspected that 13-year-old Makenna, a competitive
gymnast, needed more protein in her diet to get her through her
intense schedule of practices. “We were going through a
period of poor eating habits,” recalls mom Pam Wellborn, “and
we wanted to nip it in the bud.”
So Wellborn and her kids headed to the Cooper Clinic in Dallas
for nutritional coaching. Fast forward one year: Brecken has
lost 18 pounds and grown three inches taller, Makenna has added
more calcium and carbohydrates to her diet and stabilized her
weight and energy needs, and Wellborn has lost weight and gained
the satisfaction of seeing her family thrive.
“This is not a diet,” Wellborn explains. “It’s
a lifestyle change. And it’s been awesome for all of us.”
Nutrition “Coaching” Takes
Off
Parents today are savvier about the relationship between good
nutrition and good health — and so are pediatricians
and family doctors. Concerned parents are picking up the phone
to call a nutritionist, based on a gut feeling that what their
kids are eating may be setting them up for health problems.
And physicians recognize that heading off nutrition issues
earlier rather than later sets the stage for lifelong health.
We’ve
all heard about children who have to watch their diets based
on diabetes, food allergies or other
health problems.
Since good nutrition touches on virtually every area of health,
nutritionists can help with a whole range of issues for healthy
kids, too, from losing weight to eating disorders to sports nutrition
and even the infamous picky eater.
As
with grownups, weight issues are the most common problem driving
kids to dietitians and nutrition programs. “The
vast majority of kids we deal with are overweight or at risk
of being overweight,” says Patty Kirk, a registered and
licensed dietitian at the Cooper Healthy Habits for Kids program
at the Cooper Clinic in Dallas.
“Next, we see kids who
have specific nutrition needs based on ballet, gymnastics or
other sports like football. We also see a good number of graduating
high school seniors who are going off to college and want to
learn how to eat when they’re living away from home.”
Dee
Rollins, Ph.D., a registered and licensed dietitian at Baylor
Regional Medical Center at Grapevine, observes
that issues are
generally divided by age range. Younger children most frequently
encounter problems stemming from poor food choices presented
by their parents, she says, while older children’s suffer
more often stem from sedentary lifestyles.
Rollins
coordinates with a therapist for many of her young patients. “For
kids with anorexia, bulimia or binging, I have a counselor working
with me because these are also psychological issues,” she
says. “I also see a lot of young athletes with body dysmorphia,
who don’t like certain parts of their bodies or want to
bulk up.
We
life coach these kids into leaving nutritional supplements
alone and eating healthy diets, exercising appropriately and
accepting their genetic physiques.”
But
parents are also seeing the value of nutrition “coaching” for
healthier eating habits in general. “They come in saying ‘My
child isn’t eating healthy, and I want help figuring out
how we can do better,’” Kirk says. Most of those
kids, she adds, are so-called “picky eaters” or have
special sports performance needs. The focus is somewhat seasonal;
she sees more general issues during the summer when kids are
out of school and more sports performance issues during the school
year.
A Family Affair
Nutritional counseling for your child isn’t really for
your child alone. What’s good for the goose is good for
the gander — and helping one child eat better is actually
a family affair. “Many families who have issues with one
kid bring the others, too,” Kirk says. “It’s
important not to treat one differently than the others.”
At
the Cooper Healthy Habits for Kids program, Kirk starts with
parents. “The bottom line is that they are the ones responsible
for what’s in the pantry,” she says. “It’s
a big responsibility for a parent.”
Especially
with weight issues, notes Rollins, what parents provide for
their children
sets the tone for the rest of a child’s life. “If
you bring me a child between 4 and 10 or 11, I can fix their
issues,” she says. “By the time they’re 13
or 14 and they’ve been heavy since they were 6, they’re ‘broken’ and
it gets much more difficult to handle.”
But
most kids are more willing than their parents think. “You’d
be surprised at the number of children who are motivated,” Kirk
says. “If they are overweight, they want help.” For
those kids, Kirk and other nutritionists keep the emphasis on
making them feel good about themselves, while learning that nutrition
can be fun.
Food
models turn learning portion size and food selection into a
hands-on, entertaining activity. They visit multi-media
web sites about food and nutrition. They talk about such practical
matters as fast food and pizza parties. “One of the best
things Brecken learned was how to deal with going out with his
friends and still eating healthy, how to not feel different,” Wellborn
says.
They
also touch on something that’s not about eating at
all – exercise. An active lifestyle is a key component
of good health, and a good nutritionist gives families ideas
on making physical activity fun: family bike rides, back yard
scavenger hunts, hiking and camping trips and “alternative” sports
such as ice skating or other solo sports.
Perhaps
more than anything else, nutritionists can give kids more relevant
advice than they could get from
books and magazines,
the Internet, or even coaches and school nurses because they
can provide individualized programs tailored to each child and
family’s needs.
For
Makenna Wellborn, nutrition coaching addresses what she needs
as an individual athlete rather than
as just another member of the team. “My coach says we can’t
have carbs,” she explains, “but Lara (Hassan, a Cooper
Clinic dietitian) said I needed it for my energy. We figured
out how much I really needed for my own weight and energy.”
A
Kid’s Point of View
But what about the kid who’s not so eager for change — the
kid who likes snarfing potato chips with his video games and
scorns the idea of riding a bike around in the blazing Texas
sun? “For those kids, we work ‘silently’ with
their parents to ‘silently’ do things to help,” Kirk
says. Tactics include eliminating unwholesome choices from the
household, providing plentiful options of healthy foods, organizing
active family activities — and above all, to preserve their
kids’ sense of control. “Parents need to give kids
a choice, to let them pick their own snacks,” she says.
And that means making sure that the available choices are healthy
ones.
Of
course, picking a nutritionist who’s experienced at
working with children can spell the difference in turning around
a reluctant attitude. Kirk tells Brecken Wellborn that there
are only two things he absolutely cannot include in his diet:
anything moldy and anything rotten — spot-on humor for
an 11-year-old working on healthy choices.
And what about communicating
with infamously stony teens? When Irving resident Lynn Lamothe
sent 13-year-old daughter Brooke to Rollins for a consultation,
she was met with a wall of resistance. “She was adamant — she
did not want to go,” Lamothe reports. Brooke elaborates: “I
was mad because it was summer and all my friends were eating
all these foods, and I couldn’t have them.” But behind
the stonewall, things were starting to sink in. Lamothe reports
that although Brooke passed her first session with arms crossed
and cursory replies to Rollins’ remarks, she chose to walk
to her friend’s house that afternoon rather than ask for
a ride — a first.
Since
beginning counseling with Dr. Rollins a year ago, Brooke has
lost 37 pounds and volunteered for the
swim team. Lamothe
goes too, and has lost 14 pounds. Portion control and label reading
has made a big impact for both of them. “I ask myself, ‘Do
I want to wear this?’” explains Brooke, now 14. “I
want to be the size of my friends, so I just ask myself that
question and go from there.” She says while the process
of making healthy choices is sometimes frustrating, she encourages
others to stick with it. “It pays off!” she says. “I
don’t want to stop seeing Dee (Rollins) because it gives
me something to look forward to.”
Successful
nutrition coaching means empowering kids with a sense of control. “Patty (Kirk) taught me about what those things
are on the backs of packages,” Brecken says. “If
I want a piece of cheesecake, I can have it — I just need
to figure out what else I can eat that day.”
The right program for your child
Most nutritional programs involve an initial parent consultation
to uncover the issues. Your nutritionist will ask what your
child eats, when and how much. She’ll want to know how
much activity your child gets on a regular basis. She’ll
review your family health history and ask about the health
and eating habits of the rest of the family.
The parent consultation is usually followed by a visit between
the nutritionist and the child. Most programs and professionals
see patients starting at about age 6. Nutritionists reach out
to kids at an appropriate level, engaging their interest, sparking
discussions about healthy and unhealthy choices and helping kids
maintain a sense of self-worth and control throughout the process.
After
that, the usual path is one to a half dozen or so follow-up
visits or program sessions for the parent,
the child or both — and
very often with siblings, too. “For younger children, nutritionists
work more with the parent,” Kirk explains. “As the
kids get older, they’re more involved in the process.” Follow-up
visits every two to four weeks can be helpful for bigger problems
or more goal-oriented kids.
But
when it’s over, is it really over? Kirk and Rollins
both cite excellent reports from the vast majority of their young
patients, a sign that their new prowess making healthy food choices
is for keeps. However, if kids fall off the wagon, a 15-minute
problem-solving follow up usually pinpoints the problem and helps
them get back on track. And many families — in fact, all
the families interviewed for this article — enjoy the continued
feedback of regular visits.
How to Find a Nutritionist
Facilities such as the Cooper Clinic in Dallas www.cooperaerobics.com/clinic/HealthyHabitsKids.aspx,
the Walker
Wellness Clinic in
Dallas and Plano and area hospitals offer educational programs
on nutrition
for kids. Some schools participate in nutrition education programs;
ask your child’s school nurse for information or local
referrals. Or you can search for a registered dietitian. Making
sure your nutritionist is a registered and licensed dietitian
ensures that she has earned a degree in nutrition or a related
field, has interned at an accredited facility and has passed
a qualifying exam. A good place to start can be a referral
from your own family physician, or check with the American
Dietetic Association (or 800/366-1655).
Once
you identify several candidates, call each and ask some key
questions: Have they had experience counseling
children?
What’s their philosophy in dealing with kids? “You
want someone who cares, not someone with a military style,” Kirk
says. “You want someone who’s sympathetic and going
to listen to their needs and concerns.”
Holistic
and alternative nutritionists, while not necessarily registered
or licensed, may also be helpful
in some situations.
Vegetarian families might want to investigate resources such
as Raw Heaven and Crosby
Café.
And breast-feeding mothers will want to check with someone doubly
qualified in nutrition and nursing, such as Nicole
Roth, a registered
dietitian and certified lactation consultant.
How Much Will It Cost?
Depending on the practitioner and the problem you’re dealing
with, a session with a nutritionist can run from $40 to $250.
For example, the Cooper Clinic’s program, which includes
six sessions, a nutrition book and a pedometer, costs $430; single
visits and separate follow up visits are also available, though.
Some insurance plans will help cover the costs, especially if
you have a referral from your physician, and some costs may be
tax-deductible. Check with your insurance provider before making
an appointment to find out what their reimbursement policy is.
© First
appeared at Dallas
Child magazine
NFO
Editor-in-Chief Lisa Poisso is a writer and editor specializing
in attachment parenting and natural family living. She lives
with her homeschooling family in Texas.
