Combating Coercive Feeding: High 5 for Kids Observes Fruit and Vegetable Consumption in Relation to Common Parenting Strategies

Holly Bante, B.A., Kimberly Hessler, M.S., R.D., Amanda Harrod, M.P.H., Michael Elliott, Ph.D., Debra Haire-Joshu, Ph.D.

Characteristic (N = 1658)Parent: MN age 28.9 ± 7.0

MN BMI 27.1 ± 6.2%

Parent Gender

Male

Female

1.6

98.4Parent Race

White

African American

Other

81.1

17.6

1.3Parent Education Level

High School or Less

High School Graduate

Some College or Technical School

College Graduate or More

16.2

38.1

24.8

20.8

Core Themes

Asking Skills: Children should learn to request fruits and vegetables from their parents. Parents should be responsive to their children’s requests of fruits and vegetables.

Fruit and Vegetable Intake: Increase fruit and vegetable intake by one serving per day. Small, slow steps toward incorporating new and more fruits and vegetables into the routine diet.

Quality of Fruits and Vegetables: Promote consumption of healthiest fruits and vegetables currently being eaten, but at less than the daily recommendation.

Non-coercive Parenting: How food is presented to a child impacts his or her acceptance of it. Parents use a variety of strategies to get their child to eat. Coercive feeding practices have negative impacts on food consumption

What is Coercive Feeding?Strategies used in which a child is made to eat.

Why do parents use Coercive Feeding strategies?Well-intentioned parents use these strategies to get a child to eat more of a certain type of

food.

What are some common Coercive Feeding strategies?One Bite Rule: forcing a child to eat at least one bite of everything on his plate.Clean Your Plate Rule: the child must eat everything on his plate before leaving the table.Using Dessert as a Reward: parents often bribe their children to eat or engage in other

behaviors by offering dessert as a reward.

How do Coercive Feeding strategies negatively impact children?Strategies that parents often use to increase consumption of foods may affect a child’s ability

to listen to internal huger and satiety cues, altering a child’s ability to self-regulate food intake which may lead to childhood overweight.

BackgroundLess than 1/3 of children eat 5 servings of fruits and vegetables per day.The average adult consumes 3.6 servings of fruits and vegetables per day.Impact of consuming one more serving of fruits and vegetables daily: Risk of lung cancer would be reduced by 10%.

PurposeDecrease risk for cancer by increasing consumption of fruits and vegetables and increasing physical activity among parents and their children Prevent diet-related cancers in families living in the Southeast corner of Missouri, often called the bootheel.

Specific AimHigh 5 for Kids is a community based program designed to intervene with parents to promote their preschool children’s (age 3-5) preference for and intake of fruits and vegetables.

Previous ResearchContinuation of “High 5, Low Fat” (1997-2002)Obesity Prevention Center: Saint Louis University School of Public HealthFunded by: National Cancer InstitutePurpose: To decrease fat and increase fruit and vegetable intake through goal setting.Results: Through nutrition education aimed at empowering parents with appropriate child feeding techniques, H5LF successfully improved the dietary intake of African American parents, as indicated by increased fruit and vegetable intake, decreased fat consumption, increased frequency of low fat eating behaviors, and parental role modeling of dietary behaviors.

Demographics

Acknowledgements Parents as TeachersNational Cancer Institute

Project Materials: The High 5 for Kids program includes 4 personal visits, facilitated by parent educators, reinforcing each of the 4 core themes.

Curriculum: Factors that influence children’s food intake and/or physical activity are presented in each personal visit:

•Neophobia (see examples on right)

•Role-Modeling

•Food Availability/Accessibility

•TV Viewing

Enjoy your gift from Parents as Teachers and High 5 for Kids!

R a i nb ow P u dd i ngR a i nb ow P u dd i ngR a i nb ow P u dd i ng I ngr edi ent s 1 box vanilla pudding 1 large can fruit cocktail 1 carton strawberries (optional)

I ns t r u c t i ons 1. Parent and Child: Wash hands before starting. 2. Child: Drain the juice from the fruit and set aside. 3. Child: Rinse other fruit (strawberries). 4. Parent: Chop fruit and set aside with the canned fruit cocktail. 5. Parent: Add water to fruit cocktail juice to make 1 1/2 cups of liquid. 6. Child: Combine pudding and liquid in a medium bowl. 7. Child: Mix pudding powder and liquid together until all lumps are gone

and mixture has thickened. 8. Child: Add fruit to the pudding mixture, stir, and serve! 9. Parent: Store leftovers in the refrigerator.

A hea lt hy c hi ld- f r i endl y

m ea l! Makes 5-6 servings.

T ip For color and flavor, add fresh fruit to the recipe!

Read and play with your children. It’s healthy, and they love it! Act out scenes from the “Gone Bananas” book with them. Ask your child questions about what happened in the book. When serving the fruits and vegetables named in the book, talk

with your children about them. It’s a good way to help your child learn colors and how to count.

You are your child’s first and best teacher!

When it comes to food, some things to remember: If your child is shy about trying new foods, especially fruits and

vegetables, don’t worry. It’s normal. Try not to push him/her too much. Be patient, wrap it up, and serve it later, when your child is hungry.

The best way to get your child to eat these foods it to keep offering them. This will help your child become more familiar with them, which will help your child learn to like them.

Try eating a serving of fruit cocktail today!

Parent Handout

7.29.02

F r oz en Del i gh t sF r oz en Del i gh t sF r oz en Del i gh t s

Recipes that fit your lifestyle!

As your child becomes more familiar with certain foods, he or she is more likely to eat and like them. Try making these recipes to help

your child become more familiar with fruit cocktail.

Parent Handout 8.7.02

Ingr edient s 12 oz frozen orange juice concentrate 1 can fruit cocktail 1/2 cup water

Ins t r uct ions 1. Child: In a large bowl, pour and mix orange juice, water, and fruit

cocktail. 2. Parent: Pour mixture into ice cube trays or paper cups. 3. Parent: Freeze until halfway frozen. 4. Parent and Child: Scoop out and enjoy!

F a b u lou s F r u i t S m oot h i eF a b u lou s F r u i t S m oot h i eF a b u lou s F r u i t S m oot h i e Ingr edient s 2 16-oz cans fruit cocktail 1 tbs lemon juice 1 pint frozen yogurt

Ins t r uct ions 1. Parent: Open cans of fruit cocktail and drain, saving 1 cup of the

juice. 2. Parent: In a blender, combine fruit with saved juice and lemon

juice. 3. Child: Slowly add frozen yogurt. 4. Parent: Blend until smooth. 5. Parent and Child: Pour into cups and enjoy!

Ingr edient s 1 46-oz can unsweetened pineapple juice, chilled 2 15-oz cans fruit cocktail 1 cup raisins 1 scoop frozen yogurt (per person)

Ins t r uct ions 1. Child: In a large pitcher, combine pineapple juice, fruit cocktail

with juice (bugs), and raisins (beetles). 2. Parent: Put a scoop of frozen yogurt a glass or mug for each

person. 3. Parent: Add juice to the yogurt. 4. Parent and Child: Enjoy with spoons or straws as a snack or

dessert.

Bu g aBu g aBu g a nd Beet le J u i c end Beet le J u i c end Beet le J u i c e

Child Storybooks

Parent Handouts and Recipes

Parent Educator-Visit Plan