The Yale Guide to Children's Nutrition

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Foreword

This book can help you develop and execute guidelines that can be readily incorporated into family life, regardless of the structure and circumstances of your family. It contains recipes with child appeal from some of the best chefs in the United States, as well as wisdom from some of the leading scientists in the field of children's health. Not only will your children benefit, but in all likelihood you will too. There is no better time to get yourself on a sensible nutrition track than when your children are learning from your example.

Of the many things I have produced in my life, I am proudest of my twin sons. I should really say "we" because my husband, Richard Engquist, had as much as I did to do with the boys' growing up with common sense as their guide, a healthy respect for the sanctity of their bodies and minds, and sound ideas about the kinds of fuel those bodies need in order to run well.

From the beginning, we were determined as parents not to play games about food and feeding. No "Open Sesame" to shove in spoonfuls of food the boys had little interest in consuming. No "Eat what's on your plate -- the children in Poland are starving." I wasn't out of nursery school when I first suggested that my parents send my dinner to Poland because I certainly wasn't going to eat it.

As soon as our sons lost interest in a meal, the food was removed. When a new food or combination of foods was introduced, they had to taste it, but they did not have to eat anything they didn't like. As lunch-box-toting school children, they were asked to bring home whatever they did not eat in school. No comments were made about how little or how much they consumed, although they were sometimes asked if there was a reason they had not eaten a particular item. That reason guided us as to what and how much to stock their lunch boxes in the days ahead.

We always tried to be adaptable instead of foisting our own standards and habits on the boys. During the early elementary school grades they were hungriest when they came home from school. So, instead of the traditional after-school snack of cookies and milk (which all too often spoils appetites for supper), they had dinner at half past three. Then they went out to play for two hours and returned hungry enough for a light supper with us at seven o'clock. As they got older and ate bigger lunches, after-school snacks were introduced and dinner followed their play-time. While waiting for their meal to be served, the boys downed fistfuls of carrot and celery sticks (one ate only carrots, the other only celery) lightly dipped in a mixture of ketchup and mayo. Because iceberg was the only kind of lettuce they would eat, iceberg was what they got, with sliced tomatoes and cucumbers. Better some kind of salad than none at all, we figured, as we chomped on romaine, redleaf lettuce, and arugula.

At that infamous age when children decide that they do not like most of the things people place between two slices of bread, their lunch sandwiches rotated between turkey breast, sardines, and peanut butter and jelly. Boring, perhaps, but pleasing to them and certainly adequately nutritious. Each lunch box also contained two pieces of fruit, one of which they could trade for someone else's dessert. And during the years they spurned the more sophisticated foods most grownups like, rather than fight with them or restrict ourselves to "kid food," we prepared a separate boys' meal of foods we knew they would enjoy. I could have sworn our boys were made of pasta, cereal, and peanut butter sandwiches, but they seemed none the worse for it, and we figured that eventually this too would pass.

When beset by the hungries, kids will grab whatever is handy. If what was handy was a big bowl of fresh fruit salad, homemade muffins, and quick breads (low in fat and loaded with nutritious ingredients) or cut-up vegetables and dip, that's what the boys ate. Chips, cookies, candy, and pop (or what we New Yorkers call soda) were bought only for special occasions and never kept in the house.

Don't misunderstand. The boys liked sweets as much as any other youngsters. In fact, the first phrase I heard them say was "more cookie." But when they did get cookies, they were served two a piece; the box was never brought to the table, and they soon learned there was no point in begging for more.

A child is likely to be irritable and unable to learn properly on an empty or poorly nourished stomach. As the early riser in our family, I made breakfast for our sons every morning, and I made sure they got up and got dressed in time to eat it before dashing off to school. I was eclectic about the contents of breakfast, alternating between cereal (hot and cold), pancakes and French toast with fruit, homemade pita pizzas, toasted cheese sandwiches, spaghetti pancakes, and sometimes soup or some other leftover from the night before. The "boys" are now nearly 28 years old, and I don't think they have once left the house without eating breakfast.

Their breakfast cereals, primarily Cheerios, Wheaties, and Kix, were garnished with granola and raisins and moistened with milk. I say "breakfast cereals" advisedly, because the classic bowl of cereal also served as a between-meal and bedtime snack once they hit that pubescent growth spurt. To this day, a bowl of cereal is supplemental nutrition as well as breakfast for those two still active young men.

When the boys were small, nothing at all was purchased from a vending machine -- we told them it was much too expensive and sometimes you lost your money. Not until they were old enough to realize that some vending machines offered milk or apples and until they were wise enough to make that choice did those machines lose their forbidden status.

When the boys spent the night at someone else's house, they could eat all the sugar-coated cereals they wanted. When we dined out and the grownups drank wine or beer, the boys could order sugar-sweetened soda. But because they were unaccustomed to having it, they were 10 years old before they could finish a whole can.

Once a week, we gave each of the boys money to buy a candy bar. At first, they nursed the candy for hours. Then one day I realized I had not seen them with candy for several weeks. When I asked, they said, "Oh, we found out that the store sells knishes, so we pooled our candy money and shared a knish instead." To say the least, I was impressed, not just about their more nutritious selection but about the benefits that can accrue from giving children choices instead of dicta.

Likewise with fast food dining. We joined the boys from time to time for a burger and shake at a McDonald's or Burger King, although we--and eventually they--preferred pizza. But when it came to eating out on their own money, they quickly realized that it was a lot cheaper to eat at home or take along a sandwich. Thus, at sporting events they spurned the hot dogs and burgers and instead brought sandwiches and drinks from home, even when they spent the entire day watching tennis at the U.S. Open.

I have told you this tale not to set up our family as a paragon of nutritious dining or to establish our approach as an ideal way to bring up children. Rather, I want to persuade you to share my long-standing belief that children come into the world ready and wanting to be guided, and it is up to their parents and caretakers to do the guiding.

Eat well, and may you all live greatly.

Jane E. Brody

Preface

People who choose a career in pediatrics do so because they love taking care of children. The Yale Guide to Children's Nutrition grew out of this love and out of concern for children's health and welfare. It represents the combined efforts of many talented people at the Yale-New Haven Children's Hospital, including physicians, dieticians, nurses, and social workers. The Children's Hospital is supported by a dedicated group of concerned people who call themselves the Friends of the Children's Hospital at Yale-New Haven. The mission of this group is to improve the health and well-being of children through advocacy, educational programs, and community outreach. And it was the Friends of the Children's Hospital who suggested the unique idea of writing a guide that would present, in understandable language, up-to-date scientific knowledge about the feeding of children, while featuring recipes for dishes that would taste good and be healthy at the same time. It's not a coincidence that the group of Friends includes world-renowned chefs, such as Jacques Pépin, and other notables in the fields of food and cooking, such as Charles van Over.

The editors, authors, and chefs have contributed their time and talent to this book for a good cause. All royalties from the sale and promotion of The Yale Guide to Children's Nutrition will go to child health programs affiliated with the Yale School of Medicine and the Yale-New Haven Children's Hospital, particularly those programs that help economically disadvantaged populations, and to researching treatments and cures for particular diseases. With the purchase of this book you benefit not only the children whose lives you directly touch but also the lives of many other children whose physical and psycho-social health is precarious.

Why produce a guide to children's nutrition? To echo a statement made by Charles Dickens over one hundred years ago, these are the best of times and the worst of times with respect to children's nutrition. Parents' awareness of the importance of good nutrition for the future health of their children has never been greater, and the media regularly issue stories relating to eating and health. Unfortunately, these short stories and sound bites are often more confusing than informative. In addition, the tempo and pressures of modern living make it difficult to put sound nutritional principles into practice. Reports suggest that in the United States more meals are eaten outside the home than inside it, and that childhood obesity has reached epidemic proportions. Moreover, children and adolescents are consistently bombarded with advertisements for foods without much nutritional value.

In the creation of this book, we were guided by several overriding principles One was that there is no such thing as a bad food. Foods that are high in fat, for example, provide a dense source of energy that may be especially useful in periods of rapid growth or intense physical activity. It is the balance of different kinds of food that determines the quality of the diet.

This book will be at home in many rooms in your house: in the kitchen, to be used during meal preparation; in the family room, to be consulted as needed; or on the night table in the bedroom, to be read at leisure. You can read it from cover to cover or jump from one chapter to another. We anticipate that there may be something in each chapter that will make you take special notice because it clarifies something you've always wondered about. Finally, my hope is that you will receive as much satisfaction from using this book as we received from writing it.

William V. Tamborlane, M.D.

New Haven, Connecticut