Despite the fact that we occasionally receive criticism of our Meal Plan for its supposed “rigidity”, what has struck me after years of reading people’s food journals is the degree to which people self-limit their food choices.  This is especially true of vegetables.  I have also noticed that our families’ food journals fall roughly into two categories: those who seem to relish a more Mediterranean style of eating (the original intent of the Meal Plan, by the way) and those who eat a more traditional American high carbohydrate/saturated fat/ low greens/low fiber diet (not the intention, but still compatible with the broad outlines of our Meal Plan).

Does it matter? I think it does. But how much so depends on where a family is in their re-feeding trajectory.  When we are first bringing a child back from semi-starvation and devastating weight loss, the exact composition of the food is less important than its caloric adequacy and acceptability to the child’s palate (with the notable exeption of hyper-palatable foods).  But once we are weight restored, we need to learn to eat for health -- lifelong health.  Not just kids, of course, but adults as well.  

And because at Kartini Clinic we believe all parents need to be in charge of food in every home, the buck stops with us (parents).  Hoping or requiring schools to teach children “to make healthy choices” (usually a code for fat restricting) is only to pass the buck.  We adults need to make healthy food choices and teach by example and with delight.

Now, if your child suffers from true selective eating disorder (SED), all bets are off, and you’d best read this.  Today’s blog is for the average child with anorexia nervosa, bulimia nervosa, binge eating disorder or similar childhood onset eating disorders.

And before I go on to talk about the specifics of what we eat, or probably should eat, let me say that while what we eat is important to our health and that of our children, how we eat is probably even more so: that is, together as a family.

The Kartini Meal Plan has children eating a fruit with breakfast, one with lunch along with one and a half cups of vegetables and a salad with dinner.  Where volume (or bulk) is a problem we recommend that the vegetable be spinach or other greens that easily cook down into a smaller amount. Which vegetable is not specified in the Meal Plan, but I have seen some interesting patterns over the years. Those families who worry most about their child “gaining too much weight” or for whom excessive weight is an inherited family trait typically choose bananas as their fruit and corn as their vegetable. These are both high glycemic index plant products and the Cavendish banana (the one you can buy in any grocery store in America, even in the inner city quick stops) are lower in beta carotene and most antioxidants than other fruits.  But they are sweet, and that is why they are chosen.

I recently read a useful book about vegetables and fruit called Eating on the Wild Side by Pacific Northwest science writer Jo Robinson.  The book is a fountain of information about individual fruits and vegetables, some of it unexpected.  Ms. Robinson is not just relating “more vegetables are good”, but she explains in detail why it is so, which vegetables and fruits are most health giving, all supported by copious citations from the scientific literature, for those who like this (thinking of you, Chris!).  Furthermore -- flying in the face of my own prejudices-- she does not shy away from telling us when a canned vegetable is as good as, or better even than, its fresh or raw form.  For example, I did not know that some canned tomatoes are more healthful than some organic raw ones from the expensive organic stores. Why? They are picked for the canning industry when fully ripe, not transported under-ripe and ripened in the warehouse with ethylene gas, and apparently the heat of canning makes the lycopene in the tomato more bioavailable to us humans.

Of the canned tomato choices, tomato paste is the king, as there is no added salt or sugar and its flavor is concentrated, ripe tomato.  So, Kartini parents, add it to your homemade spaghetti sauce or stews for a deeper, richer flavor and an easy way to add tomatoes to the menu of a child who will not eat them in a salad (a common childhood aversion).  Of course, this means cooking -- but you know how I feel about that!

Then, look for cans that say “No BPA”, or are made of glass, so we aren’t loading our children and families up on endocrine disruptors, and go for the canned tomato products.

The other very useful information in this book -- which I highly recommend -- are the instructions for correct storage of vegetables and fruit.  For example, she recommends that in order to retain the phytonutrients in most vegetables, they be stored in “micro-perforated bags” in the vegetable crisper.  What are “micro-perforated bags” you ask?  They are nothing more than the ubiquitous zip lock bags we all have at home, pricked about 20 times with a pin.  Easy--- and who knew? These fresh food items can be expensive, and if we are going to pay attention to what we eat and pay good money for it, let’s at least make sure that the nutritional goodness makes it to our stomachs.

Another small gem of information, quoted on Science Friday by Ira Flato, is that the well-known healthful ingredients of garlic are destroyed if you cook it immediately after chopping it.  The book recommends pressing garlic through a garlic press and letting it sit for ten minutes before cooking (while you are chopping everything else).  Interestingly, this is exactly what traditional Chinese cooks do.

Back to the vegetables.  Our children will, by and large, form their eating habits at home.  That means we are responsible for this.  When I see only corn as a vegetable on a child’s food journal, I ask the parents what they eat.  The answer is rarely “oh we eat greens and broccoli and steamed carrots”, but rather that they are not eating much in the way of green leafy things themselves.  And this choice seems to ride along with iceberg lettuce and bottled salad dressing.  Read the label, folks: it rarely says “olive oil, vinegar, salt, pepper”, and commonly lists ingredients that you can’t pronounce and don’t recognize: emulsifiers, colorants and stabilizers.

Now please understand, I did not grow up on a farm. I grew up in late 50’s and 60’s suburban America; “salad” to us was jello with shaved carrots and (for a treat) tiny marshmallows. Peas came out of a can and were subsequently boiled to death. Casseroles were a busy housewife’s staple for dinner and the contents were rarely fresh chopped.  Onion powder and garlic powder were time savers.  Mushrooms (exotic additions to spaghetti sauce) were wizened, grey little blobs which came out of a small can.  And we grew up just fine, right?  Well, we certainly ate dinner at the table every night with our parents -- both of them -- and that was a gift worth rubies. And yet our generation and subsequent ones are plagued by metabolic syndrome, overweight, cancers, heart disease, etc.  

To a certain extent, those of us who were part of the counterculture were able to reach escape velocity from the table of jello salads, with the new emphasis on “growing your own food” and eating exotic things from traditional cultures, like vegetable stir-fries, brown rice, fresh garlic, mesclun, etc.  But countervailing pressures took many women out of the kitchen, leaving no one behind to cook regularly for their kids.  We need to turn this around now -- men and women, of course -- and also get informed about what foods are important to health; not necessarily during the immediacy of re-feeding a child with an eating disorder, but for the patterns that will determine their health as young adults and parents themselves.

Some aspects of healthful eating are complex, but this part is simple: if we make our food out of real ingredients (not processed, no matter how expensive or organic) and eat together in a spirit of joy, we are way ahead of the game.  And the game, by the way, is our family’s health.