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START talking treats: Transcript


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Child: Mam, can I have this?

Mother: Your dinner will be ready soon love.

Child: But please, I'm starving.

Narrator: Just say yes Julie. It's been a long week.

Mother: What else has he had today?

Child: Come on just one.

Narrator: Saying no will only make you the bad guy.

Mother: No. If you're hungry you can have cheese and crackers or fruit.

Narrator: Let's go easy on the treats. Start with smaller ones less often to keep your family healthy.

Jen: Good evening everyone and welcome to this evening's Webinar. My name is Jen Hogan and I'm delighted to be your host for this event. This webinar is brought to you by the START campaign. A public health awareness campaign from safefood, the HSE, Healthy Ireland and the public health agency and department of health in Northern Ireland. The campaign has been designed to help parents and guardians start their kids on a way to a healthier life by providing practical advice and useful resources. These include parenting expert videos, healthy snack options and steps to get started, and you can find them by searching 'make a start'. This evening, we're focusing on the topic of how best to moderate our children's treat food consumption. Research with parents and guardians for the START campaign revealed that while they want to reduce treats like crisps, chocolate and biscuits for children, saying no is difficult, and there's very few parents who don't struggle with the number of treats that they give to their children. Sometimes it just seems easier and faster when life is busy. But most of us would like to make healthier choices for our children and encourage them to make healthy choices too, while striking a balance, of course. And making sure that food doesn't become an issue or a battleground. Who doesn't need help getting that balance right? As a mom of seven children, I'm certainly interested in hearing our panel's expert advice. This webinar is all about supporting you, parents and guardians who have joined us this evening. So, if you have any questions for our panel, please submit these into the question-and-answer section. I will put them to our guests a little later. Before I introduce you to the panel, we want to hear from you. We have a couple of questions appearing on our screen now asking how often your children have treats in the week. So that's foods such as crisps, chocolates, sweets, biscuits, or sugary drinks. Is it every day? Five to six days a week? Three to four days a week? Or once or twice a week? How confident are you to start the conversation of moderating treats with your kids? Very confident, quite confident, slightly confident or not at all confident. So, while you're voting, I'll introduce you to our panel. I am joined this evening by Safefood's chief specialist in nutrition Joanna De Silva, child and adolescent psychotherapist, Colman Noctor and HSE clinical lead on obesity Donal O Shea. So, have we any results in? Anything that we can have a look at?

Donal: It's more of a spread than I thought to be honest, I was thinking it'd be more heavily up to the five or six days or even every seven days because honestly, in the discussions we were having before, we've all struggled keeping it below eight days a week for treats! And that's the challenge. It's a massive challenge. So that's good. There's a lot of parents on here who are doing well, actually. Then there's more that are looking for some of the tips that will come out of this evening's webinar.

Jen: Joana, what are the actual guidelines? I think that's part of the confusion, parents don't actually know.

Joana: We can touch on what we have been doing. We have some data that says that about one fifth of the calories that children are consuming comes from these types of foods. And we know that about 1/4 of meals we include a treat food, or a sugary drink. Now this data was pre COVID data and we spoke to parents recently, they told us that this actually increased during the pandemic. So, when we talk about treat foods, the guidance is really for the smallest (child) to have a small, tiny treat once a week. And for the older child up to twice a week. This would be about a square of chocolate, or about five crisps for the smaller child and the 'fun size' chocolates, biscuits or crisps for the older child. So, it's encouraging to see that some of the parents are doing really well and it's encouraging to see that some of us want to want to improve on this.

Jen: I am shocked. I have to be honest, I am shocked at how little makes up a treat. I think that is something that's going to surprise a lot of people because I wouldn't consider a square of chocolate a treat. I think that's something that we're going to have to get our head around and I suppose we associate eating treats so much with obesity, and that's obviously your area, Donal. What levels of increase are we seeing in terms of overweight children and obese children?

Donal: I mean what's happening is encouraging in a way, in that the levels have stopped going up. We are now looking at levels of, unfortunately, one in four of our children are either overweight or obese. And that is way too high. If you were to go back 30 years ago, that level would have been maybe 6%. So, children living with overweight, or obesity has gone up about four-fold in the last 25 years. It's a combination of the types of food and nutrition that they're eating, and what's happened physical activity and our sedentary lifestyles. It's that perfect storm of the combination that has led to that increase. That's why you have to change a number of things. Simply focusing on the energy in is not going to address the problem, you have to work across our physical activity, infrastructure as well.

Jen: That's a scary number one in four. Do you think parents are recognizing this because we're looking at our kids every day and sometimes when you see somebody after you haven't seen them for a little while, you notice if they have lost weight or gained weight, is it perhaps that parents are oblivious to this?

Donal: We know that as parents, we don't recognize a weight problem in our children. That's why it's really important that the changes that are coming in now in say, GP contracts, that when both adults and children go to the GP, it will be routine to be weighed, and measured. Then you'll get the feedback. And if you get that feedback, when you're just overweight, whether you're an adult or a child, it's much easier as the adult to make changes yourself.  If you were told that your child is overweight, you wouldn’t have been thinking that, but the fact that you have been told will mean you can introduce changes at home that might just improve the nutrition side of things, and you can come to some decisions about being physically active. So, identifying it as an issue is a real challenge. But it is beginning to be addressed now, with work that's been done with primary care and the GPs.

Jen: And I know, it's not just obviously about appearance, it's not just about how somebody looks if they're overweight, what are the actual health consequences of a child being overweight?

Donal: I mean, if it was a purely cosmetic thing, it wouldn't be an issue for the health service. It's really important that children do not have issues around shape or feeling that one look is the look.  We were talking about Snapchat earlier and Tik Tok and the looks that are put out there as being desirable, are broadly unobtainable, unless you are obsessive around your behavior, both on the nutrition side and the physical activity side. So, we need to move away from that kind of obsession with image and have a positive attitude to the fact that people come in all shapes and sizes. If you wind the clock back 200 years, there was always a spectrum of weight from underweight through overweight, through to people living with obesity. It was just a tiny percentage of those living with obesity, and now that has come back into childhood, unfortunately, when it just wasn't an issue before. That's why we must address it as a society. The health benefits of being a healthy weight, if you can reach the age of 18 at a healthy weight, then your lifelong weight trajectory is so positive. Whereas if you carry overweight or obesity into early adulthood, the challenge to achieve or maintain a healthier weight is so much more difficult.

Jen: You have mentioned Snapchat and some of the other social media platforms, particularly as kids get older, they become more aware of these things. How do we get this balance right? How do we become aware of the implications for children if they're obese or overweight at a younger age? How do we bring this into a family discussion, in terms of making sure somebody doesn't become obsessed with weight? We may be displacing one problem with another one. Colman, I'm looking to you here, how do we get this balance right?

Colman: Yeah, we have to be careful about the narrative around food. It should be about health and not weight. It should not be about good and bad foods. It's about good and bad amounts of foods. I work with young people with eating disorders, and oftentimes on the opposite side of the spectrum, with more restrictive types. It can be triggered by a class in school that talks about bad fats or something. A child could become obsessive about it, or a comment from peers or, the parental behavior of strict dieting at home and how we all speak about our body and shape.  All these things can create a relationship with food, weight and shape. A childhood lasts a lifetime and so what Donal was saying about if you can achieve a healthy relationship with food up until the 18 years, the prognosis of you keeping that is really positive. But if you've an unhealthy relationship with food, weight and shape in childhood, it's really hard to get over that. And so, when we're talking about how we introduce a child to healthier eating, I think it is about moderation. I think it's not about extremes. I think it's not about fads or obsessiveness. And I think absolutely, it's not just about food, either. Like that energy out point that Donal made, again, it's about activity, it's about having the right balance. So, although the treat conversation is hugely important, it's only one of the components to how we should formulate health in that way. Would you agree, Donal?

Donal: I would agree. I agree fully with that. When I was coming up here this evening, I was thinking, what's one of the key things I'd like to get across? And it is just how difficult it is for parents. The single thing that I would like to get across is, and I'm not going to say it's an impossible ask because we can't say that, it's just a really difficult ask around the physical activity environment, around the promotion of the high fat, high salt, high sugar foods, not just in the shops, but through Snapchat, and Tiktok, the prompts come up, and that's all you need is that trigger. You say, "oh, yeah, maybe I am hungry and maybe I will go and have that McDonald's, or Burger King." Or maybe " I will have Oreos" that are promoted all over Snapchat. So, if parents know that it's difficult, I hope that will allow that conversation to happen at home about let's be a little more moderate. Let's acknowledge the fact that it's difficult and see where we can make some changes.

Jen: I know, I was talking to you in the past Colman about different things. You mentioned nagging doesn't work. So, I suppose particularly if you're going near teenagers, maybe who have that access to pocket money or if they have a job themselves, and they have that freedom to go to the shops and make these choices. We're not always there, policing every single thing. So, is it really a case that we need to involve them and engage them in the conversation? It's not about dictating to them; you can't have this, or you mustn't have that but maybe perhaps about making them more aware of the choices they're making?

Colman: Yes, I think it's a real challenge to get that balance right in that regard, because nagging doesn't work, and encouragement probably works better. The task of childhood is regulation. So, from the point of view of when you say no to your three-year-old in Tesco when they ask for Buttons, and they have a tantrum on the floor, you hope by the time they're 19, they don't do that anymore because they've learned to regulate emotion and all that sort of stuff. But you have to regulate for them when they can't do it. So, things like portion control and managing that. For example, if a child finishes a bowl of ice cream, they're going to ask you one thing, which is can I have some more? As a parent, you say no, you've had enough or you think they're going to get sick if they eat anymore, so I'm not going to give you anymore. We're teaching them about portion control.  So, there is an onus on us as parents to be the adults in the room to say this is what's okay, and this is not. But following on from Donal's point about how difficult it is, and the marketing around it is very psychologically good. This is not a new thing. Back in the day, I remember going into Superquinn. When you went in, there was the smell of bread, beautiful bread, and you'd buy tons of it, and you'd have a trolley full. It would be hard the next day, but you'd have bought loads of it because of the smell. If you go into Lidl or Aldi, it's the sweet aisles that you see first. Then on your last aisle, it's the Daz and the toilet roll and the stuff that you don't need. So, you should never shop hungry, as they say, from that point of view. That kind of psychological manipulation is everywhere, and it's difficult to be immune to the triggers or to not fall for that trick. And children are being promoted to create pester power to create the nagging ‘but so and so gets more’ and they have no problem to treat and you're comparing parent to parent. So, it is difficult in today's climate, especially where we have so much of the temptation in our wake to keep discipline. But as the adult in the room, we sometimes have to give our children what they need, not what they want. That can be very difficult. I think the year that has been in it has been a real component in this. I remember saying to my sister last year, "what are you giving up for Lent?” And she said, "absolutely nothing, food is all I have left". There was so much that we had given up. Things that we would have rewarded children with like going to the cinema, or going to the play barn, or we'll do this, and we'll do that. It just became that the default position was the treat press. I do think, however difficult it was in February 2020, it's quite a bit more difficult now.

Joana: It's not just about treats. I'm a bit biased but what START does well is to talk about different health behaviors in a very positive way and acknowledging that it is very difficult for all of us. We often say that START is a campaign from parents, for parents. That's not just a tagline, we actually talk to parents in different communities, and we try to understand what the challenges are and what they are ready to take on and to change because the last year was very difficult for everyone. But I think we are now in a better place.  It's encouraging to see parents willing and wanting to change and to try new things. I do think that it's important to involve the child, and that the child has some ownership in that decision and on that plan. I think it's important that then we lead by example, as parents, too.

Jen: We were having chats there, Joana, just before we came on, and you mentioned the things that treats are displacing and perhaps that's really something that we as parents need to think about. Especially because over the course of the pandemic, like the guys have pointed out, we maybe handed kids treats and we treated ourselves an awful lot more, because life was really tough. You were just taking your little joys where you could get them but then they obviously became a habit.

Joana: That's an important point, because it's not just about healthy weight. So, firstly, it's about having a healthy relationship with food, and Donal was talking about the way that tracks into adulthood. I do feel that positive relationship with food also tracks into adulthood. So that's important. It's also about displacing other foods. That's why sometimes it's important to make those swaps. So, is your child genuinely hungry, do you need to give them something when they finish school and go off to football practice? The packet of crisps is not going to give them any calcium or any protein, or any vitamins and minerals that they do need for growth and development. So just keep that in mind sometimes, and to be very realistic, too. If your child is looking for a packet of crisps and you're not going to offer it to them and it's not going to work. So, maybe some crackers and some cheese, maybe some popcorn. I would invite everyone to check our website because we have very practical advice and we all need very practical advice to be able to change something.

Donal: When you were talking about the promotion to kids. If you go into the supermarket, the products are placed very cleverly. So, for the three-year-old, the products are a little lower, they are designed in both taste and packaging to appeal to a three-year-old and are at a three-year old's eye level. Seven year olds are a bit taller so the dairy products and the sweets that are again targeted at that age group with taste development done so that it's a bliss point for the seven-year-old. Another problem with the treat culture is that if the child's palate gets habituated to sweet things at a young age and we're designed to like sweet things because that's the earliest energy we took on board when we were single cellular organisms. So sweet is good. But if you get used to sweet, you won't diversify, or you will diversify with great difficulty to the foods that are healthy and full of vitamins, fiber and minerals that we need for good health.

Jen: That's very interesting to say that Donal, because, I have seven [children] and I thought that I weaned them all the same and introduced them all to the same foods. And yet there are some of them who are their mother's children and have incredibly sweet teeth. When the apples don't fall that far from the tree, you do feel a certain degree of responsibility. But the other side of it is, and I don't know, sometimes what's the best thing to do here so I'm curious to hear your views on this, is that if your child won't eat anything, and will actually go hungry, rather than have a food that isn't quite as good for them, what do you do? Particularly if it's like the school day, and you're trying to make the lunch and most schools have the healthy eating policies, and they're sending you home advice that involves raw vegetables and fruit and your child doesn't eat an apple unless it's peeled, and they might eat carrots with their dinner, but they're certainly not eating them cold. You might just think, if I put a Coco pop bar in there, they might eat that at least and they'll have something to sustain them. What's the right thing to do? Do we dig the heels in? Or do we go something is better than nothing?

Joana: I think you need to use your judgment. Firstly, are you really worried about your child not getting any nutrition? If you do have worries in relation to a child being underweight, you should definitely go and talk to your healthcare professional, because there may be something there that needs to be explored further. You need to expose them to food literally, not just taste. From a very early age, they should be able to touch and to smell. Involve them. Now, it's easier said than done. You're busy at home trying to raise two, three children, you're not going to try and get them to chop vegetables with you or to see how you do it. It's difficult, but it's the way to go to expose them to foods. Give them time, it may take between 10 to 15 times for a child to get used to a flavor. Also, to acknowledge that there are foods that they don't like. I don't eat strawberries every day. And that's okay! Once they are not restricting a huge group of foods completely, that's fine. Now, if your child doesn't eat fruit and vegetables, that's not fine. But if the child doesn't eat strawberries and broccoli, and they're fine with everything else, then I wouldn't have major concerns. They are entitled not to like one food or two.

Jen: So do you then encourage your child to …

Joana: Keep calm. No pressure. Don't fight over food, you don't want them in any way to develop an unhealthy relationship with food. But yes, find things that they like. For example, if they don't want peppers or apples, but they are happy to bring a pear or a banana. So, talk to them, see what they want, what they like. Start small, use other strategies like mixing those foods, if you're talking about vegetables, with foods that they like in a sandwich, for example. So, it needs a bit of thought.

Donal: To build on that, there is a question. A four-year-old who eats only bread, drinks milk, and eats watermelon or strawberries. That's great. Trust the child and try and add things. If they want sweets, and you're at your wit's end so you have to limit the sweets. But if a child is working off the food pyramid all the good shelves, and you keep the top shelf to a minimum, then you can trust the child's hunger. You can trust the child's sense of fullness and satiety and then gradually try to broaden out.

Joana: I think that's a very important conversation, we're talking about treats and moderating them.  Sometimes we touch on limiting, but I think we also need to focus on adding because there are plenty of foods that we can very slowly add to our children's diets, and they will see the benefit of it

Jen: If you do have a child like Trish there, who has a child that has what appears to be quite a restricted diet, and there's some healthy options in there. Is that okay? Is it okay to accept that your child?

Joana: It's okay. I would encourage parents then to introduce and try to go with foods that will have a similar consistency and flavor at first, but you definitely need to encourage variety there.

Jen: You want to come in on that Colman?

Colman: We sometimes are not introduced to different foods, so we facilitate the fussy eater in some respects.  I wouldn't be encouraging anyone to have six pots on the go with six different dinners for six different children's needs. But we can build things in. We have to be encouraging children to take on the choice of taste. Oftentimes children go “I don't like that” and you’re saying ‘but you've never tried it!’ So, reward the effort, not the outcome, reward them for trying the new thing. Whether they like it or not. But their pallets will increase. It's very few children that are starving in that sense. I've seen my own kids, and they would find a heal of bread, and they'd be chewing away on that if they didn't like the dinner that was on or whatever. The case is about broadening the range. But again, not forcing and not making a big issue. Less is more when it comes to mealtime battles. For me, I just think if we have this huge tension around it, it becomes a point of visibility. This is how I get attention in the family just by saying I don't eat that. And then the big uproar that follows, oftentimes it won't end up in them eating it, but it will end up in a big row. Smaller children especially are very irrational beings, from the point of view that they can't find their shoes, but they can find that sliver of onion in the Bolognese that you tried to sieve out! So, from the point of view of it isn't about what they want, but more about what they need.

Jen: When you have a birthday party, or you have an occasion, and there's some parent who thinks they have sussed out the whole diet thing, you don't see their child inhaling chocolate on a daily basis. But then they go to a party, and you have a totally different situation. Does restriction perhaps make foods more attractive? Do you have this whole idea that you will see the child who is never allowed to ordinarily have treats or certainly has them on a very restricted basis, go crazy when there's a free for all, and there are sweets in front of them? I suppose the nature of parties, you can go and help yourself generally. Is that just coincidence? Or is there something about it?

Joana: I'll leave the bit about what the child feels. But I do think we need to acknowledge that we celebrate with food, and we celebrate with treats. We start Christmas, the week after Halloween, we bring it until mid-January and then we have chocolate or easter eggs for Easter on the shelf. So, we are exposed to the availability of treat foods, they are also very affordable. It's very difficult for parents to navigate that and for the child because as Donal was saying, the child knows exactly what they are. My children, we brought them to Frankfurt many years ago, and they wanted to visit the Haribo factory, I didn't even know that Haribo were based in Germany, but they did, and they were small. I do think that's very tricky. Birthday parties and celebrations don't make things easier for parents. I would never suggest that restricting a certain type of food is the way to go and it would impact on the child's relationship with food.

Colman: Yes, prohibition doesn't work. It either demonizes something to the extreme, or it specializes something into something that it's not. I mean, again, getting off the good/ bad food narrative, but a narrative of good and bad amounts of food would be what I would suggest. And again, that kid at the party who gets their hands on something that they've not had for months, of course they're going to kind of overindulge in that moment. But again, I just think moderation and middle of the round all the time, rather than any sort of extreme conversations around food. I think extreme conversations create extreme relationships with food, weight and shape.

Joana: And I think for parents it is important to acknowledge that we make a plan, and we try our best to stick to it. I'm sure we all did it here. Then sometimes life gets in the way, and we don't do as well the following weekend. It's fine to have that conversation again and to restart and reset the clock and to try again.

Jen: When we're talking about labels on foods - what's a good food? What's a bad food? What's an okay food? Do you think that's kind of healthy? Or that it's a good way to go? Is this the sort of thing that we should be encouraging our children to be aware of? I suppose, Donal, for you to see certain foods labelled as good or bad, is that helpful in the whole fight against obesity?

Donal: I don't think so. I think it's important to know what you're eating. I think it's important in the environment we live in that, for example, if you're having a cappuccino and a muffin, you know that that's probably 550 calories and maybe close to half your total daily energy requirements when you're just sitting down for have an 11 o'clock snack. So, I think things like calorie posting on menu boards are good for adults, and that educates us. Then we can transfer that to the kids when we're choosing for the younger kids. Food labeling is very important, in general, anything that had been vehemently opposed by the food industry is highly likely to work. So, food labeling has been opposed, clear food labeling, the traffic light system that goes red for high in all the things that aren't good for you, then amber, and green for the foods that are clearly mineral rich, and fiber filled. That's what consumers have asked for. It's vehemently opposed by the food and drinks industry as over simplistic. Good food / bad food is not the concept we want to bring into the home or into the kitchen. Instead focus on weight shape and health is that the term used? I like those three together, we want health to be in there all the time. One of the START campaigns involved portraying the parent as a hero. For me, that's what the parent has to feel. The parent has to feel good about moderating the crap that the kids are getting, and the kid’s job is to get as much of that as they can. So, I was just interested, at what age do you involve a child in that conversation in the family, because there's no point in talking to the three-year-old at all. I know it's a little different for every child.

Colman:  I think you drip feed the knowledge, according to their development. As they get a little bit older, you're able to kind of decide a little bit for them, like regulation. The core aspect of being a parent is to become redundant. What you want is for them to not need you anymore. So, you should be stepping back and allowing them more control over their own choices. But it's oftentimes best done when they show you. For example, it's not a human right to have a treat. But it's a responsibility to be able to open the treat press and go at it for yourself. You don't get the rights before you show the responsibility, you show the responsibility first, and then you earn the right, does that make sense? It's about trial and error, and about children and giving them choices, and they will fail, they will make bad choices, they'll eat too much, they'll indulge too much. But then they don't get the choice the next time until they start making smarter choices. I always use the example of if you want your child in at eight o'clock over the summer, and they want to come in at ten, say to them come in at eight o'clock for three nights in a row, no arguments, no rows, and on time, and then we'll push to quarter past eight and then if at quarter past eight they come in three times in a row on time with no arguments it will go to half 8. So, you earn the right to more choice, rather than opening the floodgates early and then try and close them. That's when the problem arises. If you're turning around to a 15-year-old and saying, I know I've never limited treats, but we're going to start now. That can be a real challenge. So, try start as you mean to go on, but I encourage them to self-regulate, but only at a level that they can.  I think three year olds can't do it. Eight year olds can't do it. You're talking about starting at around 13.

Jen: Can you predict when a child can …. I suppose that's a hard one. It really depends on how interested they are and the whole nutrition side of things and the benefits for them.

Colman: I don't think they get that till teenage years and again, you should have a tight grip on the treat press early and then loosen it very slowly. But I think really at the point of knowing health, weight, that those concepts are kind of complex.

Donal: I would think about the13 / 14 age and that's also mid puberty. And puberty is hormones gone mad. Therefore, your taste and kind of cravings vary with that. The other thing, parents become particularly - and I am going to say "the enemy" when hormones kick in, and that's a natural thing. Hormones kick in, you've reached that stage in your life where, as we talked about kind of evolutionary terms, your job is to push them out of the nest and go off and make your own life. So, as teenagers you're meant to do that to the parents. Push them away at the very time that the parents are saying now's the time to have conversation about moderating treats. The 'hero bit', I think is great because I think you have to navigate within your own family, you have to look at your kids and go, well where are we getting it right? Where could we do things differently? And I do think access is one thing. It applies to anything addictive, cigarettes, alcohol, and high salt, high fat, high sugar food, it's the same part of the brain that cigarettes hit and that alcohol hits. So, if it's in, it will be consumed. You have to have it in. But it must be in quantities that are manageable. And when they're gone, they're gone.

Colman: That's exactly the sentence that I was thinking of. That's what my mother used to say when we were growing up, I can't wait until they're gone - If there was a box of USA biscuits, because they weren't replenished. Once they were done, they were done. On Thursday, if there were treats bought on the Thursday night shop and if they were gone by Friday, they were never refilled until the following Thursday. So that encourages you to self-regulate because if you want something on Monday, you make it last.

Jen: Do you ever notice if you go to the supermarket or to your local shop, or wherever and you're buying treats, it's often cheaper to buy the bigger treats than to buy the smaller snack sized treats. So, if you're on a budget, and you're trying to buy treats to go around to a few different people, you're nearly encouraged to buy the larger treats, still only counting as one treat but it's obviously a much larger portion than what the snack sized treat would be. It's so easy to fall into that habit really, isn't it? It's so easy. But just to go back to the labels again, and the good food and bad food. And again, I suppose Colman, coming back to you again on this because it is so important when we're trying to make sure children and teenagers have a healthy relationship with food. If you label food as a good food or bad food, and you're trying to educate your child, and again, I do understand the whole need to teach them to self regulate. But is there not a danger then that you have kids feeling guilty about food or you're literally setting them up for feeling they've done something wrong in having a treat instead of it being a treat?

Colman: You'll always have extreme reactions to these things. We just said that over the pandemic, we saw a huge increase in treats. We've also seen a huge increase in eating disorders over the pandemic. We've seen a huge presentation of children who've over controlled their intake and you know, watching these YouTube workout videos five and six times a day and who take it excessively. It all depends on the person. Watch the counting steps, it might be a very useful thing for someone trying to be healthier. But if you put that in the hands of a very self-conscious 14-year-old girl who's really struggling with self-esteem, and it could become the most dangerous thing you'd ever put on their arms. All these things have the potential to be dangerous but when we go back to the relationship with food weight and shape and the good and bad foods the extremes. And again, I don't know whether you can even trust labels, you can have this kind of water meadow drink and it looks like it's amazing but, there's 17 bowls of sugar in it. There's something a bit distressing about that. There was a question just in there I saw about using treat as a reward. I think it may have been about a school teacher who rewarded children with sweets on a Friday if they did well on a test. I'm not so much against reward, I am against using it as a soother for distress. When we have difficulty with food relationships, in terms of like binge eating disorder, people will oftentimes turn to food because they feel bad, or they feel that the food will make them feel better or else not eating will make them feel better. So, the idea that if I control my weight, I feel that I'm in charge of something. That's where the relationship becomes dangerous, in the fact where it becomes a coping strategy to either overeat or under eat. The issue is that the food is not the problem but it's becoming a coping strategy for the problem. And so, when we're looking at how these relationships form, like rewarding a child or if you win something getting a bag of Haribo's and stuff that's part of life. I don't think that's a desperately bad message. But it's almost like saying, if you're sad, there's a liquor cabinet, have at it and it'll make you feel better.

Joana: Yes, it's when you normalise rewarding behavior with food.

Donal: And the food industry has very much used the 'treat yourself you deserve it' over the last two or three years to normalize the concept and to link treat inextricably, to sweets, chocolates, biscuits, and it's very clever. I think they have ownership of the term treat. A treat now means only one thing. We mentioned a reward, you can't replace a treat which is a this minute thing, with a trip to the cinema or a walk, or a game of football at the weekend. Because they're not the same thing.

Joana: It's immediate rewarding.

Donal: Yes, so it's moderating and it's about people being aware of that and saying, right, look, it's an uphill battle, but we can try to do better.

Colman: Isn't it interesting how the narrative has changed? I think when I was growing up, it was junk food. Now it's treats. It's even turned into something positive. I don't remember being called treats when we were growing up, it was junk food.

Jen: I know, we've looked at the whole idea of looking at it beyond just obesity and beyond shape, and things like that. But if there is a parent out there who is aware that one of their children is overweight, and they want to do something about it. They know that treats or junk food has been a significant contributing factor to it. They know that this is something that they need to change. How do they address that? We've talked about discussing it as a health benefit and stuff. But if you're very conscious that maybe a more drastic change needs to happen to try and get a child's weight under control. How do you address that without making a child feel bad or feel they're being punished? Because the language has changed, and it has moved from junk food to treats, like you pointed out there. How do we do that?

Colman: I think you incentivize health, you sell it, and you pitch it as something that is positive. As opposed to just kind of punitive sanction based on the narrative that you're not good enough because you don't control your weight or you're not disciplined enough, or this is not acceptable. It's almost a concern that you could get a lot more out of your life if you had more energy, if you were able to kind of get some fresh air to be more active, these are things that will offer you something as opposed to necessarily it being critical.

Donal: We also know that because there's such a strong genetic component to weight gain, that if there is a child with overweight, that it's likely at least one of the parents will have struggled and have overweight or obesity. So that parent saying, I've decided I really need to do something and get healthier, will you help me? And what can we do, and involving the child and helping the parent, and as a whole family thing is the only way. Focus on the child, I would say, is highly likely to not end well and not positively.

Colman: Also, the success of something like an exercise regime, if it's done in company is way more likely than if you're trying to do it solo. If you have someone else who's journeying with you and will go for a walk every day. And this is the thing, cultures are always difficult to introduce in the house. So, for the first six weeks it will be a Battlezone. And people will go [hesitant noises]. But after six weeks, it just becomes what you do. Once you can get past the initial resistance. For example, say you go for a walk on a Sunday, your teenagers will moan about that for the first six or seven times you do it. But then it'll just be what you do on a Sunday. Culture has to be created. It's not something that you can just invent overnight. You have to kind of sit with the disgruntlement in the initial phases for that to become a habit.

Donal: That's something I didn't realize, for a long time working in the field of weight management. It's that the six week /40 days period is almost a magic number to change or begin to change a habit or begin to change a culture. So, if you know that, then you're prepared for the four to six weeks of uphill failure and then things should begin to get a little bit, I wouldn't say easy, but easier after that because a lot of people would give up after a fortnight and think oh my God, look, it's a disaster. Whereas, if you know you have another four weeks to push through and as parents, you need to keep taking the lead, you just may get there.

Joana: That is important, isn't it? Any change you're looking to make, it's to be made as a family. It's not you or she or he, it's us.  I think that's empowering for both the parent and the child.

Jen: I'm conscious that we're going to come to some of the viewer’s questions now in a second Joanna, but I just wanted to address something. Again, there were conversations happening just before we went live about parents not really knowing what treats are and the amount of food. That we were sitting here feeling a little bit small, you know, because we gave them a yogurt, it's yogurt to name but perhaps not totally healthy for them.

Joana: It's still a yogurt. Donal touched there on the labels and it's important. Some yogurts will hit the red sticker for some nutrients. When we talk about treat foods, strictly you're talking about crisps, chocolates, sweets, cakes and ice cream. Then of course, just with any food, there are two extremes for each food group, and you can get better quality or not. For example, we talk about whole grain cereals, we talk about vegetable spreads instead of butter. But I think the focus on treats should be if you look at the food pyramid at the top shelf in red. It's quite subtle, but it's actually disconnected from the rest of the pyramid. And that's to translate the message that we don't need them for health. We don't get essential nutrients from them.

Jen: Okay, well, before we go to the viewer’s questions, can I ask you to give your top tips for broaching this conversation with your children, this whole idea of broaching the need to moderate treats.

Joana: I think for me, firstly is to know that you're not alone. That we all have the same challenges and struggles. I think that's important. Aim for something achievable and acknowledge that it's going to be difficult.

Jen: Okay. Colman.

Colman: Yes, I think keep it about health, not about weight. Be patient, because it's not going to be easy to do. And just be aware of maybe how we're being manipulated through the marketing things and be a critical consumer.  That's what I'm going to take from tonight anyway, after talking to the guys.

Donal: Yes. I wouldn't really add much more to that. I think be aware. I think that it should be done within your family. I think the hero tagline is really good. Parents need to become heroes in the face of a food industry that are only thinking about this year's profit, and nothing beyond that. Parents are thinking about the next 70 years for their kids and trying to overcome that power of the food industry. So, if they know they're up against it, and then if they have a conversation as 'us' and discuss what way we can change things to make our lives a little healthier. Then there is that six-week timeline. Don't give up until you've given the six weeks a go. If at the end of six weeks, that particular change hasn't worked. Look at one other. One thing at a time, one small change, don't try three things.

Joana: Just to say, Donal touched there on the hero tagline and I find that tagline quite empowering, too. Someone was asking about grandparents and how to talk to them about making some changes. I think it's actually very empowering to say to someone, look, we looked at what we were doing at home and we want to make some changes. I would really appreciate it if you could support us here. So, if the kids are going to stay over, we try to think about something beforehand. We try to manage treats, and we made a plan, that we would like to stick to as much as possible. I think it's actually okay to talk to other people about it. And you'll find out that other people have similar struggles to yours and similar challenges.

Colman: Yeah, I don't think your child will ever thank you for being strict. But they certainly won't thank you for not managing it for them either. It goes back to Donal's point, if at 18, you have a good relationship, it's a lifelong habit. Whereas if you don't, that's a lifelong habit too. So just because they're not grateful, doesn't mean it's not important.

Jen: I think we'll go to some of the questions now because there's loads that have come in, absolutely loads. I can see one there from Sabrina asking, if a child doesn't eat a meal that you have made, do you give them something else that they will eat? I suppose that's what we were talking about a little bit earlier on, about those battles, do you make them finish their corn? Do you offer them something else? Or do you let them go hungry? Do you remember the days when your mother reheated your dinner for your breakfast the next morning if you didn't eat it! Is that what we should be doing?

Joana: Yes, don't make a battlefield out of the dining table. Try your best and see if there is, depending on what you're eating, a bit of the meal that the child can eat? Can you negotiate a bit, and try to expose them to those foods? Or is there a genuine dislike for something? But I would definitely not put any pressure or make it confrontational, it won't lead to anything.

Jen: Agreed lads?

Colman and Donal: Yes.

Joana: Be very patient.

Jen: Emma is asking what healthy snacks can we give our children?

Joana: I would ask Emma to check our website or the HSE website. The guidelines have a huge suite of resources with ideas. Again, does your child need something very light such as a piece of fruit or a yogurt? Two or three crackers? Or do you need something a bit more substantial? Like half of a bagel with a bit of peanut butter? Does the child need a piece of toast and a bit of cheese and tomato before going to football practice? There's plenty of ideas. I would go to the Safefood or the HSE website for those.

Jen: Okay, we had another viewer. I can't see the question now but there was somebody who just asked a few minutes ago; In the case of separated parents where mom is very conscious to make sure that the child only has a certain number of treats. But when the child goes to dad, all those rules are out the window, how do you balance that?

Colman: Very carefully would be my answer to that.  I think that the triangulation of a separation, the child becomes a token of the currency of good cop, bad cop and all that sort of stuff. And this would be a symptom of their relationship, as opposed to necessarily anything that could be fixed in isolation. So, I don't think it's about the treats. But it is about being the favorite. And it's a bit like the grandparents, we don't like saying no to them because they'll be in bad form. You can try and explain what you'd like and try to explain what you're attempting to do. But I think that may go deeper than just a conversation perhaps.

Jen: I suppose it's the same as we heard earlier about the teacher who was maybe giving treats at the end of the week. I suppose it is the same sort of thing, isn't it? Perhaps with grandparents, [for them] it's a treat. So, I know, my own pair, you're often cursing what they give. But is that not the privilege of being a grandparent? Is there not a difficulty there? I know you want to keep people on board. But you are also talking to somebody who has raised a family and might feel a bit put out to suggest [that they should not be giving treats] It's really hard.

Colman: Grandparents can be hypocritical as well. I find that my parents give my children far more treats than they ever gave me! I don't mind it when I see them coming home in the car and they have smuggled Jaffa Cakes or something up their sleeves that nana has given them on the way out. Once it's in moderation, I don't think it's necessarily a source of great argument. And again, it's not about ruling out every treat and becoming really militant about it. Those extreme views will create extreme relationships. But just within reason, maybe asking Nana to tone down a little bit rather than saying no more treats in Nana's.

Jen: It is all about the language, isn't it? I see one there from Bernadette that I would say is of particular interest to you, Donal. Should governments ban all high sugar, high fat foods and drink advertising aimed towards children, including those shown on technology before watershed? This would possibly involve taking toys out of cereals and meals etc.

Donal: I could read that sentence for the rest of the night and just change governments and should around. Yes, so governments should act and legislate. Not against all high fat, high sugar food, but it's the promotion to children. It's the product placement in shops. It's the Buy One Get One Free bog-of promotions, which are always on the treat, high fat, high salt, high sugar foods, and never on the fruit or healthy sections. So, the government has a role to play. There is a plan for an obesity public health act, similar to the public health alcohol bill, which will look at all these things as a suite of measures to effectively help parents with making the healthier choice, the easier choice and that's what society needs to do. That is also going to address active transport to and from school and issues like that because that physical activity side of the equation is really important. It's about energy balance. You don't address energy balance just by looking at one side of the equation. There are some kids who do so much sport that the rules about what they should eat and drink, that there aren't rules, they need to trust their hunger, trust their satiety, and you hope that their focus is a healthy diet. There was one question in there from a parent; my child loves veg but hates fruit. That's great. The seven or five a day that we're meant to have from the shelf on the food pyramid, the more veg and salad there is, the better. And if it's all veg and salad, that's fine.

Jen: Okay. There was a question from a parent about a fussy eater. If you have a really, really fussy eater, and you have somebody who just refuses to try a different food, what do you do? And I mean, I think I own one of them who just digs his heels in. I know how hard that is, I hear that parent. But what do you do? Because I want to know!

Joana: You are patient, don't fight over food, and you keep trying. It's hard. It's very hard. Now, if you do have concerns about your child not getting enough nutrients? Absolutely, I would definitely recommend going to your GP who will be able to then direct you to a registered dietitian. Absolutely. But if your child is having enough from all the food groups, I do think it's about exposure and trying again and being patient.

Donal You can contradict me if this is wrong, but I've spoken to a lot of the psychiatrists that I've worked with, who work with eating disorders, and they've had a lot of discussions. A focus on healthy eating within a family will not trigger eating disorders, the genesis of eating disorders does not come from the focus on healthy eating. Now, if that focus is obsessive, and if it's on bad foods, good foods and weight, then that's a different thing. But a conversation in a family about how we can become a bit healthier and discussing that we'd like to be healthier, and we'd like to eat healthier and questioning what can we do and involving the kids in that will not generate an eating disorder.

Colman: Yes 100%. Once it's not demonized and extreme. It's absolutely fine. Actually, children do pick up on those habits.

Joana: The trick is  to normalize those behaviors. So you actually don't have a lot to talk about them because they become the norm.

Jen: I think we could talk about this all night. I'm afraid it's time to wrap up. I think we're going to revisit the poll again.

Colman: While that's coming up, I just think there is another side. The narrative at the moment is a lot about the excess of everything. If you look at unlimited, binge watch, all you can eat data, all these sorts of things. We're not immune to that stuff. But it normalizes excess. It just means we must be more vigilant and, on the ball, because this stuff is everywhere. They're unhelpful turns.

Donal: Yes. Binge watch and boxsets, everything is in excess.

Colman: [Poll Results] So, 40% now are very confident and 47% quite confident

Joana: Oh yeah, you have 87% that are quite or very confident, it's very good.

Jen: That is very positive, isn't it? That is absolutely great. So, as I said, we could have spent hours here discussing this topic and I have certainly learned some useful tips. I won't be reheating the dinner for breakfast after that! I think poll two may be coming up, or sorry, that was poll two. We hope that you're feeling more confident and empowered to start that conversation of moderation with your own children at home. We just wanted to ask you that same question, which is what the poll was, and now that you've heard from our experts, so if you have anything new to add to the poll, please do. It is great to see that people are feeling so much more confident about it now. While you're submitting your answers, I want to say a huge thank you to our panelists who were absolutely brilliant tonight. And to everybody at home for tuning in. I really appreciate it and all the questions that you sent in. Thanks also to everyone involved in the organization and production of the webinar. If you want to watch it back, it's being recorded and will be available on the events section of safefood's website in the coming days. It'll also be emailed to everybody who registered for the event.



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