Supporting a Healthy Eating Pattern
A healthy eating pattern refers to what a child will eat and drink on a regular basis, and helps the child and family feel good, maintain health, and meet nutrition needs. Regularly eating a variety of vegetables and fruits, whole grain foods, and protein foods while appealing to taste, culture, budget and lifestyle may be a long-term goal to support balanced nutrition and long-term health (Government of Canada, 2019).
Limited food variety may result in constipation from inadequate vegetable and fruit intake, low appetite related to iron deficiency, B12 deficiency related to poor intake of animal products, and over or under nutrition of other nutrients. Limited food variety is often multifactorial in its etiology, however, pinpointing key social, behavioural and economic concerns may assist in prevention and/or management.
Early assessment and intervention can positively impact the ability of the child to accept new foods to overcome suboptimal food variety. The severity of a feeding-related medical condition is likely to influence the severity of food restriction.
Key Concepts for Managing Risk of Limited Food Variety
Understand parent expectations: realistic expectations are key to achieving progress. Education for parents about age appropriate portions and frequency of food types per day can help to establish realistic expectations of their child. See Canada’s Food Guide and Healthy Eating Pattern for recommendations.
High levels of parental anxiety can lead to limited food variety for many reasons. Anxiety about lack of intake may lead to force feeding. Parental anxiety may also contribute to limited variety if parents offer only what the child will most likely eat. An environment that includes stress around food may influence a child’s willingness to try new foods.
Consider socioeconomic factors like parents’ cooking and food preparation skills, financial barriers, parent or sibling ‘role modelling’, cultural practices and expectations, and how food is offered. For example, if a family does not have vegetables in the house, and does not know how to cook vegetables then it is unlikely the child will be offered these.
Offering secondary choices after a food or meal is refused is counterproductive to improving food range and may contribute to overreliance on preferred foods. Offering preferred foods with non-preferred foods supports gradual acceptance of new foods (Alberta Health Services, 2017). Instead offer alternative foods that offer a similar nutrition benefit. For example:
- eggs, fish, legumes or tofu if meat and poultry is refused
- cooked, dried or tinned fruits and vegetables if raw varieties are refused or textures are not well managed
- limit highly processed foods (higher in sugar, salt and fat) when possible
- changing the form and presentation of the food may support texture progression or acceptance of a food.
- avoid hiding or sneaking refused foods into preferred foods as this may negatively impact parent-child trust at the meal and may cause avoidance of previously enjoyed foods
Management Strategies for Limited Food Textures
Playing with food may support a no-pressure approach to food and texture exploration. Use a variety of food preparation techniques to assist with intake such as soft cooking methods (casseroles, minced meats), assembly meals (tacos, salads, platters, sandwiches), or condiment offerings such as dips and sauces. And, offer a gradual progression of food textures. For example:
- Puree meat ➜ minced ➜ soft-cooked pieces ➜ strips of meat/whole chop or cutlet
- Puree fruit ➜ mashed ➜ naturally soft peeled pieces ➜ whole fruit products
Children with sensory preferences may require more gradual texture progression and an individualized approach to management.