Episode 3: Did my baby eat enough food? with Prof. Marion Hetherington
Audio Podcast
In this episode I am speaking to Professor Marion Hetherington. She is a Biopsychologist with interests in human appetite across the lifespan and will be discussing satiation and satiety, that’s when we start to feel full and eventually stop eating. You will also learn how to read your baby’s cues that tell you she’s had enough to eat, how foods served in a variety of ways can help you reach satiety faster and did you know that eating patterns are inheritable? Listen in for dense knowledge that’s easy to digest.
Show Notes
The BLISS trial: Williams Erickson, Liz, Rachael W. Taylor, Jillian J. Haszard, Elizabeth A. Fleming, Lisa Daniels, Brittany J. Morison, Claudia Leong et al. "Impact of a modified version of baby-led weaning on infant food and nutrient intakes: the BLISS randomized controlled trial." Nutrients 10, no. 6 (2018): 740. https://doi.org/10.3390/nu10060740
Weighted bottles further reading:
Ventura, A. K., & Hernandez, A. (2019). Effects of opaque, weighted bottles on maternal sensitivity and infant intake. Maternal & Child Nutrition, 15(2), e12737. https://doi.org/10.1111/mcn.12737
Barbara Rolls is at Penn State and she has written a lot on satiating value of foods, including the best selling book “Volumetrics”; the main paper which helps readers to understand this is: Rolls, B. J. (2009). The relationship between dietary energy density and energy intake. Physiology & behavior, 97(5), 609-615. https://doi.org/10.1016/j.physbeh.2009.03.011
The ALSPAC data:
Northstone, K., Emmett, P., Nethersole, F., & ALSPAC Study Team. (2001). The effect of age of introduction to lumpy solids on foods eaten and reported feeding difficulties at 6 and 15 months. Journal of human nutrition and dietetics, 14(1), 43-54. https://doi.org/10.1046/j.1365-277x.2001.00264.x
The freddy doll paper:
Keller, K. L., Assur, S. A., Torres, M., Lofink, H. E., Thornton, J. C., Faith, M. S., & Kissileff, H. R. (2006). Potential of an analog scaling device for measuring fullness in children: development and preliminary testing. Appetite, 47(2), 233-243. https://doi.org/10.1016/j.appet.2006.04.004
Transcript
In our society we are at risk of overfeeding our children and it's from a good place, a place of concern that they're not eating enough and a concern about food waste and about planetary health. But actually we have to think about the child's health and the child is very able to indicate to us that they've had enough to eat.
This is Healthy Starts Early a podcast about eating healthy as a family I am your host Sarah Roesink, founder of the Phoebe AI and passionate advocate of healthy eating at home. A quick disclaimer, our content is for informational purposes only and should not be taken as a healthcare advice if you have any concerns over the health and well-being of your child please contact your GP or health visitor now let's enjoy the next episode today's topic is satiation that is the process that causes us to stop eating and satiety which is when we have had enough food to eat and are not hungry anymore I have the great pleasure to speak to Professor Marion Hetherington Professor Hetherington is a biopsychologist with interest in human appetite across the lifespan she has established an infant lab within the human appetite Research Unit at the School of Psychology at Leeds University her interests include researching human appetite across the lifespan research in the HARU infant feeding group involves characterising appetite expression from the early years of life and there's also a specialist interest in loss of appetite in older adults in particular the group is interested in the development of food preferences in infancy the expression of hunger and satiety cues and how caregivers respond to these and also the group has developed an interest in the loss of appetite in ageing specifically how to manage malnutrition at the end of life she is now professor emerita and continues to serve as a co-supervisor on five PhD projects and two newly funded research Awards Welcome to our podcast Professor Hetherington firstly I would like to ask you to define satiation and satiety for our listeners. Sarah it's a pleasure to be on the Phoebe podcast and it's a question that we struggle with quite a lot that how do we Define satiation and how do we Define satiety and typically the way that we Define satiation is to think about the processes that start in the gut as soon as we start eating actually it's a way of indicating that we're going to slow down eating and we're going to finish so even as we begin to eat at the very beginning of a meal when we've got a very high level of appetite and we're very hungry already the satiation processes begin and that means that these are processes coming in from the gut telling us to slow down a little bit and to help us to meter what we're eating and then ultimately we're going to stop eating so satiation is a process by which eating is terminated and then satiety is the phase after eating that stops us from eating again until the next meal so satiety is that interval between the meals and it is basically a nice feeling of satisfaction it is the absence of hunger there's very low appetite and we don't eat again we eat our eating is suppressed and then when we start eating again that's when our appetite is high our hunger is high and then satiation helps us to slow down everything and then it helps us to stop our eating
and in our society children are more at risk of being overfed than malnourished yet many parents and carers are instinctively more concerned whether the child has eaten enough and not if the child has reached actually satiety could you explain a bit about the psychology behind this what drives us to unwillingly overfeed our children
um in our society like very many Western societies we have children who are at risk of living with overweight and obesity and partly that's because of low levels of activity and being more sedentary and being more um in front of a screen having more screen time but it's also that right from the very beginning of Life many many parents and caregivers are so worried about children not eating enough that they actually don't listen to the children as they show signs of satiation and Society so we are often very driven by what's on the plate and we're also very driven by not wasting food so these are very understandable reasons that we don't want to waste food we don't want to spend money on food that's then not eaten and we're caring about our environment and we don't want to have food waste but children are very good at telling us when they've had enough to eat and parents are often more concerned about their child eating enough but a child eating enough is the child's decision and the parent provides the child decides how much to eat but actually a lot of parents want to wrestle control from the child and they are more inclined to encourage children to finish what's on the plate so we hear people saying clean the plate or have what's on your plate but actually what the child's got is telling them what their GI system is telling them what their brain is telling them is that they've had enough so unfortunately in our society we are at risk of overfeeding our children and it's from a good place a place of concern that they're not eating enough and a concern about food waste and about planetary Health but actually we have to think about the child's health and the child is very able to indicate to us that they've had enough to eat and could you talk me through some of the signs that tell the parent or the caregiver that the child has actually had enough so babies even when they're first born are very capable of communication and it's not language in the same way that you and I are using language today it's language of a different sort it's facial expressions it's motor movements but right from birth babies are able to tell us whether they like something or they dislike something so a newborn baby who's not yet been fed breast milk if you give that baby a sugar solution they will smile and if you give that baby a bitter solution they will gape and their mouth will get wide open and they'll release the liquid from the mouth and if you give them something that's sour to taste like citric acid then they'll purse their lips so right from the very beginning there are facial expressions that indicate liking and disliking and over time we also see babies capable of showing us that they've had enough breast milk so they pull away from the nipple they start to sleep they get very very woozy so the science behind this communication is that we observe babies as they become satiated and we observe how they tell their mothers that they've had enough to eat now in a breast-fed baby baby is very much in control of the feet so the baby falls asleep at the breast the baby is telling Mom they've had enough they're very satisfied they've had enough but with a bottle-fed baby sometimes Mamas are worried that there's a there's a still a remaining amount of fluid in the bottle they'll still see some formula or some breast milk remaining in the bottle and they'll not want to waste it and they'll encourage their babies to have a little bit more even when the baby is now very very satisfied very happy with what they've had to eat and they need no more but because we have this worry about not eating enough we may encourage them to consume the milk now interestingly enough there's been some research studies looking at opaque bottles where the mothers cannot see how much is in the bottle and the bottle is waited and that means that no matter how much the baby drinks you the mothers would have a very hard time um trying to figure out if they've had something to drink because the bottle has waited yeah and when you do that mothers don't over feed their babies because they don't have any of those cues of volume they just have what the babies communicate and they communicate very easily and they've had enough to eat they pull away from the teat they've had enough or they start to fall asleep or they start to look away so in the science of hunger and satiety cues we see a transition from gaze towards the breast towards mom away towards other objects and environment because they've had enough to eat and they also pull away and they look disinterested and later on once we've part past the breastfeeding and the only bottle feeding stage from six months onwards around six months Mark how does offering a great variety of foods have an impact on satiety well babies will show at six months of age and interest in solid foods and they'll reach out for solid foods and they'll eat finger foods they're very capable and if there's a variety of foods on the table then they will help themselves to different textures different flavors different foods but they'll show satiation satiety in much the same way that they did with breast milk which is they become distractible they'll look away from the foods they actually start picking the food up as play objects rather than as something that they wish to put into their mouth because at the beginning of a meal when they're very hungry they'll reach out for these different foods like broccoli or a piece of cheese or whatever it might be and they'll start to eat it and as soon as they start to fill up these Foods become less interesting so their gaze turns away from the food um and if mum is spoon feeding she might offer the food but the baby will turn away they turn their head away they push the spoon away they arch their back there are all of these indications that satiation is beginning and if mothers um listen and tune into that they will not offer any more Foods they will realize that the baby is satisfied and they'll take all the food away or they'll bring in a new food to see if they can interest the child and maybe a piece of fruit or something at the end of the meal but if they've had enough they won't take any more and again you just said interestingly the you know there's a difference between spoon feeding and baby let weaning approach where the baby just helps themselves um can you see a relation um between those two weaning approaches and how children are doing later on in life with regards to their weight no not at all so the research on baby LED weaning versus spoon feeding is very mixed whereas if you look at most baby-led wind babies they're not just baby LED weaned they are given solar foods and a little bit of spin feeding and that's very natural to have a little bit of both because some mothers don't have the hours that you might need at the beginning of a feeding experience to just let the babies have a little bit of everything they might want to encourage them with a little bit of spin feeding as well so quite a lot of mothers are not strictly one or the other they have a little bit of everything thrown in there then if you look at the trials like the Bliss trial from New Zealand where mothers were randomized to either babyload weaning or spoon feeding there were no differences in body weight so I cannot say with any confidence that one method is better than another and in any case I would say that mothers are very good at tuning in to what their babies are saying to them and if a little baby needs a little bit of help with spoon feeding or they're very competent at reaching out for finger foods but they need a little bit of help with yogurt for example then I would say tune into what your baby wants and needs yeah that's the best way to win rather than strictly one or the other I'm absolutely not for one or against one I think that mothers have a mixture of methods and they'll use what's best for their children yeah yeah and um what is or is there a relationship between different food groups and their impact on satiety yeah for sure I mean in the adult literature we know that there are very clear relationships between different types of foods and satiation responses so for example we know that foods which are high in fiber are very satiating we also and it produces a longer term satiety so you might have something that fills you up in the meal like a soup but because it's very water-based you might be hungry two or three hours later but if you have something that's very high fiber you might not be hungry for another four hours later so there are some foods that are very satiating whilst you're eating but you'll get a rebound hunger and there are some things which are satiating like protein and that will last for four or five hours of fiber very satiating and see and produces satiety protein foods high fiber foods these are the most satiating and the least satiating Foods happen to be foods which are high in fat so those are the foods that they are very dense in energy but they won't fill you up and so foods which are high in fat salt and sugar often they go together those foods are very palatable very tasty that they won't fill you up and therefore children will be seeking something else to eat yet they've had a lot of calories so in order to fill a baby up or to fill up a child you're looking at foods which are nutrient dense lots of nutrients a lot of less energy dense so lots of water content and we're talking about fruits and vegetables soups that are made from vegetables and lots of protein plant proteins as well as other protein meat proteins these are very satiating but there are some foods that are really not satiating at all and those tend to be the things which are the foods that were meant to eat in moderation or exclude from the diet anyway many people blend soups when they make soups for their children does that have and how does it affect um satiety because it does change obviously the composition of the vegetable and whatever else is inside the soup does that have an impact on satiety yeah for sure so Barbara rolls my PhD supervisor when I was a PhD student she went on to do some research in which she looked at the satiating value of different forms of food so she had a chicken soup that had been Blended or she had a broth with chicken and chunks of vegetables or she had a stew of chicken with vegetables and the water was on the side and so you've got these three different ways of looking at the exact same foods but Blended or in chunks or as a stew with water on the side and what she found was that the most satiating as you would imagine is the stew with the big chunks of the food and the water on the side because that way you have the maximum texture and because you have big chunks of vegetables and chicken that will slow down your eating and it's very very much more oral processing whereas with the soup although it was very filling obviously because everything's been Blended it's so much easier just to um you know take with a spooning and supper up quite quickly so if we another way of looking at that is to say well what's the difference between apple juice and apple puree and an apple well an apple will take you several minutes to bite into to chew properly and then to swallow but as with an apple juice you can drink that in a few seconds and you'll get all those calories and none of that satiation that you'll get from eating an apple which is the very satisfying effect of biting into the Apple crunching into that lovely fibrous object and then starting to tune then swallow and then with pureed Apple puree for example you know that you can spoon feed that or eat it but it's very much a monotonous to actually sure so if you think about mothers preparing a soup for a baby I would say blend a bit but keep some chunks so that the baby is able to take a bit of vegetable like broccoli or a little bit of potato a little bit of carrot and the sign shows that the more little chunks and lumps that the children are getting around that waiting age so eight months or so if they're already getting between six months and eight months these little bits of texture that will have a very good impact on their ability to eat well when they're older and that data has come from the else back studies where they look at the difference between mothers who are using Jarred foods which were very Blended and very smooth versus homemade where there was lumps and chunks and bumps in the food because that's the way mums make their their food for their babies so having a little bit of texture is very important partly because it helps the child to process the food that is helps them to learn how to bite to process the food and mouth but it's also about oral Transit time through the mouth into the gut slowing down will maximize the feelings of satiation and then subsequently satiety let me take a quick break and tell you about our great up Phoebe that gives you all the inspiration for cooking healthy food for your family Phoebe is currently free to use so make sure you get it today the link is in the show notes and if you find this episode helpful please give us a five star review on Apple podcast to help more parents Discover it now let's get back to our episode do you think satiety could be induced by offering certain foods to help children that live with obesity well first of all I think that that's a very good question it's a very complicated question and the reason that it's complicated is that obesity is highly heritable and it's there's an interaction between genes and environment so let's not speak about the genes at the moment because you're asking me a question about environment which is about the sorts of foods that we give our children and the answer is yes we can certainly optimize satiation Society for anyone including children who are living with overweight and obesity whether or not they fill up is a different question because some children have a high level of satiety responsiveness and some children have a low level of satiety responsiveness so say we've got a chill a child who is giving given foods that are much more satiating then if ideally that child will fill up with filled foods that are you know the diversity of vegetables and lots of proteins and lots of grains and fiber so in an ideal situation if we give children a variety of foods and we give them a variety of complex textures then children will learn to satiate on those Foods the problem I think becomes that we don't yet understand how how quickly these temperaments these highly heritable traits kick in but we think that even from breastfeeding we can see children with very Avid appetites who do not easily get satiated and therefore we see very early on that some children have a very weak satiety responsiveness so Professor heatherington we talked earlier about mothers trying to empty the bottle and or you know cleaning the plate how it does this or how could this affect a child's ability to know when they've reached a satiety well I suppose it all depends on what's on the plate and how much is put on the plate and I think that um what moms and dads and caregivers generally need to do is not to worry so much about what's on the plate but rather um to look at how the baby is communicating so if you've put several items on the tray like a stick of broccoli some plant protein some um you know something that's made from some fresh fruit or some cheese or something like this if you've got a little vegetable variety or a little meal variety on the on the tray and the baby is trying a little bit of everything and they're showing you that they're interested then that's all good and well and then when they start to be disinterested pull those Foods away and then offer maybe a little something else see if they're interested in something else and if they don't want anything else to eat that's enough the problem is is that if it's happy to listen that half eaten broccoli half eaten cheese half eaten piece of you know plant protein or whatever it might be like chicken or whatever which is meat protein but if it's half eaten moms are very reluctant to get rid of it but if the baby is showing that they've had enough to eat they've had enough to eat and they're not going to be persuaded just because it the mum wants them to try a little more and if we keep on asking them to try a little more and they're expecting to be encouraged to eat something else and something else and something else then that wears the baby down and then the baby has to trust mum dad or caregiver to decide what they're supposed to be eating rather than themselves but babies are perfectly capable of seeing how much they need so parent decide provides right parent provides child decides and if you use that Maxim you can hardly go far wrong the problem is only when children are really really having problems with eating in which case you need to seek some help or if a child is so Avid and they're eating so much that it's causing problems in terms of worries for the parents and worries for the child then these are the extremes of not eating or eating way too much but in between that is the spectrum of everyday life of eating a little bit often or eating a lot and then not eating at all for hours an hour so baby's very hugely in their appetite now going back to earlier in our conversation where we spoke about being worried that the child eats enough and I'm thinking about quantity and not the variety of food what is your advice for parents whose child finds it difficult to try and accept new flavors and textures how could you avoid limiting your diet to the the three meals that your child really likes to eat
well I would say that um if a baby or child is really not keen on a variety of different foods one thing that we know from the research is that sensory play is a safe space to explore new flavors and textures without the expectation of eating so if you provide lots of color lots of flavor lots of variety of texture lumps and bumps and chunks but you don't expect the child to eat it you just use it as a sensory play sensory exploration like Dora the Explorer or something like this and you invite the child to tell you about the color how Vivid it is or how lovely it is or is it a rainbow like put the foods in order of colors and things like this this is a calm safe space for children to explore with their eyes explore with their ears explore with their fingers and then their mouths but if there's no expectation to eat it and it's something which is playful and fun then that way children become familiar with an idea I tried something but not really having to eat it one of the problems that we find is that parents are so worried about food waste that every opportunity to eat is one in which they expect the child to want to have something to eat and I think that if we can take that pressure off for example my colleague Dr Mick Wilkinson who runs a charity called flavor School and flavor school is all about safe space to explore food sensory education without the expectation to actually eat anything and in that way children become very familiar but it's not going to solve all problems because some children are highly food avoidant and they're very very sensory sensitive and they're very food fussy and these are highly heritable eating traits so all you can do is do your best encourage them to eat a little bit of these different things or touch these little things and try and smell and listen to the sounds that they make and if they don't want to eat it you have to back off and let them tell you that because responsive feeding you know listen to what the child is seeing and tuning in to what the child is saying also includes where they will not and will not try or want don't want to try something new and that's something that you have to accept but you can still take the same foods that you like and you can do lots of different things to make them more interesting and varied and you can also do a little bit by stealth adding a little bit of something unexpected and just to see if the child is willing to try it if that flavor is masked by something that they do like so there are lots of little tips and tricks but if a child is highly food resistant and very food avoidant and very food fussy then that's not something that you can simply change with sensory play you can definitely get them to eat a little bit more than you might expect them to normally but you are really in a situation where you might need to do a little bit more than just sensitively and is this something that you think children might outgrow I I remember from my childhood not liking a lot of the foods that I had to eat because there was no other options so I did eat it and now I'm eating I think I'm a quite adventurous eater I eat a lot of different foods most of them are healthy foods that I really like and I think it's because my mother was very persistent in what she offered to me so it you know what what does research show is this something that parents should do and hopefully by 20 the child will eat a lot of different things although they might be different and very difficult eaters in the very beginning well food fussiness is highly heritable but most children will go through a fussy phase and that Peaks are between two years and six years so between two and six some children become a little bit neophobic a little bit um uh more cautious around new foods they might have started off quite adventurous eaters and then around it too it kicks in that they start to be a little bit more cautious and we think that from an evolutionary point of view that's because at two years of age children will be fully mobile at this point running around so if they're a bit more cautious around new foods that's going to help them to avoid toxins and avoid things that might not be that good for them because they now have that Mobility to go and search for food themselves really um there are some children that are fussy and they're fussy from the very beginning and that's highly irritable very very much something to do with that child and as long as they're growing well and they're active and healthy in all other ways then it's not really a concern it's more that parents and caregivers might be puzzled by the lack of variety in their diets but if they're really eating well and they're growing well then that's not going to be so much of a worry but there are some children who don't grow well and who are not eating well and for whom they need to seek advice so I think in your case you were given foods to eat and you your mum was persistent and that exposure to those Foods early on in your life meant that you were more willing to eat them as an adult even though you didn't particularly like them as a child and now you're familiar with them and even though you could choose anything you still include those Foods in your diet so for a lot of children that fussy feeds they do grow out of it absolutely and they become very much more adventurous but what we have to do is between six months when solid foods are introduced to 24 months before fussiness really kicks in for those children in that phase we need to make sure that that period they've got children have lots of variety lots of opportunity to play with foods and to really enjoy the playful nature of of trying new foods and becoming an Explorer becoming adventurous little eaters but we have to accept that some babies are born highly fussy and some babies are born with a really Avid appetite and they love to eat and they'll try just about anything and that's what makes every child very different these different these individual differences that's really positive to hear that um and actually it links in really well with a two of the parent question that I received so I'd like to ask you the very first one there is a mother who asked me um she's very interested in tips for how and if to talk to a three to four year old about the balance of food and energy in and energy out and eating enough and also how to encourage a three to four year old to slow down the pace of eating um so the brain has some time to catch up and get the message that the body is actually full and the mother said she's also happy to hear if she should just leave her child to get on with the way that she is eating at the moment at her own pace because she doesn't want to make food an issue so she's very wary how to talk to her child about fast eating slow eating and um yeah without creating another problem basic quickly well I would say that in terms of eating meat let's start with that one eating rates are highly heritable so babies when they first breastfeed some will have a very Avid appetite and they'll drink a lot with every um you know circle at the breast and some babies are more measured they take their time and some babies are really really slow and they take a long time to um you know take the the breasts and they'll fill up at their own pace we need to then accept that that's exactly how they're going to be when they start to eat solid foods some babies are going to have an avid appetite so we're going to take the time and some are going to take a really long time because they're quite you know cautious about what they eat and that's just the way they are they're very cautious about food altogether and some are just they just love to eat and most babies are in between those two extremes so in terms of rate of eating let them eat at their own rate be very responsive to that but also if you want to slow down the pace of eating make sure that the foods that are offered to a three to four year old have enough chew and enough texture lots of fiber lots of variety lots of you know smooth and hard and crispy and you know chunky and all of these things so that that will slow down the babies eating with child eating three to four year old trying to explain energy and energy out to three to four year olds you just have to make it fun you know it's the same thing as any concept that we try to teach children at that age you have to do it with great young patients and you know something like thinking about a car and how you have to top up a car you know food is fuel it's the same idea if you have enough fuel you'll be able to run for longer and let's do lots of activities if you don't have enough fuel then you'll you'll run out and you'll just you know the car will stop so things like that is quite easy to do but in terms of having enough that's not a decision that the parent can have nor is it one that they could teach because having enough is really an internal signal satiation is an internal signal and all we can do is respond to the external communication of that so by 34 years of age maybe children are very capable they have had enough of this I want some of that or I've had enough of eating all together I want to go and play outside and then you have to listen to that and even if that means they're not eating everything that's on the plate they haven't had everything that's on the table that's their choice parent provides child decides and then in terms of things teaching about things like filmness there's a my colleague Catherine Keller at Penn State University School of nutrition she has developed this thing called Freddie doll which is an illustration of how Freddie the doll fills up and it's it's a nice way of explaining to Children three to four years of age how your stomach gets full and then it empties and then it gets full again after you've eaten and these things are playful but they're also educational and the other thing that we can think about is mindful eating so really engaging children with ways to notice what they're eating so having no distractions parents are not on the phone there's no radio on there's no TV on there's nothing going on apart from the meal and in that way that will be a slow eating occasion because all you're doing is focusing on the food and the more you focus on the food the more opportunity the brain has to monitor and meter what is being eaten and that will help to slow down anytime so there are lots of things that we can do to prevent children from being distracted through eating take off the TV get up the radio off stop using your phone don't have distractions like toys around or something that's more interesting than the food make the foods the occasion make the food the center of attention and that will help to slow down eating and make it a really enjoy mobile experience I was always breastfeeding all my three children on demand but I also know a lot of people do breastfeed their children to a schedule and especially if you bottle feed your child many mothers stick to every three hour routine or roughly every three hour routine could that have an impact on how your child feeds later on in life
well the only research that's been done in this sort of area is between breastfed babies and babies who are formula fed whether they're fed on demand or whether they're fed on a schedule and it tends to be that babies who are breastfed on demand I'm not sure about formal affair on demand I really am not sure about this data but I think that the more the babies are fed on demand that means that they're in control so if you've got a formula fed baby who's being fed on demand and the mother is is getting rid of um volumes of milk that the baby is rejecting because I've had enough to eat then that entrains the appetite to mean that the baby's trust their internal signals of satiation and satiety so those are experiments that have been done to study the comparison between breastfed babies and formula fed babies tend to show that the breastfed baby has the advantage in terms of intraining appetite but also in terms of flavoring exposure because breast milk is so complex and flavored by the maternal diet um if mums have a very diet then that will be passed on to the baby so there are advantages in terms of entrainment however if mothers are formula feeding on demand they have a similar advantage in that the babies are in control and their layer that if they want if they've had enough they can stop eating and there's no cajoling there's no pressure to eat anymore and they're in control of their appetite and that that will help them to set the boundaries for being hungry being full and having enough to eat that's that's an interesting link it's it's great that this has been um researched as well um I've got one other parent question um it's a parent of a six-year-old boy and she said that she's almost worried that he has a too big of an appetite so she said that she if she would let him she he would eat about seven or eight Weetabix in the morning followed by fruit or a toast and he won't act as he as if he's being weighed down by the food but he would be very active afterwards and he's on an 80s Center for his height and 60s for the weight so there's this is all in balance it seems and this mother has also talked to Specialists about his very mobile gut movement and everybody seems to be not worried about um his health but she said she is a bit concerned about his very very strong appetite and she's wondering you know is this normal that her boy eats so much and people have also told her that boys just eat a lot and they've laughed it off um or is this something that she has reason to be concerned about because she feels it she feels that it's a bit too much the appetite well one thing to think about is this is a sexual she's grown but they're very active they have lots of energy requirements so that fuel analogy we talked about in a moment ago this is somebody who needs a lot of fuel to to support all their activity and they're obviously being boisterous and active and girls can be exactly the same it's just that boys tend to need more because they tend to be larger and they tend to need more than a six-year-old girl for example so entrusting the appetite is what we've been talking about in this podcast very important that we do that and if she's worried about how much has been eaten then there are a few things that can be done in order to help to understand the difference between you know what is really needed and what is really wanted right so there's a difference between need because that's about energy and Topping up and fueling the activity and wanting so if you've got something that's delicious like burgers and fries or sausages and sandwiches or whatever it might be it's so palatable that's very desirable but if you start every meal say lunch and dinner with a soup that's a vegetable soup lots of chunks and lumps like big bits of broccoli big bits of carrot potato whatever that will slow down the appetite and then if the delicious food is then giving us a second course like uh you know something that's uh more Savory then but they'll be less eater because they've had so much sip So In some cultures like Portugal they have soup before every meal and it kind of gives them that top upper vessels they eat about nine vegetables a day in Portugal they've got an amazing variety of fresh produce that they eat and that soup is usually filled with cabbage and lots and lots of delicious vegetables but it's a technique it gives you the vegetable that you need in your diet but it also helps to fill you up and therefore you can tell the difference between what is needed and what is wanted because after a big bowl of soup if they're still willing to have and want to have a full meal then this is true hunger right but if you start the meal with something delicious and then you're expecting to have vegetables and stuff like that on the side then that's going to be quite tough so we've done experiments looking at competitive Foods in other words if you put vegetables next to something like chicken nuggets or fish fingers or something like this those fish fingers those chicken nuggets will be eaten first the vegetables be eaten last so we often give the vegetables first in our studies because that's when they're maximally hungry and most interested in eating helps to take the edge off the appetite makes sure that the vegetables are being eaten and then if they want what to eat they can have it but that's a that's about you know hunger rather than just wanting wanting something that's delicious to eat so I think if this is a young boy who's going well it is all these professionals have worked at his appetite and they think it's wonderful then so be it if mum wants a technique to help with balancing across the day then you've got to mix it up in terms of things that he really loves that start with a vegetable soup or start with veggies and dips or start with fresh fruit slices these are chunky and take time to eat before they then get into the Savory delicious palatable Foods I've got one question it's probably another whole podcast in itself but um I've also read a lot about um food hierarchy so what you just suggested would that fall into the into the spectrum of food hierarchy where we offer things that are maybe not as attractive for the child first and then we offer something else so do we ask the child you you have to eat your veggies first and then you can have something else or you have to eat your soup and then you'll have another food and then there might be a dessert at the end um well I think the word would have to is quite strong I think what you might want to think about is simply there's two types of hierarchy one is about hierarchy of palatability and that's what we've just been mentioning the other one is the hierarchy of satiation society which were mentioned earlier so some foods are much more satiating than others and some foods are much more palatable than others so um if you start a meal with the offering of fresh fruits and vegetables or fresh soup fresh freshly made soup for example and there's a sort of family atmosphere of eating together and communal eating once that soup has been eaten all those fish vegetables have been eaten all those chunks of fruit to be eaten and then there's another course if there's an expectation of those less light Foods first that becomes the norm so we entrain children's appetite and expectations of eating through habits so if this is a habitual part of their meal that they start breakfast with these chunks of fruits and then they have the cereal rather than jumping into the cereal and then being expected to have things that particularly like then yeah we've got to get that hierarchy right the very very nicest Foods it's a bit like you know giving dessert last that's the nicest part of the meal but you don't give this out first you try to get something in that's highly nourishing delicious and a tiny bit of something special at the very end so we tend to try to get children to eat things which they may not like the most but they do them the most good okay and then first when the children are maximally hungry so we have a maxim which is veggies first and then his menial seconds and that you know giving vegetables as a first course we find as a meal service strategy that helps fill children up but it also means that they're going to expect to get and eat vegetables at lunch and dinner we're even doing studies colleagues at loughley University are also doing research studies uh Chris McLeod as colleagues of giving vegetables at breakfast so trying to get those vegetables in at breakfast as well so that we get three meals a day with vegetables and that would be ideal that's a really nice it's a really nice point to end it on I think you've given us so many um reassuring answers and also so many tips on how to balance our diet and how to yeah how to how to feel good and how to approach every meal with the right tools and tips and tricks I think this will be so useful for many many other parents and caregivers so yeah I'd like to thank you very much for joining me today and um I hope we get the opportunity to speak to you again soon because I'm sure there will be lots more questions after this podcast I can imagine from listeners and um yeah thank you thank you so much for joining me today thank you very much Sarah thank you so much thank you so much for tuning in today make sure you download our app which provides free recipes and weaning tips for families with young children look for Phoebe on the app store that's p-h-o-e-b-e and if you found this episode helpful please give us a 5 star review on Apple podcast to help more parents Discover it that's it for today.
*Disclaimer: Please be advised that any information is given as general guidance only. Should you have any concerns over the wellbeing of your child such as intolerances, allergies and weight, or your baby was born prematurely or you are unsure if your baby is ready for solids, it is always best to consult with your Health Visitor or GP.*