Anne Arundel County Public Schools, MD At Your Service, 1 Nov 2014

Previous Meeting

⏯

youtube image

►

From YouTube: At Your Service - Healthy Eating & Eating Disorders

Description

At Your Service is a program hosted by Susan Love and Christy Perdomo from the Student Services department. Each show presents topics of importance to students and their families. This month, Christy & Susan talk with Adina Fradkin from The Renfrew Center of Baltimore. Originally aired November 1, 2014.

A

Today, on at your service, our topic today is healthy eating and eating disorders.

B

Thank you for joining us today. Today we have a special guest, miss Adina Franken from the ren few center. So what is healthy eating so.

C

When I talk about healthy eating, three things really come to mind. The first is moderation right, so healthy eating is being able to eat all kinds of foods in moderation, so foods that you might think are healthy foods or you might think of as really indulgent foods being able to incorporate all of those into your diet and moderation.

C

The second thing is a variety, so healthy eating is incorporating a variety of foods into the diet, so all different kinds of food groups all different kinds of foods, from different places so really having all food groups represented and eating all different kinds of things. The last thing is balance, so healthy eating is having balanced meals, so not just having one food at a meal, but having a variety of foods that represent the different food groups. So.

B

Can I before we move on to the other question that I have to ask when I was growing up there was. You would have to have this many servings of fruits, this many servings of vegetables, this many servings of protein does that is that still true, so.

C

Those kinds of guidelines are hard for I, think adolescents and children, and even parents to work with because who goes through their day and is tracking okay. This is my third serving of vegetables and my second serving of dairy. We don't think that way, but what that was trying to get at was having balanced meals, so that was really trying to emphasize making sure that you are getting all those food groups in and having the right number of servings, so I think those tracking or food intake. That way is a little complicated for today.

C

But if you, if your diet and your eating habits really embody balance and variety and moderation you're getting at the same thing in a lot of ways, it's.

A

Really hard to gauge how how well your child is eating mm-hmm.

C

It absolutely is, and you know parents definitely should be seeing what their child is eating. They should be laying eyes on it. Family meals are very important because it it gives parents the opportunity to normalize eating model. Appropriate eating habits, show their children that they to eat a variety of different kinds of foods. So it's very helpful for parents to see what their children are eating.

B

So with that being said, portions, because I go to the store and I'll go to like a home goods or a home store and I'll notice that the plates I've, gotten, bigger and bigger and bigger compared to when I grow up the dinner plate looks like it's three times sighs. So what is that portion size or how should we gauge that as parents for children and even for ourselves, yeah.

C

So that's a really good point because plates and bowls and everything are getting bigger, but that doesn't mean that you have to fill the plate. I think the important thing to keep in mind is that there isn't. There isn't really a perfect answer to this, because children of different stages and their development need different amounts of foods. So the thing to remember is that children are actually pretty good at regulating their food intake. They know when they're hungry and they know when they're full.

C

Now, as we start to talk more about eating disorders, that's not necessarily true, but for a grown child and a healthy child without an eating disorder, they're pretty good at regulating their food intake, and if you notice that you don't think they're eating enough at meals, you may want to emphasize having them have snacks. You know throughout the day and giving them you know an after-school snack or an after dinner snack, even to supplement what they're eating or not eating during meals.

C

So again, that's part of why it's so important for parents to see what their children are eating lay eyes on it. Let.

A

Me growing up to we talked about growing up that used to say, you're a clear your plate off mm-hmm. Is that the general rule that that you should live by now. You.

C

Know I, don't know if that philosophy has been proven or disproven right.

A

C

Know in some families that works and children respond well to that in some families. You know it does not work well and it's not. It's not a good philosophy, so I think ultimately different children have different challenge. It's eating some kids, you know, have really strong proof. Food preferences, some children, have eating disorders.

C

So I think you really have to know your children and know what's going to work for them, but I think you know what a lot of parents overlook is you have to model healthy eating for your children if they never see you eating something that you're telling them that they have to eat and finish their plate with every night? You know, of course the child isn't going to want to eat it. You haven't normalized that for them they don't see that modeled. So they may not see that food as necessary. So.

A

B

You think about you work with the public if you could give a piece of advice of what would really if parents and students need to eat more of one area, what would it be so.

C

I actually think that a healthy diet is not so much one specific food, we're really looking at the sum of the whole. So again, are they getting moderation? Are they getting a variety of foods and are they getting balanced meals? So you know when I think about one food that someone needs to eat more of its, so child dependent or individual dependent. If someone never eats their dairy or doesn't like to drink milk, well, they need, to, you know, have a good source of calcium in their diet.

C

If some child, you know hates the taste of all vegetables and never touches a vegetable, they need to eat more vegetables. So it's very you have to know your child, and you know it's very specific.

A

B

Helping children in the morning what are some healthy, breakfasts and some lunches, because that seems to be something in our society that we're looking for, because we don't we're not able to sit down. Most families are working. You know, households. So what are some quick, healthy breakfast ideas, even maybe lunch ideas so.

C

At the renfrew Center, we we teach our patients balanced meal, so our breakfast have some carbohydrate, it's important for energy. Throughout the day they have some calcium or some sort of dairy, they have fruit and they also have fat, which is important for satiety, that you know the feeling of fullness after a meal. So you can really tackle your day.

C

So sometimes we might do a bowl of cereal with milk and a fruit, and some sort of a fat like peanut butter with the fruit or nuts, even like a bagel and cream cheese is, can be a great breakfast. With some fruit we do yogurt and granola, occasionally so the fastest breakfast might just be grabbing. A granola bar is not always the best most balanced breakfast for lunch. I think you know you have to think about what your child will eat.

C

So you want to pack them something that at the end of the day, they're going to eat so for some children. You know that maybe a sandwich that has protein and maybe cheese on it and some sort of condom in or fat to the sandwich for some children that maybe a salad that has croutons for some carbohydrate and protein on it and dressing. So you know think about what your child will eat and have that conversation with them.

C

You know you takes a lot of the guesswork out for the parent when they sit down and say you know what what do you want to eat for lunch? What would you enjoy because it's also meant to be enjoyable and a pleasurable experience. Look.

A

People grew up, I know, I grew up there. Hearing that breakfast was the most important meal of the day and I know that some families like we're just discussing, might just grab something real quick in the morning and then maybe have a bigger lunch. Can you talk a little bit about that? Yeah.

C

I mean breakfast is absolutely an important meal to the day. We have a lot of research and evidence that shows that children who eat breakfast do better on testing their more attentive throughout the day. So it's absolutely important. We would not, you know, recommend for children, especially school-aged children, to be skipping breakfast. Also, when you think about children in school, I mean they're growing. They need this nutrition.

C

So if you take away a meal, you might be taking away a third of the nutrition that they're eating throughout the day, and you know I find when I think of it that way or when I pose it that way to parents. It sounds really significant. I mean. Can you imagine, like a pie, is all of your nutrition and taking a third away from that? The child would not be getting what they need. So all three of those meals are very important.

B

So what is your idea? I see that many children are going on diets. That's a conversation, even elementary students.

A

B

Conversation is you know, my friend is on a diet. People are coming home and sharing that information. What is your thought about? Children and diets so.

C

Diets in general diets, in general, you know for certain people that may be what they need to make lifestyle changes. People respond to different approaches for children. We don't want to put them on diets and we don't want them following diets, because what the diet message sends is a good food, bad food message and at the run first Center. That's one of the things that we really try to. You know battle and say: look all foods can belong in the diet if you're eating all different kinds of foods in moderation, every food fits.

C

So the diet mentality really sends that good food, bad food message. You know it makes children think of certain foods as an allowed or forbidden foods that they should never eat, and really there aren't foods that we should never ever ever eat. So.

B

It comes back to that moderation and variety. Absolutely.

C

B

When you work with family members and you work with parents, it's really just about healthy eating and that the lifestyle of variety of things and then the moderation of portions mm-hmm,.

C

Absolutely and we see I work with a lot of children whose parents might be on diets and the children, even if it's unintentional on the parents part begin to follow this parent diet, because that's what they're seeing at home and that's what's being modeled for them. So even if you're not putting your child on a diet, they have so many different avenues where they can be exposed to it.

C

So, like you said, you're you children might come home from school and say you know, so-and-so is on this diet or it may be a diet that a parent or a grandparent is on and they just they latch on to it and they start to follow it. So it's not always you know the parent putting the child on a diet, but they don't live in a bubble. They hear things unless.

A

You mentioned if you're having dinner together as a family and the parents are having a diet of some sort. Then there's.

C

Those two exactly.

A

Yeah, what about eating disorders? Can you tell me about that? I mean sure.

C

Is an eating disorder yeah. So in very general terms, an eating disorder is any sort of abnormal or disordered eating. An eating disorder can look like a lot of different things. Look like restricting your food intake, so sometimes this is referred to as starvation.

C

It can also look like binging or eating abnormally large amounts of food at one time it can look like purging, so vomiting foods that one has eaten purging can also be a way to rid the body of calories, so that can look like laxative abuse, diet, pill, abuse, diuretics and also exercise as a way to purge the body of calories.

C

So an eating disorder can look like a lot of different things and there isn't there's not a cookie-cutter eating disorder, which I think is a very common myth that there's one thing to look out for it's going to look like one thing: every child with an eating disorder is going to present in a similar way, and that's not true, they're very different and.

B

That can pose you, no difficulties may be with identifying for parents. Can you talk.

C

A little bit about that absolutely I think parents, a lot of times, will say well, my child eats so they're, looking primarily at the restriction aspect, but you might see your child eating and you might not know that they are purging they might be. You know going in the bathroom and vomiting what you see them, eid they may be over exercising. They may be eating in front of you and not eating anything for the rest of the day, so it can look very different and just seeing that your child is eating, sometimes isn't enough.

C

So a lot of times these eating disorder behaviors are very secretive right.

A

C

Do they develop? That is what you know. I refer to a lot of times as the perfect storm, so there are so many different ways that an eating disorder can develop and reasons for developing. So some of the common you know causes for an eating disorder can be trying to find some control. So especially when we think of adolescence, it's a very uncertain time and you know their life, so they're trying to figure out who they are their identity.

C

There's a lot of things that they may not be able to control, but food is something that often times adolescents and children will turn to because they feel that they can control that sometimes it can be media driven. So we have this thin ideal. That's you know, put out in the media and children and adolescents think that that's what they need to look like, so sometimes it's trying to fit in or trying to conform to what the public sees as normal or acceptable.

C

Sometimes a child just wants to be noticed by the parent, so they think we'll all do something drastic so that they'll notice me and sometimes they're, just coping with really uncomfortable feeling. So it could be. The eating disorder could develop as a way to cope with depression or anxiety, or you know some other sort of mood disturbance. So a lot of times there isn't just one cause for an eating disorder.

C

We also know that there's a strong genetic link so about fifty to eighty percent of eating disorders are rooted in genetics, so that's not to say that the genetics caused it, but there's a strong association. So it's the perfect storm like I, said it's a lot of things that can beat a situation. It can be the family dynamic. It can be in the needs of the child or things that they're trying to cope with.

B

Well, we're going to take a quick break. Please join us in a couple of minutes. Stay tuned.

D

Hi I'm Sydney hi I'm Caitlin and we're both dancers at Southern, High School. We.

E

Have done our research to come to the conclusion that taking dance classes as an athlete will help improve your athletic skills and ability. Many athletes use dance and ballet to cross train and help improve their physical skills. Athletes.

D

Need certain skills, such as strength, agility, flexibility, concentration and coordination classes like ballet, it can help tone your muscles and help the athlete develop. Better body awareness.

E

Also taking creative dance classes can help improve your self confidence and self expression, as well as help you relax for when you're on the field.

D

Dancing improves your memory because you have to remember certain choreography. Just like you have to remember your team's moves and plays the.

E

Only disadvantage of taking a dance class as an athlete is the risk of injury. If you already have bad joints or muscles and may make it more strenuous on the athlete, if you're.

D

An athlete and want to excel in your sport, you will seriously consider taking a dance class after learning about all the wonderful benefits they can offer. You.

B

Welcome back to at your service we're having a discussion today about healthy eating and eating disorders. So, prior to break, we were discussing a variety of characteristics that you would find with eating disorders, and so what are some early prevented or some early signs so that parents can take almost a preventive action, so it does not become a full eating disorder. There's.

C

A lot of signs for parents, coaches, teachers, anyone in the adolescent or child's life to look out for one of them, which is not always present, is weight changes, so the child may lose a large amount of weight in a short period of time or gradually. On the flip side, the child might gain a large amount of weight in a short period of time or prolonged period of time. So that is something to look out for drastic changes in weight.

C

It's important to mention, though, that this doesn't always happen, so the child, the adolescent, could be acting on eating disorder, behaviors and their weight may not change. So if you're, just looking for weight, changes, you're going to miss a lot of eating disorders, so that's a really key piece to understand. Other things. To look out for our changes with the way that the teen interacts with their friends with their family. They may be avoiding situations where they have to eat in public. They may be avoiding family dinners team dinners things things like that.

C

They may almost like depression, like lack an interest in things that they used to like to do. They might not like to participate in the same activities anymore, the same sport, the same teams, so you want to look for changes, changes in their mood, their personality, sometimes eating disorders, go hand-in-hand with anxiety or increased levels of depression in some individuals. So you would want to look for a worsening of those symptoms.

C

Sometimes, though, when the child or the adolescent, starts using the eating disorder symptoms, it might mask as helping that depression or helping that anxiety, because it's giving them another way to cope. So really, you know, there's not one sign, there's not one symptom. You have to be aware, and just you know hope that you can catch these changes because ultimately, their changes in the way that the child or teen interacts acts their mood and sometimes their appearance.

B

So earlier you talked about the perfect storm and it's almost you have all these factors floating around and it would be individualized for each child, each family unit, there pierce their peer groups etc. How do eating disorders develop in children and young adults? Can you kind of discuss that whole perfect storm into developing to a fool, eating disorder? Sure.

C

So, as I mentioned, there could be a large genetic component, there could be family, dynamic components, social components and just the teen developing a different way to cope with things that they're going through and the way that it continues to develop our snowball. A lot of the time is that no one? No one intervenes. So no it adult in the child or adolescent life, steps in and says, I think there is a problem or I'm, not sure. If there might be a problem and if everyone stays silent, it enables the eating disorder.

C

So what if so important is that early detection and early intervention is key because the child or the adolescent will have the best chance for recovery from the eating disorder? If it if early intervention occurs.

A

That's the kind of the same thing with a lot of disorders that are out there. Can you speak a little bit more about the genetic piece I find that fascinating and I I also feel that that's something that most people have never heard of so.

C

If you think about it, a lot of teens may develop eating disorders and it may run in their family. So there may be that strong genetic association. So what we know is that the chemistry might be different in these people. Also, it may be like when we talked about parents modeling, modeling behaviors. They may be seeing things occurring at home that they are going to start behaving accord Lee.

C

So, for example, they may see the parent never eating, or you know the parent puts the children's meal out and never eats with them, and this may be a way that the parent acts on their eating disorder and the child thinks that this is appropriate, or this is okay. So there's definitely you know that chemical genetic component, but I think the modeling piece is also really huge and that this is the example that sets for the child and they're almost following in the footsteps of the examples that they get and so.

B

When you think about coaches and athletes and club members and parents and community members, what can they do because, especially in a school or on the rec fields, they work with children all the time you know I, think about my daughter, she's in dance but she's, also in soccer and I know, there's certain athletes and sports that lend themselves to not gaining a lot of weight or you know, I think one pops in my head is I, think of wrestlers. They have to weigh in at a certain level.

B

So how can cut when two coaches need to get involved? If family members need to recognize, if you are a coach or just the layperson, a neighbor when what are some of the signs? And you know what can you do so.

C

Coaches can look for a lot of the same signs that parents should look for. Teachers can look for so you know they want to look for drastic changes in appearance or weight, and also keeping in mind that this is not always present. So it's one thing to look for: it's not the only thing to look for again.

C

They can look for changes in mood or behavior personality changes, lack of interest and maybe an activity or the sport that the child used to love and kind of lacks enthusiasm for now, and the coaches especially, are in a very unique position because they have a lot of pull. So coaches should definitely not be afraid to speak up. Sometimes a child with an eating disorder is suffering in silence and they're waiting for someone to notice that they're suffering or that they're hurting.

C

So speaking up even you know if you're not sure, but you just want to. Let them know that they're there is so important and offering to connect them with services and treatment so that they can get the help that they need so the coaches.

C

They don't have to be a treatment center, they don't have to treat the child or the teen, but I do think it is their responsibility if they suspect that something is going on not to let it continue and worsen, because that is putting the child at risk and, like I said, if there's early intervention, there's a much better chance for recovery from the eating disorder.

C

The coaches also have you know a lot of pool and a lot of authority with letting the eating disorder behaviors continue, so by letting them continue to practice with the team or engage in the sport. If you know that they're not eating all day is not a good thing, so they can set limits.

C

They can say you know I'm going to let you miss practice for a certain amount of times that you can work on your treatment and receive treatment, and when you come back, you're spot on the team is, is safe, so they're in a very unique position to be supportive and to provide those connections and ultimately let the parents know clue them and let the parents know what is going on, because this is their child and they, you know, ultimately need to be the ones who are involved know. What's going on and.

B

I think it's important because we work in the area of student services. Christy is a counselor ppw and in school counseling, and it's really important because many times I find, if you don't work in the field, you're, not real, comfortable and you're, not sure what to do so. It's really important if you refer to a school counselor to the social worker, to a nurse in the school just so that somebody can get the child the help or make that connection for the parent in the student. Absolutely.

C

Teachers can be such a great support and a lot of times. Students feel such a positive and strong connection with their teachers. They may let the teacher know something that's going on before they let the parent know. But again, the teacher just like the coach is not a treatment provider they're, not a therapist they're, not a dietitian, so you want to get the child experts and get them the help that they need. So parent teachers are a great support. You want to clue the parents in want to have that dialogue with them.

C

You know the child can be present. That's okay, we're not trying to hide anything from them and there's no shame in having an eating disorder, but we want to help them there.

A

Might be some students actually watching this show? What would you recommend for the bystander? That's actually, you know might have a friend that they're concerned about what would you suggest for them? I would.

C

Definitely suggest that the friends should speak up, don't be afraid to talk to your friend. If you think something is going on like we said, the eating disorder thrives on very secretive, behaviors and then the child may not ever come out and say: look I have an eating disorder and I need help. So in order to not let this go on and really take over their lives, friends should not be afraid to have that conversation. I. Think also.

C

You know the friends are in a unique position to because they, you know, maybe eating lunch in the school cafeteria with their friends. They see things that parents may not notice. For example, a child may be coming into school and throwing out their lunch. The parents might never know, but the friends the friends will see. So we need to really abandon the stigma of an eating disorder and that it's a very shameful thing, because it's not it's a very real struggle, and so many boys and girls are suffering from eating disorders.

C

So you know the stigma has to go out the window in order to get them the help that they need. So.

B

I have a couple of scenarios that I think are pretty common and I. Think it's important to get the word out. So what when, when you hear parents say to you, my child does not look like she has an eating disorder. He or she eats dinner with us. Why are people saying that about my child so.

C

Again, a lot of times weight, loss, weight, gain, weight, changes never occur. So if that's the only thing that the parent is looking for or they're only looking to see that the child eats with them, they could be missing a lot. So, for example, is the child skipping breakfast and lunch because they know that they have to eat dinner with their parents. This happens a lot, it's very common.

C

So if that's all that the parent is singing they're eating dinner, they're missing two-thirds of the meals of the day, you know also, if they're just looking for a week change this may never happen, and so.

B

As here's the other other little scenario, you know they just came from the pediatrician, their weight is fine for their developmental, their height than all that you know the doctor was not worried. How can my child have an eating disorder and it kind of goes back to what you were saying about just if that's the only symptom right.

C

And also eating disorders, it's a specialty, it's a niche and not all doc. Doctors and pediatricians have been trained to detect eating disorders and they're, not always aware of all the warning signs. So it's really important to connect these children and teens with professionals that know the signs to look for also with doctors, offices and pediatricians. They may only be looking at the weight, but the child's at and not looking at changes, so they may be ignoring. You know, large weight changes that are concerning because now the child's at an appropriate weight.

C

Well, if they got there using very harmful and unhealthy measures, that's my good. We would want there to be an intervention. Here's.

B

A

C

A

Another scenario: the two: is it a lot of times the the parent and the teen are trying to build that trust level and.

E

A

The parent might say, oh my my child, told me she ate when she got him from school. She.

C

A

Lie to me I'm supposed to trust her. You know and.

C

Again that that eating disorder thrives on secretive behaviors, so the you know the individual with the eating disorder is trying to hide the fact that they're acting on these behaviors, so it could be saying you know, I'm going to go up and eat in my room and throwing the food away or I'm going to go out and eat with my friends and never eating. So you know trust between a parent and a child is great, and it's so important, but with an eating disorder.

C

We can't rely on that because the child is trying to maintain the eating disorder and it's not that the child is untruthful or that the child is a liar, but the eating disorder is a liar. So you know we reflect that a lot in treatment. Your child is not lying to you. The eating disorder really is deceitful and lying so again getting them the treatment and the help that they need and can doing them with. Professionals can take some of the burden off the parents.

C

The parents do not need to be a treatment center and putting the parents in a bad cop situation where they have to play good cop, bad cop doesn't help the family dynamic so sometimes having a treatment team having a therapist in a dietitian. You know to make some of those judgment calls and to almost let the child know. What's expected, can can take some of the pressure off of the parents. Well,.

B

Thank you for joining us today. I really appreciate this topic of conversation, because we've really learned yeah. This is very vital information for for ourselves, for our students for children just about healthy eating, what's appropriate, so I really appreciate your time today. It miss francon, absolutely and thank you for spending time with us at your service join us next time.