A publication of The Center for Mindful Eating ~ www.thecenterformindfuleating.

org

Food for Thought

May 2015

SPECIAL
Mindful Eating
Connecting Hearts and Minds
ISSUE!

to Nourish Our Children

IN THIS SPECIAL ISSUE ON MINDFUL EATING AND KIDS:

Childhood Empathy Mindful

obesity and as a tool for Bites: The
mindful therapeutic Magic of the
connection counseling Moment
page 3 page 6 page 10
 We have very little research on
Introduction by: mindful eating in children. An experiment
Jan Chozen Bays
About The Center from the 1930s showed that babies
offered a variety of foods on the tray
MD
for Mindful Eating: of their high chairs ate an appropriate
number of calories and a balanced diet,

A
s a pediatrician, I became aware not in one day but over the course of a
Our Mission: of the epidemic of childhood week.1 It was as though they were guided
The mission of The Center for obesity when obese toddlers by an inner nutritionist. An experiment
Mindful Eating, also known as TCME, began showing up in my office. I became in 2000 showed that 3-year-olds will eat
is to help people achieve a balanced, worried when I read that obese children an appropriate amount of a very large
respectful, healthy and joyful were developing liver damage, high blood plate of macaroni and cheese and then
relationship with food and eating. By pressure and high cholesterol, problems stop eating, while 5-year-olds will make
providing an easily accessible source we never saw 40 years ago. I became very a valiant attempt to eat it all.2 Sometime
of information and opportunities worried when I read that 30 to 50 percent between the ages of 3 and 5 the inner
to interact via the web and in other of children born in 2000 are expected to wisdom that says “stop eating now” is
ways, we seek to train and encourage develop Type 2 diabetes and the resulting overridden by an inner voice that says
professionals who can then foster complications to eyes, kidneys and heart. “clean your plate.”
this capacity in others. I became alarmed when I read that my Recent research indicates that 1014
medical colleagues were performing beings inhabit our guts and that a healthy
bariatric surgery – rearranging the and diverse microbiome seems to play
Board Members: anatomy of the stomach and intestines on an important role in preventing obesity.
Megrette Fletcher, President teens and even younger children. It’s not a big surprise to learn that a diet
Lilia Graue, Vice President We have a medical problem in our high in fat and caloric density promotes
Mary Farhi, Treasurer country, one that is spreading to other a microbiome that leads to obesity and
Marsha Hudnall, Secretary
countries like an infectious disease. The that the microbiome found in lean people
Caroline Baerten
Shirley Kessel problem sounds simple: Children are seems to thrive on a diet high in fiber,
Cinzia Pezzolesi eating poor quality food in inappropriately fresh vegetables and fruits.3
Claudia Vega large quantities. In looking at the I am very happy that The Center
solutions we have tried for overeating for Mindful Eating has invited four
Advisory Council: in adults, I found we seem to take on knowledgeable authors to contribute to
strategies of incarcerate or attack. Diets this special issue on obesity in children.
Donald Altman
Jan Chozen Bays put certain foods in jail, where we are To work on bringing this epidemic under
Ronna Kabatznick forbidden to visit – until we do. Research control and to provide a future of physical
Jean L. Kristeller shows that diets don’t work. In fact, early and mental health for our children, we
Barbara Reid dieting is the best predictor of eating need to combine the knowledge and
Char Wilkins disorders later in adolescence. Diets teach experience of people who are working in
kids to rely on external rules, rather than all relevant fields: nutritionists, doctors,
Learn more & get in touch: to trust their body’s innate wisdom. therapists, nurses, social workers,
We’ve also tried attacking fat through researchers, community health workers,
www.thecenterformindfuleating.org
liposuction and attacking the digestive teachers and parents. I invite you to read
e: [email protected] p: 603-664-3444
system through bariatric surgery. These these articles and think about how you
Find us on Facebook: are not appropriate treatments for can bring the joy of healthy eating to all
http://www.facebook.com/ growing children. children the world over.
TCME.Mindful.Eating We need a solution that is Jan Chozen Bays, Roshi, MD, is a
inexpensive and fun, needs no extra pediatrician specializing in work with abused
Follow us on Twitter: equipment (outside of a body, heart and children. She is the author of “Mindful
http://twitter.com/MindfulTCME mind), a solution that is easily learned, has Eating: A Guide to Rediscovering a Healthy
Follow us on Pinterest: positive side effects, and has a beneficial and Joyful Relationship with Food” and
http://www.pinterest.com/ effect on the rest of our life. I propose that “How to Train a Wild Elephant and other
mindfulTCME/ the missing piece is mindful eating. Adventures in Mindfulness.”

2 FO OD F OR T HOU GH T ~ M IN DF UL EATING & KIDS : SPECIAL I SSU E M AY 2015

Childhood Obesity
and the Mindfulness of Connection
Lenna Liu
MD, MPH

A
s a general pediatrician
focusing on childhood obesity
for over 20 years, I have
seen the ramifications of the obesity
epidemic on a daily basis. I work in an
urban clinic with a very diverse, mostly
low income, Medicaid population,
and close to 40 percent of my patients
are overweight or obese. While many
see obesity as an issue of individual
choice and responsibility, it is clear
in caring for these families that most
parents are doing their best given their obesity requires the development of
circumstances and limited resources mindful connections. Connection here
(e.g., economics, parenting skills, access means conscious and intentional linking
“We must learn to
to healthy food and/or activity, etc.). and building of relationships among trust the natural
Social inequities that prevent equal organizations, entities and people.
access to opportunities for healthy eating Stronger connections are needed among growth and develop-
and activity have, in my view, superseded levels of society (e.g., governmental ment of children, and
personal choice as the driver for obesity. policy, industry and schools), within
The Institute of Medicine (IOM) has also sectors (e.g., developing nutrition strike a balance be-
identified cultural and societal factors as standards for child care and early
root causes and ultimately the solutions learning centers), within families (e.g.,
tween giving them the
for turning the tide on childhood obesity. supporting parenting skills and family foundation that they
In its 2007 report, the IOM put out a relationships) and within the individual
call to all sectors of society – federal (e.g., more awareness of one’s body and
need without inter-
government, industry, communities, the impacts of food and activity on the fering with our own
schools, and families – to play a role in body).
addressing the obesity epidemic. Again The relationship between federal agendas or fears.”
in 2012, it called for more synergy policies and their downstream effects
among these sectors to accelerate the on our children is one example of our
pace of change: “There is an urgent need connectedness. According to Dr. David soybeans – that were easy to produce,
to employ large-scale, transformative Wallinga, a leading science and policy store and ship.2 While the impact of
approaches focused on multilevel expert on health and our food system, these surplus foods was an increased
environmental and policy changes within early in the 20th century, when hunger fat and sugar content in food and a
interconnected systems to reduce the was the predominant nutritional problem consequent reduction in hunger and
threat of obesity and sustain enduring in children, federal agricultural policies malnutrition, in our current age, children
impact.”1 supported increased production of are no longer deficient of calories
Turning the tide on childhood commodities – corn, wheat, milk and continued on page 4

MAY 2 0 1 5 FO OD FOR T HOU GH T ~ MI NDFU L EAT I NG & K I DS: SPE C IA L I SSU E 3

 early childhood, overruled by external
childhood obesity (often parental)/environmental cues to
Continued from Page 3
eat outside of stomach hunger and/or
(perhaps deficient of nutrients but not beyond fullness.4
calories). Many surplus commodities Supporting families to cultivate this
produced under farm bill programs make natural instinct is one part of building
their way into federal child nutrition trust in a child’s abilities. Another comes
programs, such as the National School in the toddler age, when their growth
Lunch and Breakfast Programs. “We naturally slows and their palate often
need much more than another farm bill,” narrows. Parents understandably are
Wallinga writes. “We need a Healthy concerned if their child’s eating drops, and
Food, Healthy Farm Bill.” It is not always their worry can result in over-encouraging
easy to foresee the far-reaching impacts eating. Some even distract their kids with
of a policy change, but mindfulness in TV or computer screens to keep feeding
assessing the consequences of a decision them. Again, reassuring and normalizing
and a commitment to addressing the slowed growth (and consequent
its effects over time are two ways of lower caloric needs) can foster trust in
sustaining a mindful connection. the child’s natural growth. One of my
An emerging, new connection in favorite parenting quotes is from Wendy
addressing obesity is the relationship receive more consistent messages about Mogel: “Try to see your child as a seed
between the built environment and healthy behaviors and environments, that came in a packet without a label. Your
health. Architects and urban planners they are more likely to make these healthy job is to provide the right environment
now interface with public health and choices for themselves and help their and nutrients and to pull the weeds. You
health professionals as they develop new children learn a new “normal.” can’t decide what kind of flower you’ll
buildings and neighborhoods. Not only Furthermore, the recognition that get or in which season it will bloom.” 5
are building plans reviewed to evaluate obesity prevention needs to occur in We must learn to trust the natural
their safety and environmental impact, early childhood (and even in pregnancy) growth and development of children,
but they are also analyzed to predict the highlights the link between early growth and strike a balance between giving them
health effects on the people who work in and later health outcomes. Schools are the foundation that they need without
and around the building. For example, being asked to increase physical activity, interfering with our own agendas or fears.
neighborhoods have been designed to improve access to healthier foods, Finally, the connection within the
encourage walkability with sidewalks and decrease sedentary time to create individual is for me the most compelling
connecting homes to community healthier environments for their students. arena that I hope to impact. Individuals
resources and shops. In 2013, in addition But because schools are measured by the in much of Western society are very
to capping soda sizes in New York City, academic achievement of their students, disconnected from the internal body.
Mayor Michael Bloomberg also issued an the emphasis on health in learning is As much as we overly focus on external
executive order requiring city agencies often lost. Time spent at PE or eating appearances, we are, ironically, often
to promote the use of stairways and to lunch is often reduced to increase disconnected from ourselves – our
use smart design strategies for all new classroom time. Yet healthy children learn intuition, the impact of food and
construction and major renovations.3 Our better. This connection should not be movement on our bodies. When I was
behaviors are often dependent on what is overlooked. growing up, my parents would say a
easiest. If, by design, we make the healthy The connection between parents and Japanese phrase to me at mealtimes,
way the easy way, people will follow suit. their children is another important piece “Hara hachi bu,” or “Eat until 80 percent
For children and adolescents, the of the puzzle. I find one missing piece to full.” They taught me to pay attention to
connection between school and child-care be the parent’s trust in normal childhood fullness in my stomach and to stop before
policies and healthy behavior is especially growth and development. I teach parents being completely full.
salient. By implementing healthy eating from our first moments together that It is important to note that practices
and activity standards across child an infant has the ability to self-regulate around feeding can be strongly influenced
care, early learning and school settings, around eating – eating when they are by socioeconomic circumstances or
administrators can support obesity hungry and stopping when they are full. culture. If parents are dealing with food
prevention. As children and parents This innate instinct often gets lost during
continued on page 5

4 FO OD F OR T HOU GH T ~ M IN DF UL EATING & KIDS : SPECIAL I SSU E M AY 2015

 How to Take
Connectedness
Into Practice:
1) Teach parents about their child’s
innate ability to regulate hunger
and fullness as early as possible, in
infancy and early childhood. Support
them in recognizing hunger and
fullness cues.

2) Help build trust in the child’s ability

to self-regulate his intake.

3) Help build trust in the child’s ability

to grow. Normalize the change in in-
take and subsequent rate of growth
childhood obesity – are calls to all of us to shift from the
from an infant to a toddler. Reassure
Continued from Page 4 status quo toward new paradigms of families of toddlers that they will eat
connectedness. To me, the obesity enough to grow. Teach parents the
insecurity, poverty or the fear of hunger, epidemic is an opportunity to awaken division of responsibility: The parent
they may encourage their children to eat to consciousness and connection at all is responsible for what a child eats
based on a broader context rather than levels. In the words of Joanna Macy: and the child is responsible for how
the child’s internal cues. This can lead much.7
“Imagine that future generations
to disconnection. It is important to be
aware of this context to best counsel
will look upon this as the time of the
Great Turning, an epochal shift from
4) Normalize the variation in eating
over time (children grow in spurts;
and support the family. We have the an unsustainable consumer growth they may eat less for a few weeks
opportunity to share the value of this and then eat very well for another
world society to an interdependent
connection with children and parents few weeks because they are having a
life sustaining society. There is among
today. growth spurt).
people everywhere an urgency to
In addition, we are often not
attuned to the link between emotions
taste and know this dharma of 5) Teach children to pay attention to
their own hunger and fullness. Help
interconnection. Perhaps our survival
and our bodies. I see this in practice them be aware of various degrees of
depends upon our doing that.”
when parents complain that their fullness and to support them eating
until about 80 to 90 percent fullness.
child just “eats and eats and has no Acknowledgments: Much gratitude
off button.” After digging deeper, the
parent will often acknowledge that her
to Jan Chozen Bays, MD, and Char 6) Recognize that parents’ lack of trust
in their child’s eating or growth may
Wilkins, MSW, LCSW, for their teaching;
child eats when bored or lonely. Helping stem from their upbringing or a
Megrette Fletcher, MEd, RD, CDE, for her
bring awareness to heart hunger is one history of food scarcity, poverty or
support and collaboration; and Alex Varela, hunger. Explore and acknowledge
way to link the boredom or loneliness MPH, and Ariel Hart for their wise and these fears, support their access to
to the body and help the parent and thoughtful editing. healthy foods, and gradually work to
child see another path toward caring for Lenna L. Liu, MD, MPH, is a build their trust.
that emotion.6 Mindfulness practices, professor of pediatrics at the University
including mindful eating, are the path of Washington School of Medicine and a 7) Build community. Get connected
with other people and organizations
to bringing awareness to the body. pediatrician at Seattle Children’s Hospital in your life (e.g., workplace, schools,
Furthermore, they occupy the gap or and Odessa Brown Children’s Clinic. She is child care, nursing homes, religious
missing link from the “what” (healthier active locally and nationally in childhood organizations) and see how you can
foods, physical activity) to the “how.” impact them in bringing mindful-
obesity efforts and is the physician lead
The great environmental and ness to eating and activity. Plant a
for Seattle Children’s Obesity Program, vegetable garden, start a walking
public health crises of our current focusing on clinical services, advocacy, school bus, invite a farmers’ market.
society – climate change and obesity research and education.

MAY 2 0 1 5 FO OD FOR T HOU GH T ~ MI NDFU L EAT I NG & K I DS: SPE C IA L I SSU E 5

 Empathy
as a
Therapeutic
Counseling
Tool
in changing their perspective with
respect to food, nutrition and health.
Angelina Maia “We all have emotions As a practicing dietitian for 13 years,
MS, RD, LD
and we all feel, but I have found that empathy is one of
the most powerful tools we have in
applying empathy to effective communication and successful
“Mary” was a beautiful 5-year-old counseling.
girl from India. She came to my office
clinical practice effec-
Empathy as a concept has been
on a referral from her primary care tively and sincerely researched and applied clinically within
physician, who recognized the health the psychotherapy field beginning with
risk from her elevated BMI percentile is a skill. Focused the works of Dr. Carl Rogers in the 1950s.
and suggested nutritional counseling as practice will lead to Although critics dismiss using empathy
a method of treatment. Mary’s mother as a therapeutic tool as “soft,” researchers
shared the doctor’s concern and was greater success.” have demonstrated positive clinical
obviously frustrated with her own efforts implications.1 Empathy is, however,
to change her daughter’s weight. a broad concept with no universally
“I put her on the scale and I weigh makes you feel very, very sad,” I said with accepted definition. Instead, empathy is
her every morning and every night. sincerity and honesty. Mary’s big brown the observation and acknowledgment
She is getting too fat.” As her mother eyes filled with tears and she started to of another’s emotions and feelings.
spoke, she lifted up her daughter’s shirt, sob. This breakthrough was the beginning Empathy is the product of mindfulness,
exposing her stomach. “You see? She is of our relationship and the start of the communication that can only come
fat.” effective treatment for a healthier life. from a nonjudgmental environment
I watched Mary respond to her Effective nutritional counseling where provider and client live and work
mother’s words. Her body slumped, is a balance of skills. Providers must in the present moment. In clinical
and her head dropped lower and lower communicate evidence-based practice, practice, empathy can be demonstrated
as she stared at the floor. I gently protocols and procedures in a manner by three main components:
interrupted her mother and said, “Mary, that reaches a patient on a deeper level. 1. Is the provider able to
I’m wondering how this makes you feel.” We not only ask our clients to observe, be understanding of the client’s
My invitation to share her feelings was evaluate and assess their behavior, but perspectives, feelings and/or situation?
met with stoic silence. “I am guessing this also ask if they might be interested
continued on page 7

6 FO OD F OR T HOU GH T ~ M IN DF UL EATING & KIDS : SPECIAL I SSU E M AY 2015

empathy
Continued from Page 6
2. Is the provider able
to communicate her perceived
understanding to the client in a
nonjudgmental, non-shaming manner?
3. Is the provider able to assess
the client’s response in order to build a
therapeutic relationship?
It is important to differentiate
between sharing the client’s feelings,
which requires the provider to “take on”
those feelings, and simply observing
and acknowledging the client’s feelings.
The former leads to a cumulative
emotional toll on the provider, whereas
the latter allows the provider to address
an emotional component of treatment
without it being emotional for him as a and sometimes even their providers. By quietness into treatment will provide
provider. allowing Mary the opportunity to simply a safe environment to heal.
The successful and strong sit with her pain and trying to fathom • Do not be afraid to verbalize what
relationship established with Mary using what that must be like for her every they may be feeling or experiencing
empathy is not unique. Researchers day, it allowed me to make a connection without judgment. You may be
have found that when patients perceive with her broken little heart and start wrong, but simply opening a dialogue
their provider as demonstrating the healing process with both her and that involves identifying their
empathy, there is an increase in patient her mother. I simply verbalized and emotion is important.
satisfaction,2, 3 an increase in adherence reflected her feelings. Mary immediately
• Clients will correct you if your
to recommendations,4, 5 and an increase reached a level of comfort and safety that
perception of their feelings is wrong.
in clinical improvements.6, 7 In addition, allowed us to bond and begin a healthy
Recognizing what they aren’t feeling
researchers have also found a correlation therapeutic relationship. Working with
will help them to identify what they
between empathy and providers. children typically requires working with
are feeling.
Providers actively using empathy in parents as well. Researchers have found
practice report decreased incidence of that a parenting style perceived by the • Focus on reflecting their feelings
burnout,8 increased well-being,9 and child to be high in warmth/responsiveness and emotions. “You feel sad” is more
increased clinical competence.10 Building is associated with positive health effective than “I feel sad for you.”
an empathic clinical environment benefits behavior outcomes,11 and that parental This will allow you to hold their
not only the clients, but the providers empathy plays a significant role in child experience in both heart and mind.
as well. Clients want to feel heard, to attachment.12 This indicates that the more • Take time to listen and repeat back
know they are worthy of treatment, empathy exhibited by a parent with her their words. Clients will feel heard,
and to feel important. In a time when child, the healthier attachment between validated and important. This is
so much of our success in health care is them, and the greater the success of the first step to building a trusting
based on technological developments to treatment. relationship.
improve productivity and treatment, the We all have emotions and we all feel,
importance of maintaining humanity but applying empathy to clinical practice
Angelina Maia, MS, RD, LD, is a
cannot be forgotten. effectively and sincerely is a skill. Focused
Registered Dietitian who has been in practice
I used empathic curiosity to open practice will lead to greater success. As you
for over 13 years. Angelina is a doctoral
a dialogue with Mary. She was initially begin applying empathy to your clinical
candidate in food and nutrition sciences with
unresponsive to talking about her feelings. practice, use these basic guidelines:
her research focusing on childhood obesity
This is a common barrier that I have found • Allow clients to sit with and be and Motivational Interviewing.
in younger clients, a result of judgment mindful of their feelings. They may www.maianutrition.com
and shame from their families, friends, not know how they feel and allowing

MAY 2 0 1 5 FO OD FOR T HOU GH T ~ MI NDFU L EAT I NG & K I DS: SPE C IA L I SSU E 7

Building a Better Diet-Family: How Mindful Eating Fits
interrelated. People select food to eat,
they eat the food and these choices
Megrette Fletcher
ultimately nourish the body. It may
MD, MS seem simple, but many choices and
decisions surround each of these steps,
creating doubt, uncertainty and fear
Wentworth-Douglass Health System about the ‘right’ way to feed a family.
is a community hospital in Dover, N.H. Creating a personal philosophy about
In 2014, the Build a Better Diet-Family food, eating and nutrition can be helpful
program was created to respond to to parents and caregivers. How to
the growing demand from health care begin? Start by asking questions. WHY
providers, employees and the community does the child eat? Babies eat primarily
to offer a nutrition program for families. because they are hungry. In a short time
Build a Better Diet-Family was developed babies associate eating with being held,
as a weight-neutral program. The format warmth, comfort and love. Eating is one
of Build a Better Diet-Family allows all of the ways the child bonds with parents.
children to receive the same learning offer benefits in diabetes management, It is easy to see that eating is different
without creating feelings of guilt, weight loss and reduction of binge than feeding. Eating is the ingestion
shame or self-loathing. This program eating.2 3 4 5 Research is helping the of nutrition, but feeding is creating a
includes information regarding the health care community understand that bond that becomes the foundation for
larger concepts of mindful eating and mindfulness and mindful eating training a healthy relationship between parent
encourages both the parent and child normalize a person’s relationship with and child. The function of food expands
to consider the complex and dynamic food. More important, mindful eating from nourishment to offering a critical
nature of feeding a family. For many promotes a healthy, lifelong approach secondary benefit of creating a secure
participants, this is their initial exposure to food selection, preparation and emotional bond between caregiver and
to mindful eating for families. consumption. child. Babies grow, and the role of the
meal changes. Eating now becomes
Why Mindful Eating How “Build a Better the training ground for expressing
for Families? Diet-Family” Is Set Up independence and getting physical needs
met. This complex relationship between
Mindful eating is an ancient The learning objectives of this
food, eating and nourishment becomes
wisdom that promotes awareness of program focus on increasing motivation
a ‘culture.’ As families grow, this culture
a child’s direct experience. Mindful and access to resources, concepts and
and common food choices fade away
eating education is also associated nutrition tools for families to change
to become a series of invisible habits.
with developing a more positive their diet. Two unique program features
Every family has a food culture that is
relationship with food. Specific aspects are: Understanding Your Family’s Food
unique. Think about your family culture.
of mindful eating that are helpful for Philosophy and a Tool Scramble.
The culture around food, eating and
children include promoting family After introductions, the participants
nutrition is often subtle and hard to see
meals, cooking, growing food, hunger/ begin to explore why changing a
because it is considered ‘normal.’ To help
fullness training, decreasing mealtime family’s diet is challenging. This activity,
you understand, pause for a moment
distractions, exploring taste, slowing Understanding Your Family’s Food
and imagine that there is a person from
the pace of eating, sensory integration, Philosophy, is published in Discover
France eating breakfast. This person
and creative play. All these aspects Mindful Eating for Kids 6. The instructors
doesn’t think there is anything unusual
increase the satisfaction with food and begin to unravel the complexity of food,
about French foods. Now imagine that
eating. Encouraging children to engage eating and nutrition by offering the
a person from China just joined the
in these types of activities has offered following education.
breakfast table. Eating French foods for
improvement in nutrition and learning.1
breakfast might be a new and different
Additional applications for mindful “Food, eating and nutrition
eating are being explored in adults and are three distinct concepts that are continued on page 9
8 FO OD F OR T HOU GH T ~ M IN DF UL EATING & KIDS : SPECIAL I SSU E M AY 2015
Pearls of Wisdom: Tips on How to Counsel Children
on Eating More Mindfully
For Counselors: For Parents: strong negative emotion in you, take the
time to pause and review how could that
1) Please remember that • Take the time to listen to your
be related with you. What we do not like
shame is violence. Many of the children, but listen attentively and
about them has more to do with ourselves
children we are working with nonjudgmentally. If allowed, children express
than with them.
experience shame on a daily their needs in an honest and assertive way.
basis. Offering a nonjudgmental • Ask questions about
• Water the seeds you
environment gives a safe place to what your child thinks. Create
have planted. Wisdom
share how they feel. a space to connect with the
and loving support are like
child, his feelings and fears.
2) Believe in your clients and water to your self-critical
Daniel Siegle, MD, author
share that with them. Tell them child. When you offer
of The Whole-Brain Child
you believe that when or if they that hug, quiet space, or
reminds parents: “Connection
want to make changes, that they a few words of honest
before correction.” Children
will. Support their autonomy and encouragement, you are
(and adults) need to feel
their path. watering these seeds with
empathy before they can hear
empathy, understanding
3) Ask permission from your you. Creating an empathic
and support so that self-
client before directly offering connection opens the brain and improves
care and well-being can take root.
advice. By simply saying “Would listening, memory and understanding.
it be okay if I shared some things • Dedicate time to be present with
• Ask them if they are a friend to
that have worked for some other your children: play, cook, read a book, go
themselves. You might say, “Are you being a
kids I have worked with?” it will out with them. The time we dedicate to
friend to [insert child’s name]?” If the child
allow you to build empathy by be fully present with our children are the
isn’t responding, you might add, “Well, you
respecting their boundaries and memories they will treasure the most!
better because [insert child’s name] is my
where they are in their journey.
• Children are our mirrors. When friend and I am not going to let you beat
something about your child triggers a him/her up.”

diet-family participant is asked to identify the deeper of two books, including Eat What You Love,
Continued from Page 8 desire surrounding his family’s food and Love What You Eat with Diabetes with
experience for this diner. Mindful eating eating choices. Above each handout, taped Michelle MD, Discover Mindful Eating: A
asks you to pause and try to see food to the walls, are motivational graphics resource of handouts for health professionals,
and eating in a new way, like imagining that the instructors downloaded from the with Frederick Burggraf. Megrette is a
you were from another country (or even Internet. These images offer a variety of professional speaker and spokesperson in
planet)! What do you notice, observe, or themes and are funny, fresh and touching. both the U.S. and U.K. She is a dietitian and
witness?” Participants are encouraged to take the certified diabetes educator and works in a
images that are motivational. After 15- diabetes clinic.
After participants have considered 20 minutes the group gathers and the Megrette is an avid cyclist, passable
their family’s food philosophy, they are program closes after participants share cook and a terrible bowler. She lives in
offered a chance to participate in a Tool why they selected the chosen handouts. New Hampshire with two girls and too
Scramble. This is described to participants This allows all the participants to hear many other animals. She has maintained a
as a way to access over 30 handouts on a about different approaches to changing daily meditation practice since 1999 when
variety of topics ranging from low-cost the family food, eating or nutrition she began studying Buddhism. To learn
cooking to mindful eating. Handouts choices. more about Megrette, visit her website at
appeal to a range of ages, starting as Megrette Fletcher is a cofounder of The Megrette.com
young as 5 and through adulthood. The Center for Mindful Eating. She is a co-author

MAY 2 0 1 5 FO OD FOR T HOU GH T ~ MI NDFU L EAT I NG & K I DS: SPE C IA L I SSU E 9

 Educational Handout

Mindful Bites:
Bringing the Magic of the Present Moment into Practice with Children
have contributed to an unbalanced
relationship to food. On one hand,
Claudia Vega
children eat emotionally and excessively,
MD, MS which has translated into an epidemic of
obesity; on the other hand, the number
of eating disorders among youth has also
Many of us know firsthand that increased.
children are naturally aware. We If we focus on obesity, several
ourselves were curious children. Kids research studies have shown that diets
have an innate connection with life. do not offer a solution in the long run.
They can spend minutes observing the The studies show that between one-and-
walking of an ant, the flight of a fly, two-thirds of dieters regain more weight
the transforming shapes of the clouds. some years after they finish their diets.5
They also have a great capacity to be With children, there is not enough clear
surprised with the little and the big evidence to recommend one particular
discoveries they make through their diet regime. What has been shown is that
attentive eyes and their nonjudgmental family-based interventions that promote
minds. Kids simply ARE. And, although
they daydream, they get to be and live
“When children are a behavioral lifestyle change, through
a balanced diet, an increase in physical
mindfully because of their amazing allowed to, they can activity and emotional management
capacity to come back to the present seem to offer the best results6.
moment. explore, experiment Taking advantage of the large
We are living at a constantly and discover through capacity that children have to connect
accelerated pace. We are busy beings: with themselves and with the world
fathers and mothers working in and food different ways around them through their senses,
out of home; children who spend long
hours at school and also have multiple
of nourishing their promoting a curious attitude and the
practice of mindfulness can help them
extracurricular activities. The result is minds and bodies.” understand the relationship between
that grownups and little ones have less their thoughts, feelings, actions and
and less time to simply be, to spend time reactions.
together in mindfulness. environment favor a disconnection of In a climate of acceptance, children
Many children whose parents work themselves and of the world around can thrive, heal and transform.
long hours away from home have had to them. They, too, enter into the fast pace Mindfulness favors a progressive
find resources to feel accompanied and to of our daily lives. discovery and acceptance of themselves,
spend their free time.1 Social insecurity Furthermore, we also have creating emotional security for children.
in the streets, long exposure to TV, and the influence of the media, which By increasing body awareness, children
the use of video games and electronic continuously bombards our children can identify physical hunger and
devices contribute to a more sedentary with the idea that beauty is attained understand other triggers for food
life for a lot of these children.2 Their eyes through slim bodies,4 but at the same seeking, diminishing emotional and
and minds are constantly stimulated, time, they are exposed to tons of mindless eating. When children are
but their bodies move less and less. 3 advertisements that create the desire allowed to, they can explore, experiment
This limited sensorial stimulation and for poorly nutritious food. This could and discover through food different ways
the ever less exposure to an outdoors confuse anyone. All these factors continued on page 11
10 FO OD F OR T HOU GH T ~ M IN DF UL EATING & KIDS : SPECIAL I SSU E M AM
RCAY
H 2015
mindful bites Mindful eating exercises help bring
Continued from Page 10 awareness to the act of eating. Although
of nourishing their minds and bodies. they are based on a millenary philosophy
In my private practice I work with and practice, their use in Western society
children and their families. I combine and in the clinical field is relatively new.
nutritional education, mindful eating It will be necessary to implement these
exercises and psychotherapy. Of these strategies and do research studies to
three tools, I am always amazed by the observe the actual impact that mindful
usefulness of mindful eating. With easy eating, together with a holistic approach
exercises, children start to understand can have on overweight children as
their relationship with food, as well well as on the prevention of disordered
as their emotions around eating. For eating. Bringing the magic of the present
example, they become aware when moment to each bite, I think and believe
anxiety, anger, loneliness or boredom that children will be able to eat with more
become triggers for emotional eating. awareness and will be able to make better
Through mindfulness they are able to decisions for their self-care.
recover their self-control, to embrace their
emotion through their breathing and Claudia Vega, MD, MS, is a pediatrician,
observe how it transforms. Or as one of Since I was not sure, I waited for a couple Mindfulness Based-Nutritionist and
my teenage patients told me once: of minutes, went upstairs to my room to do Psychotherapist, specializing in work with
other things and I am not even sure when it disordered eating and weight issues with
“The other day I found myself looking for happened, but the desire for food went away. children, adolescents and their families.
food right after I had finished lunch and then I discovered that I was anxious, not hungry; She serves on the TCME board. She leads
I thought: Am I really hungry? So, I stopped … And that felt good!” Mindful Eating workshops and retreats for
to breathe and check with my body and mind. ~ Mary, 11 years old children, teenagers and adults. http://www.
nutrintegra.com

More Resources for Mindful Eating & Kids:

Favorite Most Helpful acceptance) Favorite Most Helpful
Books for Parents: • Princess Camille Gets Her Way - by Books for Professionals:
Hiawyn Oram (a storybook about
• Parenting from the Inside Out – by Daniel moderation) • The Skilled Helper: A Problem-Management
J. Siegel and Mary Hartzell • No Ordinary Apple - by Sara Marlowe (a and Opportunity Development Approach to
storybook about mindful eating) Helping – by Gerard Egan
• War and Peas - by Jo Cormac
• A Handful of Quiet: Happiness from • The Psychology of the Child – by Jean
• Your Child’s Self-Esteem – by Dorothy
Pebbles - by Thich Nhat Hanh and Piaget
Briggs
Wietske Vriezen • On Becoming a Person: A Therapist’s View
• How to Talk So Kids Will Listen and Listen
• Family Dinner - by Laurie David and of Psychotherapy - by Carl Rogers
So Kids Will Talk – by Adele Faber and
Elaine Mazlish Kristin Uhrenholdt • The Mindful Therapist – by Daniel Siegel
• Planting Seeds – by Thich Nhat Hanh • The Surprising Power of Family Meals - by • How to Get Your Kid to Eat but Not Too
Miriam Weinstein Much - by Ellyn Satter
• The Mindful Child – by Susan Kaiser
• The Five People You Meet in Heaven - by • Secrets of Feeding a Healthy Family: How
• The Blessing of a Skinned Knee - by Wendy Mitch Albom to Eat, How to Raise Good Eaters, How to
Mogel, PhD
• Eating Mindfully - by Susan Albers Cook - by Ellyn Satter
• How to Get Your Kid to Eat but Not Too
• Mindful Eating - by Jan Chozen Bays • The Art of the Inner Meal - by Donald
Much - by Ellyn Satter
Altman
• Secrets of Feeding a Healthy Family: How • Mindless Eating - by Brian Wansink
to Eat, How to Raise Good Eaters, How to • 364 Days of Mindful Eating - by Donald
Cook - by Ellyn Satter Altman Favorite Websites:
• Eating with Love and Good Sense - by Ellyn • The Art of the Inner Meal - by Donald • AAP.org
Satter Altman • Healthychildren.org
• There’s No Such Thing As A Dragon - by
Jack Kent (a storybook about fear and • KidsHealth.org

MAY 2 0 1 5 FO OD FOR T HOU GH T ~ MI NDFU L EAT I NG & K I DS: SPE C IA L I SSU E 11

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12 FO OD F OR T HOU GH T ~ M IN DF UL EATING & KIDS : SPECIAL I SSU E M AY 2015