Kids Make Healthy Choices When Parents Model the Behavior

Megan Adamson, MD, was determined to get more vegetables into her family’s diet. “My husband and I kept talking about it,” says the mom of three children. “But at mealtime, vegetables always became an afterthought.” Dr. Adamson’s solution was simple: make vegetables the entrée as well as the side dish. In other words, adopt a vegetarian diet.

The Duke Primary Care family medicine doctor and her husband have now been on a vegetarian-plus-dairy diet for two years. And although they have not required the diet of their children (they allow them to order meat when they eat out), their oldest, 7, has independently decided to follow in his parents’ footsteps and to not eat meat.

Dr. Adamson’s son's decision to choose a healthy diet without being forced is a great example of parents modeling healthy lifestyles for their children. And now there is scientific evidence to support the benefits of this type of parenting.

A 2013 study by Duke Health researchers found that kids whose moms encourage them to eat well and exercise, and model those behaviors themselves, are more likely to be active and healthy eaters.

It sounds like common sense, but Dr. Adamson thinks the research is important because it underscores the influence parents have on their children’s health. “I think it should be encouraging to parents to know that they can really make a difference,” she says. And the fact that the study showed healthy modeling had an even larger effect on preschoolers was further proof of its effectiveness. “Because preschoolers spend more time at home than older children, parents can have even more influence on their healthy behavior,” Dr. Adamson says.

In the United States, more than a quarter of kids ages two to five are already overweight or obese. “Obesity is a complex phenomenon, which is influenced by individual biological factors and behaviors,” says the author of the Duke healthy behaviors study, Truls Ostbye, MD, PhD, professor of community and family medicine. “But there are variations in obesity from one society to another and from one environment to another, so there is clearly something in the environment that strongly influences the obesity epidemic.”

The home environment and parenting can influence a child’s health by shaping dietary and physical behaviors, such as providing access to fruits and vegetables or encouraging kids to play outside.

“The ‘obesogenic’ environment is broad and multifaceted, including the physical neighborhood environment, media and advertising, and food tax policies, but we feel that the home environment is critical, particularly among children. However, we didn’t have a lot of evidence as to how important this was,” Dr. Ostbye says.

Sugary drinks are unhealthy food choices, advises Matthew Mathias, MD, medical director at Triangle Family Practice in Durham. When combined with a sedentary lifestyle, they are one of the main reasons why more children in the United States are considered at risk for obesity, and they are partly to blame for the rise in type 2 diabetes.

“If your child is overweight or considered obese based on their body mass index, they should be tested for diabetes and other health issues that may be overlooked,” Dr. Mathias says. “Reducing your family’s risk for diabetes should be a family endeavor. Encourage daily exercise for everyone, and stock your kitchen with healthy food, including products with the barest minimum of added sugar.”

Encouraging and modeling healthy behaviors for your children is not complicated, but it does take some forethought. Dr. Adamson suggests offering a variety of foods, instead of sticking to what you know your children will eat. As for junk food—out of sight, out of mind. “Kids will eat what’s available, so just don’t keep junk food in the house,” Dr. Adamson says. “It’s less temptation for everyone, including parents.”

Sugary sodas and juices can be especially tempting for children, but parents should not assume kids won’t be happy with just water. “I think some of us get bored with water, and think, if I can have a fun drink, why can’t they?” Dr. Adamson says. “It can be tough, but parents should offer their children water or milk to drink, never soda, and no more than 8 ounces of 100 percent juice per day.”

Getting kids active takes effort, too. It’s more than sending them outside to play, but that’s a good start, Dr. Adamson says. “It depends on the setting,” she says. “For some, it would be reasonable to send kids out to play in the backyard, but it’s helpful to provide a variety of equipment to spark their imaginations. Or, take them to the playground and let them go crazy.”