Q&A

Ultraprocessed Food Is Linked to Obesity and Disease — So Why Are We Feeding It to Our Kids?

Talking to Bettina Elias Siegel, author of ‘Kid Food’

As a parent of two children, aged 6 and 10, I can say this without hesitation: My kids are always hungry. Whether they ate 10 minutes ago or two hours ago, their bodies seem to physically ache for food.

And that means I am always feeding them. When I pick them up from school, I try to bring healthy snacks — a banana, sliced apples, some pretzels and hummus. But I’m not always near a fruit market or a kitchen to make something. So I grab some Pirate’s Booty (not a real food), Veggie Stix (there are few veggies in there), or a granola bar that I know is mostly sugar. They’re fed and happy; I am guilt-wrecked.

At restaurants, when my son wants the grilled cheese off the kids’ menu with fries and a sugary drink, I relent. I don’t want drama, and I don’t want to spend money on food he will waste. So he gets the kids meal, and I shovel a little more guilt onto my plate.

Bettina Elias Siegel gets it. The author of the essential and thoughtful new book, “Kid Food: The Challenge of Feeding Children in a Highly Processed World,” Siegel is a former lawyer and mother of two who became a journalist and took an unlikely turn into school food advocacy in 2010 over what I will describe as the animal cracker incident.

Siegel and her husband had just moved their two kids to Houston from Manhattan when a friend invited her to a meeting of the Houston Independent School District, where they were discussing ways to improve school lunch. Siegel balked. “No thanks. I send lunch from home,” she told her friend. “But what if you could give that up?” countered her friend. “Wouldn’t you rather skip making lunch every morning if school food were better?” Siegel agreed.

At that first school food meeting, she was given a primer on school lunch, learning how little money the government gave each school to spend on it. But one of the more bizarre things she learned that day was that every child was forced to take a package of animal crackers with school breakfast every morning, in addition to the artificially flavored maple pancakes and glazed honey buns — vehicles for sugar and hyperactivity, not much else.

‘Can you tell us why we’re serving animal crackers every day at breakfast?’

Siegel could not stay silent on the animal crackers. She raised her hand. “Can you tell us why we’re serving animal crackers every day at breakfast?” she asked. The district dietician didn’t miss a beat in her reply: “Students are required to have a certain amount of iron every week and the animal crackers provide it.” Seeing her confusion, she added, “You know, from the fortified white flour.”

Siegel was in a state. “It wasn’t so much what the dietitian had said about iron and white flour, it was the utterly blithe tone in which she said it,” she wrote in her book. “To her, and apparently to the rest of our nutrition services department, giving kids sugary, white-flour cookies along with a sugary, highly processed breakfast was a perfectly fine way to fulfill children’s iron needs. And somehow the federal regulations under which these people were operating made this an entirely acceptable choice. It was baffling.”

The animal cracker incident set Siegel on a rather unexpected journey as a school food advocate and author of The Lunch Tray, a thought-provoking blog about all things related to “kids and food, in school and out.” She also became quite the activist; she’s the person to thank for removing beef scraps known as “pink slime” from school food menus and for starting a petition criticizing McDonald’s for its in-school marketing efforts.

I chatted with Siegel about her new book, in which she dives into the highly processed world of convenience and examines the reasons why kids find so much unhealthy food at every turn. Siegel tackles the way “picky eating” drives poor diets in kids, and how the processed food industry exploits parents’ mealtime worries and guilt to promote its products. She touches on school food and why it still appears to be fast-food despite recent federal reforms like the Healthy Hunger-Free Kids Act.

AS: You have been writing about children and food on The Lunch Tray for almost 10 years now. Why did you feel you needed to write this book?

BES: There’s only so much material you can cover in a blog post, and for a long time now, I’ve wanted the chance to dig deeper, to connect certain dots, and to offer readers a more comprehensive picture of our children’s overall food environment. Because we really do need to be having that big-picture discussion: childhood obesity rates remain stubbornly high and, statistically speaking, even kids within a normal weight range aren’t eating anything close to a truly healthy diet — that is, one consisting mostly of nutrient-rich whole or minimally processed foods. It’s a tragic outcome in a country as advanced as ours, with such an abundant food supply.

At the book’s outset, you distinguish between processed foods like a bag of pre-sliced carrots and ultra- or highly processed foods — those that contain ingredients not found in any kitchen or naturally anywhere on earth. What are the dangers of these highly processed foods, particularly for children?

Putting aside any potential issues with particular food additives, there’s a growing body of research finding a correlation between the consumption of ultraprocessed foods generally and a variety of chronic diseases. There was also a small-scale but fascinating study published earlier this year by Kevin Hall finding that when people were offered a diet high in ultraprocessed food, they typically ate an extra 500 calories a day as compared to when they were offered a diet consisting mostly of whole foods, even though the two diets were nutritionally matched. If that finding is replicated in other studies, it’s really quite significant in terms of isolating the role of ultraprocessed food in driving obesity and disease. And when it comes to the ultraprocessed grocery products specifically directed toward children, there always seems to be the promise of some kind of special excitement or entertainment, whether through the use of fun shapes, unusual colors, cartoon characters, or games. All of those factors — especially when combined with the hyper-palatability that’s typical of almost all ultraprocessed foods — can effectively lure kids away from the healthier foods they should be eating.

In the book, you talk about the food and beverage industries’ “divide and conquer” strategy to break down the family unit. What do you mean by that, and why is it a problem?

The food and beverage industries get their products into families’ homes through a two-pronged approach: by aggressively targeting children with powerfully alluring marketing, while making often misleading nutrition claims that break down parents’ ability to act as nutritional gatekeepers. Say you’re out grocery shopping with your child when he spots his favorite cartoon superhero on a box of toaster pastries. He loudly begs you to buy them, and since you’ve already said no to a bunch of other products, you’re eager to avoid a scene. Then you look more closely at the box and see that the toaster pastries are “made with real fruit” and “contain whole grain.” Those claims may be relatively meaningless: “made with real fruit” can just mean the product contains concentrated fruit puree, which is actually a form of added sugar, and “contains whole grain” can mean the majority of the grain is still processed. But few parents know any of this, so instead those “nutrition” claims offer the justification they need to feel OK about putting the product into their cart. It’s incredibly effective.

The food and beverage industries get their products into families’ homes through a two-pronged approach: by aggressively targeting children with powerfully alluring marketing, while making often misleading nutrition claims that break down parents’ ability to act as nutritional gatekeepers.

How do you raise children to want to reach for something healthy in a world where they are inundated with junk food marketing?

Well, first and foremost, I hope parents will think critically about the why of all of that junk food marketing. Most of us grew up watching fast food and sugary cereal ads, and we just take it for granted that Dora the Explorer is allowed to wave at our toddlers from a box of nutritionally worthless “fruit” snacks, or that Gatorade and McDonald’s can infiltrate our kids’ smartphone apps and social media feeds. But it actually doesn’t have to be this way. Several other countries have banned child-directed marketing for unhealthy products; in Chile, for example, Kellogg’s can’t even put Tony the Tiger on a box of Frosted Flakes, let alone advertise the cereal to kids. I’m certainly not naive about the immense lobbying power of Big Food in this country, but I also believe that if the majority of American parents rose up en masse and said, “Enough already!”, it’s possible we could accomplish the same thing here.

Until that day comes, though, there are things you can do. Limiting screen time isn’t easy — I’m a mom of teens, so I know! — but doing so helps cut back on the overall amount of food and beverage advertising to which kids are exposed. I’m also a big believer in teaching kids media literacy, because once children understand that they’re being played by a profit-motivated industry, at the expense of their own health, those marketing messages can lose some of their power. Two teaching tools I highly recommend are Andrea Curtis’ wonderful book “Eat This!” and a great new video I just discovered from Bite Back 2030, a UK advocacy group led by Jamie Oliver. I’ll also offer a little plug for my own free, rhyming video called “Mr. Zee’s Apple Factory,” which teaches the littlest kids about highly processed foods.

As a mother of two, I know how hard (and rewarding, sure) parenting is. When you come home and manage to get a nice dinner on the table only to hear your kid say, “I don’t like this,” how can you not reach for the mini bagel pizzas or chicken nuggets in the fridge? What strategies do you have for parents struggling with this?

Believe me — I get it! Nothing drove me crazier than taking the time to plan, shop for, cook a meal, only to have my kids refuse to even try a bite of something I served. So I, too, often took the easier way out with the chicken nuggets, mac and cheese, and all the rest. And it’s not that there’s anything inherently wrong with serving those foods now and then, but since kids are also served those same kinds of foods in so many other contexts outside the home, it can really drive home the fiction that kids have “their” food, distinct from “grown-up” food.

So my best advice (and this is culled from my own experience as well as speaking to many child feeding experts) is to avoid this kind of short-order cooking at all costs. Instead, keep offering a single family meal, but also try to make it at least somewhat customizable. For example, if you’re serving a more complex dish, maybe keep the sauce or some of its other ingredients on the side, and also consider more make-it-yourself meals like a taco bar or baked potato bar. And sure, maybe when you lay out your fish taco bar, your kid will still pass up the grilled fish and the shredded cabbage, instead filling her tortilla only with shredded cheese. But that’s worlds better than saying, “We’re having fish tacos tonight, honey, but I know you won’t eat fish or cabbage, so instead I’ll make a quesadilla for you.” Nutritionally, the outcome is the same, but the latter approach sends a destructive message: that you don’t really believe your child is capable of learning and growing at the family table.

But — and this is the hard part! — you also need to refrain from commenting at all on your children’s food choices, even to offer praise, once you’ve put the food on the table. Studies show this kind of pressure is only counterproductive, and I can say from my own experience that once I truly learned to back off (which in my case meant no longer giving my kids the side-eye when they refused to try things, and no longer extolling the healthfulness of this or that food), my more selective child did gradually start trying new foods on his own.

You’ve got issues with kids’ menus in restaurants. What’s wrong with them, and how should we feed our kids if we don’t use them? They are certainly more affordable often than regular menus.

The items on children’s menus are definitely more affordable, and they also cut back on food waste by offering more kid-appropriate portion sizes. But despite some recent improvements, such as some big restaurant chains dropping soda as the default kids’ drink, studies show that the overall nutritional profile of most children’s menus is still pretty bleak. Of equal importance is the troubling message they send kids: that adults can choose from a wide array of items, including soups, salads, and sandwiches, but that children are only supposed to be eating from this tiny universe of mostly unhealthy foods.

Photo by Miguel Andrade on Unsplash

I don’t take the affordability issue lightly, but it’s often possible to create a reasonably priced kid’s meal by piecing together items from the list of appetizers and sides, or even by having parents divvy up food from their own plates, given how massive our own portion sizes have become. Ultimately, though, I think restaurant chains are very afraid to change the status quo because they’re worried they’ll drive patrons away. But in “Kid Food,” I cite a study of the regional chain Silver Diner, which meaningfully improved its kids’ menu and actually saw its revenues increase. So I think restaurants also need to hear from parents: If you’re silently grumbling about the poor choices made available to your child, why not let the chain know through social media, or even in a direct email to the head of the company?

I recently began a discussion with my school principal about establishing a snack policy that would create a list of banned foods — candy, cakes, cookies, and sugary beverages. Ultimately, we decided against it because of the fear of shaming parents. I find it’s hard to tell people what to feed their kids without the added value judgment that often falls on economic and racial lines. I sound like a food elitist. What are your thoughts on this struggle?

I’m totally sensitive to the socioeconomic and cultural fault lines in any conversation about food — I have an entire chapter in “Kid Food” about the food culture wars — so I’m not making light of your and your principal’s concerns. But kids are captive in the classroom, and I think we’re in a very bad place if schools feel they can’t say, “Parents: Please don’t send in Airheads for snack.” It’s also important to note that children of color and children in low-income households are disproportionately harmed by childhood obesity and chronic disease, so that’s one more reason to care about the food that gets sent in for everyone to share.

Andrea Strong writes about the intersection of food, business, law, and policy. She is the founder of the NYC Healthy School Food Alliance, a parent-led advocacy group working to bring holistic reform to school food in NYC. Follow her @strongbuzz @NYCSchoolFood.

Andrea Strong is a journalist who covers the intersection of food, policy, business and law. She is also the founder of the NYC Healthy School Food Alliance.

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