Episode 104: The Secrets to Healthy Eating in Children with Julie Brake

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Episode 104: The Secrets to Encouraging Healthy Eating in Children with Julie Brake

Many parents know the recommendations for healthy eating for their kids, but how does work exactly when meal time comes around?  What happens when children and families have problems with eating?  Julie C.H. Brake, MS, RDN, LD, talks with David about her approach that has worked for her clients.

Highlights of this episode: 

• Family and children nutrition
• Competence eating
• Disordered eating in children
• The division of responsibility in eating
• Family food habits and culture

Introducing Our Guest

Julie Brake is a Registered Dietitian Nutritionist, Licensed by the State of Georgia, specializing in family nutrition, sports nutrition, and prevention and treatment of disordered eating. She has also counseled clients for weight management and various nutritional concerns. She received both her Bachelor’s degree and her Master’s degree in Food Science and Human Nutrition from the University of Florida.

Julie has been a private practice dietitian since 2005 and has worked with families and kids with eating issues since 2002. She is a member of the Academy of Nutrition and Dietetics as well as the Georgia Academy of Nutrition and Dietetics. She is also a member of the Sports, Cardiovascular, and Wellness Nutrition (SCAN) Dietetic Practice Group; the Behavioral Health Nutrition (BHN) DPG; and the Nutrition Entrepreneurs (NE) DPG; as well as the International Federation of Eating Disorder Dietitians (IFEDD). She has presented several webinars for Dietitian Central as a speaker since 2017. Her private practice is currently located in Marietta, GA. Julie participates in networking groups in metro Atlanta with dietitians and other professionals. She has provided presentations to professionals as well as to businesses and schools.  She also writes nutrition articles and tips as opportunities arise.

Julie enjoys helping others find a healthy balance with eating attitudes and behaviors. She has experience with various approaches and it is her pleasure to work closely with other counselors and professionals to change people’s lives.

FULL DESCRIPTION (not a transcript): 

[00:00] One Small Bite – Origin Story

“One Small Bite” comes from David’s approach with his daughter’s eating habits. His daughter used to eat shrimp, and then, suddenly refused to eat shrimp. David and his wife encouraged their daughter to keep trying “one small bite” whenever they served shrimp at meals. They served shrimp different ways and paired it with other foods she liked. Sure enough, with patience, time, and consistency, his daughter accepted shrimp again and even asks for it sometimes.

[3:53] Julie’s Story

Julie grew in upstate New York and loved to swim as a sport. In her family, her parents pushed a diversity of foods and vegetables. Her mom was never on a diet that affected her. However, a high school friend was diagnosed with anorexia nervosa and went into treatment. Later in college, another friend was diagnosed, but did not seek treatment.  In college, she started in pre-pharmacy, but she switched to nutritional science.

She has worked at WIC, in public health with an obesity prevention program, hospitals, including Scottish Rite for Children, and then started her private practice in 2007. Since then, she has been focused on families and children nutrition.

Julie’s professional introduction with eating disorders began when a RD spoke to her high school class. During her dietetic internship, she worked with a sports nutrition dietitian who also helped athletes with eating disorders. These two nutrition-related specialties overlap often.  Sometimes, the sport itself can create an environment that sparks eating disorders in some individuals.

Her previous lactation consultant background also exposed her to eating disorders in lactating women. Some new mothers develop eating disorders in a desire to return to their pre-pregnancy body.

[14:28] Julie’s Approach to Children’s Nutrition

Julie incorporates lessons from the Ellyn Satter Institute. (She is not an employee, nor does she hold a certification with the Institute.) Ellyn Satter is a social worker and RD who created numerous resources for families and dietitians. There are many free resources on family feeding. Satter and Julie emphasize the division of responsibility with eating. Typically, parents have the responsibility of the eating schedule and the types of food available. Then, the child decides on the portions and which foods they pick from the parent’s available foods. This method also emphasizes a no pressure approach. This is an evidence-based methodology with plenty of research to justify the method.

Many families don’t use division of responsibility because they are caught up in their own rules and external messages. Julie works with the parents to understand children’s intuitive eating. This method also works in favor of the child’s nutritional needs. There are different approaches for different ages and families learn age-appropriate responsibility.

Julie says she sees a mix of clients. Sometimes, picky eating may just be multiple food preferences, not disordered eating or eating disorders. It is important to distinguish so that children can get the help they need.

Julie helps parents realize that there are no short-ordered cooks at home, but parents can work within their child’s preferences.  Research shows that offering diversity will eventually help the child eat a diversity of foods, although each child has a different timeline.

Allowing the child to eat what they want in that moment can be scary. Parents are pressure themselves to eat differently in diet culture and then that fear gets passed on to the child. Parents evaluate their kid’s intake daily and this creates worry. Julie helps parents through the decisions and the outcomes. Her advice is to talk to their kids about their preferences, what they want in their lunch box, and help them understand to eat when they are hungry.

She also sees clients with food insecurity. Insecurity often leads to overeating due to a fear of not being able to get food in the future.

[24:36] Intuitive Eating is Compatible with Competent Eating

Julie does not use intuitive eating as a focus because children don’t talk about hunger and fullness the same way adults do. When a child says, “I want…”, this may be true hunger or a desire. Parents can check in on this statement to clarify and use their judgment if hunger could be the case, especially if the child has not eaten in a few hours.

The difference between a need and want, is something to work on with parents on as well. Julie teaches parents to recognize signals from their children, like the relationship between energy and fatigue. Her clients also develop an understanding of how the body communicates to us what it needs.

Not all parents buy into this model, but it is up to them. It can be hard to do because of doubts, familiarity, and medical concerns. One of the biggest challenges is realizing that parent’s food offers can be manipulative and not really providing choices. Another challenge is addressing parent’s fears, whether they are realistic or not.

With the medical concerns, a financial burden comes into play. Insurance for kids is tough to manage. Sliding scale payments are available for families who need nutrition counseling and support. The trouble with free online resources can land parents into further struggles with their child’s eating.

[32:09] How do Nutrition Referrals work?  

Julie hears from new clients by phone call or email. She makes sure she is speaking to the responsible authority for the child or person needing counseling. She gathers their concerns for her initial assessment and explains how sessions work and the fees involved. She also lets them know how many sessions they may need. Disordered eating and health issues take longer to work on, but family eating sessions are shorter. The goal is for the parent and child to be on their own, living life with the best health possible.

37:07 Suspect Eating Disorders: Signs and Signals

Children can develop an eating disorder as young as seven years old. The first step is to talk to your child’s pediatrician. The doctor will do a medical check and possibly refer children to an eating disorder screen. Screening is never harmful if anyone suspects a disorder.

Julie gives ten signs and signals that a child may have an eating disorder:

1. 1. 1. Drastic changes in eating habits
      2. Avoid going out to eat or eating out
      3. Changes in weight
      4. Super secretive
      5. Being extra involved in the kitchen or multiple questions about the food
      6. Counting calories (no one needs this – really)
      7. Disordered exercise patterns
      8. Finding food wrappers
      9. Going to the bathroom directly after eating
      10. If you think it, why not screen?

Breaking through the discussion can be challenging and the child can be manipulative on saying what the parent wants to hear. Parents can ask questions like, “you used to love mac and cheese, what’s going on?”; or, “you seem to be really interested now in food, what is going on?” Kids will realize their parent is noticing. Encouraging kids to talk to you is so important. Tell them you are a parent and you are there to help you with different things in life. Communicating what happens to them outside of the home is important too. Parents can figure out when is the time to ask more probing questions.

[42:33] What if my child has excessive weight?

Children’s grow is tracked on growth charts and when a child lands in the obesity category, what happens?

Major growth spurts can add 20-30 pounds in a year. This can be scary for child and the adult. This does make them more at an increased risk of chronic disease later in life. However, restricting foods is not the way to go.  If a child has a medical condition associated with obesity or if the child is uncomfortable in their body, this means that they may need help re-attuning to their body and may need more physical activity. Endocrinologists are so helpful with hormone related weight gain. Remember, the body wants to be healthy. The stigma of the obesity label can become a bigger problem to tackle. A better approach is not telling, but asking. Questions like, “are you feeding yourself well?”; or, “do you have the energy?” If the body needs to lose weight, it will.

Where do I go from here?

I can’t wait to have you listen in and let me know what you think! If you like this episode, hit that subscribe button so you won’t miss an episode, wherever you listen to podcasts Apple, Spotify, Castbox, Google, or Stitcher. While you’re there, let me know what nutrition or health topic you’d like me to cover or leave a review.

Links from This Episode: 

• Julie Brake’s private practice – Positive Nutrition
• Julie Brake’s blog
• Julie Brake’s Facebook page
• Julie Brake’s Twitter
• Julie Brake’s Instagram
• Ellyn Satter Institute, Competence Eating

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