September 2007

A Nurturing Relationship: Mothers as Eating Role Models for Their Daughters
By Kindy R. Peaslee, RD
Today’s Dietitian
Vol. 9 No. 9 P. 62

Recognizing that moms can have a huge impact on children’s food habits goes a long way toward helping to break familial cycles of disordered eating behavior and dieting.

REMEMBER... Daughter see, daughter do...
“Mom, I am so fat! I look awful. I can’t go to school today,” my daughter, Kristin, pleaded.
“You are not fat. You look fine.” I tried to answer calmly and confidently. We’d had this conversation before.
“I am fat. Look at my legs. I’d be fine if I could just cut my body off from the waist down. I feel awful,” Kristin groaned. “Nothing I wear looks right. Isn’t there a pill or something I can take to lose weight? I mean it. I can’t go to school!”
Fear gripped my heart and stopped me dead in my tracks. I didn’t know what to say. As a therapist, I was all too aware of the potential for eating disorders, as well as the epidemic of dieting among adolescent girls. “You are not fat, “ I answered firmly.
“You just don’t get it, Mom! You don’t understand!” Kristin headed for her room, tears beginning to stream down her face.
“Maybe we can take an aerobics class together after school,” I called after her, grasping at anything to turn the conversation in a more positive direction.
“I knew it!” Kristin cried harder. “You think I’m fat too!”

— Excerpt taken from the first chapter of Mom, I Feel Fat! Becoming Your Daughter’s Ally in Developing a Healthy Body Image. Author Sharon Hersh shares a maddening moment that occurred with her daughter and planted a seed for her book.

Confirming the reality of the previous dialogue, a recent Teen People magazine survey of 1,000 teens showed that 39% worry about weight. Many factors influence whether an adolescent will develop a positive or negative body image. When we look back in time at the evolution of the changing body shape and size of American women and girls, we see actresses’ sizes decreasing and real women’s sizes increasing. Regardless of the reason, the common trend points to a slenderizing standard of the female ideal. In a culture in which girls are bombarded with skinny, glossy, and superficial images, moms need to be a mirror their daughters can look into and see a reflection of understanding, reassurance, wisdom, and love.

The Biological Connection
Last September, I attended the Mother-Daughter Role Modeling Summit in New York City (www.mother-daughter.org/summit.html). This research presentation was organized to explore a mother’s impact as a healthy behaviors role model for her daughter. Special guests included Joan Lunden, former cohost of ABC’s Good Morning America, and her daughter. Both participate in a campaign to challenge mothers to pass on a new legacy of making better food and beverage choices, promoting positive self-esteem, and supporting physical activity to their daughters. The campaign aims to educate mothers about their influence in shaping their daughters’ eating habits, dieting behaviors, and self-image.

As the first female role model, a mother’s choice about what she eats and drinks impacts her daughter’s choices and how she feels about her body. The mother-child bond is the first primary relationship we experience, and it powerfully impacts what we believe about ourselves. The evidence shows that, unintentionally, mothers often model both positive and negative behaviors.

“Mothers, especially, are very influential,” says Debra Waterhouse, MPH, RD, presenter at the summit and author of Outsmarting the Mother-Daughter Food Trap: How to Free Yourself From Dieting—and Pass on a Healthier Legacy to Your Daughter. Mothers “unknowingly pass the torch” to their daughters, says Waterhouse. She surveyed more than 100 mothers who had good and seemingly innocent food intentions toward feeding their preadolescent daughters, yet these good intentions still ultimately led to unhealthy eating behaviors for their daughters. Mothers were limiting junk food in their daughters’ diets, putting them on low-fat diets, making sure no sweets were in the house, and not allowing for snacking between meals. Waterhouse discourages mothers from restricting their daughters’ food intake, reminding them that daughters will react in one of two ways: rebelling and overeating when mom is not looking, or accepting and not eating at all when mom isn’t looking.

“More mothers are dieting; more daughters are dieting. More mothers are disordered eaters; more daughters are disordered eaters. More mothers are overweight; more daughters are overweight. This sequence is not coincidental,” says Waterhouse. She explains that if a mom is a disordered eater, she is more likely to try to control her daughter’s eating, and her daughter is more likely to become a disordered eater and be overweight. However, if a mom is an intuitive eater, she is more likely to trust her daughter’s eating decisions, and her daughter is more likely to become an instinctive eater and maintain a comfortable weight.

In her book, Waterhouse shares many mother and daughter examples. One is of a 26-year-old daughter who remembers, “My mother dieted every January and June, so I thought that it must be a normal part of womanhood to vow a 20 pound weight loss with each New Year’s resolution and the same 20 pound loss with each presummer diet.” Another daughter, aged 35, says, “My mother once told me that I had long, lovely legs and a short, fat waist. Twenty years later, I still like my legs but curse my waist each and every day.” Once a mother’s words are spoken, they are seldom forgotten. Perhaps your own mother’s statements echo in your mind even now as an RD counseling others about nutrition and body image. Do any of these well-meaning comments sound familiar? “You’re getting a little chunky, aren’t you?” “Pull in your stomach and stand up straight. You’ll look thinner.” “Only wear dark colors. They will hide your fat.” Or, “I want you to have a normal life, so please lose some weight.”

The Legacy of Dieting
Every day, more than 56% of U.S. women are on diets. Parents, especially mothers, can do much to spare their children a lifelong struggle with eating and weight. In her counseling, author and therapist Sharon Hersh challenges moms to examine their own beliefs and prejudices about their weight and appearance. Her suggestion to mothers is to pull out photos of themselves at different ages. What photos are they drawn to? Why? Organize the photos chronologically. How has their body changed? When did they become aware of their body? When did they like their body or not like it? What was going on in their life then? Hersh believes that as a mother, it is important to communicate acceptance and respect to your own body regardless of weight, which will reduce some pressure daughters may feel to change their bodies. Do not model or encourage dieting. Accept and talk about the fact that diets don’t work and the dangers of altering one’s body through dieting.

Moms preoccupied with dieting who try to influence their daughters’ weight and eating habits may actually place them at risk for developing negative eating behaviors, such as the lack of response to internal cues to hunger and satiety.1,2 Mothers who use pressure or coercive feeding strategies are more likely to have daughters who are picky eaters or at risk for obesity. Girls whose mothers criticize their eating habits or weight may develop lasting problems with body image and self-esteem. Restriction only cries out for self-indulgence.3,4

Yet, girls may still choose to diet even without a mother’s dieting influence. Cheryl Rice, a nurse from upstate New York, was fortunate to grow up with a mother who didn’t diet. However, she started dieting in high school and college and put pressure on herself to diet. Her mother never criticized her daughter’s weight. Rice remembers that even her father never made negative comments on what she feels was her “chunky body type” growing up. It was only in later years, when her mom was in her 60s, that mother and daughter attended TOPS (Taking Pounds Off Sensibly) weight loss classes.

Role Modeling
“In order for role modeling to occur, the child must observe the model’s behavior, have the ability to perform the behavior, and be motivated to perform the behavior,” says Leann Birch, PhD, director of the Center for Childhood Obesity Research at Penn State University and one of the research presenters at the summit. “Same-sex models are more likely to be imitated. Mothers are more influential than fathers on their daughters.” Mothers are strong influencers because they still have the primary responsibility for making food available in a family and providing food experiences for a baby during pregnancy and breast-feeding.

Mothers also play a role in modeling physical activity to their daughters. “Being a soccer mom isn’t confined to a minivan: Moms can play or coach,” says Christina Economos, PhD, assistant professor and New Balance Chair in Childhood Nutrition at the Friedman School of Nutrition Science and Policy at Tufts University. Economos, who presented research on physical activity topics at the summit, says that by modeling and engaging in the activity themselves, mothers with high levels of healthy activity were less overweight than mothers with lower levels of activity. The percentage of highly active girls was significantly higher when at least one parent provided physical activity support.5 Recommendations from the American Academy of Pediatrics encourage parents to become good role models by increasing their own level of physical activity and incorporating an activity that family members of all ages and abilities can do together— not only daughters.6

As far as positive role modeling with eating behaviors, moms with a higher fruit and vegetable intake have daughters who consume more fruits and vegetables. Family meals provide opportunities for children to observe parental fruit and vegetable consumption. When fruits and vegetables are available at home and adolescents are involved in meal preparation, they have lower intakes of fat and higher intakes of fruits, vegetables, folate, and vitamin A. Interestingly, mothers who pressure their daughters to eat are more likely to have picky eaters who consume significantly fewer fruits and vegetables than nonpicky eaters.7,8

Tamara Vitale, MS, RD, a department of nutrition and food sciences professor at Utah State University, raised two daughters (now aged 27 and 31) and taught them that healthy food doesn’t taste bad. Both daughters say they still remember their mom teaching them how easy it is to make roasted vegetables and other fresh foods from scratch, which taste better than convenience foods. Even though most of their friends thought vegetables were gross, they remember always having vegetables on their plates—to them, eating vegetables wasn’t a big deal. Vitale says both are now excellent cooks, at healthy weights, and one daughter is now passing the legacy of healthy eating onto her 11-month-old son, who eats a wide variety of healthy whole foods.

Vitale’s older daughter, a vegetarian since the age of 12, says she remembers, “My mom told me that I could be a vegetarian as long as I figured out how to get protein, etc, from other foods; that empowered me to understand about food choices.” Vitale says that now, whenever her daughters come home for a visit, they request a “10-a-day meal” (meaning lots of vegetables).

In our diet-crazed culture, this inspiring story about daughters experiencing healthy role modeling shows how children’s balanced mealtime experience will affect their food choices for the rest of their lives. The rewards of knowing you are teaching your daughters how to eat for enjoyment is a true legacy to leave. We can be the next generation of women to be aware of our spoken and unspoken influence and, as mothers, be motivated to become healthier role models for our daughters.

— Kindy R. Peaslee, RD, is the founder of Kindy Creek Promotions, an upstate New York-based marketing firm specializing in the promotion of natural and organic food and beverage products. She can be reached at kindy@kindycreek.com. Visit her recipe Web site for parents: www.healthy-kid-recipes.com

References

1. Francis LA, Birch LL. Maternal influences on daughters’ restrained eating behavior. Health Psychol. 2005;24(6):548-554.

2. Carper JL, Fisher JO, Birch LL. Young girls’ emerging dietary restraint and disinhibition are related to parental control in child feeding. Appetite. 2000;35(2):121-129.

3. Birch LL, Fisher JO, Davison KK. Learning to overeat: Maternal use of restrictive feeding practices promotes girls’ eating in the absence of hunger. Am J Clin Nutr. 2003;78(2):215-220.

4. Rhee KE, Lumeng JC, Appugliese DP, et al. Parenting styles and overweight status in first grade. Pediatrics. 2006;117(6):2047-2054.

5. Davison KK, Cutting TM, Birch LL. Parents’ activity-related parenting practices predict girls’ physical activity. Med Sci Sports Exerc. 2003;35(9):1589-1595.

6. Council on Sports Medicine and Fitness, Council on School Health. Active healthy living: prevention of childhood obesity through increased physical activity. Pediatrics. 2006;117(5):1834-1842.

7. Fisher JO, Mitchell DC, Smiciklas-Wright H, et al. Parental influences on young girls’ fruit and vegetable, micronutrient, and fat intakes. J Am Diet Assoc. 2002;102(1):58-64.

8. Galloway AT, Lee Y, Birch LL. Predictors and consequences of food neophobia and pickiness in young girls. J Am Diet Assoc. 2003;103(6):692-698.

For Your Clients: Top 10 Do’s and Don’ts
Do’s
1. Appreciate your body. If you appreciate your body, your daughter will learn to appreciate hers as well. Focus on your favorite features instead of complaining about what’s less desirable.

2. Consume a variety of fruits, vegetables, lean meats, low-fat milk, and whole grains daily. Studies show that mothers who model healthy eating habits, such as drinking milk, are more likely to have daughters who do. If you want your daughter to fill her glass with milk instead of soda, you need to do the same.

3. Serve milk at every meal. Studies indicate that teens who drink milk instead of sugary sodas tend to weigh less and have less body fat. Drinking three glasses of low-fat milk per day is a healthy habit to promote strong bones and a lean, toned body.

4. Be physically active and enjoy it. Mothers who value the importance of exercise positively influence an active lifestyle in their daughters. Studies show that inactive mothers tend to have inactive daughters.

5. Eat family meals at home. Sharing meals together at home provides multiple opportunities for you to model healthy behaviors. Your own food and beverage choices may be more influential than any other attempt you make to control what your daughter eats and drinks.

Don’ts
1. Do not criticize your daughter’s body. Compliment her positive attributes and teach by example. Research suggests that girls whose mothers criticize their eating habits or weight may develop lasting problems with body image and self-esteem.

2. Do not be self-critical. Studies have found a mother’s concern about her own weight, dieting practices, and overeating are transmitted to her daughter. Mothers may unknowingly pass on poor body image and weight worries to their daughters.

3. Do not let sugary beverages dominate. Soft drinks and sugary fruit drinks are the No. 1 source of calories in a teen’s diet. Plus, they’re void of the vital nutrients your daughter needs. If you limit your intake, your daughter will likely do the same.

4. Do not talk about your dieting. Instead of talking about dieting around your daughter, educate her on foods that provide important nutrients she needs for building strong bones and a healthy body.
5. Do not use pressure. Pressuring your daughter to eat certain foods will likely backfire. Research suggests that modeling the desired behavior is a more effective approach for encouraging healthy choices.

— Source: www.mother-daughter.org/dos_donts.html

RDs as Role Models
• Educate mothers on the impact they have in shaping their daughters’ eating habits, dieting behaviors, and self-image.

• Council parents about the importance of family meals at home and eating the foods and drinking the beverages they want their children to consume.

• Educate adolescent girls on the dangers of unhealthy dieting, the unrealistic thin ideal, and the realities of maturing female bodies.

• Discourage mothers from using pressure or restrictive feeding practices with their daughters. Encourage a role model approach, making healthful foods available.

• Ensure that parents are involved in childhood obesity prevention and treatment programs.

• Emphasize the importance of teachers, coaches, and principals to serve as positive role models for students and incorporate body image, self-esteem, and eating disorder prevention into health curricula.

— Source: Mother-Daughter Role Modeling Summit

Resources
Web Sites
Finding Balance
Check out a newly launched video-on-demand resource Web site for eating and body image issues.
www.findingbalance.com

F.I.T. Decisions
F.I.T. (Future Identity of Teens) hosts Girls Only!, a weekend conference for teenage girls to teach them how to live healthful, balanced lives. Nationally known speakers, drama skits, fashion shows, kick boxing, and snacks are part of the all-day workshop.
www.fitdecisions.org

HUGS International, Inc.
HUGS for Better Health Web site features resources on how to build a nondiet lifestyle.
www.hugs.com

Remuda Ranch
Remuda Ranch is an eating disorder treatment center devoted to the unique needs of women and girls and integrates specialized therapies such as art, equine, body image, and movement program components as part of the recovery treatment.
www.remudaranch.com

Books
Brumberg JJ. The Body Project: An Intimate History of American Girls. New York: Random House; 1997.

Gaesser G. Big Fat Lies: The Truth About Your Weight and Your Health. Carlsbad, Calif.: Gürze; 2002.

Hersh S. Mom, I Feel Fat! Becoming Your Daughter’s Ally in Developing a Healthy Body Image. Colorado Springs, Colo.: Waterbrook Press; 2001.

Hutchinson MG. 200 Ways to Love the Body You Have. Freedom, Calif.: Crossing Press; 1999.

Jantz GL. Hope, Help & Healing for Eating Disorders: A New Approach to Treating Anorexia, Bulimia, and Overeating. Colorado Springs, Colo.: Waterbrook Press; 2002.

Rhodes C. Life Inside the ‘Thin’ Cage: A Personal Look into the Hidden World of the Chronic Dieter. Colorado Springs, Colo.: Waterbrook Press; 2003.

Tribole E, Resch E. Intuitive Eating: A Recovery Book for the Chronic Dieter. New York: St. Martin’s Press; 1996.


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