Raising Parents with Emily Oster - Ep 3: Are We Feeding Kids the Wrong Foods?

Episode Date: October 2, 2024

In January 2023, the American Academy of Pediatrics surprised doctors and parents by changing its guidelines on treating childhood obesity to include the use of popular weight-loss drugs like Ozempic and Wegovy, also known as semaglutide, for children ages 12 years or older. And parents all over the country were faced with yet another difficult decision: Should I consider a lifelong weight-loss drug for my 12-year-old? The fact that this is even on the table at all is a pretty shocking indictment of the state of our kids’ health. Nearly 20 percent of American children and adolescents are obese, a 300 percent increase since the 1970s. Meanwhile, a little over 42 percent of American adults are obese, a 180 percent increase since the 1970s. The United States ranks 12th worldwide in obesity prevalence. This places the U.S. among the countries with the highest obesity rates in the world. The question is: Why? And why haven’t we been able to reduce childhood obesity rates?  As obesity rates have skyrocketed, we as a society have also changed the way we talk about weight and obesity. Yes, there is less stigma today about weight—which is good. But people—including health experts—have stopped speaking out loud about the real health risks of obesity. Take, for example, how during the pandemic our health leaders wouldn’t tell the public that obesity is a high risk factor for contracting Covid, out of a presumed fear of stigmatizing obese people. In the end, all of this has led to confusion about the real health risks of obesity. Parents, in particular, are left to struggle with how to navigate food and health for their children. They may be left wondering whether the entire idea of a link between weight and health may simply be misinformation. So today, we’re setting the table: Why Is childhood obesity such a big problem in the U.S.? Why is obesity problematic in the first place? What will it take to change the way Americans feed our children? And what’s at stake if we don’t? *** Resources from this episode: Pamela Druckerman: Bringing Up Bébé: One American Mother Discovers the Wisdom of French Parenting  Robert Lustig: “The Hacking of the American Mind: The Science Behind the Corporate Takeover of Our Bodies and Brains”  Robert J. Davis: “Supersized Lies: How Myths about Weight Loss Are Keeping Us Fat — and the Truth about What Really Works”  FoodCorps Sam Kass Curt Ellis

Hi, everyone. Emily here, and you're listening to Raising Parents, my new podcast in partnership with The Free Press, where we interrogate all of the big and pressing and confusing questions facing parents today. Before we get to the show, I'm so excited to tell you that this season is in partnership with Airbnb. If you know anything about me, you know how much I love Airbnb. I think I'm currently holding like six Airbnb reservations in my account. Airbnb has provided incredible experiences for me, my family, and our friends across the country and the world time and time again. More on that and how you too can use Airbnb on your next family trip later in the episode.

For now, on to the show. Wegovi helped us lose weight. And Manjaro can help decrease how much food you eat. Drugs for weight loss now being prescribed to kids as young as 12. And last year, at least 4,000 prescriptions of semaglutide, the active ingredient in Ozempic and Wegovi, were dispensed to patients ages 12 to 17, that number expected to grow. Somaglutide drugs like Ozempic and Wagovi are seeing a boom and they're not just being used by adults.

America's too fat. You know this. Our kids too. So the FDA has approved the weight loss drug Wagovi, sister to Ozempic, for kids 12 and up. What should doctors do? Should your teen be on this? In January 2023, the American Academy of Pediatrics, the AAP, surprised doctors and parents around the country by changing its guidelines on treating childhood obesity

to include the use of popular weight loss drugs like Ozempic and Wagovi, also known as semaglutide, for children ages 12 or older. And parents all over the country were faced with yet another difficult decision. Should I consider a lifelong weight loss drug for my 12-year-old? The fact that this is even on the table at all is a pretty shocking indictment about the state of our kids' health. Nearly 20% of American children and adolescents are obese, a 300% increase since the 1970s. Meanwhile, a little over 42% of American adults are obese, a 180% increase since the 1970s. Obesity is defined as having a body mass index of 30 or higher. BMI measures the ratio of your height to your weight to estimate the amount of total body

fat you have. And while BMI is just a number and doesn't magically determine health, it is the case that BMI in this higher range is associated with a substantially elevated risk of many metabolic or other chronic illnesses. The United States ranks 12th worldwide in obesity prevalence. This places the U.S. among the countries with the highest obesity rates in the world. Meanwhile, Europe has a much lower obesity rate than America, somewhere around 18 percent, while countries like China and Japan have some of the lowest rates in the world, between 3 and 4%. The question is, why? And why haven't we been able to reduce childhood obesity rates? We've tried a lot of things.

Let's Move is a nationwide initiative that basically focuses on four key components. First, we want to improve the information and the tools that... In 2008, First Lady Michelle Obama started a campaign called Let's Move. The second is that we have to improve the quality of food in our schools. That's where kids are eating many of their meals, and we have to do a better job of making sure that that food is quality. Which sought to reduce childhood obesity statistics by 5%. Celebrities like Beyonce even got in on the campaign.

And it didn't work. Not only did the childhood obesity statistic not drop by 5%, it actually went up. Even Sesame Street tried to help. What should we eat? Fruit or cookie? This tough decision. Wait, fruit, anytime food. Cookie, sometime food. That's right, Cookie. Yeah, yeah, yeah.

He also wasn't successful. Cookie Monster is right. This is a tough decision. Cookies are very tempting. At the core of the concerns about children's weight in America today is the fact that American kids are eating an inordinate amount of unhealthy food. I see portion sizes and advertisements for hugely sugary products, particularly on the internet. I mean, my kids want to buy this brand of product because they've seen advertisements for it. Take Jessica Goldstein, a mom of two boys in Ohio. But they spend so much more time on the phone than I think we did sitting in front of the television. It's just constant bombardment. And then there are so many people that are these strong personalities that have so many followers, these influencers connected to these products and pushing these products.

So I can't even remember what the name of it was. Some drink that was so disgusting. It was just so filled with sugar, and these kids just loved it because, you know, Mr. Beast is advertising for it. So the whole food culture and problems with overconsumption, choosing things that are not healthy, is all around us. If Jessica's family lived in Europe, it might be easier for her kids to avoid unhealthy, sponsored content aimed at them. Europe enforces stricter regulations on fast food advertising to children, for instance, reducing kids' exposure to it. In contrast, the U.S. primarily relies on industry self-regulation, where guidelines are voluntary and not consistently enforced. And the data shows it.

75% of grocery store food purchases are processed foods. The average parent only gets around to making four meals from scratch per week. The U.S. subsidizes sugar to the tune of $1 billion every year. On average, sugar makes up 17% of what children consume each day. Half of that comes from drinks with added sugar. The recommended amount of sugar for kids each day, according to the World Health Organization, is less than 10% of their total daily caloric intake. Kids spend six hours a day in school where they consume half of their daily calories. And while there is a new federal limit on the total amount of sugar that can be included

in school meals, it will not take effect until 2027. At the same time, we as a society have really changed the way we talk about weight and obesity. There's reminder that fatness, so normal. All of this rules so, so normal. Diet culture just loves to gaslight you so they can profit off of your hatred on your own self. Don't let them win. Yes, there is today less stigma about weight, which is good. It's really good. When I was growing up, I remember how cruel people were to overweight kids. And I know from being a mom that that kind of bullying still sometimes happens. What I think has changed is that such behavior is now considered wrong and despicable.

And there is a growing stigma against people who bully in that way, rather than towards the overweight person. But the other thing that's happened, perhaps inadvertently, is that people, including health experts, have stopped speaking out loud about the real health risks of obesity. Just take, for example, how during the pandemic, our health leaders wouldn't even tell the public that obesity is a high-risk factor if you contract COVID out of a presumed fear of stigmatizing obesity. In the end, all of this has led to confusion about the real health risks of obesity. And parents in particular are left struggling with how to navigate food and health for their children.

They may be left wondering whether the entire idea of a link between weight and health may simply be misinformation. So let's set the table. Why is childhood obesity such a big problem in the U.S.? Why is obesity problematic in the first place? What will it take to change the way Americans feed our children? And what's at stake if we don't? I'm Emily Oster, and from the Free Press, this is Raising Parents. Emily Oster, an economist by trade, has gathered the data, crunched the numbers, and is now debunking some of the most controversial myths about parenthood. I think what everyone is most interested in, like pregnant women, they're like, can I drink? You know, you shouldn't have like a lot.

Where is this data coming from? The fundamental answer is we get data on people by asking people about their behaviors and what they do and by collecting information on how their kids do. Oster doesn't shy away from other charged topics. People are using your database as an example as to why schools should reopen. What kind of reaction did you get to that?

I imagine that was a little controversial. It was a little controversial, yes. You're an economist. You're not a doctor. I mean, what do you think people are going to take away from what you've written in this book? All that I'm trying to do here is really show women here is what the evidence is

and why don't you think about some of these decisions for yourself. Episode three. Are we feeding our kids the wrong foods? This is perhaps going to sound like a silly question, but like, why is this so bad? What's the problem with childhood obesity? What's at stake? We see that kids who have obesity are increased risk of adult problems, high blood pressure,

type two diabetes, high cholesterol, asthma. It can make asthma symptoms worse. So we see increasingly that children are developing these adult conditions, children who are obese. This is Dr. Robert Davis. He's a PhD in health policy, and he's a health journalist who has focused his career on examining the science behind popular health claims. He's the author of several books, including the 2022 award-winning, Supersized Lies, How Myths About Weight Loss Are Keeping Us Fat,

and The Truth About What Really Works. Also, we know that obese kids are highly likely to grow up to be obese adults. And we know that obesity in adults is associated with a long list of health problems, everything from kidney problems, arthritis to heart disease and cancer and premature death. What happens is that growing obesity rates among kids sets up kids for a lifetime of these health risks, really threats to their health and actually to their lives. It's a tremendous problem because fundamentally it's a cultural issue. It's the way that our culture now consumes food, the way that our kids consume food. They consume these junk foods, not sitting down at a meal, but on the go,

sitting in front of a screen, wherever they are. And it's a widespread cultural phenomenon in the United States. And so trying to change that is a Herculean effort, but it doesn't mean that we shouldn't try. In order to even begin to address the problem, we have to understand why the junk food and processed food Robert talks about are bad in the first place. What's so bad about, say, a frozen pizza or a bag of chips? Increasingly, people are eating fast food, convenience foods like frozen pizza, snacking more. And these foods, many of them tend to be so-called ultra-processed foods. Those are foods that have lots of fat, sugar, salt, chemical additives, preservatives, emulsifiers.

And so there's increasing evidence that so-called ultra-processed foods are especially pernicious when it comes to weight gain. Note, not all fats are bad for you. Back in the 80s and 90s, we were told that fat was the enemy. So people swapped fat for carbs, which actually made the obesity problem worse. Yes, there are bad fats, like trans fats, which are now banned in the U.S. But there are also fats which are clearly good, things like olive oil and avocados. How much of that do you think is something specific to the food? And how much is just when we see ultra-processed foods, they tend to be things that you want to eat a lot of. These foods are so-called hyperpalatable foods, meaning that they trigger a reward system in our brains to make us crave them even more.

And so what happens is that often we keep eating these foods without realizing we're full so that we overconsume them. So you compare, say, eating chips to eating an apple. If you eat an apple, you're more likely to feel full more quickly and to stop eating than you're eating an apple. If you eat an apple, you're more likely to feel full more quickly and to stop eating than you're eating those chips. So these foods really are designed to cause us to keep eating them. And so that contributes most to our over-consuming these foods. So when you say perhaps by design or by design, who's, who's design? I think it's the manufacturers of these foods. They're designed so we keep eating them. And it's a combination of fat, sugar, salt, and these other additives that really prompt

us to keep eating them. There's also the fact that grocery stores are set up in the worst possible way. They are designed to get us to buy less apples and more chips. Fresh produce and healthier items are typically placed around the perimeter, while processed, high-margin products like chips and snacks dominate the central aisles and the eye-level shelves. Or the fact that most grocery store items are incredibly misleading. 100% pure juice, apple juice, sounds like a healthy option to most. But in reality, it contains more sugar than soda. And all of this makes it really hard for individual parents to make healthy decisions.

You see yogurts that are often aimed specifically at kids and parents may look at the yogurt and say, well, this is marketed as being high in calcium and high in protein, good, healthy food for my kids. But the yogurts are often loaded with sugar, not a healthy food. Multigrain crackers and snacks. Oh, this looks more healthy for the kids to eat. It's a multigrain food. Well, multigrain is a deceptive marketing buzzword. Doesn't necessarily mean whole grain, which is good. It can have refined grains, which are not good. And so parents may be deceived and buy that food thinking it's healthy when in fact it's junk food. The reason why whole foods are better than

refined grains or processed foods is because whole foods are higher in nutrients, fiber, minerals, and vitamins than processed foods. The fiber in whole foods in particular is crucial to making people feel full when they eat. The same number of processed calories do not have that same effect. Finally, kids today are more sedentary. For example, the average teen spends around nine hours a day on their phone. I think also the fact that kids spend more time in front of screens, whether in the past it's been TV screens, now video screens, playing video games on social media, watching videos. That's less time that they're moving, that they're active. And so the lack of physical activity and also increasingly

while kids are in front of screens, often they're snacking. So you have a combination of more eating and more sitting. With the food system stacked against us, how can we even begin to change things? Do you think America has a problem with our approach to food? I've dedicated my whole life to that question. So I think the answer is a decidedly yes. Meet Sam Kass. He spearheaded food policy in the Obama White House for nearly six years and served as the executive director of First Lady Michelle Obama's Let's Move campaign. He also personally prepared dinner for the first family five nights a week. Upon entering the White House, his plan was to overhaul the American food system by eliminating crop subsidies, particularly those supporting sugar, and then addressing other critical issues around school food. But things didn't exactly go as planned.

So there is a well-procuretated narrative that paints a very simplistic, the government is the boogeyman. They're in bed with big industry. Those subsidies are why the cheeseburger is cheap. And if only we fix that, everything will be okay. I went into White House believing that narrative. I had my- You thought you could fix it. There you are in the White House. You're going to fix it up nice. On one hand, I had Marion Nestessel's food politics. Sam is talking about the groundbreaking book by molecular biologist, nutritionist, and public health advocate, Marion Nessel, published in 2002, which really had a national influence on food policy, nutrition, and food education, and changed the way we respond to food industry marketing practices. I came running to the White House, ready to go, like, we're in power now, we can fix this.

It's not the subsidies that is producing our food environment, it's our culture. And it's our culture that has been influenced and shaped by the industry who's pumped billions, probably trillions of dollars over the last 40, 50 years, you put it all together, to like shape our norms, attitudes, behaviors. But fundamentally, our culture is supporting what we choose. Do you think there is a role for government in trying to solve this? Absolutely. I mean, what I push back against is the narrative that government can solve the whole thing and is the core of the problem.

By just turning off some subsidies or some easy... Yeah, and change some policy stuff. I think we have a culture that has separated the connection between what we put in our bodies and the impact that it has on our health and our well-being. That said, there is one area where the government really has the potential to make a big impact, where it can influence a lot of kids in a huge way. School lunch. For kids, we know that there's a really important

flavor development profile. People like the food they grew up with. That's an opportunity to get in and teach kids that vegetables are not the devil and quinoa is an interesting food even if it gets stuck in your teeth or whatever. So can you talk a little bit about what you tried to do in the White House around kids' lunches. You know, when we got there, the standards hadn't been updated in 20 years. There's no new money for 30. There was no rules on what you sold either in vending machines or the a la carte line. So there was a school lunch program, but then the school could make and sell whatever they wanted alongside of it. And yeah, so it was basically like a junk and fast food. And so we came in and worked to put in some pretty, certainly at the time, very strong standards. So we got rid of soda and candy put some real standards around what was served, including there's a pig fight. One of the most intense fights that we had in there was over a provision called offer versus serve.

So with the industry one, the school nutrition association, which was basically industry front group for school chefs, was just to offer a vegetable as opposed to serve it. So they just wanted to be like, we have some broccoli back in the back if you want some. But of course, like what kid is going to be like, yeah, give me that. And there's plenty of evidence and science to show that if the vegetable is on the plate, they're much more likely to eat it. So we got a lot of pushback from the students. High schoolers hated it. But for young kids, it's all they ever knew. And it just became what a normal plate looked like, which included a vegetable, which is why it was so important to fight for that. But there is still a long way to go.

The cafeteria food is up and down. Sometimes it's good, but also sometimes it's like terrible. Just take it from Pippa. I love Bosco sticks. I just don't like the school's Bosco sticks because it's kind of like they just shoved a cheese stick in some dough and they didn't let the cheese melt. They just warmed up the dough. And Julia. So I normally pack my lunch, so I haven't really been in the lunch line a ton.

But I do know that there's pizza every single day. I think that they'll give you a little, sometimes they'll give you a little cup or like a little, like a tiny little container that has like two pieces of lettuce and like a shred of carrot. And Mia. I used to buy more frequently. And now when I buy, I usually just get like the peanut butter, like they have like a little box with an incrustable and like Cheez-Its and like a package of apples. And Vivi. I've noticed like since elementary school to high school, it's gotten worse. So I used to buy more often because the food was better, but now it's like, I don't trust it. So when we try to educate people about

what they should eat, the USDA also tries to educate people. They had the food pyramid and now they have the plate. It has sections. Is the plate enough? What should we replace the plate with if you don't like the plate? Yeah, well, you know, there have been a number of iterations of these guidelines. There's a pyramid, there's a plate. Before that, it was the four food groups.

The problem with all of these guidelines and pyramids, though, according to Robert Davis, is that they were often wrong, or at the very least, extremely misleading. For example, the original USDA food pyramid recommended 6 to 11 servings of bread, rice, cereal, or pasta per day. And so the problem with these is that they are influenced by a number of different vested interests. And so you have the agriculture sector, you have food companies, you have scientists who are conflicted often who weigh in on these. And so they become this kind of cluster of all kinds of different interests that end up arriving at this consensus. I'm not a big proponent of this really making a difference. I don't think the average person

really pays attention to this. I think there's a lot of debate and effort that goes into it that in the end doesn't really make much of a difference. I think really what matters is people understanding what a healthy dietary pattern is, both for kids and adults. And basically what that means is whole foods, emphasis on fruits, vegetables, whole grains, seeds, nuts, beans, fish, lean meats, dairy if you eat dairy, but low-fat dairy, and minimizing ultra-processed foods, junk foods. Now, it doesn't mean that people are told you should never eat those foods because that's unrealistic and no one's going to never eat these foods. And that's actually counterproductive when you say never eat these foods. But people should be told that these whole foods should be the major part of your diet and that these ultra-processed foods, junk foods should be occasional snacks. People should also

recognize that you can't make this change overnight, that if you're eating a diet that's high in ultra-processed or junk foods, that you can gradually work on changing your dietary habits, but that this can't happen overnight. It's unrealistic to expect someone else or yourself to change your eating habits overnight. But I think a simple formula like that, a simple set of guidelines like that is really the best way to help people understand what they should eat, rather than some of the ways that the government has come up with. Again, I think the government's effort to have these kinds of various different programs, entities, plates, other things has not been particularly effective

or even influential. In the end, while some positive changes in school food were made during Sam Kass's tenure in the White House, none of it, including the Let's Move campaign, was a smashing success. The rates of childhood obesity actually went up during this time. Left-wing critics contend that into Obama's second term, the program lost policy-changing momentum, overly emphasized individual and parental responsibility, and neglected the broader systemic and cultural factors. Why Americans learn to eat the way we do from the time we're born, well into adulthood, and eventually to raising our own families.

Meanwhile, right-wing critics argued that federal food programs, be it Michelle's Let's Move campaign or Obama's expansion of food stamps, actually increase obesity and that the government doesn't always know best. Is the issue of school food a uniquely American problem? After the break, we'll head to France for some inspiration. Stay with us. This show is supported by Airbnb. Every year, I meet a group of friends for a weekend to reconnect.

Over time, the group has grown. More spouses, more children. But we still want to stay in a single house so that we can make the most of our time together. Enter Airbnb. Every year, we've managed to find a new hidden gem through Airbnb. And best of all, we can specify ones with a crib, so whoever has a baby can travel a little later. It's not just when traveling that Airbnb has come in handy.

Recently, my in-laws wanted to come visit us for a few weeks. We were thrilled. We were also delighted to find them an Airbnb literally down the street. That way we could have family time and family harmony too. Because sometimes you just need a little more space. And here's the really cool thing. Your home could also become an Airbnb. Maybe you even have an in-law suite that isn't being used that often. You could Airbnb the extra space and make some extra money. To learn more about how you can become a host on Airbnb, go to Airbnb.com slash host.

Again, thanks so much to Airbnb for supporting Raising Parents. And now, back to the show. When my kids were born, I very much got the American slash British rules. And those were that you start your kid out on cereal, like kind of ground oatmeal, mushy ground oatmeal. So it was strange because I went to the supermarket here and I couldn't find it. And I thought, how could that be? And I ended up going to a special health food store. It was clear that this is not what French babies ate. This is Pamela Druckerman, an American journalist who's been living in France for two decades

and has been studying their food culture up close. She's also the author of the New York Times bestseller, Bringing Up Bebe. And so when we talk about introducing children to food in the U.S., we have a particular set of food culture, but I'd love to just hear about the beginning parts of that in France. So I'm a mom in France. I'm starting to give my kids food. How am I doing it? The idea for feeding kids in France is that it's the parent's job to teach kids how to eat. It's very parent-led. What you're doing is kind of like giving them a culinary education, and it starts when they're

very young. So from the start, you want to start showing them that carrots are delicious, that spinach is delicious, that pureed leeks are delicious, and that there's a world of flavor out there that they get to meet and enjoy. Cheerios and puffs are out. Pureed carrots are in. I think the starting point of a French parent is that, for example, carrots are delicious. Like, that's an objective fact about the world. There are very few adults who kind of loathe carrots.

So what you want to do is teach them how to like carrots. It's a basic food. And you kind of slowly teach them to appreciate this food without ever forcing it on them. Whereas in the American model, what I've seen a lot of times is a kid rejects an avocado because it's green and mushy and weird. And the mother says, or the father says, my kid just doesn't like avocados. It's not their taste. And so they assume their kid has this elaborate set of preference, pre-established, preordained preferences. And you have to be a respectful parent and accommodate them, which I understand.

It's what you're sort of taught in the culture in America. But the French idea is that not only are these foods delicious, but that eating is one of the great pleasures of life and being able to sit at a table with other people and all eat the same foods is kind of what we're here for. So you, of course, want to teach your child how to do that. Pamela's children went to what is called La Creche in France, aka daycare, from a young age. And that's where, for most French children, their culinary education begins. We did this sort of adaptation period, and we saw the menus for what these 6- to 12-month-old kids eat for lunch every day, and how they eat it. And it was really astonishing. There was, for every lunch, a four-course menu, starting with a vegetable course, going to a main course,

then a cheese course, or some kind of dairy. Sometimes it's yogurt, but it's often a cheese or a combination. And then a fruit dessert. And they would drink only water. So there was no juice. And the menu, I mean, partly because it's in French, and everything looks more elegant in French, but it looked like a bistro menu, like a pureed version of, you know, fish with dill sauce and pureed carrots with parsley. And these toddlers were not being condescended to in any way. And if anything, they were being treated like they were kind of gourmets in the making. And did your kid eat this stuff? Every day. Yeah. Partly because everyone else at the creche was eating it. And eating here is a communal experience. It's,

the French spend much longer at the table, even toddlers, even kids spend more time. I think I read a study that said French kids spend an hour more per day eating or at the table, at least, than American kids do. And partly because of the way they conducted the meal. You know, everyone would sit down at its tiny little table. Everyone had their place. There was a lot of ceremony. The teacher would like bring over, first of all, it was all made from scratch in the creche in their kitchen. You're looking at me skeptically,, this would never fly in Milwaukee. No, I believe you. I'm just thinking about how different this is from... Yeah, there were no like giant vats of mashed potatoes made from powder,

as far as I could tell. Or if there were, there were tiny vats. And the teacher would bring over the meal. She would talk about it. She would unveil it like you would in a five-star restaurant. She would talk about what they were about to eat. Everyone was all tucked in and ready to go. And they would all taste it. They would talk about the food. Did they like it?

Did they not like it? How did they feel about it? And then they would go on to the next course. So it was a tiny version of a proper four-course meal. And the sort of choice about what to serve in these creches in schools, there are some government at minimum oversight of those choices? There's a nutritionist for I think each city, because I did an interview when I was researching my book with the chief nutritionist for the creches of Paris, who sits down with a committee every month and comes up with a menu that all the creches of Paris are going to serve, or at least the public creches.

There's some private ones. And they debated. I can hear all the American parents now. But what about my picky eater? To their defense, there's pretty clear data that between the ages of about two and six, children get pickier. But France has a fix for that. Partly what happens in France is that kids don't eat between meals. So when they come to the table, they're hungry. You kind of learn from an early age to tolerate not starvation level hungriness, but like having a slight pit in your stomach where you want to eat and that pit has not been

satisfied. So you get to the table and you're more apt to eat what's put in front of you because you're hungry for it. You haven't been snacking. You know, your mom didn't give you a banana 20 minutes ago because you were whining. She said, we're going to eat in 20 minutes. Go play and come back. And then the first thing that's served at this moment in the meal when you're hungry is a vegetable. It's not rocket science, any of this. So there's no snacking at all in France? So there's an official snack time in the afternoon around three or four o'clock, and it's called the goûter. And it's usually a very sugary snack. The classic goûter, which I still see a little bit,

but apparently it's like what everybody's grandmothers had for the goûter, is a piece of baguette with a slice of chocolate in it. Kind of like a pain au chocolat, but homemade. Everyone in the park is having their goatee at the same time. But if you go to the park at 10 a.m. with, let's say, moms who are with their two-year-olds, which is less common to see here because mothers should probably be back at work at that point, but nobody's carrying around little bags of Cheerios. Kids are just not eating because it's a couple hours till they'll have lunch. Does this carry over into elementary school and into junior high?

It carries over into old age. Like adults don't snack either. They want to be hungry when they sit down so they can enjoy their meal. It's a tolerance for hunger. It's hard. I mean, I'm in America for 15 minutes and I find myself personally kind of backsliding in my eating habits and snacking more. And it's really hard when the whole culture is not set up to sort of root you into these eating habits. The obesity rate in France for adults is 10% and children 4%, which means the French food culture is working.

From culinary education at La Creche to relatively no snacking and simply making food and eating something to enjoy, something to sit down for at a table with family and friends, this social support piece and achieving this kind of relationship with food is so culturally pronounced that it's hard to imagine it in America. However, this doesn't mean it's impossible or that there aren't people here trying to change the status quo. My name is Kurt Ellis. I'm the co-founder and co-CEO of FoodCorps, which is a nonprofit that helps kids experience food as a daily source of joy and power in school. Like its parent organization, AmeriCorps, that covers a wide range of community service projects across different sectors, FoodCorps is specialized, focusing specifically on nutrition and food access within schools. Well, schools are essentially the nation's largest restaurant chain. There are seven times more school cafeterias in America than there are McDonald's restaurants.

And so as you think about how do you successfully shift the way a country eats, one strategy is to start with young people, because we know that's where change has taken root across so many aspects of our society, from smoking cessation to seatbelt wearing. So start with kids. And then part two, start with a system that can be changed at scale. And with 100,000 school cafeterias serving 5 billion meals a year, that's a pretty big lever to pull in the way we farm and the way we eat in this country. So when you think about the way that school lunches are working, what is the status quo and what would you like to be different? Kids were not the central stakeholder in a lot of the decisions that have been made

that led to school meals looking the way they do in this country. A lot of the program had its origin in trying to stabilize farm prices and make sure that we were using up the surplus agricultural commodities that America's farms were producing after World War II. And a lot of that was relatively cheap commodity food, corn, soybeans, wheat, stuff that could be processed into other foods that could be eaten at scale and were pretty shelf stable. We also were trying to keep people employed. Many of the school meal programs that came about in the wake of the Great Depression, just before the program was nationalized, a lot of those were about how do we put unemployed folks to work in our communities. You know, the way we've built the school meal program, we have a set of nutrition guidelines in place, which do provide a really important

floor to the program in terms of meal quality. But because there's no quality incentive beyond that, that floor is also largely seen as a ceiling. Why go further if there's no incentive structure in place to do so? And right now there isn't. Despite this, there are people trying to implement this on the ground. 85% of our ingredients are sourced locally. We get a tremendous boost from a food hub that we started, which supports 30 local urban farmers. And at this point supports like three counties where we will see Michelin star restaurants serving and naming the actual farm that they came from. I can look at that menu item, eat it, and say, these are the same ingredients that we are serving our students.

This is Vince Coggin. He's the executive director of nutrition services and warehousing at Natomas Unified School District in Sacramento, California, which serves kids 12,000 meals a day. You're cooking a lot of this stuff at school or you're cooking at? The kitchen next to my office and bowl portions. So think of a restaurant that will make 50 portions of like a bowl of nae sauce, but we make it for 10,000 and we send them out to sites and the site will act as finishing sites. They're much like what you would see at chain restaurants like a Chipotle or like an old garden where they are made fresh, they're made in a central kitchen.

They'll reheat it up and like plate it, put in a salad bar, make it look nice, putting in a specific serving size, much like they would do at high-end catering events as well. When I was in Los Angeles at Cordon Bleu, we would cater events like the Grammys and the Oscars. And what I saw there was the efficiency of their service. Same concept, they would take these sauces that they made in their central kitchen, reheat them, And we would act as the finishing sites for the stuff that they made a day before. It's really streamlined. I think it's really efficient. It's one way to keep consistency. And it's like, why don't we do this in school food? So how do kids react to this? I'm a big believer in that we have to tell people in general, not just kids, like seven times before

they get something. So I'm in the business of not just feeding kids, but most importantly, teaching kids about foods they don't know they like yet. And I think in education, we do this for reading. We do this for arithmetics. If a kid doesn't like algebra, we don't just give up the first or second time. We go through a lot of things to help them learn the importance of it, how it's applicable to life. And same thing with food. During winter season, I'll go around and I'll see like blood orange being pushed aside on the tray. They won't eat it.

And the kids will tell me, this orange is rotten. This orange looks weird. And I have that opportunity to teach them and say, think of it like a fruit punch have you had fruit punch it's like a fruit punch orange taste it has this type of flavor profile model it for them i think that's a part you'll see like the blood orange dripped down my chin they're like oh it's so cool i think just switching that narrative having that opportunity to flip the way that they look at it and teach kids like blood oranges will fly off the salad bar for the next week. So a big believer in the fact that as the culture of school food changes, so does the type of talent that we attract.

And much like the restaurant industry, the food will get better, the talent pool will get deeper, and the students will just benefit from the better foods and the better ways of thinking and making this industry much more efficient. This work on changing America's food culture is important, but it's slow. In the meantime, many parents are still struggling with their kids' diet and weight-related health now. Our producer Tamar spoke with a few parents who are currently navigating these challenges. We have always opted out of the hot lunch, which puts us in the minority, according to my children. This is Ellie. She's a mom in Toronto and has two boys, who are 10 and 12.

Along with being a vegetarian family, she takes issue with her kids' school lunch options. Why have you made that choice? Because the hot lunches are crap, and they're really expensive. My kids tell me, oh, they're really, they're fine, they're really great, they're amazing.

But when you actually look at the list, it's like breakfast for lunch. So it's like French toast, which is basically just bread and syrup and burgers and hot dogs and mac and cheese. And they have like one day that sushi, which feels like really surprising to me, actually. But it's like $8 for one roll. We've kind of put our foot down about it. And is nutrition something that is important part of your family conversation? Oh, absolutely. Yeah, we talk about nutrition a lot.

Especially, I mean, we have kind of an unusual house because we're vegetarian in our house. So the boys watch me when I cook, like always thinking about how to get proteins and making sure that everything is kind of healthy. And I cook a lot from scratch. So we don't do a lot of processed stuff in supermarkets and that kind of thing. Yeah, we talk about that a lot with them. What does that conversation sound like? They say, can we have Cheetos mac and cheese? And we're like, there's nothing in that that nourishes you. Every single element of that meal is chemicals. And so we might like look at the box

or something. And we talk about the difference between the way chemicals make things taste good and just the taste of food. So we talk about that a lot and they understand. I mean, sometimes we let them have that stuff anyway, just so that they can kind of, you know, just so that we don't like send them to therapy for their entire adult life. But then when they eat that stuff, they can identify it. They're like, oh, yeah, that stuff was like really chemically mom. Like they can taste the difference between like delicious because it's food and delicious because it's a bunch of stuff that's been like loaded on to make it taste good. They appreciate the difference. But I do think that the kids definitely see junk food as like a prize.

And then the conversation is, are we going to be like giving them that prize? Or are we withholding, like are we denying them that prize or withholding that prize? And so I'm sure they make a mental note every time they see kids that have some version of it. But kids are smart enough to understand your logic. I mean, maybe not when they're two, but certainly when they're seven, eight, nine, 10, like they understand. So if you say to them, here's my logic, my logic is I'm not going to keep a lot of this stuff in the house because I care about your growth and development. And it may seem really lame. And I know how lame that sounds to you, but believe me, this is something that I'm doing for love. And that's just the way that you

frame it. And it's like the way that you frame it. And it's like, have a piece of fruit. Fruit's delicious, whatever. Like, yeah, if we're watching the game, we can have chips. But I think that they're smart enough to understand why we say no. It doesn't just have to be like this conflict. Like, I want something, and the parent's saying, too bad. What's particularly compelling is the open dialogue between Ellie and her kids and the transparency about the reasons

behind their family's eating habits. But parents of overweight or obese kids often find themselves in a much trickier situation than Ellie. What should they say? What should they not say? How transparent should they be about their kids' weight, food habits, and decisions? There's still such a prevalent belief that fatness is because you did something or didn't do something. This is Karen. She's a mom of a six-year-old and a four-year-old from Los Angeles. Karen has spent many years of her life navigating the ups and downs of her own weight journey and now finds herself navigating a similar path with her kids. If you have a child who's living in a bigger body, clearly you're doing something wrong.

It's a moral failing as a parent. It doesn't matter of how many times we read to her, how much love she feels at home, how much she has her favorite times to be able to tell stories for hours and hours. And her art is all over the wall. We take her to beautiful places to explore and to have like adventures. Doesn't matter.

She's living in a bigger body. What did you do wrong? And that's so terrible. And like, at least for me as a parent, like she's six. So I'm able to shield her from all of this because like I can take that on and those feelings of like moral failure on me. Because I know they're not, but I know that's how people view me. But she's six when she's seven and eight.

Some of this is going to start coming to her. And that's terrifying. Karen told our producer that this struggle began very soon after she gave birth. I wasn't able to produce milk so quickly. I just wasn't. Terrifying. Karen told our producer that this struggle began very soon after she gave birth. I wasn't able to produce milk so quickly. I just wasn't. So I gave my daughter in the hospital formula. And I got so many opinions about that. And then the nurses, my baby was really, like, she was, I think, nine and a half pounds.

She was a big baby. She needed to have more formula than a seven pound baby or six pound baby. So she had more formula. And like, it killed me in the back of my head where like, I just gave birth something that I, my whole entire life had been going towards that. And I'm like, I have to worry about how much formula this baby is having instead of is this baby getting all the nutrition that she needs to make sure that she's healthy like automatically whether it's because of society or just the doctors in the hospital everything around me start already that little thing in the back of your head are you giving

your baby too much food can you imagine I know now I'm gonna cry it's just horrible and it was just kind of like a reminder that like it just took me back to so many years of having a worry about what I put into my body and just feeling an added pressure because now you're talking about am I setting my child up for success am I setting my child up for success? Am I setting my child up and giving her everything that she needs to be healthy and successful and be able to go into the world and be everything she wants to be, but also be healthy? And what does healthy mean? So now she's six and she's hungry all the time. I don't want to tell her she can't eat when she's hungry because we do a lot of like, okay, are you hungry?

Like if you're saying you're hungry and you want more food, no problem. Are you sure you're hungry? I want you to listen to your body. So when they were really, really little, both of my girls would like bend down and like ask their belly, like, belly, are you hungry? And they'd be like, yes, we're hungry. I was like, okay, well you asked your belly, then that's fine. But you know, we had dinner and sometimes we have dessert or sometimes we have fruit, whatever it is. We had all of those things. You are always welcome to fruits and

vegetables. And that when sometimes I think maybe it's too many fruits. No problem. We are moving on to vegetables. So, like, it's kind of like I will kind of regulate throughout the day of, like, when I think that, like, it's okay where, like, their belly will be, you know, it won't hurt their belly. Because also, like, sometimes she does eat too many sweets or sometimes she'll eat too much of something and then, like, get constipated or she won't feel well. But as a responsibility as the mom, I have to make sure that she's doing what's best for her body and to teach her through that. I was going to ask, like, has any of it, like, has she come to you and asked you about, you know, am I different? Am I bigger? Yeah. There's been a couple times. My daughter was at a birthday party the other day.

And she was saying something like, oh, I wasn't able to run so fast. And she was sitting next to the birthday boy. And the birthday boy was like, oh, it's because you're fat. And all of the parents, like we're all on like the, everyone's like sitting there eating pizza and like all of the parents are around the table, like just kind of talking to each other. And I could tell there was like a moment of like, like every parent was like, what's going to happen? What's going to happen? What's going to happen? And I was like, I just looked at everyone's like, so I listened to her and she didn't know we were listening. And I saw her, she turned her face and she's like, I'm not fat, but you know what? It doesn't matter because we're not supposed to talk about people's

bodies. And she's just like kind of shrugged her shoulder and the birthday boy was like, oh, okay, can I kiss you? And she goes, nope. And then they got back to their pizza. And every parent was just like, oh my God, that was like the biggest journey in 15 seconds that we have taken ever, where it's just like, these kids are figuring it out. But yeah, I mean, she's only in kindergarten, so I think it might be a little bit worse before it gets better. Karen's experience with her daughter brings up the bigger question we've been circling around about how much obesity and being overweight is in our control and how much is just biological. One of the biggest myths is that obesity is something that is fully within our control. Again, Robert Davis.

It's a matter of biology in many cases and biology fighting us so that when people put on weight, when they become obese, it can become very difficult to lose that weight because the way that we're designed is to keep the weight on, to prevent us from wasting away. So that when people try to restrict their calories, when they try to exercise more, their bodies fight them in a misguided effort to keep them from dying of famine or starvation. And so people end up fighting an uphill battle. People blame themselves. They're blamed by society for not being diligent enough, for not being persistent enough, when in fact, it's much more complicated than that. Shaming people for being overweight is unequivocally wrong. But sometimes, especially in recent years, the goal of trying not to offend people has led to a shift in the

conversation and a lot of confusion about the very real effects of obesity on health. You might hear it's possible to be healthy at every size, a movement that actually started in the 1960s but gained momentum in the 2000s that sought to destigmatize obesity. And it became very popular among celebrities and activists. And well, yes, it is absolutely possible to be healthy at a range of weights and sizes. And no, not everyone needs to be a size two to be healthy. And in fact, for some people, a size two would mean they are not healthy. But it's also true that on average, many diseases, health complications, and worse health outcomes are more likely for people who are obese. I think that the pendulum has swung too far when it comes to the

idea of body positivity and health at every size. I think there's certainly laudable components of those ideas that people should feel good about themselves, that we should be fighting diet culture, which says that everybody should be thin and can be thin. And the idea that simply just restricting calories and exercising more that you'll lose weight. And if you don't, if you're not successful at those things, it's your fault. I think the efforts to fight those ideas from diet culture is a good thing. And so that's, in that sense, health at every size and body positivity is a good thing.

But if we then say, well, let's forget about promoting weight loss or promoting a healthy weight. And let's just say that people should be able to sort of eat what they feel like and eat dessert at dinner and go with intuitive eating and what they feel like eating. I think that's a big mistake because again, we know that these foods often we're talking about are designed to trick our brains and make us want more of them. So that people are told to sort of go with your feelings and go with what you want to eat. That is not recognizing the powerful ways that these foods influence our brains. And so I think that there needs to be a greater emphasis on teaching people ways to eat in a healthy way, what kinds of foods they should be eating

that are going to help them feel full so they won't over consume foods. And that means eating more whole foods and fewer of these ultra processed foods. And I think trying to tell people that it's okay to sort of eat whatever you feel like eating as some of these movements do, and to downplay the health risks of obesity and over-consuming calories and eating unhealthy foods, I think is a real disservice, both to children and adults. In recent years and months, the conversation has shifted yet again to the magic shot that can make all of this go away. Oh, Zempik. Once again, confusing Americans and parents across the board.

If you've been following along, you're probably thinking, okay, so the societal conversation over the decades went from being fat is bad to being fat isn't that bad to being fat can be solved by a shot. I know, you don't have to change anything about your diet, exercise, or lifestyle in order to lose the weight. All you have to do is take a medication. As of 2024, about 12% of U.S. adults have tried drugs like Ozempic, with about 6% still using them.

While the FDA has given the green light for these meds to be used in kids, there's not much data out there yet about how many are actually using them. And this brings us back to where we started this conversation. When the American Academy of Pediatrics updated its childhood obesity guidelines last year, a lot of people were shocked, me included. While the new guidelines still state that the most effective treatment is lifestyle and behavior changes, they also suggest medication and surgery as another tool in the toolbox. Criticism of the guidelines has come from all sides,

and I agree, the guidelines are problematic. I do not think medication and surgery are the obvious solutions here. However, this issue is much larger than the relatively small share of children who might be offered these treatments. Whether the food we offer to kids is healthy or unhealthy affects everyone. And right now, a lot of that food isn't as healthy as it could be. The issue is that it's a hard problem to fix, which doesn't mean we should not try. We need more evidence on what might actually work. There have been many efforts made that we've heard about today on a societal, a policy level, to improve school food, to increase access to fruits and vegetables, to change how food is marketed to kids, to educate about nutrition, and so on.

All of these need more research dollars, along with a deeper dive on how we can improve nutrition in the household. What will it take to get more vegetables and fruits into the hands of kids and families? That's, in my view, the core question. But the cultural problem is just as pernicious. As we learned from Pamela, in France, carrots are just delicious, objectively. In America, that's not a fact. I'd say here, Doritos are objectively delicious. And therein lies the

problem. What would it take to have more parents like Ellie, who simply refuses to give her kids fast food, who prioritizes fruits and vegetables for them because she knows and has told her children that that's what's good for their bodies. She's setting them up for a much better chance at good health. And making that kind of cultural shift is much more complicated than offering broccoli in the lunch line.

America's relatively unhealthy diet is a problem which is not specific to children, but with children, we have an opportunity. Research shows that tastes are developed in childhood. I like to call this research, people like the food they grew up with. If you grew up in Australia, you end up liking Vegemite, a food which most non-Australians think is repulsive. No offense, this raises the stakes, but it also raises the opportunity. Kids are more flexible than adults. They're more willing to try new things. We saw that in the conversation with Vince and his blood oranges. If we are thoughtful about how we do things, we can make a difference. School food is a clear place to start. Thanks for listening. Raising Parents is a production in partnership with The Free Press.

It was produced by Liz Smith and Sabine Jansen. Thanks as well to producer Tamar Avishai. The executive producer is Candice Kahn. Last, thanks to my guests today, Robert Davis, Sam Kass, Pamela Druckerman, Kurt Ellis, and Vince Coggin. I'm Emily Oster. See you next time on Raising Parents.