At the Table with Dr. Brann and Dr. Razza

Dr. Lynn Brann and Dr. Rachel Raza are experts in nutrition and child development. They have developed a mindfulness and mindful eating intervention called Mindfully Growing, which aims to improve food acceptance and self-regulation in young children. They emphasize the importance of a strong diet early on, starting even before pregnancy, and providing children with a variety of nutritious foods. However, diet quality tends to decline as children get older, so it's important to continue promoting healthy eating habits. Peer influence and exposure to unhealthy foods play a role in this decline. Children who have lower food acceptance in their early years may continue to struggle with it as teenagers and adults. It's crucial to provide opportunities for children to try new foods and understand the importance of nourishing their bodies. Welcome to At The Table with Sarah and Julie. At The Table is a podcast by two pediatric registered dieticians and moms who love food and wine. We cover a wide range of topics with our goal to provide you with evidence-based insights but also to be a hub of true expert voices in the food and nutrition field. In this episode of At The Table, we met with Dr. Lynn Brann and Dr. Rachel Raza. Dr. Lynn Brann is an Associate Professor of Nutrition and serves as the Chair of the Department of Nutrition and Food Studies at Syracuse University. She earned her Bachelor of Science in Human Nutrition from the University of Maine and her Master's and Ph.D. in Nutrition from the University of Tennessee. She's a registered dietician-nutritionist. Her research interests include the examination of dietary intake and diet quality of children and adolescents related to growth, development, and health, as well as mindful eating to improve food acceptance and self-regulation in children. Dr. Brann received the Excellence in Graduate Education Faculty Recognition Award in 2001. She's a fellow of the Academy of Nutrition and Dietetics and is a past chair and advisor to the Pediatric Nutrition Practice Group of the Academy of Nutrition and Dietetics. She's a proud mother of two children who are now in college and enjoys outdoor activities with her husband and dogs whenever possible. Dr. Rachel Raza is a Professor of Human Development and Family Science and Associate Dean in the Falk College of Sports and Human Dynamics at Syracuse University. She earned her Bachelor in Science in Psychology from the State University of New York and her Master's and Ph.D. in Human Development and Family Studies from the University of Pennsylvania. Her research focuses on biological and contextual factors that promote self-regulation among children and youth and mindful-based practices as an intervention strategy to foster resilience and promote well-being. She's trained in multiple child mindfulness and yoga curricula and is certified as a mindfulness and a workplace facilitator through Mindful Life and Mindful Eating Facilitator through the Center of Mindful Eating. Dr. Raza is the Principal Investigator for the Self, Social, Emotional, Learning, and Functional Regulatory Lab at Syracuse and is fortunate to work with an amazing team of graduate and undergraduate students. She enjoys nature, running, cycling, and spending time with her husband, three children, and cats. Dr. Brand and Dr. Raza developed a mindfulness and mindful eating intervention entitled Mindfully Growing where they have developed interactive mindful eating nutrition lessons for preschoolers as well as workshops for parents and teachers to practice and implement mindfulness and mindful eating within home and school settings. Today we met with both of them and we talked about their research and we had a fascinating conversation about intuitive and mindful eating and what this means with their research placed into practice. Dr. Raza and Dr. Brand, thank you so much for being at the table with Sarah and Julie. We're very excited to have you here today. So if you just want to give us a brief introduction of who you are and what you do, we're excited to talk to you about your research. I'm Lynn Brand. I'm a faculty in nutrition at Syracuse University and my research has been child nutrition. So I've been doing research in this area for a couple of decades now and most recently have had the pleasure of working with Rachel on some work around mindful eating and mindfulness for young children and supporting that with helping their caregivers and their parents to provide them with the tools necessary to improve food acceptance and self-regulation overall. So I'm Rachel Raza. I'm a professor in human development and family science with Lynn at Syracuse and my research has looked a lot at children's self-regulation and I've been interested in different factors that can help promote their self-regulatory skills as well as the benefits of the self-regulation for school readiness and overall well-being. And in recent years, too, I've been really looking at mindfulness-based strategies as opportunities to increase and support children's development of self-regulation in different contexts. And so this is an exciting project that also integrates the nutritional aspect of self-regulation to really promote overall nutrition and well-being. That's fascinating. There's so much talk about just self-regulation with kids, mental health and then nutrition. So it's nice to be able to hear a little bit of both sides of the story. So we'll start with a few questions with Dr. Brand. How does diet quality in children affect their overall growth and development? Sure. So we know that it's really important for children to get a strong diet early on. So we want them thinking about this even before they come into the world. So when moms are preparing for pregnancy, they want to prepare for their nutrition early on. And so as we have kids who enter the world, we want to expose them to good nutrition and that would be promoting early infant feeding. So if possible, providing them with breast milk, providing them as they start to transition into more solid foods, providing them with a variety of different fruits, vegetables, whole grains, protein, providing them with an opportunity to try and expose them to a variety of foods early on. It's important as we set them up to think about how do we incorporate these foods as they start to grow into their formative years. And what is the most recent data or research show to support this? So we know if we think about what does the national data show us in terms of child diet quality, that in the years around, let's say, two to five, their diet quality is fairly high. So they're getting a lot of what they need, or at least it's better than as they transition out of that time period. So once they start to hit the school age years, their diet quality starts to decline and then that kind of continues through adolescence. So it's a time period where they transition, there are lots of environmental factors, there are some family factors, but we need to think about how do we continue to keep that diet quality high over those time periods. And so there are ways in which we can do that in terms of thinking about policy, school lunch, giving children the opportunity to have access to those federal programs to improve their diet quality. So unfortunately, their diet quality is lower than we would like it to be. So if we can forget some of those aspects of their diet quality in the places that are most crucial for in the home, but also at school and after school, at places where they're getting some of their food, then that's going to help to set them up for long-term health, for accepting a variety of foods, and for decreasing the risk for some of those non-communicable diseases like type 2 diabetes, which we're seeing more now in younger children. So if we can do more at those younger ages, we can prevent some of these adult type diseases that we're seeing in children, which really shouldn't be happening at those ages. That's so interesting. So with that jump from after age 5, when you're seeing children who are maybe in the daycare setting or preschool starting earlier, but you're not necessarily seeing those trends, do you feel like they are just not as aware of or influenced by their peers? Is that some of the reasoning why the 2 to 5 is still maybe eating a more healthy diet, even if they are in a school-like setting? Or is there something specific that you've also found that kind of happens around that age 5 that impacts changes in their feeding? I think there is still peer influence, even in the ages of 2 to 5. But I think as their universe starts to expand a bit after age 5, and they're exposed to more peers and more adults as they start to get into a larger school setting, then they start to see what other kids have. Then there's also that aspect of shame around what foods that they may have in their lunch versus what somebody else has. And so I think that there are lots of factors that cause that decline. A lot of it has to do with what opens up in their world in terms of what they see or what they can access. And then as they get older, what they have available to them, they're not as, for lack of a better word, guarded by their parents and caregivers around what foods that they control. So they just have more exposure to a variety of foods that we would consider some of those foods that are higher in sugar and higher in fat that we know taste delicious. And so kids are prone to want to have those foods, especially if they don't get them on a regular basis. So thinking about how do we provide exposure to a variety of foods, but in a way that allows them to understand that there isn't just this restrictive nature in food, but that foods can be enjoyable, but that we need food that will nourish us. So trying to help them understand that some of the things that likely talk about in terms of what we're doing for our research is giving them a sense at those early years of where food comes from, what does it taste like, using all of our senses to explore. As your research shows, this definitely has an impact later on life. And how does food acceptance affected in life for teenagers and adults if they are not as exposed or if there is a lack of introduction early on? So there is some education that children who have lower food acceptance will hold on to those habits as they grow into adolescence, especially if there isn't an opportunity for them to continue to try additional foods or to try a variety of foods. There are some implications of that. As a dietician, we think about some of the things that we worry about, some of the public health nutrients of concern. So are they getting enough calcium? Are they getting enough vitamin D? Are they getting enough antioxidants to help them to grow into their bodies, especially during those periods of substantial growth and development? And so having the variety is going to give them access to more of the nutrients that are going to help them to sustain that growth and development over those critical periods. So we know that that is something that we worry about when kids don't have much dietary variety, but there is opportunity for kids to still increase their acceptance of food. So it's not a lost cause, which is good. So there's some research to show that if children are exposed even during later childhood and into adolescence, then they're going to still have an opportunity to expand their family. So we can still work on this over time. It doesn't mean that if they miss a window that they're never going to have a varied diet, but it takes a little bit more thought and action to make that happen. And also peer support can be really important. So if we can get peers to provide support, but also be less of an obstacle in a variety of foods, then that helps you. And so this is why when we think about it, having all kids eating the universal school meal would be one way where everyone's having the same food. And if they're getting a variety of foods over time, that's what everyone has access to. So that could be one opportunity to expand and also work on some of those peer components of the feeding environment. Very interesting. And it's encouraging. I love to hear that window. You always hear the first two years of life and sometimes those years of most formidable impact. And so it's nice to hear that it's not a lost cause if you've kind of missed out on some of that, might just look a little bit different and have to engage in things a little bit different way, but that it's still possible to increase those exposures. Yes, we should not lose hope. Exactly. So where does the term and the concept of mindful eating come from? And can you also differentiate between mindful eating and intuitive eating? Sure. So mindful eating comes from the Buddhist philosophy around mindfulness. And so it is a component of mindfulness where we think about being present in the moment. And so as we apply that to eating, we can think of a few different aspects that are important in terms of mindful eating. So like paying attention to your physiological cues, your hunger, thinking about eating slowly, sort of savoring the food that you have in front of you. One of the things, again, that we focus on a lot is using your senses. So paying attention to how something smells, using all five of your senses. Recognizing a lot of the emotions around food is also an aspect of mindful eating. Reducing distractions, which is a really important one with kids. Trying to get them to be at the table with you and not solely focusing on the food, but being present with the food so that it's not just in five minutes everyone clears their plate and then they move on to the next thing. So trying to sit down and have a nice opportunity to have a conversation, but also enjoy the food that you're eating. And then developing an appreciation of food and where it comes from and who grows it. All of those things are aspects of mindful eating that we think are ways in which children can help to connect to some of the aspects of self-regulation that Rachel will talk about, but also how self-regulation of eating ties into general self-regulation. So how do those two things fall under that same umbrella? How do they connect? And so our research is trying to understand the connections between general self-regulation and self-regulation of eating, and how can we target both of those for children to improve aspects of those overall and self-regulation of appetite, self-regulation of eating at an early age, so that hopefully that sets them up for better success both emotionally, health-wise in terms of their nutrition and food acceptance, and some of the mental health aspects with that as well. So your second question was, how does mindful eating differ from intuitive eating? Intuitive eating is a bit more broad in scope, and so it encompasses a variety of aspects of ways in which we think about food and think about how we non-judgmentally, although that overlaps with mindful eating, consider approaches to food. So there is a lot of focus on intuitive eating as a non-diet approach for trying to be more present, but also accepting of your body. And so both are really important, I think, in the nutrition sphere, and both have a place. I think mindful eating and the concepts that we're using is the right fit for young children as we're working on some of those aspects of just understanding food and being open to exposing yourself to food and trying it. So that's sort of how we've focused our research components on. Very helpful. Thank you. And I feel like children at an early age do tend to be a little bit more intuitive than adults, but at the same time, and just for the listeners too, that mindful and intuitive eating is not something that kind of comes to you. And you can correct me if I'm wrong in this, but it's something that takes practice, correct? And that you have to constantly train your body to adapt to that behavior so that your body understands its limits and what it needs. It definitely requires people to tune in and to pay attention. I would say at a young age, children are quite good at doing those things. But then as they make their way in the world and make their way into our environment, which is often not one where you stop and pay attention to what you're doing, then they lose those cues. And then it starts to become something that you would have to sort of revert back to paying attention to. So we are not as good at stopping and being present. And those are things that will take practice now, but that practice can really improve and change one's ability to be able to be present. So, Dr. Raza, can you tell us about the biological and contextual factors that promote self-regulation among children and the youth? Sure. So I think we tend to talk about a hierarchical model of self-regulation that would include both kind of unconscious processes. So that could be things like physiological reactivity or temperament or genetics that contribute to our levels of self-regulation, as well as what we think about as more top-down processes. So more conscious, cognitive, effortful types of thoughts that are more in control of children over time. And so it's also a developmental process. Early on, we think about external factors. So it could be parents, it could be preschool teachers who are helping to provide some type of external regulation support and cues for children. And then around toddlerhood, we start to see a little bit more of that conscious or cognitive or effortful part start to take place. And during that time and kind of throughout the preschool years, children are really going through this process where external factors and external regulation starts to become more of an internal regulation process for them. And that does involve things like co-regulation, where that would involve the bi-directional processes between caregivers, adults, significant others, and children's lives and the child themselves. And so you can think about how this could be positive types of examples where children are surrounded by really supportive adults who allow them to engage in different and in-practice self-regulatory skills, and how that can then kind of continue to lead to more support from those caregivers in terms of modeling self-regulation and supporting children's skills. And then the flip side can happen as well. So you could have caregivers who may be particularly stressed out. It could be that you're in a chaotic environment, and that feeds, unfortunately, more of a dysregulation cycle where children have less opportunity to practice. They have less modeling examples for how they might go about controlling behavior, thoughts, emotions. And so then that can lead to less regulation as well by caregivers. So you're in this position where both parties are contributing to the overall self-regulation of, let's say, like the dyad. So we can think about how, over time, those external factors, those could be caregivers, those could be other significant others in the children's lives, in just the context. So things like routines, consistency, those type of more structural supports also help children. They're predictable. They let children have a sense of security, safety, and what's coming next. And so that can be really helpful for self-regulation. We think a lot about temperament playing a role in self-regulatory skills, especially early on. So we all have these kind of underlying physiological regulation and reactivity. So we would have different thresholds for stimulation. And with supports and some of these modeling and practicing, children would also have opportunities to engage with these cognitive thoughts that come on or these supports through families or from the environment to help them manage and develop tools that would be useful in terms of better being able to manage their behavior, their emotions, to really meet different types of demands that are in the environment. So what are some examples of mindful-based practices? How would you implement them? Maybe you could break it down at the dinner table. How might that look? Yeah, there's several different models, I would say, of doing this. Sometimes it's just before sitting down that there might be some kind of movement. So that's a lot of the structure of mindful practices with young children does involve some kind of movement. And that might be set to music or that could be set to a story. But sometimes just using movement as a way to check into the body can be really helpful, especially for young children who have a lot of energy and like to move around. But it can also help to be able to use that energy to then really go inward in terms of the mindfulness, in terms of being able to sit at the meal and engage. And so with mindful eating, it could be through simple stretches, movement, or things like that before sitting down. And then it might be simple breath practices, just taking a few collective breaths together as a family or as a child care table together during eating. With young children, you're not going to be able to have this kind of all fully mindful meal. We don't really have that expectation, but just these little elements of mindfulness that you can infuse throughout. And so taking a minute after maybe three collective breaths together, maybe noticing colors on the food in front of you, or maybe going around the table and sharing, what are some smells that you're noticing? Or have you had this food before? Or thinking about what it might taste like and guessing if it's a new food, but just acknowledging. And that's another part too, I would say, is that gratitude part. I think Lynn mentioned a little bit about that before, but thinking about where this food came from, taking a moment to appreciate and recognize that all of the people who contributed to this food appearing on the plate. You don't need additional tools or things with you or props. It takes work. So if you do it one time, it's not going to be as helpful or it's not going to become more of this automatic process unless we stick to it and really try to consistently implement it to some extent. I love that. My oldest, they're doing movement breaks at school, and I know she's really been enjoying those. And I think, like you said, incorporating that as part of a routine, she's really now come to expect it and it's just part of her day. And I think that's really neat. And then the second part that you said about really making it more of like an observation, the feeding experience, I think kids are so inclined to really want to observe the world around them. So really cueing into how it feels, how it looks, where it comes from, and not just looking at it, I guess, as food. I think looking at it from a more exploratory perspective is a really neat way to think about it. And I think it's really cool. And I've noticed my son, she's more on the pickier side. We have challenges with feeding him, but I've noticed that when we go and show him where something grows, he picks like a lettuce out of a garden bed, or he goes and picks apples of a tree. All of a sudden, he's very interested in the food that he wasn't eating before. And so teaching that where food is coming from has had an impact. With that, can you tell us more about your research in the self-regulation lab? Sure. So we have wonderful graduate and undergraduate students who help us and contribute to the work that we're doing with children and with youth. But we are really engaged in finding ways to support children's self-regulation in different contexts. And so our Mindfully Growing curriculum is one element of that research that supports self-regulation. It really kind of unites that behavioral piece and that school readiness piece with that nutritional aspect. And so we have been really enjoying infusing those two parts together, bringing mindful yoga for young children and those mindful elements, as well as mindful eating with the nutritional elements to really help children better be able to connect some of those regulatory skills in ways that they may not have been doing before or may not have practiced. What we're finding is that children are really open and accepting of this, and they are able to use and build from these foundations to do things like try new foods that they may not have done before. And so we've been in classrooms where we brought some snacks to mindfully eat, and the teachers have at first said, a specific child is not going to try that or won't like that because of smell or because of texture or because of taste. And so what we found, though, is that by presenting it in this kind of united way that children are more accepting or are taking bites of things that are surprising them and surprising their teachers. But I think that that's part of that collective support, that they feel like they're in a safe environment. We do not pressure children to try any of these things. It's more about making them curious about the foods. And so we have been working a lot trying to see what types of practices and what kind of activities that are working well for the children. And we learn a lot from them. So they are always kind of helping us tweak the way that we present things. And then we are also really trying to engage the parents and the caregivers. And so we don't want to leave out these important, significant people in children's lives who are also there to provide those kind of external supports and model and help children be able to develop healthy eating habits as well. So how does diet play a role in all of this? I know we talked a little bit about diet and how it affects development, but we hear about certain foods sometimes give you high energy. How does diet affect like self-regulation? So I think that's something we're still learning a lot about and trying to understand in terms of that relationship between diet and self-regulation and what is the direction of those things. So we think of school breakfast, for example. If children have access to school breakfast, their scores on some of their tests are improved. So if they have access to calories and energy to start their day, then it's going to be a good thing for them in terms of their academic performance. And that probably translates into lots of different aspects of their lives. And we're starting to learn a lot more about diet and mental health. And so how can we use these connections to try to advocate for the opportunity for kids to have access to more nourishing foods than what is available to us? And again, I'll reach back to some policy issues where let's make policies where children have the opportunity to have access to food and have that food be the foods that we know will improve their trajectory for health, but also for learning and for their ability to have increased attention. So I think they're all connected. It's complex, though. It's a complex system. And so we're trying to tease out a part of that as are several other research groups around. But I think it's getting more attention. And that's a good thing. Certainly there's work to be done. But there's also the school food service folks out there are doing an amazing job with the resources that they have. So it is very hard to feed a child on a very small amount of money and give them something that is going to meet what we think would be the best setup for them to succeed. And so we need to put more resources into more feeding programs. We need to have more guidelines that would support allowing parents and families and schools to connect with local food systems to and a lot that is happening, but maybe not to the scale at which we would like it to at this point. So it is one of those things where the progress is slow and people are invested and interested. We need some more supports for those things to really put into place. And so a lot of that has to do with our government regulations and policies. If we can improve the school lunch, we should give it more money. We need to give schools more opportunity. Also, I think sometimes they're doing a really good job with what they have. And we shouldn't be blaming them for what they're putting on the tray as much as supporting them in a different way to help them to have more resources to do better. The other thing, too, that we noted in talking with the range of preschool teachers is just the variety of types of meals that occur. And the preschools provide the lunch or the breakfast. Others are going to own. And so there's variation that occurs to some extent based on like the policy of that program. But I think even within that diverse type of setting, we can still think about ways to support this curiosity around food and acceptance of other foods as well. And so sometimes even that is just becoming part of more of the language that's used in the school setting around how we talk about food and different foods is really important to support all children in terms of their meals. I wanted to talk about the caregivers. So I know we talked about their role. And I know there's this movement with the younger parents now to gentle parents and how that involves with self-regulation. How does that affect a child's self-regulation? What have you seen? I can just say in terms of just general self-regulation, I would say that most of the literature out there, and this would include research that we've done in our lab as well as the larger national or longitudinal studies that follow children, is that we do see warm, responsive, sensitive parenting, those types of processes really being supportive of children in terms of their self-regulation. And that then kind of creating a more positive trajectory in terms of how they do academically, how they do social emotionally, how they do mental health-wise. Whereas we look at the more harsh aspects of parenting or the controlling of the coercive types of practices as being detrimental. There's thought that those kind of things may stop the behavior in the moment, but that they contribute to more of a dysregulated cycle over time. I think a lot of the literature that comes from what we call responsive feeding comes out of the parenting literature. And that's sort of come down from there for practices around not pressuring children to eat and providing opportunities to have a variety of foods. And so those aspects for the kids that have been studied to date have the more authoritative but responsive parent in terms of feeding. Those outcomes are better in terms of oftentimes it's looked at with weight status for children, so less likely to be overweight. Also oftentimes more likely to have more fruits and vegetables or some outcome related to diet. So I think that there's promising understanding of how to provide children with less harsh feeding and more opportunity for them to self-regulate. So again, going back to that idea of are they hungry, not forcing them to eat just because you think they should, but providing them with structure, giving them opportunities to eat on a regular basis, and by allowing them the autonomy in a lot of cases for them to listen to their body and know what they need. Very insightful. Thank you so much. What you're doing in your research just validates a lot of the practices that we're doing. Dietitians, I think both as moms and dietitians, to be honest, it's fascinating. And I hope we want to stay in touch and as the research progresses, hopefully we'll be able to have you again and get an update on where you will be at. Great. Thank you for having us. It's been a pleasure to talk to you. Thank you so much for joining us at the table. Be sure to follow us on Instagram as well as on Spotify, Apple, or wherever you get your podcasts. We are Sarah and Julie. Talk to you next time at the table.