by Marion Nestle
Oct 27 2010

Eating Liberally asks Marion: Is stealth the way to healthy eating for kids?

Every now and then, Kerry Trueman tosses a “Let’s Ask Marion” question at me, and these are invariably a challenge.  Today’s: “Is stealth the way to healthy eating for kids?”

(With a click of her mouse, Eating Liberally’s Kerry Trueman, aka kat, corners Dr. Marion Nestle, NYU professor of nutrition and author of Feed Your Pet Right, Pet Food Politics, What to Eat, Food Politics, and Safe Food):

KT: NPR’s Morning Edition ran a story today about “stealth” strategies that some schools and researchers are employing to get kids to eat healthier foods–for example, by sneaking pureed vegetables into a line of cafeteria foods being marketed under the name “Hidden Healthies.”

But doesn’t this approach reinforce the perception kids have that vegetables taste lousy? David Just, co-director of the Cornell Center for Behavioral Economics in Child Nutrition, pointed out that “Taste is a suggestion more than anything else. If you think something is going to taste really good — if you’ve been told by others that it tastes good — you build that into your head when you eat it.”

A researcher who’s experimenting with enhanced cafeteria lighting to make healthy foods appear more appealing to kids told NPR, “We got to figure out some things so that the last thing in the world they know is that we’re trying to get them to eat well.”

We know that kids (and plenty of grown-ups!) turn up their noses at foods that are presented to them as healthy. Kids have also come to expect that their preferences should be catered to, which is why carrot and apple growers have begun packaging their products to resemble snack foods like potato chips.

In short, veggies have a serious pr problem. Do these strategies strike you as a good solution?

Dr. Nestle: Oh no! Not stealth again. I thought we were done with that in 2007 when we had to live through the plagiarism fight between Jessica Seinfeld’s Deceptively Delicious, and Missy Lapine’s Sneaky Chef, both of them pushing stealth strategies.

I remember being given hamburgers as a kid and how betrayed and condescended to I felt when they turned out to contain ground spinach—a vegetable I detested at the time but now think is terrific, especially when young and tender. Kids’ tastes do change, and should be encouraged in an honest way.

That is why I am so intrigued by the approach shown in the New York Times “Lunch Line Redesign” op-ed last week. Check out the way that Brian Wansink and his colleagues suggest redesigning lunch lines. These do nothing draconian or deceitful. Instead, they gently nudge kids to made healthier choices on their own.

How? By doing such things as putting salads near the cash register, using bowls instead of trays, and describing the foods more attractively. My favorite of these strategies is simply to ask the kids whether they would like a salad. All of these increase kids’ selection of healthier food choices.

But will the kids eat the foods? Of course they will. From my observations of school meals, the single most important indicator of whether the kids are eating healthfully is if the school food service people know their names and talk to them about what they are choosing. It helps a lot if the food tastes good, but kids respond to adults who care about what they eat.

When I hear parents say that the kids won’t eat anything healthy, I suspect that I’m talking to someone who isn’t willing to take adult responsibility for what kids eat and finds it easier to be stealthy than direct. Kids need to trust the adults in their lives and food should be used to instill trust, not destroy it.

This exchange appeared on the Huffington Post website on October 25 and elicited a response from Missy Chase Lapine, the original Sneaky Chef herself (reproduced with permission):

Dear Dr. Nestle,

I understand you had a bad experience with sneaky spinach as a child, but I respectfully disagree with your position that sneaking healthy food in kids’ meals is a bad idea. As the author of the Sneaky Chef cookbooks, I receive thousands of testimonials from parents to the contrary. They are thrilled that their kids are finally eating veggies–and most of the kids are in on the secret and love it.

The reason sneaking is needed is highlighted in the recent CDC report showing that all of the efforts and billions of dollars spent on nutrition education has failed. Everyone now knows that they SHOULD eat their veggies. The problem is HOW to get them to do it. Teaching alone is conclusively insufficient–we need to sneak and teach. They work hand in hand.

Sneaking veggies gives people an easy way to experience the benefits of eating veggies, yet lets them enjoy their favorite foods, like spaghetti and meatballs–-only now they’re loaded with spinach, broccoli, peas, wheat germ and cauliflower. This direct experience opens the door to learning.

Parents from around the world write me letters like this:

“Every time I use one of your healthy (and sneaky) tips or wonderful recipes, I just want to scream with joy because they eat it.” –Mindi B., TX

The bottom line is: combining “sneaking and teaching” works for everyone.

Respectfully,
Missy Chase Lapine, The Sneaky Chef

Not exactly everyone, if I may respectfully submit.  But I’m glad she wrote.  OK, readers: opinions, please!

  • Cathy Richards

    @Linda — aw shucks, you made me blush. Thanks for the kind words. I was having a bad night, and you just made it a little better.

  • Izzy

    You, know, I grew up on “spaghetti & meatballs” similar to Ms. Lapine’s.
    The result was that I despised “Italian” meatballs & “tomato” sauce until I was 18 and finally got tomatoes and meat.
    Sure, you can try adding a little vegie to something, but ask the kids for their opinion on a bite. Then mention you tried “x”, whether the kid liked it or not. If they don’t like it, that recipe is a failure and for your enjoyment only. Let them decide which vegetable they will prefer or tolerate until a better recipe comes along.
    A kid who doesn’t participate in the kitchen isn’t going to become an adult who knows how to cook a vegetable, let alone wants to. It wasn’t till I started cooking the dinner that I decided I would find the yummiest way to eat a brussels sprout. I still don’t like them as much as other vegies, but now I can appreciate their nutty fresh flavor for what it is.
    But putting parmesan on a brussel sprout does not make it “taste just like pizza!”, any more than a grilled mushroom tastes just like a hamburger.

  • izzy

    P.S. –
    1. A couple studies said some kids hate the mouth-feel (texture/consistency) of different foods, more than the actual taste.

    2. I’m amazed how people will do all sorts of things to, say, poultry – an ingredient most people never refuse in any form. Yet most people cook vegetables with no additional ingredients, no spices or herbs, using one unvarying temp&time – and when the unadorned stalk lands on the plate and sits there forlornly, without any dressing more complex than cheese, they assume they “hate” all vegetables.

    3. This story has no “vegetable” tag. Apparently there are no other stories about “vegetables” on this blog either (oh wait, there’s one about killer tomatoes). Unconscious vegetable profiling, perhaps? ;)

  • Rachel

    I’m not a big fan of stealth veggies, because they don’t teach my kids to actually eat veggies. Now, sometimes foods have stealth veggies or fruit in them (banana bread, zucchini bread, etc) but those are just bonus veggies and fruit. I also think it is important that parents whose kids won’t eat vegetables look at whether or not they themselves eat them.

    My husband is a doctor who deals with obesity, and when he asks about vegetable intake, he will often discover that one or both parents (if it is one, it almost always the father–I don’t know why!) does not eat vegetables. Kids are smart–why should they eat what their parents don’t?

  • skitt

    My semi-picky 3 year old eats her veggies just fine. What I need is a book that helps you disguise meat as broccoli. Maybe I could hide little bits of steak inside snow pea pods…

  • Allison

    I have no problem with offering more whole and nutritious foods to kids in the lunch line. Whole wheat desserts/baked goods can be made and adding local veggies to the pasta sauce and other foods makes sense. These can become a norm. A great way to do this is through taste testing of the food. Give the kids a chance to try it first (and this may be needed to be done multiple times) and give an opinion on it. A whole food education around the taste test and an overall supportive environment for whole foods can go a long way but can take years.

    Allison, Community whole foods advocate

  • http://www.awakenedwellness.com Rachel Assuncao

    Kids will love what they are taught to love, for the most part. If, as parents, aunts, uncles and grandparents, we model healthy eating, that’s what the kids will eat too. If we’re eating something unhealthy, and telling the kids to eat their veggies, why would we expect them to comply? They are going to want to be just like mom or dad.

    My daughter loves just about every vegetable put in front of her (except green beans). Part of that is that we eat healthy foods together as a family at least once a day, but usually twice. She sees what we’re eating, and she wants to eat it too – just like a big girl.

    Part of it is in the preparation. If we just serve our kids steamed veggies, but the rest of their plate is filled with marinated and grilled meat and pasta with a tasty sauce, it’s no wonder they skip over the veggies. We need to spice them up just like we do the rest of our food.

    The last strategy I use is about choice. The first level of choice is ‘do you want this vegetable or that vegetable’ not ‘do you want veggies’. This way, they get the control of making a choice while I get the control of ensuring veggies are on the plate.

    The second level of choice, particularly when introducing new foods, is the one-bite rule. Whatever is on your plate – you have to have one bite. After that, you don’t have to eat any more. Often, it’s getting over the fear of something new. Once the one bite is in and tastes good, the rest quickly follows. Sometimes, it’s getting used to a new flavor or texture. That can take some time to do – and so by insisting on one bite, I’m slowly introducing it into our diet. Since it can take anywhere from 1 to 100 exposures to a food before we form a firm opinion on it, this can be a slow process. But, slow and steady wins the race.

    Sneaking veggies (or other healthy ingredients) isn’t something I practice. Nor is it something I’d recommend. All you are doing is reinforcing the bad habits, but secretly feeling good about all the veggies you hid in that unhealthy dish. Teaching and, perhaps more importantly, modeling, is the name of the game when it comes to developing healthy eating habits.

  • Sheila

    I don’t like stealth food. Trust is as important as healthy food choice, and stealth doesn’t seem to encourage either. I much prefer good role models, careful attention to quality of preparation, and allowing the child to make choices as Rachel has outlined.

  • http://www.carolfenwick.com Carol

    As a child, my daughter, Amanda, did not like fish of any kind. The others weren’t crazy about it, but they tolerated it to a point. I lied to my kids when I served salmon patties – I told them they were eating chicken and they ate it. But they were little then. As they grew older, I couldn’t fool them with the salmon/chicken trick and Amanda refused to eat the salmon patties. She also refused to eat salmon not out of a can, or any other fish, whether in a restaurant or at home. I think she was mad about being lied to about the salmon patties. So, I left her alone about it. When I cooked fish for dinner, I told Amanda she didn’t have to eat it. She could eat the rest of the meal or make something of her own. I asked if she would take one bite and give me her opinion because I explained, “You never know when you might start liking fish. I used to hate broccoli as a child.” That impressed all the kids because we all loved broccoli and had it two or three times a week. This strategy worked out fine. She ate one bite and the rest of her meal. Sometimes she would make a sandwich. When she was in high school, one of the clubs she was in went out for a fish dinner. She didn’t eat the fish. I didn’t force any of my kids to eat anything they didn’t like. As a result of one person complaining at this meal and another complaining at the next, I decided the kids would cook 3 nights a week, with one kid in charge and the other two supporting their effort. They made a menu and brought to me for tweaks. I took them to the grocery store and let them go in with my debit card to purchase the ingredients for their meals. One day, I was surprised when Amanda, now driving, called me at work and asked me how to cook fish. I told her and she cooked it. Later, during her first year in college, she worked part time at Red Lobster. Carol Fenwick RD

  • http://www.eastewart.com EA Stewart

    Growing up, my mother didn’t like too many vegetables, and my father liked pretty much EVERYTHING! As a result, vegetables were always offered at meals but NEVER forced. I remember liking lettuce (iceberg!), carrots (raw, never cooked), green beans, and tomatoes (technically a fruit). As an adult, I like ALL vegetables, including the ones I wouldn’t eat as a child (broccoli, spinach, beets, squash, cooked carrots…). My children (7 and 9) eat fruit at most meals. SOMETIMES they eat the vegetables offered, but at least half of the time they do not. Do I wish my children ate more vegetables? Of course. Am I worried about it? Not at all. I am not a sneaky person. I have no problem adding vegetables to enhance other foods, but I ALWAYS let my children know what’s in the food. One thing you can do is offer something over and over again. My daughter never used to like lettuce, but now she eats it on occasion (topped with feta cheese!) My husband and I are good role models for eating a variety of healthy foods. I suspect our children will be pretty good veggie eaters one day, but it will be because that is their choice, not because it was forced upon them!

  • http://loveknowledgezeal.wordpress.com/ Maya

    I’ve got two minds on the stealth food issue. On the one hand I think it is completely counterproductive in the long run. Sneaking fruits and vegetables into dishes for the sole purpose of increasing consumption of them means that the kids (and adults) will only eat the vegetables while someone is being sneaky. There’s no process of learning to love them on their own merits, so in the long run the kids are not as likely to continue eating vegetables by choice.

    But on the other hand there are examples like applesauce in cake to cut oil, which is a win-win-win situation. Or adding pureed vegetables to soup instead of cream. Sometimes sneaking the vegetable in really is beneficial, and can actually encourage a love of vegetables. I guess it’s in the presentation and the purpose(s) of the sneaking.

  • Jennifer Montague

    I don’t think we need to be sneaky about vegetables. We need to be sneaky about the existance of processed, high-sugar, high-salt alternatives! I wish my daughter could grow up in a world where vegetables weren’t competing with uncrustables. It is vital children knowwhat they are eating, and that they are eating vegetables! If children understand they need to eat foods that are good for them they might have a chance.

  • Jodi

    It’s important that kids are encouraged to try healthy options but I also think there’s nothing wrong to making favorite comfort food more healthy. It’s like the TV show and cookbook “Cook Yourself Thin”—making healthier alternatives to favorite meals. It is important that kids are exposed to vegetables as they are…. no stealthing.

  • Jon

    Actually, that’s funny. When I was a kid, I hated white sauces. I just had an aversion to them. It turns out they were all high in calories, and most of them were high in trans fats. (This was the 80s, when margarine was good for us.) Like most kids, I had a bit of an anti-vegetable prejudice. Except broccoli, for some reason. Around age 11, I started eating romaine lettuce and carrots (in salads) and onion (on hamburgers). I found I actually liked them. Soon after that came tomato.

    People even continue the stealth strategy into adulthood. Look at all the vegan replacements for animal products. They don’t taste the same, but they look the same.

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  • Pete

    I wouldn’t call making dishes healthier “stealth” per se. Recipes aren’t etched in stone. I make pumpkin pie with half spaghetti squash, stevia and brown rice flour. Is that SteHeatlhy? (ohh good brand!) I don’t think so. Just like cauliflower instead of or mixed with potatoes isn’t. It’s just different.

  • http://babysbibliomama.blogspot.com/ Christine

    I have a couple thoughts on this issue. You don’t need stealth if you pair education with dietary empowerment. And that includes experimenting with the healthier, stealthier versions of recipes, but being candid about that. They can be healthier recipes, without being “stealth”. But to my mind, this all begins with infants and first foods. I believe very strongly that always feeding baby’s canned and jarred (so, processed) baby foods leads to the development of a taste for vegetables cooked in a particular way. And that preserved way of food — even if organic — does not always capture the fresh flavor of a vegetable in all it’s natural glory. I think that if we want our children to eat vegetables, we should feed them the same vegetables we eat, right from the start. And that includes with seasoning. There’s no reason that a baby cannot have a bit of mint and butter on her peas, just like you, once she’s been into solid foods for a couple months. Infants are developing their tastes at that time, so while you don’t want to do a lot of salt on a baby’s food, you can give flavor with spices and herbs, just like you would yourself enjoy. A simple inexpensive food mill and a blender, which is standard in most kitchens anyway, are all a person needs to provide infants with the same foods we eat, right from the beginning. If you are giving your baby green beans from a baby food jar, then why not make green beans with your own dinner and puree a bit for her? Simple. Then jarred food becomes a back up. Our 14 month old insists now (and has for months) on having exactly what we have. She eats curries (mild) and all. There are things she doesn’t like (only slightly green bananas pass her lips, for example), and we don’t force it. That’s the same philosophy we’ve used with our other daughters. When our second decided she wouldn’t eat lamb because lambs are too cute and cuddly, she also stopped eating beef for a while. And so I found ways to make sure she had protein from other sources such as nuts and lentils. Our family ate black beans and rice once a week during that period. She now eats both lamb and beef again, but we supported and respected her food choices. We never make separate meals for any of the kids. If they don’t like something, they don’t have to eat it, but the alternative is to find something in the fridge that doesn’t involve additional dishes on the stove. We also give them input into the menu, and try to feature some of their favorites regularly, so they feel part of the process. And if they don’t like something, like the author above, there’s a rule about tasting things again. A two bite taste rule exists. And over the years things that have been loved are no longer loved (we hardly ever make mac and cheese for lunch anymore, thank goodness), but other things are now adored. One has her favorite squash, all love my mother’s lentil soup, and they even ask to have salad with dinner from time to time. One last note — I think the RDA focuses too much on DAILY intake. If we take a slightly longer view regarding what we eat, it follows more naturally our body’s way of being — ask if your children are getting enough fruit and veg over the course of a week, and you might be pleasantly surprised that you and they are doing better than you thought. We do try to have veg and fruit with every meal, but if we have burgers and chips and ketchup is all they get that resembles a vegetable for that meal, we certainly don’t beat ourselves up over it, because we know in the bigger picture, they’re getting a lot in other ways.

  • http://www.squarerootcatering.ca Jan

    I think part of the problem is how we present vegetables. Culturally, we understand that they’re important and nutritious, but we’ve also become accustomed to our nutritionally barren foods. The solution, it seems, has been to add vegetables to the plate as a sort of ex post facto solution. Ex:

    Problem: I like McDonalds but I also understand that I need more nutrients.

    Solution: Cheese burger with a side of green beans.

    That dichotomy of healthy and unhealthy on one plate makes it really easy for distasteful food (i.e. healthy food) to be left out. The stealth method I think is sort of the right idea, but the approach doesn’t reinforce what you want to be teaching kids, that is, that food can be tasty AND healthful. Instead, it tacitly impresses on them the idea that healthy food isn’t tasty and that the solution should be to hide healthfulness in tasty, and presumably unhealthy, foods.

    What’s lacking, really, is culinary skill. People just have no clue how to make brussels sprouts delicious, or green beans, or radicchio. We simply need to start developing our culinary skill again. We need to reestablish a culture of home-made food that reflects the season. In so doing, kids will be accustomed to delicious and healthful foods that include vegetables from a young age. That way, by the time they get to the cafeteria and see vegan shepherd’s pie, or roasted cauliflower, they’ll respond in the way that they do now with junk food: “I’ll take one of those.”, except instead of “one of those” being a handful of nachos smothered in florescent yellow cheese, it will be Caprese salad.

  • Emily

    The research by folks like Paul Rozin says that familiarity with a food is what makes us like it. It can be good to pair a new food with something familiar and loved– cauliflower in cheese sauce, for instance. The old strategy of forcing kids to eat their veggies to “earn” dessert strikes me as very similar to the sneaky approach: the kids (who, of course, go on to become adults) learn to associate the good feeling they get after a meal with the last thing they ate– or the thing they thought they were eating.

    Plus, I hate the idea of lying to kids in order to trick them to eat things. Why don’t we just learn to cook things better? Oven-roasted broccoli, for instance, is one of my all-time favorite things to eat.

  • http://cynthia-robinson.healthcoach.integrativenutrition.com/ Cynthia Robinson

    I am a parent of a 34 year old daughter, and I used to “HIDE” vegetables because she ate tuna, mac n’cheese, pasta, corn, scrambled eggs, and fruit cocktail. NO VEGGIES. I raised her as a baby on steamed fresh veggies as finger foods and she even ate cauliflower much to the surprise of her pediatrician.

    Later on she became ultra picky and “decided” she no longer liked green foods – or most vegetables. I made meatballs and put vegetables in the food processor with some of the meat to really blend them together, I also was raised on Portuguese Kale Soup and we would ladle out a bowl for her, take out the kale and the beef and some broth, whip it in the blender and put back into her bowl… and I told her it was Oscar the Grouch soup… she ate it EVERY TIME! If I put the bowl of soup in front of her, unprocessed… she would pick out the potatoes and not eat another thing. Today… she has changed but her son is horrible with food choices and she chose not to adopt my methods. As a result, her son has been battling weight issues since he was 10 because of his food choices of McNuggets, French Fries and Mac n’ Cheese. He is not 14 and has made additions to his list of foods, but they still are not healthy choices. I don’t believe hiding food is such a bad thing. Once my daughter learned I hid food within the meals, she was very surprised… but she found transitioning into more health conscious choices easier once I told her she had been eating them all her life and just didn’t know it! For her, it was a mind over matter issue. Today she is a Corp. Attorney for a Vitamin Company… how ironic!

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