March has been declared "National Nutrition Month" by the Academy of Nutrition and Dietetics, the national professional association of registered dietitian/nutritionists. Every year has a different theme for consumers and health professionals, and usually it's focused on health and specific nutrition goals. This year the theme is "Savor the Flavor of Eating Right." The campaign has grown every year and is now even promoted by the Centers for Medicare and Medicaid Services.
The current theme might sound fun and frivolous, like something you might expect to see on the Food Network, but having fun with eating is one way I've found to help motivate my patients to make simple, positive dietary changes that last. The families I work with are real people with real food likes and dislikes.
Traditionally, it's been assumed that kids won't like food that's too spicy. We tone down the heat and offer nothing too strongly flavored, nothing that could disturb delicate taste buds. There's something to this, as some kids are "supertasters," meaning that they notice flavors a little more than do other people, even other kids, either due to a genetic predisposition or simply because they are blessed with more taste receptors on their tongues. Of course, there are hundreds of other compounds that flavor every food, so it gets complicated, but it's common to assume that kids won't want overly flavored foods.
Flaws in flavor thinking
There is a reason this thinking can have flaws. Some kids not only tolerate and like spicier flavors, they actually NEED more-intense flavors to become interested in eating. At the Children's Evaluation and Rehabilitation Center at Montefiore, we have a weekly therapeutic feeding team that focuses on building feeding skills and teaching parents how to help their children develop better eating habits. Taste is one sensory property we work with, but so are texture, the mouth-feel of food and its "hotness" or spiciness.
Many children coming to our feeding clinic can have severe hypersensitivity to tastes and textures, so we start with bland foods and pureed textures. These often work best for children with sensory sensitivity.
Other children, however, are "hypo-sensitive" and need a lot of sensory input even to feel that food is in their mouths. They don't do so well with pureed textures and bland flavors. These are the children who need crunchy foods, hard textures and sometimes larger bites to be able to remain aware that food is in their mouths. They can actually stop chewing and swallowing before their mouths are empty, as they may not even be aware that there is still food in their mouths that needs to be swallowed.
We often tell the parents and caregivers of these children that homemade food may work better than baby food, because it's more strongly seasoned. If the child has graduated to table foods, then we often encourage serving the family's usual foods, not preparing blander versions of them. These children need more of the sensory input that herbs and spices can provide.
I remember my Greek grandfather preparing his pasta sauce when I was a child (in my book, it's still the best) and noticing that it made my mouth buzz. He loaded it up with numerous cloves of garlic, herbs and dried crushed chili peppers. My mother was flabbergasted that he'd serve it to his young grandchildren. (My brother and I were about 3 and 5 years old at the time.) Worried that it would burn our mouths, she asked if we were okay. We said "it tingles" and that it was really good and we wanted more. Spicy food became a regular part of our childhoods and we were the better for it.
Enhancing flavor to improve nutrition
We currently are working with a child -- a fussy eater -- whose parents have found that she eats better when the food is spicy. Taco seasonings, soy sauce, garlic: she likes them all. The point is that for some children, not only is spicy food okay, but it can be a great vehicle for delivering the foods we want kids to eat -- more vegetables, for instance.
This can apply to adults as well. Indeed, the 2015 U.S. Dietary Guidelines for Americans have encouraged using more herbs and spices to help flavor food in place of sodium and to help boost consumption of fruits and vegetables. I'd actually take it a step further and use flavors, extracts and spices in beverages and dairy foods. A patient might not like plain cottage cheese (don't knock it; it's a dynamite protein source and easier for kids to chew than meat) but she might eat it if it were laced with some cinnamon or even a sprinkle of paprika or cayenne pepper.
For some kids, (less) sugar and (more) spice can be nice. The science on herbs and spices is still emerging, but many of them are loaded with antioxidants and anti-inflammatory compounds, so as long as you like the flavors, there aren't any negatives to including more of them. Maybe it's time to bring those spice jars out of the cabinet and onto the kitchen table. Kids (and adults) may like being able to customize the flavor of their food, and if it gets them to eat more of the foods their diets lack, I'm all for it.
This post was originally featured on The Doctor's Tablet, the blog of Albert Einstein College of Medicine.