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There are few things that give parents more pleasure than the sight of their young children eating and enjoying food. Yet somehow this pleasure has turned to anxiety as we have become more distanced from our food traditions and more aware of the science of nutrition. We know that vitamin A deficiency causes blindness and vitamin D prevents rickets. We've read that children need zinc and iron, but how much and in what form? We can't remember exactly, especially when it comes time to prepare a meal or offer a snack. And so we become concerned that our children could lack essential vitamins.

These days, we don't leave the house before weighing ourselves down with water bottles to prevent dehydration and vitamin-fortified snacks designed to fill the nutrition gap and tame the behaviour of a peckish child. In spite of our best efforts to nourish our children intelligently, or perhaps because of them, our children live in an age of obesity.

The rate of obesity among Canadian children between the ages of two and 17 has tripled over the last quarter-century. In the United States 10 per cent of children under two are overweight. A two-year-old is still essentially a baby, and these are children with more than a little baby fat. We have to ask ourselves how a baby can become overweight.

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When my own baby was that age and a little younger, I worried about the opposite problem. Whenever I took Nico to the doctor for his checkups, his weight was on the low side. He was, and still is, a tall, skinny boy.

The pediatrician was a Belgian woman with what she described as a very European attitude about the benefits of keeping a child's weight low. She told me not to worry, that very young children are self-regulating so I shouldn't try to force him to eat just one more bite, or we might end up with a different problem. She discouraged indiscriminate snacking on the go, because he had to train his stomach to know when it was time to eat, so that his hunger would make him receptive to the nourishing food that was presented to him at meal times. She wasn't just giving me medical advice, she was passing along cultural rules.

While it's difficult for any concerned parent to back off the child at the table, I tried to do what she said to do. And I watched Nico. It was fascinating to see that he would sometimes be eating something – it might be his favourite broccoli soup or a plate of spaghetti with tomato sauce – and really enjoying it when he would suddenly stop eating. It didn't matter how much was left on his plate: When he had had enough, he put down his spoon or fork and wiped his mouth (not on a napkin – he was more likely to wipe his mouth on his sleeve or my dress). The urge to encourage him to eat more was overwhelming, but I didn't do it (well, sometimes I did).

He would walk away from the table seemingly content. But if he was offered something sweet afterward, even when he clearly had eaten enough, he always took it, and he always gobbled it up. His desire for sweets had nothing at all to do with hunger.

The fact that there are so many overweight toddlers and preschoolers suggests that something has happened to override their natural weight-control mechanism. We give them certain foods because they like them, so there's no fighting or cajoling at the table, and it makes us feel good to see them eat. But foods aimed at children – a grilled cheese with fries on the kid's menu at a restaurant, a package of cookies or a granola bar – seem to override their innate sense of hunger and satiety.

And there is science that suggests these foods trigger an addictive response in our brains. A study on rats fed a diet of processed foods – like bacon, cheesecake and little packaged cakes that children often take to school for snacks – found that their brains reacted to these foods as they would to heroin. Rats that ate the junk-food diet developed compulsive eating habits and became obese, compared to a control group of rats that ate a lower-calorie, higher-nutrient diet.

The results confirm something we already know. We talk about chocolate being "addictive," and we call those who can't resist it "chocoholics." We live in a culture where it's everywhere – you can have chocolate or a junk food fix any time of day or night. It's no wonder we lose control.

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A cursory look at the foods regularly offered to children can make a parent's stomach drop. Most children consume twice the daily recommended amount of salt, which puts them at risk for heart disease and stroke. Obese children are starting to experience kidney stones for this reason. A co-director at the new Kidney Stone Center at Children's Hospital in Boston said that in the 1970s and 1980s, they might have seen one child a month with kidney stones. Now they see nearly one a week.

Heart disease is becoming a disease of the young. Obese children have been found to have thick artery walls, something that used to happen only to people in middle age. And some have enlarged hearts. Extremely obese children suffer from reflux, which can lead to chronic respiratory problems and cancer.

When a child becomes overweight, especially at a very young age, it is unlikely that the child will grow out of it, or lose the extra weight and become a normal, healthy-weight adult, unless many factors in the child's life change. We should try to change the child's eating habits, because there might be a chance of sidestepping a life of obesity-related ill health. If we do nothing, the child faces a difficult life and, perhaps, an early death.

More important, though, is to ensure that entire communities do what they can to ensure that children have a healthy diet and never become overweight or obese in the first place. The answer to these problems cannot be found in specialty food products. We need a culture of real food, as local and fresh as possible. An answer might begin to emerge when we recognize the importance of structure, which means three meals a day, plus one or two simple, unprocessed snacks at a designated time (and not on the run) for children. Most importantly, we need to introduce pleasure, the enemy of anxiety, to the dinner table once again.

Adapted from Jeannie Marshall's Outside the Box: Why Our Children Need Real Food, Not Food Products , published this month by Random House.

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