Family Talk

Dr. James Dobson: You're listening to Family Talk, the radio broadcasting division of the James Dobson Family Institute. I am James Dobson, and I'm so pleased that you've joined us today.

Roger Marsh: Welcome to Family Talk, the broadcast ministry of the Dr. James Dobson Family Institute. I'm Roger Marsh, and here we are now two days into the brand new year. We're still talking about the importance of health and nutrition while so many people have this as a top-of-mind conversation.

Since the 1990s, childhood obesity rates have skyrocketed all across America. Many kids struggle with their weight simply because of poor nutrition and a lack of exercise. But here's the good news. With the right guidance, families can develop healthy eating habits that last a lifetime. Our founder and chairman, Dr. James Dobson, understood this all throughout his life. He was kind of a health fanatic, whether it was on the tennis court, the basketball court, or after his first heart attack, on the treadmill.

On today's edition of Family Talk, we're continuing revisiting a classic conversation Dr. Dobson had with Ally Elliott. She's a registered and licensed pediatric dietitian from Birmingham, Alabama. Ally's private practice helps families navigate the challenging world of childhood nutrition. She previously worked at Children's Hospital of Alabama and also served on the maternal and infant team at Gerber.

In just a moment, Ally and Dr. James Dobson will tackle some of the toughest questions parents face, like how do you deal with picky eaters, or what role should sweets actually play in a child's diet? And what about all those trendy diets we keep hearing about? Let's dive into those questions and more as we get into part two of Dr. James Dobson's conversation with nutritionist Ally Elliott on today's edition of Family Talk.

Dr. James Dobson: Ally, as a place to begin, I'd like to know how you work with patients, with parents, and with little kids. Do you, in your private practice, make yourself available to parents who are having problems getting their kids to eat properly?

Ally Elliott: That's correct. Usually, it's initiated by the pediatrician. They've heard the parent come in enough times and say, "I just need help." They've given them the practical advice that the kid's not going to starve, it's okay. But that parent just really needs time to talk. I spend an hour and a half for my first session with the father and the mother if I can. That's always best just to listen to them and hear what's going on.

Dr. James Dobson: Do you have the child there?

Ally Elliott: No, I try to keep the child out for the first session just because I want to hear what's going on. I want to hear how they're parenting, not just with the table. I want to hear what you do when a ball runs out in the middle of the street and a car is coming. Parents, what I've found, have so many different definitions of discipline.

Some think it's a very bad word; they have a bad connotation with it. Some think it's a good one. But without it, you just can't be successful in moving forward and seeing any change in this process if you have a really limited eater, one with very little variety, or even poor growth or too much growth because of it.

Dr. James Dobson: You build the child's diet around vegetables and fruit and some protein. Let's talk specifically about a three-year-old. What kind of protein do you give them?

Ally Elliott: That's a good question. Most three-year-olds by that time have a mouthful of teeth. They even use them for biting, don't they? They can pretty much eat anything that their parents eat. If you look culturally at other countries, they feed their children what they're eating. For some reason, in America, we don't always do that. We feed our kids mac and cheese and chicken nuggets, and then we sit down two hours later to our salad and sweet potato and the things that we've learned as adults to eat.

I think it's a great thing very early on to teach the children and expose them to the flavors and the textures and foods that we also are eating. The number one studied diet is the Mediterranean diet. There's really nothing all that special about it. It's just lots of fruits and vegetables. It does have really good healthy fats in it and lean protein. It's lower on red meat and higher on fish. It does contain eggs, Dr. Dobson.

Dr. James Dobson: I hope you don't know what I'm talking about because in the last program, I said I don't like eggs, and I haven't since I was four years old. That's a lifelong pattern; that isn't going to change.

Ally Elliott: It's okay as long as you're eating fruits and vegetables. But the Mediterranean diet teaches about nine servings a day of fruits and vegetables. That's a lot.

Dr. James Dobson: How do you get a kid to eat Brussels sprouts?

Ally Elliott: You may not get them to eat it, but I would really recommend you put them on the plate, especially if you and your spouse eat them. I put them on my kid's plate many times to sit on the plate. But they don't get supplemented. I don't go back in the kitchen and re-feed them what they wanted in the first place. I really do believe over time, you'll see that the kids will become familiar with these things, with the smells, maybe even with a small taste, and over time they will accept.

Dr. James Dobson: How often do you run into the youngster who doesn't really like food, period? They don't eat very much, and the parents are terrified that something's going to be missed here. What happens?

Ally Elliott: I do see that, very little interest in food. I see it most of all with the children who have been diagnosed with maybe ADHD and are even on medicine for that. Often times it can decrease their appetite, decrease their interest in just eating overall. That's where the parents make sure that they provide food consistently every three to four hours at the table, and then the child will decide if and when they're going to eat.

Dr. James Dobson: I have observed in our family and in my own work with parents that oftentimes food is associated with love. If you really love a child, you'll have something sweet available for him when he comes home from school or sometime during the day. Frankly, my family is from the South, and my mother was a great cake baker and pie baker and things of that nature. Every happy moment is associated with something sweet for me. I grew up with that, and I had to deal with that. Talk about it.

Ally Elliott: You might be surprised at my answer, but I love that. I teach with sweets and treats that there should be a boundary. Really early on, as soon as your kid can even identify shapes and colors, you can start to show them foods that may be labeled as a sweet or a treat. Call it what it is.

They are lovely. They are to be had with friends and family. They are beautiful, and the fact that your mom made a pie was a beautiful thing. You ate it as a family. But what we see in adults is that they eat them alone and they're ashamed by it. It can sometimes stir the wheel and make it something that they want even more.

We celebrate those things, but we also as parents know that any kid without boundaries in sweets and treats is going to have too many of them. What I notice with my own kids is that they're everywhere. Every sporting event, there's going to be a sweet or a treat. School's going to offer some sort of cake because it's somebody's birthday, and then they turn around and the ice cream truck is coming down the street. Maybe they even made a trip over to Grandma's during the day. Because they come so frequently and so often, our kids have to have limits with them or it's just not safe. It's not healthy for them.

Dr. James Dobson: In what way? Explain that. What does sugar do? Why does it need to be limited?

Ally Elliott: I don't think we fully know. I think the media right now is on a big "sugar's terrible" and maybe so. But I do think there's a morphing of the taste buds. They really like that hyper-sweet, and they start to eat less fruits and vegetables.

We do know that it's associated with diabetes. That's something we're seeing really early on in kids. We didn't see it prior to the '70s; it was called juvenile diabetes because it was type 1 diabetes. But today, we see diet-related diabetes. If there are too many sweets and treats in the diet and it's not limited to one a day, there's an excess in calories over a time period, which can result in excess weight.

Dr. James Dobson: You just said something: one a day?

Ally Elliott: One sweet or treat a day. Now, there's grace with that, because if there's not, it ends up being a battle again. You don't want to frame these as bad foods. They're lovely. You mentioned it before; your mother was a wonderful cook and she made pies, and that's great.

But we want them to start making this choice on their own. We want them to become wise. Part of that is teaching them really early on. If you want the sucker at the dry cleaners, that's fine, but later on when it's Grandmother's birthday, we're having cake, so you have to make that decision. I tell parents, especially with overweight children, be prepared to say no and don't feel bad about it.

The child made the choice; they chose the Dum Dum sucker after ballet, and so later on you tell them no. What does that teach them? Next time they go to ballet or the dry cleaners and get handed a sucker, they may turn it down and wait for that other opportunity.

Dr. James Dobson: Another issue that I've heard discussed is whether or not an obese child has that problem because they eat too much or is it hormonal in nature? Or is it both, or either?

Ally Elliott: I believe it's both. What I see is around 10 years of age, if they start to gain weight prior to puberty, prior to the onset of puberty, the growth chart will start to look very steep, upward and steep. As they approach that 95th to 97th percentile, which are indicators of overweight and obesity and comorbidities that go along with that, it's really hard to stop that ball and to turn the ship around.

If we can start catching kids before they hit the 85th percentile when we start to see the upward trend, it's actually really easy to correct. You can change a BMI one to two points, and that changes the course of that child's health for life.

Dr. James Dobson: I think I read that in your training or in your practice someplace you worked with obese girls. There were three of them that you worked with. Tell us about that.

Ally Elliott: The question was how I ever got interested in childhood nutrition. It took me back to not too long ago, but it was really prior to the time where our medical community started even knowing what to do with obesity. At the time, we didn't have standards for it; we didn't even call children obese. Even in clinical terms, you didn't write it as obesity.

I was assigned three students in Mississippi in undergraduate. All three of them, I believe they were in middle school, but they neared 300 pounds. They suffered greatly. They couldn't tie their shoes. They weren't able to sit in desks with the other children. It was very embarrassing, and they didn't have energy. They had no energy to even get up a hill. Very hard.

Dr. James Dobson: Ridicule by peers has to be the most difficult.

Ally Elliott: Oh, horrible ridicule. Even hygiene becomes very difficult when obesity is manifesting itself.

Dr. James Dobson: How did you help them?

Ally Elliott: I just learned how to relate to them and connect with them. For me, it was just to see that God had designed their bodies to function and have purpose, but because of their condition of obesity, they were unable to function according to design. That's just sad. If it gets to that point, it's so difficult to reverse other than bypass surgery, which we are doing in kids these days.

Dr. James Dobson: That's kind of a last resort, isn't it? What in the meantime do you do?

Ally Elliott: Again, I always go back to just the basic principles: fruits and vegetables. Now, they're expensive and it's hard. You see obesity definitely plague the lower socioeconomic groups: Hispanic, African-American. In our own home, it's expensive to eat healthy. It is hard to buy fruits and vegetables.

Dr. James Dobson: Have you seen what I've seen in restaurants where if a family comes in and Mom and Dad are overweight, the kids tend to be also?

Ally Elliott: Yes. It does run in families, and there's probably a genetic component to that. But I like to try to think again of this two-year-old. Eight-month-old, they're eating food at the table. Starting it very early. We know breastfeeding, breastfeeding infants, every mother can do that, and now we have so many resources and support to do that.

There's a small number that can't, but there are resources that have and are really helping mothers to do that and provide that benefit to their baby. We know from the science that it's very beneficial in keeping a healthy weight.

Dr. James Dobson: In your practice, do you get satisfaction from seeing a family that's dysfunctional at this level and learns to deal with it and the children learn to eat better? Is that a goal professionally?

Ally Elliott: It's the best thing to see. It really is. I like to follow them for six sessions over three months. That gives us enough time to actually see a child grow. They will grow in three months, many of the children I work with. Then really see a difference in what we call a BMI, a body mass index, and just see the changed trajectory for them. Sometimes they have labs that have come out abnormal, and those go back to normal. It is really exciting to see.

Dr. James Dobson: We talked last time about something you call the 5-2-1 principle. Some people didn't hear that. Repeat it.

Ally Elliott: So 5-2-1 principle came out of the American Medical Association obesity task force early 2000. They started to dig through the literature and try to figure out common themes, what we could really say might prevent children from becoming obese or help healthy families to not ever have to struggle with that.

Five stands for five servings a day of fruits and vegetables. To make that even more simple, I just say half the plate every time you feed your child. You probably feed your child breakfast, lunch, and dinner, maybe two snacks of a fruit or a vegetable. The two is for two hours or less of screen time. That should be monitored by parents. It's a big deal. Dr. Dobson, there are so many ways for them to get screen time, and the schools use so many devices and screens.

Dr. James Dobson: Talk about gluten. This is an important one because all of a sudden it's faddish; it seems that everywhere you're hearing about gluten. I never knew what it was 10 years ago, and all of a sudden it's everywhere. I'm not sure that all of that makes sense. Do you think so?

Ally Elliott: Ten years ago, I worked in a GI clinic, and we might have one celiac diagnosis every three to six months. I would walk in that room.

Dr. James Dobson: What does that mean, you're not able to tolerate?

Ally Elliott: You are not, and that is true. You should not have gluten if you have the diagnosis of celiac disease. It can be very abrasive. But the thought now is everybody should eliminate it. What's interesting is by the time I left and even today, it was like the beeper was going off every 30 minutes with a new diagnosis. Not that many, but it did increase.

So I do think we have seen a rise in celiac disease for whatever reason. It's probably autoimmune, and I have theories of that that happen really early on in infancy and how we feed our children. But it is an indication in the event of celiac disease.

Dr. James Dobson: But that's a very small number.

Ally Elliott: It's a very small number. Very small number.

Dr. James Dobson: Well, what is this with adults particularly who think they can't tolerate a bite or two of gluten?

Ally Elliott: The way I think of it is if you take gluten off of the plate, you're going to be eating more fruits and vegetables just because what else are you going to be eating? I think they feel better.

Dr. James Dobson: Is it not true, though, that if you're compulsive about that, you also will not be eating some of the nutritious foods that you should?

Ally Elliott: That's correct. I do think when you give up a major food group like grains, you're missing out on fiber, folate, key nutrients, iron, B vitamins that the body desperately needs. I will walk alongside a parent and support them if they want to trial it for something like autism or ADHD or even GI issues. But we have to make sure that it's really complete and that they've thought it out because it's restricting from a child. It really is. It's pulling a major food group out. I'm not opposed to it.

Dr. James Dobson: Do you see self-diagnoses that don't make sense?

Ally Elliott: Lots. I also see doctors, adult doctors in particular, that sometimes I think have no other answer, and so they'll say try it. So maybe it's a placebo effect.

Dr. James Dobson: It does not help ADHD?

Ally Elliott: We have no studies that it does.

Dr. James Dobson: Or autism?

Ally Elliott: No studies.

Dr. James Dobson: Let's emphasize that. That's kind of a hot button for me. I have friends who are following these. You're going to get beat up. I want to tell you something.

Ally Elliott: I don't judge. I would try anything myself if I had a child. I would try any diet to help. So I'm all for that. But there is not scientific grounds for it, and I can't say that I've noticed it anecdotally either that it helps to take that food group out. In fact, it is a big gap, and kids need carbohydrates for brain development, for growth.

Dr. James Dobson: Some people, I think, particularly need it, and I think I'm one of them. I tried the Atkins diet one time, and by 2:00 that afternoon I was so weak that I couldn't hold my head up. I was doing a radio program and I was just slumped in the chair because I was flat out hungry. I don't know if I'm like other people, but I need a certain amount of carbohydrates to function. Have you ever seen that before?

Ally Elliott: Carbohydrates help the body to function. They are a form of fuel. They're the body's primary form of getting fuel and converting it to energy. They're necessary. I think our world has become so fixated on diet and nutrition and health and really helping a parent to see what is the definition of health. What are we looking for here?

Dr. James Dobson: Ally, I want to tell you something. I've done over 9,000 radio programs through the years, and there are two or three topics that will get me beat up big time, and this is one of them. I'm expecting all kinds of wrath for talking about this because everybody's got it all figured out.

Ally Elliott: You might get in trouble, and I might too. It's frustrating as a registered dietitian because you've studied this and I'm teaching this to students in a classroom setting that are going to become registered dietitians. We have to go based on science and good science. We can't just come up with theories because if we do that, there's really no truth in what we're saying. It's just not grounded; it can change.

Dr. James Dobson: We're almost out of time. I've got a minute or two. I'm going to really fast-track you, okay? How about fried foods?

Ally Elliott: Fried foods, they have their place. They are not evil. In fact, if we again look at the '70s, no childhood obesity, I'm pretty sure families were eating fried chicken. It's okay, but within limits. It's of course better to eat lean meats that are grilled and broiled, and even plant-based proteins are very healthy. So, limited, but not forbidden.

Dr. James Dobson: Fruit has a lot of sugar in it. Do you have a problem with that?

Ally Elliott: No. Fruit has fructose sugar in it; it's a different molecule than sucrose sugar or even high fructose corn syrup, which is man-made. But I believe God has made fruit. It is wonderfully perfect.

I've never pointed my finger at an obese child and been like, "I know what it is; you're eating too many carrots and too many grapes or too much salad." It's just not those things that are causing the problem. In fact, it's the opposite. Kids who eat fruit and eat a lot of it tend to have very healthy lives.

Dr. James Dobson: When it comes to vegetables, green leafy vegetables? That's what you want? Why?

Ally Elliott: The idea is that it not only provides good nutrition when they eat salads and green leafy vegetables, but it also helps control the other side of the plate from growing too large. Less calories too. It really has its place, and then we know if you eat the rainbow, if you eat colorful foods, they're antioxidants, they're usually fiber-rich, really healthy.

Dr. James Dobson: Ally Elliott is our guest, and it's fun talking to you. Obviously, this is a subject specifically related to children that I don't think we've dealt with before. Last thing you want to say to parents?

Ally Elliott: I think one thing I did want to say is just, and I was asked this earlier, it can be difficult to feed your child and no matter what your circumstances are. If you're a single mom with limited time or if you have limited resources or a limited budget, it can seem daunting to feed your family and to feed them healthy foods.

The number one thing that you can do for your children if you are a family of faith is to feed them at the table together as much as possible. It doesn't always work that way, and that's okay. Have grace on Dad coming in late and not being able to get there. But as much as you can find time for the table, I really do think that things will fall in place.

Dr. James Dobson: That's not only a nutritional issue, but that's relational. The research on that is really clear.

Ally Elliott: It is relational. It's where we show our children that we're committed to them. It's where we connect with them. It's where we pray together. It is where fellowship happens and community happens, and because of that worship happens.

Neighbors see it. They see when the family goes in consistently over time. They see that the kids have different behaviors. They see other people coming into the home. It's a very obvious thing when families make that commitment to eat together.

Dr. James Dobson: Ally, I appreciate your being here. You've flown all the way from Birmingham with your husband, Edward, and it's fun getting acquainted with you. We've never met before. I'm going to give you an assignment. This is a must-do. Go home and write a book. You have not yet written a book on this subject, and I think there's a lot of interest in what you have to say and in that whole area. Next time I see you, you bring your book, okay?

Ally Elliott: Thank you. I will do that.

Dr. James Dobson: Thanks for being with us.

Roger Marsh: The simple act of gathering your family around the dinner table creates a powerful space where connection happens, where values are passed down, and where your children learn that they truly matter.

Today on Dr. James Dobson's Family Talk, we've been revisiting a classic conversation Dr. Dobson had with registered and licensed pediatric dietitian Ally Elliott. Now, if you missed any portion of today's broadcast or if you want to share it with a friend, go to drjamesdobson.org/familytalk.

As we remember Dr. Dobson's legacy as we continue into this brand new year of ministry here at the James Dobson Family Institute, it's amazing how many people will hear a conversation like the one you just heard and then say, "Wow, that is great advice. I'd never heard it put that way before." Well, that's why keeping Dr. Dobson's memory alive through these broadcasts is so vital right now.

Remember, when you support the Dr. James Dobson Family Institute, you're investing in families all across America who are searching for trustworthy answers in an increasingly confusing world. You can always make a secure donation at drjamesdobson.org. You can also reach a member of our constituent care team when you call 877-732-6825. Or if you'd like to send your donation through the US Postal Service, our ministry mailing address is Dr. James Dobson's Family Talk, PO Box 39000, Colorado Springs, Colorado, 80949.

I'm Roger Marsh, and from all of us here at Family Talk, thanks so much for listening today. Be sure to join us again next time right here for another edition of Dr. James Dobson's Family Talk, the voice you can still trust for the family you love.

This has been a presentation of the Dr. James Dobson Family Institute.