Food rewards are common practice in South Africa. One of the first questions I ask a patient when they step into my office is ‘What does your relationship with food look like?’ The answer gives a good indication and insight into their eating habits.

It’s no coincidence that the first time any of us were exposed to eating or nourishment, it was literally in our mom’s arms as babies being fed and comforted. Food, comfort and rewards are so closely linked and are then strengthened through repeated exposure.

However, we are in a dangerous zone for developing an unhealthy relationship with food when we reinforce those neural pathways in our brains (thought patterns) by:

• Offering food as a response to discomfort, pain or hurt (e.g. going to the dentist).
• To regulate emotions (e.g. when a child is sad, offering food to make it better).
• As a reward for achievement (e.g. good marks on a test).
• To elicit desired behaviours or to avoid an undesired one (e.g. using food as a bribe).

What does the research say?

When it comes to food, the research is clear that persuading children with dessert to eat their vegetables, for instance, is not effective. There are various other risks involved with food rewards, such as:

They will perceive the reward as more desirable than the food they are being bribed to eat.

• Studies have found that when parents use food as a reward or punishment, children are more likely to prefer high-fat, high-sugar foods (which are often used as rewards). Food rewards are often desired more and become the favourite. This is because they tend to be ‘treats’ that may be restricted at other times and in essence, they become ‘prized’. Studies suggest that when these foods become freely available, they tend to be overeaten.

There might be a decreased preference for non-reward foods.

• When children get used to reward eating, their liking for the food-that needs-to-be-eaten to get the food reward decreases. Consequently, offering a child a reward in exchange for eating their peas will not help them to like peas more. Rather, they could begin to dislike them.

Food rewards, such as being obligated to eat something or given food to alter behaviour (e.g. sit still or keep quiet), might also override children’s natural hunger and satiety cues.

• A study in the journal Eating Behaviours found that adults who recalled their parents using food as a reward or punishment were more likely to report issues with food like binge eating and restricted eating. Professionally speaking, I can confirm this. These are usually patients who tend to emotional or comfort eat and use foods to soothe.
• Development of an emotional crutch. When food rewards are used to make a child feel better, children can become reliant on them to help regulate their emotions. This has been associated with emotion-induced overeating in later life and can contribute to overweight and obesity.

Alternative rewards

Just because we have established that food is not a healthy or viable way to reward children (or ourselves) doesn’t mean that performance or achievements can’t be celebrated or rewarded.

Parents can offer several other rewards, not related to food, to reinforce good behaviour. Consider these creative options:

• Trip to the library, zoo, or another favourite outing.
• Embarking on a physical activity together as a family, such as hiking, cycling or playing tennis.
• New art supplies or colouring books.
• Pencils, stickers, or other supplies that can be taken to school.
• Listening to their favourite music as a family.
• Extra reading time before bedtime.
• Playdate or sleepover with a friend.
• Playing a favourite board game with a parent.

Perhaps the most powerful incentive is something we don’t even consider as a reward: the time parents spend with children (such as quality time together following positive behaviour).

Food may therefore feature somewhere in an effective reward plan, but rewards found in the parent-child relationship count far more than those found in the fridge.

Parents need to be the role model

Strategies that encourage healthy eating include creating a positive, healthy food environment and for parents to be the role models. Below are some examples.

• Being offered healthy choices and watching parents enjoy good food are strong influences.
• Involving children in vegetable gardening, shopping and preparing healthy meals and snacks can also nurture lifelong healthy food habits.
• Let them listen to their bodies. Try not to force them to eat when they’re not hungry or if they don’t like a certain food (try offering the same item again at other meals, perhaps cooked a different way).
• Serve a wide variety of nutrient-rich, kid-friendly foods.
• Don’t show concern or get upset if your child turns down a food.
• For young children, keep servings small. For all family members, use portion control and healthy serving sizes.
• Don’t use food as a plaster or to make your child happy. Children are like sponges, not only soaking up information but learning associations that can stay with them for life. Recognise that how you deal with your child’s upsets now can influence how they deal with their emotions later in life.

Finally, make mealtime pleasant. Don’t argue, talk about problems or discipline children at the table. Family meals should be relaxed, happy occasions where you can talk about your children’s day and share experiences.