Anorexia expert Dr Dee Dawson told Jennie Bristow why we should not deprive children of fatty foods
Let them eat cake - and crisps, chips and chocolate
'Chocolate and chips are nice, everybody likes them. Carrot and celery sticks aren't.' These may not sound like profound remarks from a specialist in eating disorders, yet they were enough to catapult Dr Dee Dawson into the headlines last November and spark off another debate about what food children should be eating.
Dr Dawson is the medical director of the Rhodes Farm clinic in north London, a 32-bed unit that deals with six to 16 year olds in the advanced stages of anorexia nervosa. On 27 November she addressed the Girls' Schools Association conference with a speech on how to prevent the growth of anorexia among schoolchildren. Her recommendations included weighing girls on a regular basis to spot weight decline and shooting Rosemary Conley of Hip and Thigh Diet fame. But in a time when we are increasingly obsessed by the food that we eat and the need to consume healthily, it was not surprising that her less extreme proposal to feed kids on high fat foods attracted the most attention.
So apart from being 'nice', what is so good about crisps, chips and chocolate? 'There is no evidence to show that if you allow children to eat crisps and chips and chocolate that they are going to have any higher incidence of coronary heart disease than children who have had so-called healthy diets', she argues. 'In fact, so-called healthy diets are usually so low in fat that they haven't enough fat.'
'One thing that annoys me is that whenever there is any mention of low fat diets nobody ever says, "but there is a minimum amount of fat that you must eat".' Dr Dawson says 20 per cent of a balanced diet should consist of fat, and a diet with 30 per cent fat is 'absolutely fine'. 'So why would you try to stop children eating crisps and chips and things, because where would they get their fat from if you start cutting that out? You are going to have to feed them fat in some other way. It's ludicrous.'
But surely those who think it is better to feed their children 'healthy' food rather than allow them to gorge themselves on junk food are being sensible? Not really, says Dr Dawson. 'Of course children shouldn't eat chips and chocolate all the time: obviously they have to have balanced meals. But these are provided by their parents and by the school. Outside those meals, if they are hungry then it doesn't matter how they make up the rest of the calories, because they're going to be burning it off.'
In any case, the growing concern about children having an 'unhealthy' diet is misplaced, when you consider that children today are healthier and better nourished than ever before. 'Children have grown two centimetres, I think, on average over the last 20 or 30 years. We have not got a problem. We have not got a major problem with child obesity: about four per cent, that's not a lot. Why do we suddenly now decide that we are going to stop children eating the foods that they like?'
Good question. If there is no scientific evidence that a low-fat diet is good for children, and a fair chance that it can actually harm them, where did we get the idea that we should cut out the crisps and force-feed kids low-fat yoghurts? Dr Dawson does not know. What she does know is that adults are increasingly obsessed with their own diets, and are imposing these obsessions on children - with often disastrous consequences.
'We are very confused about our diet', she sighs. 'Teachers don't know, doctors don't know, kids don't know, parents don't know whether kids should be eating less or more, whether adults should be drinking alcohol, whether margarine is good or bad. Every day you read in the paper that something you read yesterday was out, is in, and now it's something else. It changes like the wind.' Staff at Rhodes Farm give their teenage patients buttered bread, and the girls are terrified because all their lives they have been told that butter is bad for them.
The role played by government in heightening confusion about what kinds of food are 'best' for us has not gone unnoticed by Dr Dawson. She is scathing about the 'healthy lifestyles' philosophy promoted by the previous government's 'Health of the Nation' report, which encourages a low fat diet from the age of seven without any recommendations as to a minimum intake of fat. She is also opposed to proposals considered by the Labour government to restrict the sale of 'junk food' in school canteens and the sale of certain high fat and high sugar foods in tuck shops and vending machines. She objects to government 'nannying our children in this way'. 'Checking people's lunchboxes: it's almost like communism', she scoffs. Well, it certainly is all too New Labour.
Sitting in the bright, colourful kitchen at Rhodes Farm clinic, it is easy to see why Dr Dawson is so passionate about the need to 'stop making children feel guilty about the food they eat'. The teenage girls sitting around chatting about pop groups seem little different to any others their age: bright eyed, lively and beautiful. But these are the girls who have almost completed their treatment and are going home for Christmas. Alongside them the newer patients have hollow eyes and jutting bones. Engaging in the daily task of encouraging these children to be less nervous about food would be enough to make anybody angry about the way in which up-tight adults in a health-obsessed nation pass their paranoia on to the young, when living longer and healthier lives should be the least of children's worries.
Although Dr Dawson's concerns have been shaped by her proximity to anorexic children, she is not trying to scare people into believing that depriving children of crisps and chocolate will cause them to develop anorexia. This disorder currently affects only one per cent of schoolchildren, and develops from so complex a range of problems that it is unlikely to affect the majority of well-balanced, happy children.
Dr Dawson stresses that self-starvation is only one of the many ways in which psychologically disturbed children respond to their problems. 'These children could have chosen to steal, to mug old ladies, to play truant, not to do any school work at all. Instead they have chosen not to eat.' But the very fact that they can 'choose food as a weapon' is significant. Self-starvation could only happen in circumstances where food is plentiful: 'I don't think you use food as a weapon when you have brothers and sisters who do not have enough to eat.' The obsession with eating 'healthily' that grips our well-fed society compounds the notion that controlling the kind of food you eat can give you more control over your life. Dr Dawson's concern is that this unhealthy obsession may cause cases of anorexia to increase among children who are already disturbed.
Because she is preoccupied with those young people who react to their problems in the most extreme ways, it is perhaps understandable that Dr Dawson tends to overplay the extent to which media images of the thin and beautiful pose a danger to young people's general self-image. It is one thing to note that society views slimness as desirable, and that a disturbed child who seeks to deal with her problems through 'perfecting' her body image may see this goal as obtainable through self-starvation. It is another to argue, as Dr Dawson does, that fashion magazines are promoting a dangerous message through their use of skinny models: if four per cent of children are obese and only one per cent anorexic, clearly the images themselves are not all-powerful. Dr Dawson's suggestions that schoolchildren should be routinely weighed to spot early signs of anorexia also carry the risk of compounding the paranoia that already exists among many parents and schools about the welfare of children in their care: the same paranoia that has encouraged the desire to feed children those 'healthy' foods that turn out to be bad for them.
But despite this, Dr Dawson's call for a more relaxed attitude to children's diets is one that should apply to all children, whether they are in danger of developing anorexia or not. All she is really saying is that parents should feed their children the kind of balanced diet they would do anyway if governments and so-called professionals would stop panicking them. Meanwhile kids should eat the kind of things kids have always eaten, for no other reason than that they like them. 'It's just common sense', she says. 'Isn't it?'
Reproduced from LM issue 107, February 1998