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   Inside Out - East: Monday February 28, 2005

THE JAM SANDWICH DIET

Craig Flatman
For 15 years Craig has survived on a diet of jam sandwiches

We all know a balanced diet is essential for our health and well-being. Whilst we may not always achieve the nutritional ideal of five portions of fresh fruit and veg each day, 15-year-old Craig Flatman refuses to eat even one portion, opting instead for a diet consisting of little more than jam sandwiches.

Inside Out discovers what affect this unconventional diet has had on Craig's health.

"When he was a baby he was fine at first, but by the time he was a few months old he would hardly eat anything," explains Craig's mum Almira.

"He had sugar sandwiches, then jam and little else".

Far from being a child who has refused to eat to be difficult, Craig insists he has tried other foods, but can't bring himself to eat them.

"I've tried to eat other things but it makes me sick," he says.

"Jam sandwiches are really the only thing I can eat. I have them every day for lunch and dinner and I have jam pop-tarts for breakfast".

Not unusual

Tips to combat faddy eating in childhood

Provide a variety of good foods for your child to eat at each meal. Keep in mind that it takes multiple exposures to a new food for a child to see it as familiar and okay to try.

When you do offer a new food, simply place it on the dinner table with everything else, and don't make a fuss about it. Eventually, after they have seen you eat the food a few times, your child may feel more open to trying it themselves.

When introducing new foods, offer just one or two, and present them in small quantities.

If your child is willing to try a new food, give them just a taste before putting a whole serving on their plate. This way they won't feel overwhelmed - and it won't seem like a waste of food to you.

Some children's palates are more sensitive than others'. They simply won't like the texture, colour, or taste of some foods. This is why a child will often claim to dislike a food the have never even tried.

Likewise, some children may have an aversion to a food because it reminds them of a time when they were sick or has some other negative association. If your child complains that a particular food will make them sick, stop offering that food for a while. You can always try again when your child is a little older.

Whenever possible, let your child be involved in food decisions, including shopping or making lunch. This will give them a sense of control over their diet, and they'll be more likely to eat something that they've chosen for themselves.

Source: BabyCentre

Most children naturally go through a phase of not eating well, so much so that 'faddy' eating is now recognised as a normal part of a child's development.

In a survey conducted by University College London, nearly 20 percent of children under seven were described as "significantly food neophobic," meaning they are reluctant to try new foods.

For some children, this reluctance stems from negative associations they have with food, for example, children with food allergies, or those who were tube fed as babies.

In other cases it can be a statement of independence, a demand for attention, or sometimes it can follow an illness.

In most cases it lasts for a few weeks or months.

For a minority of children like Craig however, this faddy eating becomes a way of life.

Little pickers

Craig is one of a small number of British children who live on very limited diets, but his story raises many questions.

Craig may look healthy and is certainly full of energy, but with a diet that is deficient of many essential nutrients, Almira worries her son may be left with long term health problems.

So Inside Out has arranged for Craig to undergo a range of health tests at a private hospital.

During his check-up, Craig's blood is sent away for testing.

The results will reveal whether he is getting enough vitamins and iron, if his kidneys are working properly and if there has been any long term damage to his body.

The results of these tests are not only important for Craig, but could potentially alter widely accepted views on child nutrition.

If Craig proves to be in good health then are parents worrying unnecessarily about children's diets?

Food glorious food

When Craig was seven he took part in a six month programme at Great Ormond Street Hospital in London.

The programme was designed to encourage him eat other foods.

Whilst the media claimed he had been cured, as far as Craig was concerned nothing was further from the truth.

"They made me eat baked beans and chips, I tried hard but kept gagging so I went back to my old ways," he says.

"I'd like to eat burgers with my mates but I just can't".

In fact when he goes out with friends for a burger - the staple of choice for most teenagers - Craig simply packs a jam sandwich to take along with him.

Tempting?

Fruit and vegetables
Will Craig ever manage the recommended five portions?

For most if us it is hard to imagine life without the variety of tastes and textures of a wide array of different foods, but for Craig, it is familiarity of the jam sandwich which offers him security.

Inside Out presents a selection of food types for Craig to sample, but he finds the task impossible.

"I can't just do it, it's difficult to explain," he says.

"Whether the texture is different to jam sandwiches, the taste - I'm not sure - it's just that it makes me feel ill. I can't do it".

Testing times

Craig getting a health check by consultant David Rae
Will Craig's diet have a detrimental affect on his health?

Aedin Cassidy, Professor of Diet and Health at the University of East Anglia, suspects that Craig's limited diet will prove detrimental to his health.

She says, "I'd be really surprised if there hasn't been some kind of long term effect on him.

"You can't eat jam sandwiches all your life and not have any effect".

Despite Professor Cassidy's warning and to the surprise of consultant David Rae, Craig's test results conclude that on the whole he is in good health.

His blood test results however are a different story.

The results indicate that Craig may be bordering on suffering from an iron deficiency which, if left unchecked, could lead to anaemia.

Untreated, anaemia can become a debilitating condition leading to low energy and lethargy, which in the future, could have detrimental effects on Craig's sporting activities.

As a keen sportsman, David hopes this will inspire Craig to improve his nutritional intake, impressing upon him that the best source of iron can be found in fruit and vegetables.

Facing the prospect of a future without football, Craig vows to attempt to expand his diet, not only to improve his nutrition, but hopefully to develop the enjoyment that most of us experience in eating a wide variety of food.

"I know it's going to be difficult, but I can't carry on like this," says Craig.

"I can't go through my adult life eating jam sandwiches, I need a new start".

See also ...

Inside Out: East
Buffalo milk
Local produce

On the rest of Inside Out
Local produce
Food school
Food sensitivity

On bbc.co.uk
Health - Nutrition
Radio 4 - Tricky eaters
News - Jam today - health tomorrow?

On the rest of the web
The Childcare Nutrition Resource System
My Nutrition

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Readers' Comments

We are not adding any new comments to this page but you can still read some of the comments previously submitted by readers.

Sandy Foster
My son is four years old and since he was eighteen months old he has refused to eat anything except Dairylea cheese slices and bread and butter. My doctor is totally unconcerned about this but I am tearing my hair out with worry. He has a low attention span but is on the go all the time. I find it difficult to cope with this. He is always very constipated because he has no fibre in his diet. The doctors don't seem to care because he has plenty of energy. What is this doing to him in the long term though?

Anne Tompson
I'm now in my 40's and very healthy, though I have eaten no fruit or green vegetables since early childhood. I ate normally until I went into hospital when I was 3. I came out very traumatised, and wouldn't eat any fruit or veg, or drink tea, all of which I did before I went in. I was very constipated until puberty, then the constipation just stopped. I gag if I try to eat fruit and green veg. Over the years I've increased my veg intake to include root vegetables, and drink fruit juice, but still can't face the things I used to eat. I keep trying, but if I can get them down, they go straight through me.

yvonne
I cried when I read about Craig because he is just like my son and I am desparate for help. it started when he was a few months old and he is now nearly 13. No-one will help because he is not underweight, but he is the smallest in his class and has no stamina. He is terribly upset about the fact that he cannot bring himself to eat more than his extremely limited diet of dry bread, crisps and pancakes. To make things worse, he seems to have a very highly developed sense of smell, so I cannot 'doctor' any of his food. He is now being teased at school and says he really wants to be 'normal'. I have done everything to try and solve this - fixed mealtimes, witholding treats, bribery, ignoring the problem, having buffet-style meals, getting friends to persuade him, serving only one pea, or one grain of rice only, letting him first sniff the food, graduating to touching then licking it....... I am at my wits' end. His friends do not influence him and he will make himself ill rather than try anything new. Please, someone, can you refer me to anyone who can help? We can't carry on like this. The reason he has got to this age with this problem is because of the 'experts' who have told me it was 'just a phase' for the last 12 years.

Dr. Judith Shapiro
It seems to be that the central problem here is nausea brought on by the taste and texture of new foods. This is the problem not only for Craig, but for several of the other people who have written in as well. Severe nausea brought on by many foods is a problem seen in cancer patients undergoing chemotherapy, and also in many pregnant women. Perhaps an obstetrician or oncologist could be consulted regarding therapies to combat nausea. If the nausea could be stopped temporarily, this would give an opportunity to become used to new foods. In some cases, I know that marijuana or Marinol (a prescription drug made from marijuana) is used to combat nausea and temporarily increase appetite, but I'm not sure of the legality of this therapy in England, and whether it is safe for young people. Another possibility would be desensitization therapy in which Craig gradually gets used to having the other foods on his plate, or bringing them towards his mouth, without actually trying to eat them. When food could be brought to the mouth without nausea, the next step would be to place a bit of the food on the outer lip, again without trying to actually eat it. Perhaps after this, the food could be placed on the inside of the lip (again without trying to swallow it), followed by chewing (without swallowing), etc. It would be best to start with foods similar to those tolerated (for example, sandiwches made with preserves that have bits of fruit) and then gradually progressing to foods that are more different from jam sandwiches. The key would be to go slowly enough that the new foods don't trigger nausea.

Sarah LeGoood
My son aged 2 and 5 months also lives off bread and jam however unlike craig he does eat sweets crisps chips yoghurts and bananas. i have followed much advice with much ado. i have starved him, force fed him and disguised food even put him with other kids to eat. my son will put new foods in his mouth and chew for a few seconds then either gags or spits them out. i have got to the point were i give up i now give him toast for breakfast crackers for dinner and jam sandwiches for tea with side orders of new foods which he may or may not try. i have found that he is now asking what i am eating and now likes pastry off pies and garlic bread, not much improvement but a move in the right direction. I won't give up but it is very frustrating and worrying for mums who only want whats best for their kids.

a girl from holland
I can understand it to, my brother is only eating bread!!!! bread for breakfast, lunch and dinner, and he is almost never ill( something I don't understand!) I really don't know what to say because it is very weird when we are eating, vegetables, fot example, he is eating bread. always. It would driving me nuts eating every day the same!!!!!! so Graig if you wanna live longer( and you will I hope) you should really eat something else. I know I am not your mother but........ SO good luck and take care!!!

craig flatman
hey this is craig flatman i would like to say thank you to Emma Wood it is nice to know that i am not the only person out there THANK YOU !!!!!!!!!!!!!!!!!!!!!!

Rachel Flatman
I was intriged by your coverage of this story. As a mother to two children, I worry daily that their food intake is balanced and healthy. My 10yr. old is very similar to Craig in many respects. She does not eat any veg, despite my greatest efforts- not even chips. Neither will she eat meat.She does consume fruit,& fresh fruit juice, only other fluid is water. Im so concerned that they both have a daily vitamin tablet. She too will eat jam sandwiches at any opportunity, but I impose strict limits on her sugar intake otherwise. Sharing the same name I take comfort that she is not unique. She is underwight,& small in statue, which concerns me greatly. The younger child is quite different, in that she will/does eat all veg,& fruit. But only drinks milk and water. This is comforting in that it cant be all my fault as a parent. I have empathy with Craigs mother, & share her concerns for the long term health of the children.Life is made difficult, its not easy to get a child to eat new food. I cant make her go without food until she eats veg. All I can do is inform her of the importance of a balanced healthy diet, & lead by example.

RW
My son, who is nearly 5, has a very limited diet-milk, fruit and bread. He too gags and sweats if made to eat anything else and I am starting to get very worried about him. The rest of the family eats quite well but since my son was ill at the age of 11 months and then choked on some food at 18 months there has been no progress in his diet. We have seen a doctor who said that his height and weight are in proportion (although he is small) so there was not much that he could do. My son also has an incredibly strong sense of smell and I was wondering if that could have anything to do with his eating habits? He has been at an independent school for nearly a year and his food issues are causing problems there. His attention span is not very good either which I think is down to his diet too. If there is anyone who can help I would be glad to here from them. My son's eating habits effect nearly every aspect of our lives so I would love some advice.

Stephen Corcoran
Dr David James's comments above are, in my opinion, nonsense. What scientific basis does he have for making such claims?

Geoffrey Guymer
My grandson, who is nine years old will eat only a limited range of foods. These are mainly crisp sandwiches, bars of milk chocolate, an occasional piece of bread and butter and sometimes he can be tempted with a few Yorkshire puddings with mashed potato and gravy but no fruit and vegetables. He drinks large quantities of milk and maybe a drink of blackcurrant juice. We have tried every trick possible to get him to eat a more conventional and healthy diet, including bribery, but without success. Obviously we are concerned about his objection to eating any 'real food' and the long term effects this may have on his health. With this narrow diet he feels that he can't go on any longer school trips as he would not be able to get the food that he finds acceptable. Surprisingly, he is quite an energetic, bright youngster who is growing quite well, and keeping up with his contemporaries. A noticeable downside to his eating pattern is his pale face and the fact that after refueling with milk and chocolate he is inclined to be over active for a short time.

Donna
I would be very interested to hear the results of this test as my 3 yr old son has a very limited diet too. He eats Jam or Marmite sandwiches and Chicken nuggets. Anything else he will not try. I have given up putting meals in front of him that he refuses to eat so he has Jam sandwiches for tea as well as Dinner. He will however eat other things like crisps, sweets or yoghurts but mainly Jam sandwiches. He has been known to shout out in restaurants that he only wants a Jam Sandwich.

D K Morgan
I found your report on this young man very interesting. Yet I do question, why he was fed sugar sandwiches and then onto jam? I could understand this as a treat, but not replacing normal food. One area that was not covered was young mans fluid intake. does he drink cold & hot fluids, or has a problem here too? I question this due to a former neighbour, who would eat normal, but could not take hot drinks of any type, at any time of the year.

Susan Spinks
I can sympathise with Craig, as since I was about 5 (i'm now 34) I have lived on mostly fish fingers & chips, crisps, toast & a few cakes. At the present time I have no major problems although I am having B12 injections on a 3 monthly basis as this was discovered to be low along with folic acid. Although not eating any meat, I wasn't found to be aneamic, but my mother who eats normally is! I cannot remember why I stopped eating normal foods & like Craig the thought of eating some foods make me gag. My boyfriend is annoyed at my eating habits & refuses to take me out! My doctor has suggested trying a new food out like the doctor suggested to Craig, but I'm afraid its not that easy. Please pass on sympathies to Craig & tell him he's not alone.

Phyllis Groom
I can understand this. My grandson, when he was small would only eat baked beans, sausages & chips (possibly a better diet than Craig's) but wouldn't try anything else. He is now in his late 20's, eats most things, dislikes much in the way of vegetables, used to gorge on icecream, whereas his sister, 5 years older would eat anything. It's a phase, tho in Craig's case has gone on rather longer. If he's not careful he will probably end up with diabetes, refuse to give him jam sandwiches for a week & see how he goes, hungry or not.

Cheryl Wagstaff
I have to say after watching your report on craig i was some what relieved, as i thought my eating habits was hardly common at all, and i felt like i was the 'odd ball'. I can sympathise with Craig because since an early age of about 5, i was also reluctant to try new foods. I started off just eating meat or potato in breadcrumbs e.g. fish fingers and croquettes, however over the years i have progressed to eating spaghetti bolognas and Chinese, i have managed to get out of that wrapped in breadcrumbs phase, although i still do eat something's like fish in breadcrumbs. The only main battle i have now is eating veg and fruit, and although i will eat the odd bit of tomatoes and potato, it's hardly anything to brag about. Also my fruit intake is appalling, and the only vitamins i do get to my body is usually by orange juice. I know the reasons for my so called 'phobia' of trying new foods, and for me it's the texture... and i have to say i know where craig is coming from with that feeling in the pit of his stomach because i get that too when i see foods i have to try. I suppose recently i have made a lot of progress due to the fact i have a boyfriend and he made the lovely on purpose mistake of forgetting to tell his mum that i'm fussy at eating. So as you can probably imaging, not wanting to disappoint on my first meeting i ate everything on my plate. For that i suppose i am grateful for my boyfriend as it has started me in a new direction, as well as me wanting to actually change my eating habits for him.

Emma Wood
I saw this story and alarm bells started. is this something that many people suffer? my husband certaily does. all he eats is jam sandwiches, chips and omelettes, plus the junk like crisps and chocolate put omly certain types and flavors. he has suffered since he was a baby and he can't explain it either. he just gags at food. he really does try hard but when inches from his mouth , he's sick. he's been to doctors so many times for help but they say theres no explanation for it, they simply say put it in your mouth, chew and swallow which really upsets him. it is so nice to actually hear that someone else has the same problems and maybe we might get to finally know what it is. he really wants to try new food and he longs for the day where we can go to a resturant like any other couple.

Lin Lee
As a wife and mother to a husband and 2 sons with Asperger syndrome, a form of high functioning autism, my first thought on hearing Craig's story was to question whether he too may be on the autistic spectrum. It is not unusual for autistics to have a very limited diet...and/or to be extremely fussy about food combinations and/or textures. We also noticed that he seemed to avoid eye contact - another classic autistic trait. It may be worth Craig and his family pursuing this with a specialist pyschologist. I was somewhat surprised that the psychologist Craig saw at Addenbrookes did not recommend a referral to the nearby Autism Research Centre, who would have been able to offer a specialised assessment. It is however a sad reflection on the services available that most people with autistic spectrum disorders see a vast array of medical professionals before finally finding someone who knows and understands the condition and is able to offer a diagnosis.

david parker
i know exactly how craig feels because i am fussy aswell but not as bad as craig. some food, just by looking at it can make me gag. i am 28 and i was diagnosed with crohns desease 3 years ago and i cant help thinking that my diet may have contributed to it. i am still fussy now but people think you are being stupid, but i cant help it.

Dr. David R James
The importance of enzymes and what they mean to the human body bear special significance to Craig as he is using up his precious store of metablic enzymes for digestion: “We know that there is no way to force the body to make more metabolic enzymes, but what if there was a way to cause the body to use fewer of them? Guess what? There is! Nothing can help you achieve your health goals more quickly, whether it is to lose weight or to achieve a higher degree of overall health, than to streamline the digestive process and free up energy for the purpose of cleansing the body. What do you think the effect is on the body when foods are eaten after they have had all their enzymes destroyed by cooking? Since food in the stomach is a priority that cannot be ignored, the body must produce, on the spot, the enzymes necessary to digest the food. There is no alternative to this; food cannot simply sit around in the stomach undigested. And guess where these enzymes come from that are produced to digest the food? From the only place they can come from – they are taken directly from the precious storehouse of metabolic enzymes, thus decreasing the amount available for all the activities that extend life. We are all born with the ability to make a set amount of enzymes in our lifetime, either digestive enzymes or metabolic enzymes. So, every time any amount of cooked food is eaten, in the most literal sense possible, length of life is shortened because the more digestive enzymes the body is called upon to manufacture, the less metabolic enzymes will be able to be produced.” Jam sandwiches are not the answer and neither is 5 portions of shop bought fruit and vegetables.



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