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How do you get children to eat healthier food? “That’s a complex story,” says Edgar van Mil, pediatrician-endocrinologist and professor of Youth, Nutrition and Health on behalf of Maastricht University. Brightlands Campus Greenport Venlo. “Complex problems require customization.”
As a child, Edgar van Mil once pulled kohlrabi from a farmer’s field near his birthplace Waalwijk. He cleaned it with his knife and ate the vegetables he hadn’t known until then. “I will never forget what I tasted then and every time I eat kohlrabi I have to think about that moment again.”
He doesn’t just tell the anecdote. The chair at Brightlands Campus Greenport Venlo is intended to investigate how you can help children with a healthier diet. Not only young obese people whom Van Mil sees weekly in the Jeroen Bosch Hospital in ‘s-Hertogenbosch, but all children. Experiencing what you eat, such as Edgar van Mil’s adventure with the kohlrabi, could help with that. “When you let children experience the entire food chain – and that’s what we do here Kokkerelli Kids University – then they get excited. Vegetables are about much more than just food; there is a story to it, that makes it tasty and perhaps even tastier.”
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Wrong incentive
Edgar van Mil (Waalwijk, 1969), trained as a doctor in Maastricht, has always been interested in nutrition. Because we are constantly working on this, but also because his father Gerard van Mil was a renowned pastry chef and pastry chef. “As a child I really thought about following my father’s footsteps. He was not so much concerned with a healthy product, but with a tasty product that stimulated your taste so much that one such pastry was enough. Now things are being made of which you can use ten. That’s actually the problem. You are also encouraged to eat even more.”
He sees the consequences in practice. “Initially I concentrated on pediatric docrinology and drug research, but ultimately it is all about eating behaviour, taste development and what that does to the metabolism of the young child. We still know too little about this and that is why this chair is interesting, which is why behavioral psychologist Remco Havermans is involved in this as an endowed professor.”
We get children of 150 kilos over the floor, then you think: where the hell did that go wrong?
Edgar van Mil
Refreshing
Van Mil is an authority when it comes to obesity in children. He wrote a book about it and was involved in the establishment of the National Prevention Agreement. The chair is the next step. This was mainly achieved with the support of the business community. “What makes me happy is the direct contact with the companies here in Venlo. What you see happening here in practice is confessed with the mouth in other places. Here we are really doing something. That entrepreneurial spirit is very refreshing. Coming from the medical world, you often have the feeling that you are fighting a dead end. We get children of 150 kilos over the floor, then you think: where the hell did that go wrong? How did that come to be? Not that we have a ready-made solution here, but at Brightlands Campus Greenport Venlo we can at least investigate how we can make healthy choices easier.”
Taste sensations
It will be a fight, Edgar van Mil realizes. “All those high-calorie products have become very cheap. People are busy and that’s why it’s easier to literally give children a sop. It’s a clincher, but in my youth there was also enough candy, it just wasn’t in the house. Not even in a pastry shop. When I got a pastry I couldn’t even finish it all, so many taste sensations were released. Now the taste is much smoother. While natural products often have much more taste sensations that affect your satiety. You just have to make an effort for that, you have to cook or create. Pulling something out of the fridge is of course faster.”
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Van Mil and Havermans are trying to find an answer to this on the Venlo Brightlands campus. “We understand how the choices are made. But what are the biological and behavioral factors that play a role in this and how can you respond to this with healthy food? It’s interesting to see how you can influence behavior. We constantly fall prey to stimuli. That is partly our biology, but partly that is also learned.”
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Innovations in healthcare: TNO would rather prevent than cure
Obesity
There are, of course, starting points. “We know, for example, that breastfed children tend more easily to a healthy and varied diet. With a level scoop of formula, you may develop a monotonous taste.” And the fact that children eat less potatoes, vegetables and fruit and play outside less also plays a role. Between 15 and 20 percent of children are overweight, 3 to 4 percent of all Dutch children are obese. Van Mil: “We focus on all children because healthy food is important for everyone and you can’t just say to overweight children: you should do it this way and that and the rest can eat what they want.”
Maybe just for the record, why is being overweight so dangerous? “If you look at it very simply, being overweight leads to accelerated aging. With all the associated medical complications: diabetes, cardiovascular disease, brain problems. We see children with old-age diabetes, which was impossible until recently.”
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lifestyle
Despite all the food gurus, diets and media attention. “It is complex: there is not one answer,” says Van Mil. “Overweight is the result of many factors combined: your environment, your predisposition, and your lifestyle. And they interact with each other. Everyone is looking for the golden solution. Eating less and exercising more is such a clincher, people already know that. It’s about customization and professional guidance. Doctors often find it very difficult to do something with lifestyle. They already have to ask a lot of questions and explain things and hardly have time for a lifestyle consultation. To make it easier, we have all kinds of lifestyle counters in the Jeroen Bosch Hospital. People are referred by the specialist with a warm transfer, so with information about what exactly is wrong with this patient.”
How wonderful it would be if things were developed at the front that help to make a healthy choice at the back
Edgar van Mil
vegetable queen
Edgar van Mil is on the Brightlands campus one day a week and has one day a week to devote to his part-time position as professor.
“Products are being developed on campus that we can really do something with. We should not just talk about health, but tell the whole story and bring back the experience: where does our food come from, how do we prepare it? How wonderful it would be if things were developed at the front that help to make a healthy choice at the rear. Here children come into contact with fruit and vegetables, with healthy products. You also have a company here that is able to combine a lot of fruit and vegetables in a shake,” he says.
“A project with vegetable boxes at this age turned out to be very instructive. Each time, children tasted a different vegetable from the box, so you can see that when children do this together, they do like it. Whoever ate the most of it became vegetable queen or vegetable king. It seems so simple, but our PhD student Britt van Belkom has even made the front page of the UK Times with it. The next goal is to scale up this knowledge through technology so that more children can reap the benefits for a longer period of time. How nice would it be to take the health theme to a higher level from this region, it really is about value.”
Also other Brightlands campuses
But fast food is of course always within reach. Van Mil: “We must remain vigilant about what our work yields. Healthy products are always more expensive and the additional cost will ultimately have to be translated into health benefits.”
Furthermore, Van Mil and Havermans work together with the Healthy Primary School of the Future of Maastricht professor Onno van Schayck on Brightlands Maastricht Health Campus† An app is also being developed that young people can use to maintain their desired eating behaviour. The data may be of interest for further research with Brightlands Smart Services Campus in Heerlen, where that data can be examined. “We are also constantly looking for technological developments that can be supportive.”
Edgar van Mil is a classically trained scientist, he says he has not had much to say about data science. “Health is something complex, if the problems were easy to solve, we would have fixed it already. So complex problems require a complex approach. All the expertise of the different campuses can be very helpful.”
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