Who's in charge here?

DEAR DR. GOTT: My grandson is 3 years old, 30 pounds and on the thin side. The problem is his picky food habits. The foods he will eat willingly are Cheerios, Ramen noodles, chocolate cake, ice cream, wieners, bacon, sausage, scrambled eggs, cashew nuts, sausage-and-cheese pizza, pancakes and PediaSure. If he continues eating in this manner, will he suffer the consequences of high cholesterol, heart problems, high blood pressure and other issues?

His parents and I have worried over this but don’t know how to cure the terrible habit. We can’t force him to eat or use spanking. Do you have any suggestions? How can we get him to eat more varied and healthy foods? Do we need to be more firm in withholding certain foods and let him go without if he refuses to eat as punishment, or do we continue to cater to his whims?

I feel this is a threatening situation that needs immediate attention. We have two working parents and one long-distance grandma in the picture. Help!

DEAR READER: Unless I am misreading you, you already know the answer but don’t know how to put a plan into action.

Your grandson is 3 years old. It is apparent he has been allowed to run the show and eat what he pleases. He will continue to do so as long as he can push the issue. This never should have occurred to begin with.

I can understand he has two working parents and a balance to that situation is to allow a sitter or relative to keep him happy until his parents return home after work. Then, when his parents return, they further indulge him because they have been away all day and feel they owe him.

This is the wrong way to view the situation. Do they really owe him a life of obesity, possible diabetes, hypertension, coronary artery disease and high cholesterol? No!

Unless this situation is checked, your grandson is on top of a slippery slope that will inevitably take him to the bottom. Thousands, if not millions, of dollars will likely be spent on his ultimate declining health.

The good news? Your grandson is only 3, and, if steps are taken now, these health problems don’t have to happen.

Sit down with your family members and his caregivers. If you all agree — and this must be a unanimous decision — formulate a plan of action, one that might have an impact on his parents, as well. The refrigerator and pantry shelves must be restocked with more appropriate foods. It might be necessary to make a grocery list and stick to it when shopping.

Forget the frozen pizzas, chocolate cake, Ramen noodles and pancakes that are likely covered with maple syrup and/or butter. Substitute fresh vegetables, which should always be available when that refrigerator door opens. Cut up carrot and celery sticks, broccoli spears and other fresh vegetables. Consider raisins or fresh fruit for a snack. Prepare healthful meals, and don’t deviate.

Everyone must be firm. If your grandson goes to bed crying and seemingly hungry, he’ll adjust rapidly when he knows there is food readily available. This won’t be an easy transition, but everyone — your grandson included — will be glad you did. Finally, discuss your plan with your grandson’s pediatrician.

To provide the rest of your family related information, I am sending you a copy of my Health Report, “Understanding Cholesterol.� Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 U.S. check or money order to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title.

Peter Gott practiced medicine in Lakeville for 40 years.

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