Healthykidshealthyfamilies

Yummy Kale Recipe for Adults - Take 2 (an antidote to Valentine Treat Overload)

2012-02-14T12:49:00.005-05:00

I played around with the Kale salad recipe to accomodate the cold outside and the beautiful greens in my fridge (thanks to Green Edge Organics). Here is what resulted and warmed us up deliciously....

Mama Mia's Warm Greens braised with pine nuts and raisins

1 cup finely minced onion
3-4 cloves garlic, pressed or finely minced
2-3 Tbspn olive oil
salt
6-8 cups greens - spinach, collards, bok choy, kale, chard, turnip greens, etc. (I used spinach, bok choy and chard), chopped.
1 cup raisins
1/2 cup pine nuts (toast for 30s in microwave)

Heat oil in large pan, cook onions and garlic till soft and fragrant. Add greens to pan and cook only until all are a little wilted, if there is a lot of stem, and it is fresh, chop stems up and add first. Cook stems for 1-2 min and then add the leaves. Salt, to taste, and add raisins (raisins will take up the greens' extracted juice and become really delicious). Once all is cooked through but not overly cooked (about 5 min), remove from heat, add nuts and serve.

Yum!

Ugly Duckling Stage

2012-02-08T11:07:00.000-05:00

This is just a note that my blog is going through some reconstructive work and is going to have an ugly duckling stage for a wee bit. This just the looks though, the content will continue to be fantastic.

The Games We Play

2012-02-05T17:40:00.003-05:00

I made the most scrumptious soup ever last week, the main ingredient of which was TURNIPS. The obvious name would have been 'Turnip Soup'. When the kids returned from school and smelled the aroma filling the house they all asked what was in the pot. I didn't bat an eye, I said 'Cheese Soup'.

Playing games with food names, shaping foods, decorating food containers, manipulating a food's color or texture, have always seemed an exhausting exercise in parenting. It can also create an eater that has very high expectations for their meals. Generally, it is not something dietitians or pediatricians recommend because it can make for a picky eater later down the road.

Now here is the admission, I do resort to some of these tactics. I create delicious sounding soups, I add beans and beets to make desserts more healthful, I routinely substitute in higher protein flours when I am baking, I puree soups that would otherwise get rejected because of the floating herb bits and more. I am not sure that this is all bad. I hope I am expanding their palates with few complaints and I am increasing their servings of fruits and vegetables. However, as my kids get older I am trying to avoid the games and work towards an adult that would enjoy 'Turnip Soup' without pause, which by the way is below....

Mama Mia's Turnip 'Cheese' Soup

3 large leeks, chopped, white parts only
2 cloves garlic, minced
4 Tbsp butter
3 large turnips, peeled and chopped
3 medium to small potatoes
1/2 cup parsley, chopped
5-6 cups stock (the amount depends on the thickness you want)
salt and pepper to taste
2 sprigs fresh thyme
1/4 cup milk
1/2 cup grated gruyere

Heat butter in soup pot on medium, add leeks and garlic. Cook till tender and caramelized, add potatoes and turnips. Sautee till tender and add parsley (if there is sticking, add a very small amt of water), cook an additional 2 minutes. Add stock and simmer for 30-40 minutes. I puree at this point b/c it does taste delicious to blend the potatoes and the turnips into one uniform flavor. Add remaining ingredients and serve.

"Polite Bites"

2012-01-09T14:41:00.001-05:00

This the story of a soup and a girl....our girl dazzles our lunchtime table every few weeks and is typically a hungry lunchtime eater (unlike my wee man). She has become accustomed to our mealtime rituals/ground rules since she is a very regular guest. One of these rituals is to take "polite bites"... meaning that when something new is put in front of you then you take one bite to taste the new food, one bite to feel what that new food feels like in your mouth and one bite as a thank you to the chef (or "cooker" as they like to say).

This has never been a problem for our little friend but often she will stop after three bites. A wonderful thing happened when I put my orange squash soup before our orange-haired friend.... she made a face, took her "polite bites", kept on eating and asked for seconds!

"Polite Bites" have been a great tool for our family. They stem from my feeling under appreciated as the sole family chef, toiling each day to try to make something yummy and healthful. I got very tired of our kiddos looking at the meal, making snide remarks and not even tasting the food. So we began "Polite Bites". They don't have to love the new food ("it is not my favorite") but they have to try it. I won't say that they are eating Kale chips and Beet Chili at every meal, now; but it has increased the number of foods they eat. It has also given them a way to cope if they are at friends' houses and they are presented with new foods they are intimidated by.

By the way the soup that our ginger girl loves, and so do my kids is as follows:

Roasted Butternut Squash Soup
(modification of Jessica Shimberg's recipe)

1 large Butternut Squash (or two small) or another winter squash that has a nutty flavor (Hubbard, Pumpkin, Kabouchi, etc.)
3 Tbspn olive oil
2 Onions
1 Potato (can use sweet potato), large
2-3 cloves garlic
2 carrots
2 bay leaves
3 tsp regular paprika (can use smoked paprika but that is more for adults)
3-4 cups chicken or veggie stock
salt to flavor

Halve squash, remove seeds, salt, and place facedown on oil pan, roast for 30-40 minutes at 425 till soft and skin darkens. Remove and let cool.

While squash is roasting, heat olive oil. Chop onions coarsely and saute till translucent, in oil. Peel and chop potatoes and carrots. Add veg to soup pot. Can coarsely chop everything since soup is pureed at the end. Salt veg in soup pot and keep stirring till aromatic. Mash garlic and add to soup, along with bay leaves, and paprika. Once veggies are soft, add three cups of broth. Remove peel from squash and add to soup. Let the soup come to a gentle boil, turn down and simmer for twenty-thirty minutes. Then puree soup with a soup stick, taste and add salt as needed. The soup should be thick but still a soup consistency not mash potato consistency, so add broth till you are at the right thickness.

Can serve with a dollop of full-fat plain yogurt...this is often popular especially in the form of a smiley face.

Snack's in preschool: take 3

2011-12-09T17:02:00.001-05:00

Sometimes just seeing what people are doing well, and pointing it out, is all it takes.

In year's past, preschool snacks, brought by the parents, have ranged between cocoa puffs with chocolate milk (whopping 20gm of sugar) to cheddar goldfish with cheese on the side. For years, I have written handouts for parents suggesting healthy snacks for kids under 6. These handouts have never seemed to have much of an impact. Given, I think, that those interested in healthy snacks were already bringing healthy snacks.

That seems to have all changed this year. The first week had lots of fruit, dried fruit, even veggies with hummus. I am not sure what started this trend but I complimented everyone on the great snacks and all the fresh fruit, on the preschool email listserv. Since then it has only gotten better and better. Some parents said the emailed encouragement pushed them into the produce aisle when it was their turn for snack. I am not sure I was the catalyst; but whatever made the change the preschool snacks now look like things we would serve at a meal rather than 'treats' with a lot of sugar, fat or salt.

Why we shouldn't push grains, breads and cereals on our kids...

2011-12-07T14:46:00.001-05:00

I have been intrigued, as my regular readers know, by the idea of having a grain-free diet. Numerous cultures around the world have little to no grains; and those populations have lower rates of Heart disease, autoimmune disease and certain cancers. They typically have lower ovarian, breast and lung cancer; but often they have their own set of cancers that beset their aging population.

Why? Why are these populations healthier? Researchers have said it is because they are more active, they eat less meat, they eat more fish, they eat more vegetables and they eat less calorically. All of those might be true; but a piece of these is one that is coming up more and more in agricultural and nutrition journals.

Grains (and all foods) are not what they use to be. Below is a figure from this month's Mother Earth News, not my regular science reading; but it is the nicest figure I have found demonstrating this point. Our food is not nutritionally what it use to be. Cornmeal from even the early 20th century had 2x the protein as today's cornmeal, 2x the Niacin, 3x the fiber and more of every nutrient tested. Some of this comes from the soil being depleted of nutrients but a lot of the changes come from breeding we have done to obtain desirable characteristics, i.e. today's cornmeal is sweeter and less chewy than that of the 1950's.

The data is appearing in The American Society for Horticultural Science and Journal of Science of Food and Agriculture, and other journals. It is not just grains that are being altered by our breeding and our pesticide use it is also vegetables, eggs, meat and dairy products.

The food on the American plate is being diluted nutritionally. Our grains have less protein and fiber, our vegetables have fewer micronutrients and less Vitamin C, our meat is lower in Omega 3 Fatty acids and our Dairy products are lower in vitamins.

So how do we combat this? We have to eat those items that we know are still nutritionally rich even after dilution. Which foods are those? Not surprisingly, they are vegetables; and not grains, which have suffered the most and have the most empty nutrition profile today. Once again it is the same bottom line, grain-free diet or not, we all need to eat more veg.

Heriloom corn called 'Squaw Corn', dates back to 1600's

Mordern Day Corn

2011-11-06T22:28:00.001-05:00

Sitting is Bad for Your Health and Their's
(American Institute for Cancer Research Conference, November 2011, Washington, DC)

This past weekend, I had the fortune of attending the AICR Conference in Washington, DC. This conference focuses on lifestyle factors that prevent cancer, promote longevity with cancer and improve survivorship. The hot topics this year Vitamin D, calorie restriction, soy protein, Omega-3 's, stem cell research, physical activity and yes, sedentary activity.

Why look at sedentary activity on its own, I wondered. Isn't it just important to engage in 'exercise'. The answer is no...Even heavy exercisers commit an hour or maybe even two hours each day to exercise, leaving 14 to 15 hours in the rest of the day. How adults and CHILDREN spend those remaining 14-16 hours each day is very important for longterm health.

And how do most of us spend the rest of our waking day? Sitting.

We wake, ready ourselves, sit for breakfast, commute (typically sitting in a car), sit at work, take a break, sit for lunch, sit again to work, commute home, etc. This isn't too disimilar for our children once they are in school. Most US school children no longer walk to school but drive or bus. Additionally, beyond after-school sports teams, US school children are typically sitting after school, whether for homework or video games. The average US child watches 4-7 hours of TV or video programs each day. All that watching means, 4-7 after-school hours spent sitting.

*logo from an activity-based Mississippi School program

At the AICR meeting researchers explained that our muscles don't do anything when we sit, the mitochondria in them are 'flatlined'. Even squatting or standing has our mitochondia firing and our muscles engaged. Therefore several researchers at AICR wondered if there was a difference in those people that sit all the time and those that stretch more, break more, stand more, go to the bathroom more, etc. and various health outcomes. Another words was there a danger to muscles not being used the majority of the day?

The answer is yes. It turns out those of us that sit continuously are at greater risk for illness, cancer, higher body weights, waist circumferences and more.

Bottom line.... all movement is important. Think about how you and your wee ones spend your hours at home. Increase the little movements.

Exercise is important; but how we spend the remaining 16 hrs/day are a piece we need to think about.

KEEP IT MOVING....

Don't Pile Up the Veggies

2011-10-06T14:57:00.000-04:00

I noticed an image similar to this in a pediatrician's pamphlet recently. The pamphlet was designed to help parents visualize a child's plate (far left) as compared to their parent's. The picture has an image of a lean meat and some nice looking green veggies, so why am I blogging about it. What concerns me about this picture is the amount of food on that plate and the proportion of vegetables to meat. It is TIME we offer a different image...one with a balance.

Every parent knows their child, so for those of you with voracious eaters, getting 5-9 servings of fruit and veg each day should move on to one of my other blogs :) ; but for those of you that wrestle with:

making sure your children are getting enough veggies in each day
keeping wee ones healthy that are not growing on target
getting everyone to sit down together for a meal

then the following steps can help you...

1. Don't pile the food on, even the veggies....

It is human nature for moms and dads to want to nourish our beautiful bambinos; and knowing veg is the cure for all ills, we will pile their plates high with vegetables. Actually, it is intimidating for children. They take one look at the stack of 6 brussel sprouts and they want nothing to do with it. You will be gobsmacked when you make it one brussel sprout, along with two slices of chicken and a smaller portion of whatever else is being served, and they eat it with hesitation or direction. These piles even send kids away from the table. Try little servings and they will sit longer. It is a small change but a huge one.

2. Two Peas, please or self-serve.
Give children up to age 12 a very small portion of everything you are offering, including the veggies; or let them serve the veggies themselves. Ask them serve themselves small amounts from each and all bowls on the table. Kids will try everything on their plate when they have put on their own plates. Then make it a rule that if they want more food they need to eat some of what is already on their plate; and if they are still hungry more food is available.

3. Round Two.
When they finish the small initial serving, do it again. Don't just serve what they like or pile up the protein. Serve everything in small amounts again. Again, they will eat the food in proportion and get more veggies, in. It is crazy but it works.

4. Complaints?
These changes may take adjustment, although strangely my 11,9, and 3 year olds didn't blink when I started doing this with veggies served with their mac and cheese. I suggest telling them they can have seconds once they have tried everything on their plate........

because why would we put more food on a plate if they already had food there.

Do Video Games Increase Their Waistline?

2011-09-16T12:20:00.000-04:00

Does playing video games differ calorically from reading a book? Wii advocates would tell you that playing the Wii expends calories; but a lot pediatricians have been warning that video gaming leads to weight gain in kids.

It seems logical that something like the Wii or other videos that are not sedentary, which have been shown to burn calories, would lower weights in kids. But there is a conflicting report that shows that kids that play Wii for an hour or more each day are gaining weight. Anecdotally, I believe I am seeing this among my kids' friends who are big gamers, those are the kids in their peer group who are getting much heavier each year.

Interestingly, some researchers in Denmark helped put the debate to rest this month with a study published in the American Journal of Clinical Nutrition. The looked at caloric output AND input in kids ages 15-18 who were randomized to play games ("one hour competitive soccer video game") or to rest for an hour. Indeed, the kids that played the video game expended more calories but during the buffet lunch those same kids ate much more. The end result.....those video gamers took in 160 calories more than they needed. It would make sense that over months and years those 160 calories (the equivalent of a can and 1/2 of coke) would result in weight gain. Why?... We don't know why but the prescription remains the same, eat less, enjoy it more and stay active.

How to train the toddler's palate - prescription for a healthy food loving child

2011-08-09T14:34:00.000-04:00

Last week, I had a chance to catch-up with a good friend who has just had her third child. She had been eager to talk since her child's 2 year check-up when the doctor had classed him as 'at risk for failure-to-thrive'. The doctors remedy for her child was a diet rich with milkshakes, butter, gravies, and full-fat anything.

I have heard this story so many times among my peers. This diagnosis and prescription seems to be on the rise among my friends and family. This is in part due to poor methodology used to measure growth in children and the limited amount of time the doctor's are given with each child to assess growth. However, that issue is for another blog. What got me thinking after talking with my friend was related to how misguided this Doctor's prescription was. The prescription - pushing fatty, salty, sweetened, calorie-dense foods all day long follows the logic that the more calories in equals weight gain. Logically, this prescription should increase intake in kids and help kids put on weight; but it backfires because kids don't eat 'logically' and parents end up with picky eaters who eat a very limited diet.
Why? Because this diet 'mis-trains' their palates.

What is the cure? Parents need to keep in mind that along with socializing their children to function in the world, they are also socializing their children's palate. Children's palates will shut down to vegetables if they are subsisting on milkshakes, butter, cheese and fatty foods.

To train their palates:

1. Keep kids eating fruits, vegetables and lean proteins, the majority of the time. This means all kids, even those that are not growing at the standard rate, need to have the majority of their intake be from 'healthy' foods. Sounds easy but remember if those snack foods are not something we would put on their dinner plates then it is not something they should be eating; b/c US kids eat a lot at snack time.

2. Limit treats... This includes a lot of foods we categorize as 'healthy' like yogurts, breakfast cereals, sports drinks. There are a lot of foods marketed to moms for kids that are loaded with as much sugar as a 6 oz of Coke. Keep their palates appreciating natural sweetness by limiting the amount of unnatural sugars in foods.

**For yogurts buy plain yogurt and add a teaspoon of maple syrup, this will be much less sugar than what they get in a tube of yogurt (and much cheaper).
**For cereal start weaning down the sugar/per serving. If you are at 10 gms/serving then next shopping trip buy only cereals with 8gm/serving and eventually only purchase cereals that 5gm or less.
**For Sports Drinks, just don't go there. Kids don't need them and adults don't either. If you are out playing hard, sweating profusely for over an hour then have a diluted juice (3 parts water: 1 part juice). The minerals in the juice are better absorbed and come along with some vitamin C; and still you'll be having less sugar.

3. Keep up with the competition... I have said this before but it bears repeating. Make healthy yummy by adding some salt, fat or sweet to the veggies. Even when you add some of these ingredients to the vegetables, the veggies are still good for the kids and it is still a lower fat, salt and sugar product then what we buy at the store.

Training a child's palate at a young age or at an older age is key to opening them up to healthy foods or keeping them open to eating well. Even when the prescription is high fat all the time, the 'failure to thrive' kids will be healthier for their entire lives if they learn to eat well rather than training their palates to only value unhealthy fare.

Dedication

2011-07-29T07:54:00.000-04:00

As with all that I do, this blog and the work I do with families professionally, is dedicated to my mom, Libby Oppenheim, September 13, 1935 - July 21, 2011.

Veggies: The Whens, Wheres, and Hows of Encouraging More Veggie Consumption

2011-07-29T07:35:00.000-04:00

I am always playing with how to mix things up and get the kids at our table to eat more veggies. As I said in "Veggies First", offering veggies as an appetizer is a great way to curb the 5 o'clock hunger pains and get veggies in their bellies. But there are a couple of other tricks that have been working great in our family this past year.

1. Veggies as the first course....
This is bringing us back again to a time when meals were much slower, had smaller portions and typically had a vegetable course at the beginning of the meal. In our house we are invoking this time by offering a little bit of salad first to the kids or small bowls of soup. The salads have been elaborate with my homemade dressing and they have also been super simple chopped up cukes with tomatoes and my daughter's favorite food - ranch dressing.

2. Small portions....
Kids are turned off when their plates have heaping servings of vegetables. It is our attempt to get them to eat more vegetables but it backfires all the time. Try a very small portion size of EVERYTHING on their plates, including the veggies. This is an odd suggestion but I have tested it out on my kids, all their friends and my friend's kids. Serve them one bit of chicken along with 5 peas, it intrigues them and they eat all the peas. Serve them three bits of chicken and a pile of peas, they eat the chicken and leave the peas. Smaller portions work but make sure all the foods are a smaller portion, they can always have more.

3. Any time/All the time....
The more veggies that are served, the more kids are exposed to them, the more they eat. There are studies documenting kids in immigrant families, in the US, whose families eat vegetables at breakfast. These kids eat more vegetables than other US kids, even if the remainder of their diet is fairly Americanized. Serve tomatoes with breakfast on their buttered toast, serve sliced cucumber on the side, carrots with cream cheese and anything else that is a favorite (My son just suggested a microwaved potato with butter and salt). Keep vegetables in all the lunches and snacks, too. Again, make portion sizes small.

4. Match the competition....
Vegetables are up against rough competition that doesn't play fair, they are fighting against Cheetos, super sweet yogurts, rich cheeses, salty crackers, etc. to try and get your kid's attention. These foods are creating a taste palate in kids that is hard for vegetables to compete against. Kids and adults will typically choose the foods that are richer, saltier and/or sweeter over the plain taste of vegetables. So....don't be shy, go ahead and flavor the vegetables. Vegetables can compete if they are straight from the garden but most of the time that isn't an option. Veggies just need a little help. Using salt, sugar, a little cheese or butter is not a sin and it will make the kids like the veg more.

Is Gluten-Free the optimum diet for the US, what about kids?

2011-06-16T22:05:00.000-04:00

Gluten-Free' is it the new 'Health Diet'????

I have had several moms ask if I am suggesting that "grains are not necessary" (blog posting March 2011), do I then believe that gluten-free diets are healthier than typical US diets.

Like so many nutrition questions there is no black and white answer.

Gluten-free diets can be incredibly healthy even for those of us who tolerate gluten. Why? There are numerous reasons related to grains, that I discuss in my previous blog, but the primary reason is these diets eliminate the processed foods we love to eat. Most of our snack products, be it savory or sweet, contain wheat. These products also contain calories and ingredients that our bodies don't need. Gluten-free diets, because of the wheat, eliminate these snack foods. As a result people eliminating gluten from their diet replace those snacks with healthier substitutes and eat fewer calories. Studies on individuals adhering to a Gluten-free diet, ten years ago, showed a dramatic increase in the intake in fruits and vegetables in that population.

However, the food industry has caught up. Now there is a plethora of 'Gluten-free' products. In every grocery store these days their are Gluten-free cakes, breads, cookies, frozen meals and more. The consequence... people going Gluten-free for the health benefits are not replacing their gluten snacks with veggies but with Gluten-free products. They are consuming the same amount of calories as they were with gluten and they are potentially eating even emptier calories. Emptier b/c where wheat contains some protein and B vitamins, a lot of the Gluten-free products use Rice Flour, Potato Starch, Xanthan Gum and other fillers that are virtually protein free (and some are nutrient-free).

So, what is the answer then...do we cut Gluten from our diet. If that means replacing Gluten sources with whole foods such as fruits, vegetables, nuts, seeds, beans and other unprocessed food sources, then yes this would be a healthier diet for adults and kids alike. But if Gluten-free means adopting a new list of food products from the grocery store, I suggest you save your money and enjoy a whole grain bread.

Time to Parent....Soccer Snacks part II

2011-05-17T14:25:00.001-04:00

We are fully into soccer season again and those soccer 'snacks' that go with them. Many moms have asked me what I do about this conundrum. I have had conversations with concerned parents about classroom snacks, baseball snacks, party snacks, soccer snacks and even pre-school snacks hundreds of times over the past five years. There are so many parents out there concerned about the types of foods being provided to their children outside the house and the quantity of food. But often those same parents feel bullied by their kids and the community to participate in the fun of feeding the kids 'fun' foods. It is critical that parents change their perspective on this, they are not being "killjoys" they are parenting. It is our job to teach our kids what is healthy to eat, that extends to what they eat after 20 minutes of soccer.

Parents need to step back and think about what we as adults recognize as a healthy snack and when we would eat such a snack. Typically, as grown-ups we realize that fruit, nuts, or some lean protein source with limited amounts of a whole-grain product would be a good snack to follow a work-out. We may not follow these rules; but we also recognize
- portions should not be too large (especially if we have only exercise a little)
- if we are going to eat a meal soon we should skip the snack
- we should limit the sugar content
- water is the best accompaniment especially after exercise

These are the same rules we should apply to our children. We can't think of it as just an isolated snack and unimportant. It isn't an isolated snack b/c kids are getting these types of 'snacks' at school or even preschool, at story time in the library, from the bus driver (my daughter gets off the bus with a Caprisun some days), and after each athletic activity. Unfortunately, it is cumulative and over a week, a month or a year they are ingesting a lot of unhealthy snacks.

Childhood obesity is growing in this country and so too are the size and lack of nutrition in our soccer snacks (and all other outside the house snacks). In years past, orange slices served as the snack, calories would have equaled 70 if the child had 5 slices. Today we are serving them Cool Ranch Doritos or Cheetos (160 calories) plus the required Capri Suns (100 Calories). That is 190 calories more and whole lot of nutrition less than children were fed year's ago. Do our children need 190 more calories than we did?

Last week was our week to bring soccer snacks and of course, much to my son's embarrassment, I sent along bananas. This seemed perfect to me, it was a later game, closer to noon and the kids might actually be hungry. Bananas come in around 100-200 per banana and that would tide them over (with a smidgen of protein, to boot)till they got home for lunch. My husband came home announcing that he didn't get lynched for having the bananas because someone had also brought.... CAPRISUNS.

Walk, Bike, Garden or Run - just get active

2011-04-22T17:15:00.000-04:00

I have been reading more and more studies examining the importance of physical activity in our daily lives. Studies like "Walking and Cycling to Health" (American Journal of Public Health), the Amish paradox (Med Sci Sports Exer), "Life Sytle Practices and CVD" (Cardiol Res Pract)or "Medical Dangers of Prolong Sitting" (Exerc Sport Sci Rev) and many more studies. These papers all address the issue of which is more important the food we eat or the activity we engage in but they study the issue from different angles.

One of my favorite studies among these papers is work of David Bassett. He tries to decipher what I would call the Amish Paradox. The Amish sect, in this study, shuns motorized, electrical inventions and live a mid-1800 lifestyle. Yet their diet remains very 1950's, rich in white flour baked goods, breads, meat, potatoes, gravy, eggs, vegetables, pies, cakes, fat, fat, fat and lots of refined sugar. Despite this diet, the Amish in this sect were 1/3 as overweight as their US counterparts, 1/5 as obese. What is their trick? Calories out...the Amish in this more conservative sect engaged in moderate physical activity 40 hours or more each week. They walked 18,000-14,000 steps per day, compared to most American adults walking 7000-8000 perday. (note: despite their high activity neither the adults nor the kids have snacks)

Other studies have shown similar findings in populations that engaged in 'active transport'. These populations use walking, biking or some sort of self-locomotion to get places (this included skateboards and scooters in one study). These populations are healthier even if their diets are not. 'Active Transport' populations have lower rates of obesity but also lower rates of illness, such as Diabetes and CVD.

I know we can't all revert back to a agrarian lifestyle like the Amish. But we can take heart that even if we have have fallen too far from our active ancestors, a simple lifestyle switch can make us much healthier. The data shows that we don't need to renew our gym membership but we do need to adopt a more active lifestyle. Switching off the television, walking to school, growing our own vegetables, biking to the grocery store, can all improve our health and our kid's health.

Are grains really necessary?

2011-03-25T14:00:00.000-04:00

There has been a lot of hype related to the Dietary Guidelines that just came out, and their minimal promotion of grain consumption, relative to the Dietary Pyramid. The 2010 Dietary Guidelines state that consumers should eat 1/2 of all grains as whole grains and replace refined grains with whole grains. This is also stated in the USDA's Dietary Pyramid but with the recommendation that you eat 6-11 servings of grains each day. The new guidelines are not as specific. Is this possibly the USDA's beginning of a back pedal away from promoting a grain-intensive diet like the one we eat in the US?

Grains are foods that come from wheat, oats, barley or another cereal, i.e. breads, pasta, morning cereals. Nutrient-wise whole grains can provide dietary fiber, several B vitamins (thiamin, riboflavin, niacin, and folate), and certain minerals (iron, magnesium, and selenium). Refined grains (your white pastas, white rice or white breads) provide some of the B vitamins because of fortification and easy calories or quick sugar for the body. This food group is typically low in protein and fat.

While I agree that eating whole grains can provide a fair amount of fiber, which is beneficial for reducing the risk of CVD, NIDDM and constipation, I don't think grains are essential for a healthy diet. Vegetables and fruit are very rich in fiber. A diet that meets the Dietary Guidelines for fruit and vegetables (1/2 the plate) would easily meet daily fiber needs. As for the B vitamins and minerals that grains supply, diets that are rich in vegetables would also meet the B vitamin needs and meat protein would supply the minerals. Vegetarians would meet some of the mineral needs with legumes but would need to include molasses, raisins, and some other tricks to meet iron needs.

There are arguments that eating a grain-free diet will reduce your risk of automimmune disease, Type II Diabetes and allergies. Although, the data is not there to yet to support these claims; but there are a lot of new studies running currently that will add to our understanding of the role of grains. There are studies, however, that do indicate diets lower in grains and free of refined grains (products with refined flours) can improve arthritis symptoms and Colitis symptoms. All of these studies have been in adults to date and it will be interesting to see how this translates for kids.

There is more data coming in the next five years about grains but it is already clear from studies of other countries and their diets, that grains are not a necessary part of a diet that has sufficient fruits and vegetables. Why the Dietary Pyramind suggest you eat the majority of your diet in grains is unclear and why the Dietary guidelines state that 1/2 of those grains can be refined is mind boggling. The best approach for strong bone and gut health continues to be a diet that focuses on fruits, vegetables, lean meats or beans, limits processed foods includes only a moderate amount of whole-grain foods.

Yummy Kale Recipe for Adults this time

2011-03-25T13:10:00.000-04:00

The recipe below for kids is delish; but this one is even yummier. It is not an original Mamma Mia but comes from a friend. It is hard to stop eating this Kale dish; but my kids enjoy the cooked recipe more (more for the grownups).

Lemon Kale Salad
4-6 cups Kale sliced then
1/2 cup Pine nuts (you can also use walnuts or macadamia nuts)
1/2 cup Raisins
1/2 cup Parmesan
Toss and then mix with dressing below. Chill 2-6 hours, the longer yummier.

Dressing
1/4 cup Lemon juice
2 garlic cloves, minced
2/3 cup olive oil, could get away with less if desired
salt and pepper to taste

Diet and Disordered Behavior - is there a clear link

2011-03-01T06:44:00.002-05:00

Is there a clear link between what children are eating these days and the increasing numbers of kids with ADHD (Attention Deficit and Hyperactivity Disorder) and autism? I have heard, read and seen in data on associations with gluten, dairy, additives, MSG, antibiotics in meat. After meeting another family searching for answers last week, I did a little digging. This really should be two distinct categories, one diet and its role in mediating autism and the other diet and its role in ADHD. The two discussions get blurred.

Diet and Autism

After doing a cursory search of the primary literature, it is clear that there are a lot of anecdotal reports of dietary therapies and a decrease in Autism symptoms. There are no articles showing a complete cure with any dietary therapies. However, there are two studies suggesting that the gluten-free and casein-free diets improve behavior in autistic children. The theory is that gluten and casein peptides are involved in excessive opioid activity associated with autism. Within these studies, a small subset of the Autistic children responded to the diets. A placebo-controlled, larger study needs to be done to determine whether this subset represents a percentage of the Autistic population. NIH is currently recruiting identified children to look at the role of Omega-3, Folic acid, vitamin C, various peptides, Gluten-free / Dairy-free diet in Autism.

Diet and ADHD

In general there are fewer ongoing and completed studies on ADHD and diets. However, a couple studies show weak associations between ‘Western Diets’ and ADHD up to age 14. Western diets in these studies typically refers to diets higher in additives, coloring and preservatives; and diets lower in omega-3’s. There does seem to be some relationship between additives and ADHD but the response is wildly varying in children. A subset of ADHD children are additive-‘sensitive’ and others are not at all responsive to additives. This goes back to the idea of the ‘Feingold’ diet explored many decades ago. Feingold did a cutting edge study on additives in the 1970's. He found a small population in his group had ADHD type behavior in response to additives. It was a small number of kids, so it was discounted as not being significant; but in such a strong study protocol that small number of kids might represent a larger percentage of the adolescent US population. The hypothesis of ADHD being correlated with low Omega-3’s has been described as making biological sense. They have even correlated low dietary intake and increased ADHD symptoms. However, increasing Omega’-3’s only improves symptoms in a small percentage of the children and other studies have not been able to replicate their results. It is clear, that with ADHD in particular any nutritional intervention would need to be individually tailored because food sensitivies seem case-specific. Elimination diets may help in some cases but are challenging to execute in this population; therefore each family may need weigh the costs and benefits of such diets.

The question of diet and Autism or ADHD has not been answered. Given that the current theory of Autism, that it begins with alterations in the DNA at multiple gene sites, correlating such a syndrome with one diet intervention may be impossible. However, for those families wrestling with how to mitigate their struggles with these disorders, trying different interventions might have some value. In Autism, trying a dairy free (casein free diet) and then a gluten free diet might have some impact on symptoms. Similarly, in ADHD trying a diet that avoids additives - coloring and preservatives, would be good for the whole family and might help the child suffering from the disorder.

These are some really good overviews:

Nutr Clin Pract. 2008 Dec-2009 Jan;23(6):583-8. The gluten-free, casein-free diet in autism: an overview with clinical implications. Elder JH.

Cochrane Database Syst Rev. 2008 Apr 16;(2):CD003498. Gluten- and casein-free diets for autistic spectrum disorder.

Nutr Rev. 2008 Oct;66(10):558-68.Nutritional and dietary influences on attention deficit hyperactivity disorder

Harv Ment Health Lett. 2009 Jun;25(12):4-5. Diet and attention deficit hyperactivity disorder: Can some food additives or nutrients affect symptoms? The jury is still out.

Am J Psychiatry. 2010 Jun 15. The Role of Histamine Degradation Gene Polymorphisms in Moderating the Effects of Food Additives on Children's ADHD Symptoms.

Dessert-Addicted

2011-02-03T14:25:00.000-05:00

We seem to be in recovery. After traveling in January and unlimited access to sweets in December, it seems as though the kids are in a sugar detox program. With Valentine's day upon us we have come up with some strategies to help us with our recovery.

My kids love sweet treats. I don't believe in an abstinence approach with these items for kids; but we do limit their access to sweets, especially candy, and talk about balancing treats with food that keeps you healthy. Come holiday time and periods with a lot of traveling, the kids have sweets all around them and often consume sweets multiple times each day.

Often when we return home after our sugar-filled holidays, the kids have to readjust. This year the kids and I decided to ease them into things by offering treats that are not all sugar and have some food value. My daughter's creation above is whip cream, with a smidgen of sweetener in the cream, and a whole lot of fruit. This turned out to be a great treat because of all the fruit but also the pleasure they took in creating their dishes. A favorite after basketball practice is, now, a whole banana with a little Nutella or a bowl of peanuts with raisins and chocolate chips. On the weekends, we will sometimes have chocolate chip, whole wheat, banana pancakes. These treats appease me greatly, as well, since they offer the kids some nutrients and they don't super saturate their taste buds with high intensity sweetness.

Kale for Kids.... I am not joking!

2011-02-03T14:08:00.000-05:00

Kale Delish (Modified from Beth Conrey's Recipe)

1/4 cup olive oil or canola oil

2 cloves garlic

1lb raw Kale or other mild greens, chopped finely

2 Tbsp Soy Sauce

4 Tbsp Apple Cider (if in season) or 2 teaspoons table sugar or 2 tsp honey

Heat up a large skillet over medium high heat with olive oil and toss in minced garlic once pan is hot. Then add greens in batches till just wilted, this doesn't take long. Turn the heat down to medium/low and add remaining ingredients. Mix up the dish for a bout a minute and then remove from heat.

You can't see it on his tray; but this kale dish is there and he was digging it. My older kids enjoy this one, too. It is always best to start serving any and all dishes that are green, green, green to kids when they are young. However, if you have a "Green-avoider" don't be disheartened. Empirical data and countless of dietitian moms can tell you that you will succeed at getting a child to eat his or her greens, whether as a salad or as a cooked dish, if two things happen:
1. You eat them with relish in front of the child
2. You serve them repeatedly (it can be 10 times) and patiently

I have a lot of experienced parents who also suggest:
- serving the veggies first with the caveat that they must be tried before other items join them on the plate.

- serve them with the emphasis on their being a 'growing food' and very important to have a bite before leaving the table.

Omega-3 Fatty Acids - part 2 - What does a Vegetarian do?

2010-12-25T11:46:00.000-05:00

Alright, I am back on my Omega-3 soap-box. More studies have iterated the importance Omega-3 fats for a developing brain and for lowering the rates of major chronic disease, including cardiovascular disease and cancer. There is also good data associating Omega-3 rich-diets with delayed cognitive impairments seen with aging and decreased rates of early Alzheimer's disease. In my May blogs, I review dietary Omega-3 sources and stress the value of marine sources. However, what about stricter vegetarians that don't eat fish and don't want to use gelatin-coated supplements (gelatin is most commonly derived from meat by-products).

Plant oils, nuts, some seeds, algae and, interestingly, organic vegetables (the reasons for that are for another blog) do contain small amounts of Omega-3's in the form of ALA. ALA is an Omega-3 fatty acid that is most beneficial when it is converted in our bodies to DHA or EPA, which are the more potent Omega-3's. ALA has some benefits on it's own but it isn't as potent as DHA and EPA. ALA is readily converted to DHA and EPA if there isn't too much Omega-6 around. Omega-6 fats compete with ALA for enzymes. The more Omega-6 that is around the greater the chance it will win that competition. Diets rich in Omega-6 fats have 40-50% less ALA conversion to DHA and EPA.

Vegetarians typically have 60-80% LESS omega-3 fatty acids in their blood; and it is thought that this is because their diets are very rich in Omega-6 while low in Omega-3 rich-sources such as fish.

Vegetarian diets are rich in whole grains which contain Omega-6 fats and most processed foods are heavily enriched with Omega-6 fats. Flax is the most popular alternative to fish for Omega-3's but Flax contains mostly ALA fat along with a lot of Omega-6 fats. I have been reading a lot lately about the veracity of Omega-3 enriched eggs, which have been promoted as a vegetarian source of Omega-3's. The hiccup is that these chickens are fed flax seed.

Alright, enough bad news, the good news is that a great study was just published that shows vegetarian diets lower in Omega-6 fats were higher in Omega-3's. How did they lower the Omega-6 fats? They cut processed foods. The study population limited their packaged product intake and increased their whole-food intake. Meaning instead of a ready-to-eat frozen dinner or breakfast cereal, you would make a sauce to have with your whole grain or have nuts with your cooked oatmeal. The study's authors state " The results indicate that alpha-LA-rich (ALA) vegetable oils can be used in a domestic setting (in conjunction with a background diet low in LA) to elevate EPA in tissues to concentrations comparable with those associated with fish-oil supplementation."

Bottom Line: If you are a vegetarian, increase those plant foods that are rich in Omega-3's (ALA, EPA and DHA) but it in conjunction with eating fewer processed foods....less boxes opening and more veggie chopping.

Note on eggs: Regular egg yolks have EPA and DHA that doesn't need conversion. So you don't need to buy any special product. The more the chickens roam the richer their yolks are in Omega-3's.

Sources:
Am J Clin Nutr. 2008 Dec;88(6):1618-25.
Int J Vitam Nutr Res. 1998;68(3):159-73.
Am J Clin Nutr. 1994 Jun;59(6):1304-9

Why do we care if something is 'Grass-fed' or 'Pasture-fed' or 'Grain-fed'? Labelling of Meat and Dairy Products

2010-11-29T15:36:00.001-05:00

Blogger's Note: Sorry about the long pause in blogs. After much sibling encouragement, thanks Doc Nitrous, I am back to my blog.

I have been thinking a lot about the different labels out there for meat and dairy products these days. I had a friend who needed help finding hormone-free products for his children. This was much more challenging then it should have been simply because there are numerous labels out there that are not federally sanctioned and are confusing. When a federally sanctioned labelled is used most consumers don't know what they mean. I will tackle a piece of this big topic. This is not just a US issue, these labels are being used all over the world and they actually have the potential to tell consumers a lot about the nutrient content of the product.

Until the 1940's, most beef in the US was reared on grass. In the 1950's, research catapulted the efficiency of beef production by introducing the method of feeding cattle in a restricted area high energy grains. These are 'Grain-fed' cows. This was a huge boon to the cattle industry because they accelerated the cow's growth rate and improve marbling (fat content in the meat). The majority of meat in North America is now raised in this fashion.

Pasture-raised or grass-fed ruminants refers to that pre-1940's style of animal rearing, where the animals have at least 12 hour access to the outdoors, eat primarily grasses and have little to no grain in their diets. Ethics and karma aside, there is a nutritional debate about which meat is better...and the winner is Grass-fed.

Grass-fed ruminant meat differs considerably from its grain-fed counterpart nutritionally. The most dramatic change is in the cow's fat composition. Not only is Grass-fed beef leaner but the fats it does have are great fats. Grass-fed beef is rich in conjugated linoleic acid (CLA) (C18:2) isomers, trans vaccenic acid (TVA) (C18:1 t11), a precursor to CLA, and omega-3 (n-3) FAs on a g/g fat (see previous blog as to why this is so important) basis. While the overall concentration of total saturated fats isn't lower in grass-fed beef. The fat that is saturated are not cholesterol elevating saturated fats, such as neutral stearic FA (C18:0), myristic (C14:0) and palmitic (C16:0) fatty acids. That might sound like a lot of gobble-dee goo but another way of thinking about this is Grain-fed beef are eating the same grains we already eat to much of in our own diets. Therefore, grain-fed cows have the same distribution of fats that we already get too much of in our diet, i.e omega-6 fatty acids, cholesterol, saturated-fats. Grass-fed beef is another great way of putting omega-3's in the diet.

Several studies also show grass-based diets elevate Vitamin A and E, as well as cancer fighting antioxidants (glutathione and superoxide dismutase) in beef as compared to grain-fed cows. They are so rich in beta-carotene that often you can see a yellow coloring to the fat, and as a result have a longer shelf-life.

The down side? $$$$ Grass-fed beef comes at a price. It is more expense, requires more land and more time to produce grass-fed beef. Consumers should also be aware that the differences in fat content will also give grass-fed beef a distinct flavor and unique cooking qualities that not everyone likes. Grain-fed meat has the typical taste and smell we are used to. However, if we want to provide our families with meat that gives protein plus a bevy of other important nutrients and doesn't supply us with more Omega-6, too much fat and excess saturated fats, then we should consider Grass-fed/Pasture-raised beef and lamb.

And what about the hormones my friend was trying to avoid, to be assured that Grass-fed beef and lamb are free of hormones, it has to be listed as organic. Most Grass-fed beef is organic; however, some farmers don't use hormones but can't afford the fees to pay for organic labeling, so ask!

Grass-fed Meat (Ruminants)

Pros:

+ Conjugated Linoleic-acid

+ Omega-3 fatty acids (g/g basis)

+ Steric and palmitic acid

7x more Vitamin A/Beta carotene

3x Vitamin E

+ Glutathione & superoxide dismutase

- Lower total fat

Grain-fed Meat

Economical

Typical taste and aroma

Anticipated Coloring and cooking

Higher in Omega-6 FA

Lower in AntiOxidants

Higher in LDL increasing saturated FA

Is Juice a fruit serving?

2010-10-05T09:40:00.000-04:00

Juice has come to represent a lot of products in the past 25 years and our consumption of it has changed dramatically in the past 50 years. A lot of parents wonder if juice is an acceptable substitute to fruit. When fruit was scarce after WWII, parents were pushed by pediatricians to provide their kids with juice. Kids love it and it can be more economical and often more digestible than fruit. BUT is it nutritionally the same as fruit?

Juice, according to the USDA, refers to a product that is 100% juice. However, manufacturers have become very sophisticated in making cheaper products that are promoted as 'Juice'. Some of my favorites are the most popular soccer drinks, like 'Sunny D' or Capri Sun. The Sunny D ingredient list is the following: Water, High Fructose, Corn Syrup, and 2% or Less of Each of the Following: Concentrated Juices (Orange, Tangerine, Apple, Lime, Grapefruit). Citric Acid, Ascorbic Acid (Vitamin C), Beta-Carotene, Thiamin Hydrochloride (Vitamin B1), Natural Flavors, Food Starch-Modified, Canola Oil, Cellulose Gum, Xanthan Gum, Sodium Hexametaphosphate, Sodium Benzoate To Protect Flavor, Yellow #5, Yellow #6. YIKES!!!!! That is less than 11% juice and you get all sorts of artificial colors and preservatives, to boot. So, clearly Sunny D, Capri Sun and other 'Fruit Drinks' or 'Fruit Cocktails' are not substitutes for fruit and obviously you get a lot of junk in addition to a little bit of fruit juice.

There are a lot of 100% juice products on the market as well and they are used by schools, families and day cares as a fruit serving. In fact, in children under 12, their consumption of juice has doubled in the past 25 years. This is disconcerting given that both calcium intake and fruit consumption has declined in parallel to this. Meaning that when preschoolers double their juice intake they decrease their fruit and milk intake by 1/2!

Is this a concern? Yes, nutrient analyses of juice versus fruit reveal large differences in their profiles. Turning a fruit into a juice involves eliminating peel, pulp and a percentage of the liquid (lost in the processing). Along with the pulp, peel and some liquid, juice also loses fiber, Vitamin A, Vitamin E, B vitamins, sometimes Vitamin C and numerous minerals that are only rich in the outer layer of the fruit. This means.....that a serving of juice is not nutritionally equivalent to a serving of fruit.

Children today are drastically under consuming fiber, Vitamin C, calcium, Vitamin E and other nutrients. They are eating less than the recommended servings of vegetables and fruit each day. In addition, most American children are over consuming calories and we have an epidemic of obese kids. Replacing fruit with juice, is not a sound approach, given that juice is higher in calories and lower in vitamins, minerals and fiber. Children should consume a minimum of 5 servings of fruit and vegetables/day.

If juice is hard to eliminate in your hourse, try to phase it out by increasingly diluting it. Also try improving your child's intake profile: use only 100% juice, use 100% orange juice (it is nutritionally superior to other juices), use an appropriate serving size (4 oz for most children), use a veggie/fruit blend and start to phase in milk or fortified milk-substitute in its place (fortified with Vitamin D and calcium).
Of course, lets also encourage our children to drink water.

references:
Journal of the American College of Nutrition, Vol 15, Issue 5 4S-11S, Copyright © 1996 by American College of Nutrition

Journal of the American College of Nutrition, Vol. 18, No. 6, 582-590 (1999)

Portion sizes, too much, too little, what does the Jewish mama say

2010-09-13T16:47:00.000-04:00

Sorting out portion sizes for kids is very hard, given that the images that we see of food in the US are far too large even for adults. As a dietitian, I would often be asked to provide patients/clients with volume amounts or volume comparisons for their portion sizes. I begrudgingly say use the palm of your hand as a guide; but I don't think this is the best approach because the whole idea of portion sizes focuses on the wrong idea.

For most of my readers, food abounds and for this reason kids need to learn to listen to their own satiety cues not our ideas of how much they should eat. Portion sizes should be pushed to the side and only be used in kids where you feel they are exceeding their needs, eating after they feel full. However, most kids, especially younger kids, need to be given small amounts (tablespoons for little ones, a few more tablespoons for bigger kids) of everything on the table. If they eat what is in front of them and they are still hungry they will ask for more. Just add small amounts more. This slows meals down and helps kids let their brains catch-up with their stomachs. It also encourages them to try everything at the table, which helps them get a greater diversity of nutrients.

The best approach is to start with your vegetables first, whether that is salad or broccoli. Put the vegetable in the middle of the plate or put the vegetable on their alone. They are the most hungry when they first sit down to the meal and since this is the most important part of the meal it should come first. I also encourage parents to let the child serve themselves the vegetable, if they are physically old enough. Then leave the vegetable serving platter in front of the child. I bet the amount of vegetables they eat will surprise you....give it a try.

Healthy school snacks for all ages

2010-09-07T23:04:00.004-04:00

I am so encouraged by all the parents asking for snack suggestions for the classroom. Below is a list of suggestions for providing healthy snacks.

Young kids (those getting school snacks) need

some hydration and calories mid-morning but they don’t need a lot of calories. Mid-morning is a great time to give fruit or vegetables, they offer some easy calories for working bodies to burn-off, they are hydrating foods and they have a great amount of vitamins to keep energy levels charged. Vegetables are super popular at this age when cups of dip are offered along with them.

#1 CHOICE IS FRUIT AND/OR VEGETABLES!!!!!!

Bags of baby carrots, cucumber, celery sticks, peppers of any color, green beans and any other crunchy vegetables are bigger hits than you would ever believe. Don't sweat offering some dressing; most children don't end up consuming that much dressing relative to how much they eat in vegetables.

Fruit is always a winner. Try offering bananas (can cut them in two if these are smaller kids), grapes, apple slices with cinnamon sprinkled on them, oranges, frozen blueberries, sliced pears and other fruits your kids enjoy at home.

For teachers wanting individually wrapped foods, Mother Nature can do some work for you. You can provide clementines, whole apples, bananas, etc.

2. Try dried fruit, such as raisins in boxes, dried apple rings, fruit leathers, dried cranberries, banana chips and the yummiest dried apricots. Dried fruit is often high in iron and other minerals. They are calorie dense which can help the older kids if it is an afternoon snack.

3. Dairy snacks are packed with protein and can help provide some electrolytes, too. Most kids under 10 tolerate dairy fine and really like yogurts (avoid tube yogurts b/c they often have 2x the sugar as normal cup yogurts), cheese sticks, yogurt smoothies or cheese cubes and crackers. Just pack them up in a cooler with an ice-pack.

4. Some low fat, low sugar carbohydrate snacks could also be included but this is the least beneficial category, since this is typically well represented in kids' diets. Most US children have carbohydrate-rich cereals for breakfast and don't necessarily benefit from having it at snack time, too. But some choices that would be okay include: low-Sugar Cereals, i.e. Kix, Cheerios, Oatmeal Squares, graham crackers (some of these can run really high in the sugar – I look for less than 10g of sugar per 2 crackers), pretzels, whole grain breadstix or crackers.

#5. Lastly, if you are allowed to serve nuts then go nuts and serve them up. Nuts are high in beneficial fats, low in sugar and rich in vitamins/minerals but they only work if you are in a nut-friendly facility. You can serve whole nuts, nut butters with crackers, nuts with dried fruit and popcorn mixed in.

Do your best to serve your child's class something that would be acceptable at home. They don't need treats at school that just spikes their blood sugar and makes it harder to focus. Serve them something from the above list that can help them maintain their energy and focus.

Brief tutorial on fatty acids...if you want to know the nitty gritty

2010-08-24T16:11:00.000-04:00

Several friends have asked me what Omega-3 Fatty Acids have to do with what is listed on the box label as Fat. So below is a quick brush-up on fats.

Fat is a fuel molecule and is stored in the body as triacylglycerol, meaning 3 fatty acid chains attached to one glycerol molecule. The fatty acid chains can vary in length and very importantly, they can vary in the number of bonds they have in them. Their bond spacing and chain length effect their melting point, fluidity, cellular role, absorption rate, etc.

If they have no double bonds between their carbons, a fatty acid is referred to as 'saturated'. With one double bond in the fatty acid chains the fat is referred to as a monounsaturate. If there are multiple double bonds then the fat is a polyunsaturated fat.

If a fatty acid has its first double bond at its third carbon then it is called an ..... omega-3 fatty acid. If it has its first double bond at the 6th carbon then it is an omega-6 fatty acid. Both are polyunsaturated fats.

Both types of fat are critical to our health but we consume vast amounts of omega-6 fatty acids, reflected by the fact that it is almost 20x more abundant in our body. If you are interested in why they are important and how to improve your ratio of omega 3:6 see my previous blog about the importance of omega-3's and omega-6's.

Greens, Greens, Greens

2010-08-04T15:53:00.002-04:00

It is time that I write an homage to my favorite vegetable, Greens. It just needs to be said again how fabulous they are for our bodies.... leafy vegetables are the most 'nutrient valuable' items on our plates. They vary in their make-up but generally they are rich in potassium, calcium, niacin, magnesium, vitamin K, vitamin A, vitamin C, vitamin E, and several B vitamins. They are great sources of antioxidants and phyto-nutrients; AND (my favorite topic) if they are grown organically, they contain Omega-3 fatty acids.

Let's not forget fresh herbs, greens include herbs, such as parsley, basil, oregano, sage, etc. Herbs contain all the nutrients listed above and are antioxidant powerhouses. Studies have found that fresh herbs contain 40 different antioxidative compounds. Oregano and parsley have been shown to be 20-40% more potent than apples with regard to antioxidative capacity. So, chop off some oregano and throw it in your salad. It grows like a weed in the Midwest and can be an ornamental border for gardens.

If we need to humanize our food into heroes and villains, which the media seems bent on doing, then greens are the super heroes of all time.

Veggies First

2010-07-17T17:04:00.001-04:00

Eating their veggies after a big day at the beach!

We are back from a wonderful tour of our favorite east coast cities. I always have a hard time getting a balance in the kids' diets while we are traveling but my tried and true "veggies first" always helps. I can't claim this idea as my own, since my sister-in-law and I started it together about 8 years ago on one of our first beach trips.

We realized when our older girls were starting to get picky, that their eating habits were even worse when we were traveling. There was a plethora of chicken fingers at the restaurant stops and hot dogs for the busy dinner gatherings. It was then that we began serving our kids dinner appetizers. When they came in after hours of playing hard on the beach and dinner was an hour away, we would give them a beautiful plate of fresh veggies. The veggies would always disappear.

As the kids have gotten older and our numbers have grown, the veggie plate has gotten fuller and disappeared quicker. Clearly it makes good sense to feed the kids veggies when they are the most hungry but it wasn't something I had been in the habit of doing. We still serve "veggies first" and it makes my heart sing to hear the kids crying out for more red pepper or cherry tomatoes.

To Supplement Or Not To Supplement That Is the Question...Or Is It?

2010-06-21T23:38:00.000-04:00

A lot of parents wonder what my thinking is on nutrient supplements for children. It is a tough question for me both because the research is complicated in this area and because supplements out there might not be what they state they are on the bottle. But the question should actually be, not whether or not to supplement, but which supplement brands to buy.

If you read my earlier blogs, I think there is a clear case to be made for supplementing both kids and adults with Vit D (more so in the fall and winter) and Omega-3 fatty acids. There is enough research to date that suggests that most American kids fall short in the mineral department, as well. This means that supplementing for iron, zinc, calcium, magnesium and selenium is not a bad idea. Some kids are identified as anemic and therefore need to continue on their iron-specific supplement.

As many of you have probably already figured out there is no one supplement that contains just these nutrients. Nor are there many mineral supplements that don't also have 20 other micronutrients that children don't necessarily need. In addition, grown-ups have different risk areas and these are gender-specific. As a result, we have a cabinet with 6 different supplements. Yikes....

So what do I suggest? Two things, one determine what you would like to supplement, I will provide some suggestions for this. Second, determine which brand. To do this second task, it is important to use one of the reliable websites that provide data on what is actually in your supplement, see end of blog for reputable sites.

What I do with my family, and recommend, is to purchase a kid's "everyday vitamin" to use year around but don't use it everyday. Make sure these "everyday - not everyday" supplements contain 20% or more of iron and zinc; and more than 50% of Vit D. If your child is not a big milk drinker then likewise make sure there is 50% or more calcium. Generally, the amount of Vitamin E, C and B vitamins are too high in these for everyday use. Therefore, provide them every other day or every third day. Our two year old thinks that vitamins are morning desert. He has Pavlovian training requiring he receive his 'gummy' as soon as he sits down for breakfast. As a result, we give him a 1/2 dose or 1/3 dose each day.

In addition to the everyday vitamin/not everyday vitamin, I also recommend a 400IU of Vit D for the darker times of the year. If you are below Atlanta, GA this is less important but all kids above that latitude should receive a Vit D supplement, especially if they have darker skin tones. Again, this can be an every other day thing. And year around, being in the midwest, we give the kids at an Omega-3 supplement that is primarily DHA and EPA.

Which supplements? As I said this is a harder question. Consumers need to know that supplements are not tested by FDA before they go on the shelf . One supplement testing agency found that 30 percent of all common multivitamins have more or less of a stated ingredient, or they might not dissolve properly; and several contain toxic contaminants. To avoid these concerns you can shop at a store that test their supplements or use volunteer testing programs to make sure there are no toxins and that they have the correct levels of ingredients. I know Whole Foods and a local chain here,Meijer, get their products test. An even better approach is to use http://www.consumerlab.com/ to check out your particular brand of vitamin. It costs 30/year but is a great resource. Another idea is a symbol on the package of the supplement indicating they participated in volunteer testing conducted by either United States Pharmacopeia (www.usp.org) or NSF International (www.nsf.org), both are reliable organizations. A recent NYTimes article addressed the issues surrounding our supplements:

http://query.nytimes.com/gst/fullpage.html?res=9C03E3D91F38F935A15756C0A9669D8B63

A diet rich in greens, fruit, legumes, healthy sources of protein and dairy needs limited supplementing but whatever supplements you do choose, make sure they are what you bargained for!

Organic - quick and ez guide

2010-06-01T13:15:00.000-04:00

Here are some great lists generated by the Environmental Working Group. They are useful guides for navigating the organic section of your grocery store. Bear in mind these lists are based only on residues left on the produce, which is actually not the only reason to buy organic. However, if you finances are a concern then be sure to at least by the 'dirty dozen' organic (Lists at the end of the blog).

Why else should I buy organic? The two other reasons I consider are the nutrient composition changes pesticides can cause and the environmental impacts of the pesticides. The idea that pesticides can alter a vegetable's nutrient make-up is controversial; but the best study did find changes in omega-3 fatty acid concentration and mineral levels. This study is criticized b/c it only analyzed broccoli; however it has such a strong study design (in contrast to most of the other studies) that it cannot be dismissed. If organic produce is enriched in fatty acids and minerals that we typically lack in our diet it is even more valuable to purchase organic when we can.

The other reason is the impact of pesticides that don't make it on to the produce. Pesticides are applied in various fashions but often in a fairly indiscriminate manner. A lot of the pesticide ends up in run-off, on the individuals working on the farm, in and on the animals scavenging around and on the farm and in the soil beyond the boundaries of the farm. As a result the use of pesticides can have far-reaching effects.

Consider buying organic when you can and when you are limited buy the dirty dozen organic.....

The Dirty Dozen
Celery
Peaches
Strawberries
Apples
Domestic blueberries
Nectarines
Sweet bell peppers
Spinach, kale and collard greens
Cherries
Potatoes
Imported grapes
Lettuce

The Clean 15
Onions
Avocados
Sweet corn
Pineapples
Mango
Sweet peas
Asparagus
Kiwi fruit
Cabbage
Eggplant
Cantaloupe
Watermelon
Grapefruit
Sweet potatoes
Sweet onions

Snacks - Hurried But Healthy

2010-05-19T15:05:00.000-04:00

Life is busy with kids involved in school-related activities and after-school activities. But nothing is busier than the month of May when all those activities come to their climax simultaneously. We have a typical May week this week, with an event 5 evenings out of 7. One of the challenges that this presents is providing snacks that are super quick or can be eaten in the car. Generally, I encourage the kids to sit and slow down to eat; but May doesn't allow that sometimes.

The snacks adhere to lunch box guidelines of including fiber, protein, fluids and limiting sugar, in the hopes of helping the kids last from one activity to the next. But sometimes these snacks have the added demand of having to be quick to eat and not to messy (in case they go in the car). Our best bets have been:

Yogurts - these are popular in our house and they are a quick source of protein. Caution - need to look for those yogurts that are less than 20g of sugar/8oz.

Pretzels and nuts - there is something yummy about starches with nuts. My son thinks fresh almonds and pretzel nuggets are divine. I have to agree there is something special in that combination.

Homemade muffins, pancakes or cookies - this is obviously great to have around but not always there. But if you are making some of these eliminate 1/3 of the sugar and substitute 1/2 whole wheat flour and you have a great snack. I make these modifications to all our baked goods and it routinely works. These changes increase the fiber and protein content and limit the sugar.

Dry cereal with nuts or seeds added - this is a quick ziploc mix that is tasty. We also add raisins and banana chips if we have an extra second.

Fruit or carrots with a nut butter - offers fiber and protein in one pop but not always car-friendly.

"Super Hurry Snacks"....When we have only a 10 minute turn-a-round time, we will grab a chocolate milk or a cereal bar. Yes, I mentioned two snacks that are typically higher in sugar. These are not ideal but there are some products out there that are more nutritious. The Horizon chocolate milk is lower in sugar than most and in general, this is a nice protein source (along with Vit D). With the cereal bars, look for products that are not too large and have less than 10g sugar/serving. Kashi makes some bars with lower sugar and their portions are not as large as most.

How do we get those Omega's in????

2010-05-13T22:28:00.000-04:00

Omega-3 Fatty acids are a tough one for us these days. This type of fat is not that common in the North American diet. and the most typical source for these fats in the US is fatty fish or supplements. Now that we live in the Midwest finding tasty fish is a very expensive enterprise; and choosing the right type of fish to maximize the omega-3 content while minimizing the toxic contaminants is challenging.

Omega 3's are fatty acids critical to brain development in fetuses and mature brain function (memory and cognition). In addition, Omega 3 fatty acids balance out another Omega-6 fatty acids. Too little Omega-3 and we get too much Omega-6, which is the scenario in the American diet where we eat 10- 25x as much Omega 6 as we do Omega 3. This is important b/c an imbalance exacerbates inflammation, depressive disorders, problems with fatigue, poor memory, dry skin, heart problems, mood swings and poor circulation.

Clearly, we need to incorporate more Omega-3 into our diets and the sources are limited. Cold-water fish are the richest source of Omega- 3's, this includes salmon, mackerel, halibut, sardines, tuna, and herring. The fish with highest Omega-3 levels and lowest amounts of PCBs are the fish that are not farmed. Farmed salmon can have Omega-3 levels as low as chicken meat and have high Omega-6 levels. Alternatively, you want to limit the bigger fish like Tuna, Swordfish and the like to 1x/wk because they have higher mercury levels.

What do we do at our house?
We mix it up and have fresh fish 1/month with a lot canned fish and fish fingers 3-4x/month. Trader Joes has a lot great canned fish - trout, salmon, sardines, etc. that are really tasty. We also make sure that the fish fingers are a serving of fish and not 2 servings of bread.

However, I feel lucky because we have kids that love fish. If this isn't true in your house there are alternatives. Plants, nuts, algae and, interestingly, organic vegetables (the reasons for that are for another blog) also contain Omega-3's but in much smaller amounts or in a form that the body can convert to an Omega-3 fatty acid if there isn't too much Omega-6 around. Flax is the most popular alternative to fish. However, the fats in flax are readily oxidized by light and oxygen. The seeds themselves go right through the human digestive system (they go in the way they come out - intact). The ground flax material and flax oil are better but only if they are consumed within 24 hrs of being made.This all makes flax not as great a source as it is hyped to be.

What about Supplements?

These are one of the few daily supplements we do at our house. Although, we manage to eat fish about 1x/wk that isn't enough. So, I compensate with supplements.

It took awhile to find one that the kids liked but there was a huge selection at Whole Foods that we tried one by one. Why Whole Foods? With omega-3 supplements you want established companies who certify that their products are free of heavy metals such as mercury, lead, and cadmium. Whole Foods only uses those companies for supplements. They are my go to place for supplements b/c SUPPLEMENTS ARE COMPLETELY UNREGULATED!!!! Whole Foods only uses companies that can verify their content and are rigorous to keep out contaminants.

Krill supplements are also a safe way to go but they can be $$$$ and cod-liver oil straight up is ideal because then you have your Omega-3's and Vit D in one teaspoonful. Yum!

Grown-ups can use the kid's supplements if they don't tolerate the adult swallow pills and all of the supplements are better tolerated if they are kept frozen.

Time to dust off those salmon patty recipes and eat your organic broccoli, we need to get more Omega 3's in our diets.

How to Make Packed Lunches a Healthy Boost for your Child

2010-05-07T15:02:00.002-04:00

Wouldn't it be nice to keep our kids out of the nurse's office, alert and creative for an entire school day and energetic enough to enjoy the hours after school? The trick might be finding the foods that help kid’s concentrate and that they enjoy eating.

I have thought a lot about school lunches since our 7 year old began having a growth spurt. Not only was he making a huge dent in our food budget but the lunches I was sending with him to school were not filling him enough to get through the day. Given that most US schools only allot 15-25 minutes for lunch, I was limited in what I could give him by how little time he has to eat. The obvious solution was to just add more fats. Fat would increase his satiety without necessarily increasing his chew time. However, many studies indicate that a fat-rich meal in the middle of the day makes most of us sluggish and sleepy. That was not the recipe for a good school meal. I went back to basic nutrition precepts and figured out how to decrease his hunger while increasing his focus at the end of the school day.

FIVE TIPS FOR ENERGY-ENDURING LUNCHES.....

Pack fiber. Foods rich in fiber slow our digestion down, which is perfect when you want energy levels to last. Fiber-rich foods include fruits (dried or fresh), vegetables and whole grain starches, i.e. Apples, carrots slices, dried apricots, oat bran pretzels, certain breakfast cereals (bag of regular Cherrios or oat bran squares), or wholegrain crackers.

Pack protein. Include a food rich in lean protein to help kids nourish themselves for longer. Examples: lean lunch meats, cut up cheeses, peanut butter, nuts (roasted nuts are great, too), hummus.

Avoid Sugar. Sugar causes a quick surge in a child’s energy level but, unfortunately, has a rebound effect. So while the sugar helps the kids feel energized for recess, it will drain their energy when insulin levels drop an hour or so later. This doesn’t mean eliminate all treats; but limit the amount and size of sugary treats and balance them with a well-rounded lunch.

Pack a Drink. Hydration keeps all our major organs working well, including the brain. So pack a drink but limit the juice drinks (even the 100% juice drinks). Fructose (the sugar in fruit juice) is metabolized similarly to table sugar. This means that juice boxes have the same energy effect on kids as candy. The kids will have an energy spike on the playground, only to feel tired and unfocused later in the afternoon.

Avoid Soda Pop. Sodas contain large amounts of high-fructose corn syrup and caffiene. Both of these ingredients ultimately sabotage your kid's efforts to stay focused at school. Instead of juice boxes or soda try sending milk-money to school, a bottle with water, low sugar yogurt drinks or boxed milk.

Here are some more specific ideas that have been a hit at our house and they go beyond the stand-in peanut butter and:

Sandwiches:

Veggie cream cheese and cucumbers

Strawberries or Blueberries and Cream Cheese

Laughing Cow spreadable cheese with turkey/ham and grated carrots

Tuna salad and a sliced tomato

Hummus and chopped peppers or tomatoes

Whole Grain Tortilla wrap – use any favorite fillings, hummus, bean dips, mayo and lunch meat, include some lettuce and wrap in tinfoil

Protein quickies:

Cheese slices or cheese sticks

Cheese squares with pretzel sticks in them - plungers

Waffles or pancakes made with whole milk and eggs (leftovers from the weekends are great lunch stuffers)

Low-sugar yogurts – avoid the Go-gurts and the others in tubes, they are doubled up on sugar as compared to their cheaper tub yogurts

Milk with lunch

Cottage cheese – can pack with some honey, applesauce or jam to sweeten

Hard Boiled Eggs – quick and easy protein that is always fun to eat

Fruit/Veg options:

Celery sticks – it is surprising how refreshing these are and how many kids like them

Baby Carrots – you can pack your own ranch dressing or a container of Peanut Butter for dipping

Box of raisins

Apple slices preserved with a squeeze of lemon

Dried fruit – combine dried cranberries, raisins and banana chips

Tupperware of grapes or melon

A big blog on Vitamin D

2010-05-03T14:54:00.000-04:00

I have been talking Vitamin D to all who will listen. I think I need to back-up and explain why I am so concerned about everyone’s Vit D status.

Here is the quick and dirty background on Vitamin D.
Vitamin D is a fat soluble vitamin which can be found in the American Diet but not in any great amount (typical consumption 100 IU/D). It is however readily made by our skin cells when they are exposed to sunlight (UVB rays). So why worry? Right? We make it. However, to make it we need sun exposure – unadulterated sun exposure. That means no sunscreens, no sun garments, no sun umbrellas, etc. We need to expose our skin directly to the sun.

What does it do in the body?
The major function of Vitamin D is to maintain calcium and phosphorus equilibrium. Because of that, Vitamin D plays a role in just about everything: bone formation, immune system regulation, brain function, nerve function and detoxification processes. It influences the production of many proteins and therefore impacts the growth and death of many cells.

What happens when we don’t have enough Vitamin D?
Rickets and bone deformities are what pop into most people’s heads. That is true if we are severely deficient in Vitamin D especially from a young age. However, these classic syndromes are fairly rare now.

What we are up against now with Vitamin D is when we are borderline deficient (under 20ng/ml blood). Low Vit D status is associated with schizophrenia, depression, diabetes, MS, Rheumatoid arthritis, cancer, cardiovascular disease, osteoarthritis, Alzheimer’s, poor immune defenses, and allergies. This is hot press b/c 30-50% of the US population is believed to be at this borderline state.

So what do we do????
It’s seasonal.
Spring/Summer
The easiest thing is to just expose your skin and your children’s skin (starting at age 0) to the sun. It doesn’t need to be your face or any other sensitive skin area, arms, hands and legs are fine; nor does it mean that you have to be out with the most potent rays of the sun. Experts have promoted the idea of having 10 min sun exposure before putting on sunscreen.

Winter/Fall
If you live above Atlanta, GA you will need to supplement yourselves and your kids. It is recommended by Vitamin D researchers (see references) to supplement at the following levels:
Infants 400-1000 IU/day
Children 1-12 1000 IU/day
Teens 13-19 1000-2000 IU/day
Adults 1000 IU/day

What is my family doing?

I actually started with having the kid’s Vit D levels tested and found they weren’t deficient. I am nagging my parents to have their doctors test them. Why? B/c if you are deficient then you will need to start with a larger dose of Vit D supplements; but you don’t want to do that unless you are deficient. Vitamin is toxic when taking too much supplement-wise.

Now that I know they are not deficient. I encourage them to play outside as much as possible. I supplement them 500IU in the winter, fall and other cloudy days. Why less than the recommended amount? We eat a fatty fish 1-2/wk and eat drink a lot of fortified milk.

For myself, I am following the same regiment of getting sunshine and supplementing in the winter with
Resources:
1. Holick, M, J Clin Invest. 2006 August 1; 116(8): 2062–2072.
doi: 10.1172/JCI29449.

2. Holick, M. Mayo Clin Proc. 2006 Mar;81(3):297-9.
3. Cranney, A. Am J Clin Nutr. 2008 Aug;88(2):513S-519S.

Soccer Snacks

2010-04-26T10:50:00.001-04:00

Today is our day for providing soccer snacks. Although my 9yr old's team doesn't provide snacks after practice, the 7yr old's team does. Last year's practice snacks for this team included chocolate bars and Capri Suns (why are these the drink of choice for soccer). I decided to email parents and the coach to request healthier snacks this year. I never suggested specific snacks. WOW... the snacks have been gorgeous. The kids have gotten apples, beautiful strawberries, granola bars and bananas. Now, my kids won't complain when I bring a healthy snack. Despite the dire predictions, the kids never complain and the fruit disappears.

Hello

2010-04-26T10:44:00.001-04:00

Here goes....

This is my first posting on Healthy Kids, Healthy Families, despite having thought about it for a long time. I am passionate about raising my kids in a healthy, positive environment and I hope I can help others work towards this goal, as well. I am an RD (dietitian) and I have a PhD in nutrition; but more importantly I have three kids, 9, 7 and 2 years old.