Ask The Expert is a weekly column on Littlestomaks.com. The idea is to have a reader-submitted question answered by a nutrition expert or a pediatrician. Feel free to submit your question in the comments section below.

This week, registered dietitian and contributing editor of Parents magazine Sally Kuzemchak offers tips for managing fruit juices in a healthy diet.

Question: Is giving juice to my kids okay as long as it’s 100% fruit juice?

Truth is, if your child eats fruit everyday, she doesn’t need to drink any juice at all. It’s certainly a quick and easy way to fit in a fruit serving and get a day’s worth of vitamin C. But it doesn’t offer any nutritional advantages over fruit. And when you drink juice instead of eating fruit, you miss out on the fiber—something kids (and adults) need more of anyway. One medium apple with skin offers more than 4 grams of fiber, but a cup of apple juice has less than 1 gram. Plus, it’s not hard for a child to meet his C requirements without juice. Just one-half cup of broccoli or sliced strawberries provides more than a day’s worth of the vitamin.

The bigger issue with juice is that a serving provides more calories than a serving of fruit. One cup of orange juice contains about 122 calories, while a whole medium orange supplies just 69. Juice is easy to drink in large quantities: Without the fiber, it’s not nearly as filling as a whole piece of fruit. Children who gulp down multiple cups of juice a day (and many do) can take in hundreds of extra calories—and may start refusing beverages (like water) that aren’t sweet.

That said, if you want to work juice into a healthy diet, here’s how:

1. Stick with the current recommendations from the American Academy of Pediatrics: No more than 4-6 ounces for kids age 1-6 years, and no more than 8 ounces for older children. Diluting it with equal parts water will stretch small amounts further. Make milk the default beverage with meals and water the go-to thirst quencher in between meals.
2. Serve juice in a regular cup at the table (or highchair) with a meal or snack. Avoid letting your child drink juice from a sippy all day, which encourages over-consumption. Bathing the teeth all day in sugar, even the natural kind in fruit juice, can also increase the risk for cavities.
3. Choose 100 percent fruit juice, which will contain more natural vitamins and antioxidants. Fruit “drinks” contain just a little bit of juice and a whole lot of added sugar.
4. Keep only one type of juice in your house at one time, such as a carton of orange juice OR boxes of 100 percent apple juice so kids aren’t tempted by multiple kinds and flavors.

©2010 Littlestomaks.com. All Rights Reserved

Disclaimer – Information provided in Ask The Expert column on Littlestomaks.com is intended to give you general guidance on a question related to toddler nutrition. It is not meant to be treated as medical advice. You are welcome to contact this expert for a detailed consultation on your specific situation to determine what actions, if any, you should take regarding nutrition and health of your toddlers. We do not recommend you to take any action based solely on the information presented in this column. Experts have agreed to provide their professional opinion on toddler nutrition related questions on a voluntary basis and no compensation is offered to them by Littlestomaks.com.

Happy Easter! It is Friday again, which means it is time for the usual Five for Fridays! Here are 5 food and nutrition related stories that caught my eye. Enjoy and let me know what you think.

New health bill will require restaurants to show calories on the menu

Chain restaurants with more than 20 outlets nationwide will be required to display nutrient content and calorie information on their menus according to Section 2572 of the recent healthcare bill. Similar rules will apply to vending machines. Menu labeling has been already in place in New York City for over an year with mixed results. Studies published last year, which I wrote about in a Five for Fridays, reported that doubts were emerging about the effectiveness of calorie labeling. What was more worrisome to me was the fact that some restaurants were actually “cheating” by posting lower calories than actually present in certain food items when tested! Clearly, this should not be allowed.

I think calorie labeling on restaurant menus is a good idea. Not only that,  there should also be other nutritional information available, particularly on salt, sugar and fat. It may take some time before consumers are fully aware of the risks of salty, sugary and fatty foods, but clearly in the long run it will help them make better decisions. The problem is that now it will require some sort of policing to ensure compliance with the law. Already there are problems with the National Organic Program (see below) due to constraints in budget and inspectors . These new requirements will undoubtedly create a new bureaucracy and another cat-and-mouse game will begin between food marketers and compliance officers. Hopefully it will become a self-policing system if consumers begin to vote with their wallets at these restaurants.

National Organic Program lacks teeth to enforce rules

You pay extra for certified organic products. You have the right to expect that they are genuine and that they do not contain pesticide residues. You do not expect non-organic products sold with the organic label. Yet, it is not an absolute guarantee! Now, wouldn’t that make you mad?

This is exactly how I felt when I read a report in the New York Times which exposed serious gaps in federal oversight of the organic food industry. Turns out that they don’t have enough inspectors to spot check organic products for pesticide residue (required by law) and that bogus organic products were allowed to be in the market for over 2 years before any action was taken. The excuse? Well, demand for organic products has grown so fast that the USDA’s National Organic Program can’t keep up with its enforcement responsibilities!

Finally, they are making a commitment to enforce spot testing for pesticide residues. They are getting more money and more people. The bureaucracy is ballooning but don’t expect it work perfectly. It never does. Meanwhile, don’t give up on organic products; just do your research and buy from a reputable brand.

Pepsico wants to trick your tongue by “designer salt”

Don’t give up on the potato chips! At least that is what Pepsico would like you to do just in case you are having second thoughts after reading about the evil sodium in their popular snacks. Recently they announced plans to cut sodium content by 25% by 2015, saturated fat and added sugar by 15% and 25% respectively by 2020. Sounds like the responsible thing to do, especially now that there is a bright spotlight on the link between processed food and obesity.

The solution, at least for sodium? A new “designer salt” which has crystals shaped and sized so that they dissolve fast on the tongue delivering a rapid salty sensation. While an innovative idea, which Pepsico is sure to market as a “breakthrough”, I think it is still a great example of incremental thinking. The problem is not with salt folks, it is the chips that we need to cut down on.

And 25% reduction is not going to make these products “healthier”! Consider Cheetos, which contain a whopping 290 mg of sodium per 1 oz serving. A 25% reduction (in 5 years) will bring it down to about 220, which is still very high. Too little, too late? What do you think?

Spinach leaves enrich their vitamin content sitting on the store shelf

Worried about picking up that box of baby spinach close to its expiration date? Well, believe it or not, you may be actually getting more value for your money compared to a box that did not sit on the store shelves for this long!

According to researchers at the USDA, spinach leaves exposed to store lighting conditions continuously over 9 days had a higher level of folate, vitamin C, K and E compared to those kept in the dark. This fascinating research was recently published in the Journal of Agriculture and Food Chemistry. The researchers reasoned that the spinach leaves continued their photosynthesis (a process by which plants produce sugars using sunlight and carbon dioxide) under the store light, which also produces these vitamins. When the same spinach leaves were stored in the dark, photosynthesis did not happen.

This is interesting for sure, but remember that the vitamin content of vegetables also depends on how you cook them. Steaming and microwaving is good; but eating raw fresh veggies is even better.

Teaching kids to eat healthy the French way

Offer preschoolers a 5 course meal, make sure they eat at the table and keep the parents out is the French recipe for getting kids to build lifelong healthy eating habits. I was fascinated to read the Nursery School Gourmets in a recent TIME magazine, which explained how seriously the city of Paris looks at the matter of school lunches.

Clearly, it is a well-structured, heavily funded state program unlike what we have in the United States. The daily menu is planned in advance for 2 months with no repetitions. Every meal includes an hors d’oeuvre, salad, main course, cheese plate and dessert (yum!). Soda and snack machines are banned. Parents are given suggestions for what to serve at dinner based on the day’s lunch menu. Discipline is intense and kids are trained to eat at the table and keep quiet.

Should we emulate the French model to solve our childhood obesity problem? The topic of school lunch is center stage these days, and Jamie Olivers’ Food Revolution is on prime time. The French model is yet another benchmark for us to consider. What do you think?

Enjoy and let me know what is on your mind.

Photo Source: Wikimedia Commons

©2010 Littlestomaks.com

Childhood obesity and overweight is becoming a major issue today. If you are facing this situation with your child, you have got to understand the notion of resting metabolic rate (RMR) and how it can help you manage your child’s weight.

I first learned about RMR from Milton Stokes, who is a registered dietitian and an expert in weight management issues. He told me that a test is now available for measuring RMR and it may even be covered by your health insurance. I was so intrigued by it that I asked him to connect me with an expert on the science behind RMR and this new measurement technique so I could share a detailed article with you. Check it out and let me know if you have any questions. I will post a follow up article to get your questions answered.

Question: What is Resting Metabolic Rate (RMR) and how does it relate to weight gain?

Scott: Weight management is a simple, yet often difficult, task of balancing energy (i.e., calories) intake with expenditure. Individuals will gain weight when they consume more calories then what they typically burn. The opposite is true for weight loss; burn more calories then calories consumed. In order to determine appropriate energy balance an individual needs to know how many calories they burn each day. Total energy expenditure (TEE) is comprised of resting metabolic rate (RMR), activities of daily living, and the thermic effect of food (TEF). RMR is the main metabolic factor and represents between 60 to 75% of TEE while TEF is approximately 5-10% of TEE [1, 2]. Essentially, the higher the RMR higher is the TEE unless you are more active then the usual individual.

Question: How does this apply to young children?

Scott: Weight gain in children is a topic of great concern. The prevalence of overweight children is 15.5% for 12 to 19-year-olds, 15.3% 6 to 11 year-olds, and 10.4% among 2 to5 year-olds. Overweight has increased five percentage points among 12 through 19 year-olds from 10.5% to 15.5% in approximately 10 years [3]. Unfortunately, future projections indicate children that become overweight as children are at substantial risk of becoming obese later in life.

The children in the U.S. lead a very sedentary lifestyle. With the advent of video games, decreased physical activity in schools, and other social pressures children are not burning a lot of calories throughout the day. In-comparison, studies have indicated that they are consuming large amounts of calories. Therefore, they are in a positive energy balance (i.e., consume more calories then what is being burned). It is not so much a question of a slow metabolism but more of an issue with lack of activity.

This being said, parents should consider having their child’s RMR and activity level measured to best determine TEE. This will help a clinician tailor a nutrition plan to meet the weight management needs of the child.

Question: What determines a child’s RMR? Is it genetic or are there environmental factors?

Scott: RMR is regulated by a complex biochemical and central nervous system. Recent advancements in the Human Genome Project have led to a better understanding of genetic influences in several disease and metabolic states. The mitochondrial uncoupling protein 2 (UCP2) gene has been linked to obesity by way of possible influence on RMR [4-6].

However, it is estimated that this specific genetic influence may only account for the about 5 % of the variance in RMR.

Other biochemical influences may be related to specific hormones (i.e., Testosterone, Leptin). Much is known about the role testosterone has on the human body by way of muscle tissue generation. However, new research has indicated Leptin influences energy metabolism as-well. Leptin is typically known for its regulation of appetite and hunger.

Individuals that are leptin-deficient are often obese and have a lower RMR then normal weight individuals [7].

Still to this day, fat-free body weight is the main contributing factor on RMR. Studies have routinely indicated fat-free bodyweight predicts 80% of an individual’s RMR. Therefore, having more muscle weight in-comparison to fat weight will result in a higher RMR.

Question: Is there a relationship between autism, asthma, food allergy or other health conditions and RMR?

Scott: RMR does change with various health conditions. Most of the time, when an individual is hospitalized for an acute illness their RMR increases. The main reason why RMR increases is the body is trying to repair itself. This is a common reason why individuals typically lose weight when they are in the hospital. In addition, medications for several psychological (depression, schizophrenia, etc.) and physiological diseases (hypertension, diabetes, etc.) have shown to slow RMR [8-11]. However, some medications may not alter RMR but have an effect on overall TEE.

A study conducted in 1999, indicated medications prescribed for children with attention-deficit/hyperactivity disorder had no effect on RMR. However, the medication did result in decreased physical activity by 16-20% [12].
Since there are many disease states and medications that can affect RMR it is important to monitor RMR during medical management of given condition. Since RMR usually changes with a 5-10% weight change it is recommended, that patients receive a RMR measurement so clinicians can prescribe the most accurate nutrition program to best manage bodyweight.

Question: Where can I get my child’s RMR measured?

Scott: Measuring RMR is still fairly new. However, technology has made measurement of RMR easier and more applicable to general wellness facilities and out-patient medical clinics. You can search for health and wellness professionals online at Microlife Medical Home Solutions . The cost for a metabolic test is approximately $50-75 depending on location. In addition, insurance companies may cover this measurement if your child is overweight and/or has an underlying medical issue that has caused abnormal weight gain.

References:

1. Segal, K.R., E. Presta, and B. Gutin, Thermic effect of food during graded exercise in normal weight and obese men. Am J Clin Nutr, 1984. 40(5): p. 995-1000.
2. Danforth, E., Jr., Dietary-induced thermogenesis: control of energy expenditure. Life Sci, 1981. 28(15-16): p. 1821-7.
3. Ogden, C.L., et al., Mean body weight, height, and body mass index, United States 1960-2002. Advance Data from Vital and Health Statistics, 2004(347): p. 1-17.
4. Yanovski, J.A., et al., Associations between uncoupling protein 2, body composition, and resting energy expenditure in lean and obese African American, white, and Asian children. Am J Clin Nutr, 2000. 71(6): p. 1405-1420.
5. Bouchard, C., et al., Linkage between markers in the vicinity of the uncoupling protein 2 gene and resting metabolic rate in humans. Hum. Mol. Genet., 1997. 6(11): p. 1887-1889.
6. Walder, K., et al., Association between uncoupling protein polymorphisms (UCP2-UCP3) and energy metabolism/obesity in Pima indians. Hum. Mol. Genet., 1998. 7(9): p. 1431-1435.
7. Klok, M.D., S. Jakobsdottir, and M.L. Drent, The role of leptin and ghrelin in the regulation of food intake and body weight in humans: a review. Obes Rev, 2007. 8(1): p. 21-34.
8. Dickerson, R.N. and L. Roth-Yousey, Medication Effects on Metabolic Rate: A Systematic Review (Part 1). J Am Diet Assoc, 2005. 105(5): p. 835-843.
9. Dickerson, R.N. and L. Roth-Yousey, Medication Effects on Metabolic Rate: A Systematic Review (Part 2). J Am Diet Assoc,, 2005. 105(6): p. 1002-1009.
10. Procyshyn, R.M., A. Chau, and G. Tse, Clozapine’s effects on body weight and resting metabolic rate: a case series. Schizophr Res., 2004. 66(2-3): p. 159-162.
11. Fernstrom, M.H., et al., Resting metabolic rate is reduced in patients treated with antidepressants. Biol Psychiatry, 1985. 20(6): p. 692-695.
12. Butte, N.F., et al., Stimulant medications decrease energy expenditure and physical activity in children with attention-deficit/hyperactivity disorder. J Pediatr, 1999. 135(2): p. 203-207.

©2010 Littlestomaks.com

Disclaimer – Information provided in this article should not be considered as medical advice. Consult with your physician if you think your child needs an RMR test and how it can be used to control and/or reverse weight gain. I have no business relationship with Microlife Medical Home Solutions, Inc., and this article is not an endorsement of their products and services.

Ask The Expert is a weekly column on Littlestomaks.com. The idea is to have a reader-submitted question answered by a nutrition expert or a pediatrician. Feel free to submit your question in the comments section below.

This week, Registered Dietitian Jill Castle suggests a few alternatives to cow’s milk for your toddler if you are concerned about introducing dairy products.

Question: I am hesitant to give cow milk to my 15 month old daughter because I have heard that there are many problems with dairy. What other options do I have?

Answer:

Choosing which milk to feed your baby is an important decision, and one that requires thoughtful consideration.  With the plethora of milks available on the commercial market, it is often confusing to know which milk is appropriate for your child.  And many of these milks advertise their health benefits and are largely targeted at the adult.  The younger toddler (aged 1-2 years) continues to have unique nutritional requirements that are different from those of older children and adults, such as higher fat requirements, adequate protein and vitamins, and sufficient calories for growth. Additionally, liquid milk still provides the majority of nutrition (up to 60-70% of total caloric intake) in a given day for the younger toddler.

After a year of drinking breast-milk or infant formula, most emerging toddlers are ready to make a transition.  The gold standard, whole cow’s milk, has been the fluid milk of choice for many years, and many generations, and remains so in the eyes of the American Academy of Pediatrics (AAP).  Whole cow’s milk, when included with a variety of foods, can support the growth and development of children over one year of age. Whole cow’s milk contains about 150 calories per 8 ounces and is a good source of calcium, protein, fat, and Vitamins A and D.

Soy milk is an alternative to cow’s milk, readily available, and is utilized frequently for children who are intolerant or allergic to cow’s milk, or who are following a vegan diet.  Soy milk is fortified with calcium and Vitamin D, and can provide adequate protein and calories for the growing toddler. Soy milk is processed to match the nutrient content of cow’s milk and often, sugar is added to mask the bitter tasted of the soy bean.  Research indicates that ~40% of children who are allergic to cow’s milk are also allergic to soy milk.

Rice milk is used in children who are allergic to both cow and soy milks, and also may be used with the vegetarian child.  Caution should be used when choosing rice milk for the younger toddler, as it contains low amounts of protein, fat, and calories.  Some research has shown evidence of growth failure in young children consuming rice milk due to its poor protein, fat, calorie, and vitamin/mineral content.  If it is necessary for your young toddler to consume rice milk, be sure to consult with your Registered Dietitian (RD) or your pediatrician (MD) so that proper attention can be given to assuring your child’s liquid and solid food intake will meet their nutritional needs.

Hemp milk is yet one other milk available in stores.  Hemp milk is a grain milk, from the cannabis plant, and contains many nutrients found in cow’s milk.  The flavored hemp milks (150 calories/ounce) are similar in caloric content to whole cow’s milk and soy milk, however, the unflavored variety (100 calories/ounce) is considerably lower in calories.  Protein and fat content are lower than cow’s milk, but higher than other grain milks.  Hemp milk can be a nutritious part of your toddlers diet when coupled with a variety of foods.

Nut milks, such as almond milk, also tend to be deficient in protein and fat when compared to the unique nutrient needs of the younger toddler.  Caution should be used in introducing nut milks to the toddler before the age of three, due to risk of allergic reaction.

Young toddlerhood is an important time for establishing healthy eating habits and is also a critical time for adequate nutrition, specifically fat, protein, and calories.  As the younger toddler is in the process of being introduced to new foods and establishing eating patterns, a nutritious milk is an important component of the daily diet.  Evidence of steady growth and acceptance of a variety of solid foods are good indicators that your young toddler is receiving adequate nutrition from all food sources.

©2009 Littlestomaks.com. All Rights Reserved

Disclaimer – Information provided in Ask The Expert column on Littlestomaks.com is intended to give you general guidance on a question related to toddler nutrition. It is not meant to be treated as medical advice. You are welcome to contact this expert for a detailed consultation on your specific situation to determine what actions, if any, you should take regarding nutrition and health of your toddlers. We do not recommend you to take any action based solely on the information presented in this column. Experts have agreed to provide their professional opinion on toddler nutrition related questions on a voluntary basis and no compensation is offered to them by Littlestomaks.com.

Usually on Friday after work we take our kids to a toy train ride in a nearby open Mall. This Friday, as I was waiting for them to return from their train ride, I watched in fascination an interesting conversation between a hot dog guy and a woman buying a hot dog for her little (probably 4-5 year old) girl. It was one of those street corner hot dog stand just outside an upscale clothing store.

Mom comes out of the store with her daughter and sits down on a bench next to the hot dog stand.

“Mommy, I am hungry”

Mom notices the hot dog guy. “Would you like a hot dog honey?” she asks the child.

She doesn’t wait for her answer – which of course was a quick yes – and takes her by the hand to the vendor. As she orders the hot dog, she asks her daughter:

“What would you like to drink?”

“Sprite”

“Good choice! Caffeine-free sprite for you”, exclaims the vendor as he hands the hot dog and the Sprite can to the mother.

“That would be $4.50″

Just as the Mom hands him a $10 bill, he quickly adds:

“You know, you can make it a combo for another 50 cents and get a bag of chips”!

Mom doesn’t even pause, and asks her daughter:

“Would you like a bag of chips, honey?” as she points to the rows of chips on the overhead shelf.

The girl thinks for a moment as she eyes bags of Cheetos, Nachos and Plain Potato Chips.

She points to the bag of Cheetos. Mom takes it out, gets the change back and walks away with a hot dog, a can of Sprite and a bag of Cheetos.

What just happened?

For an extra 50 cents,  she got 160 extra calories and 290 mg sodium. She didn’t think much of it since she did not read the nutrition label on the bag. It was simply a matter of better value.

We are conditioned, almost like robots, to respond to the irresistible offer of a combo meal or a “supersize” option for only a little bit more money. Fast food sellers have figured out a way to “squeeze” out the last few cents from your visit by making it sound like a great deal. It works almost every time – the customer feels happy because it looks like they are getting more for their money, and the store makes more money per customer.

Next time you are offered the extra value combo meal, just pause and think if you really need those extra calories. If not, then save the 50 cents!

Photo source: Doonvas on Flickr via everystockphoto
©2009 Littlestomaks.com

Hello everyone! Seems like I still can’t let go of summer – this picture was so cute, I had to post it this week to remind us of summer fun on the beach. We did manage to get out a few times to the nearby beach, although my daughter refuses to step on the sand! She finds it too yucky – go figure!! Luckily both of our twins love the pool, so that is where we spent most of our summer this year.

It’s Friday, which means it’s time for another Five for Fridays! Here are 5 interesting nutrition stories of the week that caught my eye. Enjoy and drop a comment to let me know what’s on your mind.

Finally some guidance on daily sugar intake for Americans

I almost fell out of my chair when I read that Americans consume a whopping 22 teaspoons of sugar every day. That is about 355 calories, nearly 20% of the 2000 recommended daily caloric intake. I am sure you have noticed that on a typical nutritional facts label, there is no daily percentage for sugar content. This is because a daily limit has not been established, although there is good consensus on limiting the daily intake to less than 25% of total calories. As a result, it is very difficult for consumers to keep track of their daily sugar consumption. A while ago, I wrote about how to take the guesswork out of daily sugar to help set some boundaries and regulate the sugar intake.

Now, for the first time, the American Heart Association has come out with fairly clear guidelines on daily sugar which suggest that most women should limit it to less than 6 teaspoons and most men should limit it to 9 teaspoons. Note that these are still not official USDA recommendations, which I hope will follow soon. I think the breakfast cereal makers will respond first since their products tend to make heart-healthy claims although they contain a lot of sugar per serving. But I hope to see it change other food products as well. It is possible that this will drive the use of zero-calorie sweeteners in food products.

Ideas for packing a healthy lunch your kids will actually eat

My Twitter friend @RelevantMom alerted me to this article by the Associated Press which highlighted a few interesting school lunch box ideas from TV food stars Rachel Ray and Melissa d’Arabian. It is hard to resist the ready-to-go lunchables but they can end up costing a lot without providing good nutrition. Simple ideas like peanut butter, hummus, canned tuna, beans and lentils are good source of protein. You can mix them with breads, pitas and rice to create a quick and easy nutritious item. Add fruits and veggies selected by your child on the last grocery shopping trip to make sure he will actually have an interest in eating them. Get creative on snack ideas and skip the packaged snacks to save money. Their last tip is the best – add a loving note to the lunch box; it costs nothing but it can make your child feel special and loved when out of home in school where they might still not be very comfortable.

Share your tips for the school lunch box this back-to-school season. Here is what @themenumom suggested when I asked this question to my Twitter followers:

What has worked for you so far?

How normal is your eating?

Ever wonder if you practice normal eating? I can see you rolling your eyes and thinking “please, not another diet buzzword to make me feel guilty about my eating behavior”!

I was intrigued by a short note in the Well column of the New York Times by Tara Parker-Pope this week which asked this question. I am sure if you ask different people, they will come up with their own answer, and be quite sure that their eating preferences are perfectly normal. Turns out that the term normal eating was coined by famous dietitian Ellyn Satter. She explained that normal eating is when you “listen” to your body, eat when hungry and stop when full. Sounds simple and common sense. Except that we now seem to listen more to our tongue than to our stomach when it comes to eating. There are some who believe that the food industry has figured out how to rule the tongue by loads of salt, sugar, fat and other taste enhancing chemicals in processed foods. Self-control is lacking, especially when most family meals are consumed in front of the TV. We no longer have a sense of portion control. We try hard when we are motivated to go on a diet, only to give it all up and return to our old ways when things don’t work out the way expect. From this point of view, today’s normal eating is hardly normal the way nature intended it to be. I think it is about time we paid attention to it, especially when it comes to raising healthy children.

Functional food is nothing but dressed up junk food

That seems to be the opinion of many nutrition experts such as New York University’s Marion Nestle as cited by one of my favorite bloggers Dr. Ayala on her recent post “Are functional foods healthy foods?” I liked her article very much because she reminds us that with a little bit of right information, planning and effort you can prepare your own nutritious foods without having to waste money on these so called functional foods. It is easy to slap catchy slogans like low cholesterol, zero trans fats and fortified with brain-boosting omega-3′s without really changing the basic nature of the food inside the box. Sad truth is that such marketing works since such fortified functional foods deliver over $27 billion in sales each growing at up to 20% each year.

I am not personally against all processed foods. To our busy lives, they offer the convenience of immediate consumption although there is a cost to it. I do want to credit the food industry for many innovations that have made the modern life possible. I am not suggesting we turn the clock back by making all of our food from scratch. What I don’t like is that the industry at its heart is no longer concerned about the health of its consumers, rather the profit motive has become the main driver of innovation. Surely there are exceptions, which I hope will become the norm in future.

One Hungry Monkey and a dad committed to raising a healthy eater

I was finally able to finish reading a delightful book by Matthew Amster-Burton called Hungry Monkey! If you did not get a chance yet, check out my review of Hungry Monkey published this week. And let me know what you think.

Enjoy your weekend!

Photo source -sara.atkins on Flickr via everystockphoto
©2009 Littlestomaks.com

Ask The Expert is a weekly column on Littlestomaks.com. The idea is to have a reader-submitted question answered by a nutrition expert or a pediatrician. Feel free to submit your question in the comments section below.

This week, Registered Dietitian Rebecca Scritchfield offers advice on what do do if your child eats as many as 10 times a day.

Question: My daughter wants to eat about 10 times a day. Is this healthy as long as she’s not overeating?

Answer:

In general, kids are way better than adults at scanning their hunger and fullness feelings and they rarely tend to overeat if they eat balanced meals. If you are concerned about the frequency of your child’s meals, please be sure to check with your pediatrician. The growth charts will indicate if there is a reason to be diligent about making sure your child gets enough calories for healthy development.

If your child is growing at a normal rate, then I’d say that eating 10 times a day seems a little too often. If your child is awake 12 hours a day, that means they’re eating nearly every hour.  Even the “littlest stomak” eats every 2 hours.

If a child is eating 10 times a day most days of the week, double-check how you provide foods:

• Are  you giving your child enough food at the three usual mealtimes? Toddlers need about 200-300 calories for a meal or snack to meet their daily calorie needs.
• Is there variety on the plate – carbohydrates in fruit provide “quick energy” and protein and fat in foods like peanut butter and eggs give “lasting energy.”  If you provide just carbs, your kid may need to refuel faster than if you provide a little of all the nutrients.
• Do you give your child enough time to eat? Little stomaks have little mouths and they need more time to chew and digest their food. They can’t scarf like their parents (nor do you want them to build that habit). Make sure they get to build autonomy with the length of time the eat. Don’t let them eat in front of the t.v. or computer. Teach them early to really enjoy their foods.

If you are struggling with this, I would try adding more calories and see if that brings the meals and snacks frequency down to about five to six times a day. You can add calories without adding volume by doing things like adding natural peanut butter to oatmeal or adding olive oil to pasta noodles and sauce. Visit My Pyramid for Preschoolers for meal and snack ideas and determine the calories your child needs.

©2009 Littlestomaks.com. All Rights Reserved

Disclaimer – Information provided in Ask The Expert column on Littlestomaks.com is intended to give you general guidance on a question related to toddler nutrition. It is not meant to be treated as medical advice. You are welcome to contact this expert for a detailed consultation on your specific situation to determine what actions, if any, you should take regarding nutrition and health of your toddlers. We do not recommend you to take any action based solely on the information presented in this column. Experts have agreed to provide their professional opinion on toddler nutrition related questions on a voluntary basis and no compensation is offered to them by Littlestomaks.com.

One of my good blogger friends Annie from PhD in Parenting is running a Carnival of Play theme on her blog this month. What a fantastic idea! I decided to write this post as a part of her carnival to highlight the importance of both play and good nutrition on overall growth of toddlers.

Why play?

We have all heard about rising rates of childhood obesity. Kids today are eating more junk food, consuming more sugary drinks and spending  a lot of time in front of the TV or playing computer games. To some, this lifestyle might already fit the definition of “play” because it is so much fun  and kids don’t seem to complain about it. There are no immediate health problems and parents can find time to do their own thing if their kids are happy and busy with TV or computers. So what could be wrong? And as far as obesity is concerned, if the child is not really fat and his friends are about the same, who cares?

There is enough evidence from scientific research and surveys that the overall health of our children today is in a state of decline. Childhood obesity is real;  BMI’s are rising; attention spans are shortening and immune systems are weakening. What I find most worrisome is that there are now reports of increasing rates of Type II diabetes in children as young as 8 years old. Diseases like this don’t happen overnight; they slowly creep up on you. On a day-to-day basis, a lifestyle of poor nutrition and no physical play may seem ok, but it can lead to serious health problems in the long run.

Benefits of play

Bone growth

This is very important especially in the early years of life. Most of the current debate is focused on calcium and vitamin D deficiency when it comes to healthy bone growth. But physical play has an important role in growing strong bones. The Iowa Bone Development Study concluded that various forms of physical activity, particularly vigorous physical activity, plays a critical role in early childhood bone development well ahead of reaching peak bone mass.

Muscle and joint development

Physical activity involving running, jumping and climbing builds strength in the muscles and joints as they try to support the body weight. It does not have to be a power workout for the strength to build; the good thing about physical activity is that even a small amount adds to itself. In fact it is better to go slow and watch your child carefully as she attempts increasingly difficult tasks in the playground. Over the long run you will notice a clear increase in upper body strength and legs.

Hand-eye coordination, balancing and making sense of physical forces

By engaging in physical activity, children begin to develop an intuitive sense of how the physical forces work. The begin to understand and feel how their bodies respond to gravity (jumping), friction (sliding), rotation (swinging), motion of all kinds and action-reaction of push-pull. It helps them to make sense of the physical world so they can anticipate the reaction to their actions.

Cardiovascular health

Just like adults, children also benefit from the benefits of elevated heart rates during sustained physical activity. The heart is also a big muscle, which gets stronger when it is forced to pump blood through the body at a faster rate during physical play. Lungs are also hard at work which increases their capacity of providing oxygen to the blood at faster rates. The entire circulation system benefits from physical work. The American Heart Association has some great tips for raising heart-healthy active children.

Creativity and mental growth

Although it may not seem so at first, physical activity also builds mental agility and creative thinking. As I watch my twins play in the park, I am constantly amazed by the games they invent around the simple equipment (slides, swings, tunnels, monkey bars etc). Sometimes we play “train” and run around under the big slide making all kinds of train noises. At home we play the “tunnel” in which I stand with my feet apart and they come running through the space pretending to be a truck or a train. It is a lot of fun, and the good thing is that it does not require any fancy toys. Just pure imagination and a willingness to indulge them in whatever gives them a good “workout”.

Risk taking, team work, leadership

As children grow and engage in team sports, they begin to develop a sense of teamwork and leadership. These two qualities are critical for their future success in life. They have to learn the rules of the game and figure out what is acceptable and not acceptable. It promotes a drive to achieve success, builds confidence and increase their self worth if they finish a task successfully. No wonder, sports are a big part of our popular culture.

They also develop a sense of risk and an ability to decide their action which will keep them safe. I have been amazed to watch my son pause at the top of a tall slide before coming down. I don’t see fear in his eyes; but clearly his mind is doing a quick calculation to figure out if he should really take the plunge or not. He feels comforted when he can see me waiting for him at the bottom and lets himself go!

Nutritional needs of an active child

Physical activity burns calories. It is important to make sure your child is well fed before taking him to the park. Also pack a healthy, nutritious snack after he is done. Handing out a no-sugar added fruit juice is ok if not overdone during the rest of the day. One of our favorites snacks is from Earth’s Best, which goes very well after a visit to the park. We also give organic milk and string cheese sometimes. Overall, active children need more calories during the day according to the following data from MyPyramid.gov:

Play is good for Mom and Dad too

Sometimes it may seem overwhelming to run after energetic toddlers all the time. Usually we are pretty tired when we return home from work, but playing with my twins is a lot of fun. It gives me a chance to unwind and not think about deadlines at work or the all-too-important meeting the next day. We simply run around, get silly and make up all sorts of games! Even if it is for a short period of time, it is a great bonding experience for otherwise busy parents.

Don’t ignore safety

Slips, trips and falls are the major hazards of physical activity. Even for adults, these 3 risks are responsible for a large number of injuries each year. Keeping a watchful eye on children without making them fearful while playing is very important. Expect the unexpected and stay close. Make sure children have comfortable clothing and good shoes on. And no cell phones or Blackberrys!

Summing it all up

For long-term healthy growth of your child, think PNR – Play, Nutrition and Rest. There is nothing wrong with watching TV and playing computer games -  both of them can stimulate the mind by entertaining and educating at the same time. It becomes a problem when they take over and there is no time left for play involving physical activity on a daily basis. Like everything else, balance is key, and although there is no fixed formula, common sense can help you figure out how to provide appropriate PNR for your child each day. Good luck, enjoy each day and feel free to share your ideas and opinions on how you are managing them for your child.

Top Photo Source:  OliverAlex on Flickr
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