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 creating a healthy food environment at home to foster lifelong healthy eating habits and preventing childhood obesity.

Question: My son just turned one and since I have struggled with obesity most of my life, can you suggest what I can do nutritionally to ensure my son doesn’t face the same struggles?

It’s great that this is on your radar and that you want to take action while your son is still so young. As you already know, you can’t do anything about your son’s genes. But you can make sure he grows up with healthy eating habits and physical exercise. That can make a huge difference for him and help lower his chances of obesity in both childhood and adulthood.

Here’s how you can establish a healthy food environment at home:

Keep your kitchen stocked with a wide variety of nutritious foods that are yummy and accessible, like a bowl of fresh fruit on the counter and snacks like low-fat yogurt and whole grain crackers front and center in the fridge and cupboard.

Plan regular meals and scheduled snacks instead of all-day grazing or constantly grabbing food on the run.
Include a small amount of goodies like desserts or chips that you treat as “sometimes foods”. You don’t want these foods to become forbidden and more desirable.

Eat most meals at home together as a family at the table. Researchers have found that children who eat meals with their families (and the TV turned off!) get a much healthier diet overall.

Offer milk and water as the primary drink choices. Sweetened drinks like punch and regular soda are linked to weight gain among kids and adults—and you can even skip fruit juice if your son eats a lot of fruit. You should also ask your child’s doctor about giving your son two-percent milk right now instead of whole. The American Academy of Pediatrics recently stated low-fat milk is a better option for toddlers who have a family history of obesity (after age two, you can switch to one-percent or skim).

Model healthy choices and attitudes. As a parent, you’re the single biggest influence on your child right now. Let your son see you take the kinds of positive steps you want him to make as well, like drinking water instead of soda, enjoying vegetables with meals, and being active. And avoid making any critical comments about your weight or your body, since studies shows that those negative attitudes can rub off on kids and damage their self-esteem too.

©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.

photo credit: jbelluch

Would you offer Cheetos® to your 1 year old? What about soda?

I was at a birthday party this weekend where I noticed someone giving a small child a piece of Cheetos. The child clearly relished the taste as she licked away the last bits of cheese from her mom’s fingers. One point of view could be that it is ok to introduce different tastes at an early age. Others may say that this is how children get hooked on junk food and that is why we have a childhood obesity problem.

What do you think? Do you have a list of forbidden foods you will never let your child eat no matter what?

©2010 Littlestomaks.com

Greetings! Hope you are enjoying your summer so far. In this week’s Five for Fridays, I want to focus on food advertising to kids. Many people believe that food advertising, especially on TV during children’s programming, plays a big role in influencing food choices and brand awareness among young kids. Some experts go on to linking such advertising to overweight and obesity in children and suggest we should put a ban on advertising during children’s programming. However, as I wrote in my article Ban TV Food Advertising to Reduce Childhood Obesity – Really?, there is little evidence to support the link between TV advertising and childhood obesity. Sure, there is a lot of passion and strong opinions about the effect of TV advertising on kids, but there is not much data.

In this article I want to first explain why I am against the banning food advertising to kids even though I am dead against junk food and fully agree with its impact on our health problems. Then I want to offer a few suggestions on how to reduce the influence of TV advertising so that the marketers are forced to change their message.

Here are a few reasons for my opposition to the notion of banning TV food advertising:

• It goes against the idea of freedom and personal choice – just the way consumers have a right to choose what they want to buy, food marketers are also entitled to promoting their products. Unless, of course, there are proven health risks of high degree and regulations are adopted to control public promotion. I don’t believe food advertising can be considered in the same way as tobacco advertising, at least for now.
• Banning specific advertising is discriminatory – some may say that promotion of  unhealthy food products should be restricted. That means some other type of food products may be allowed freely. This is like saying ban the ads for cars with low safety rating and allow only certain types of cars to be advertised. Who draws the line between the so-called unhealthy foods and healthy foods from advertising point of view?
• TV is not the only channel for food advertising – the fact is that there is a declining trend in watching advertising on TV. Other channels like internet, mobile phones, printed media and in-store advertising are becoming more popular with advertisers. To what extent should we ban food advertising?
• Banning unhealthy food advertising does nothing to promote healthy foods and eating habits – Even if a ban on the so called unhealthy food products is implemented, it does nothing to promote healthy foods and eating habits. The focus should be on the positive, not on the negative. Why not invest in a public awareness campaign to counterbalance the current advertising? Are we so afraid to go head-to-head against the clever food marketers?
• Banning TV food ads does not reduce the duration of TV watching – say we have no food advertising on TV anymore. It does not mean that there will be a reduction in the amount of average time a kid sits in front of the TV. What is needed is a change in lifestyle and eating habits, not a ban on TV advertising.

Now that I have pitched a few reasons why I don’t like the idea of banning food advertising on TV, I should also add that there are many ways we can collectively reduce its influence. Or at least create an environment where food marketers are forced to improve their message to serve the public good and not simply the interests of their shareholders. Government has a role to play, but so does everyone else. Here are few ideas that come to my mind; I am sure there are many more if we take a step back and think about this problem differently.

• Require a disclaimer on health risks in food ads - just like the ads for drugs have a disclaimer on potentially harmful side effects, a disclaimer should be required from foods high in calories, salt, sugar and fat. Before that happens, clear standards need to be established on a per-serving level so consumers can make an appropriate choice.
• Require a warning on product package – just like the Surgeon General’s warning on health risks of alcohol and tobacco, foods containing high calories, salt, sugar, fat and additives should be required to have a standardized warning on the label.
• Create and publicize a national database of unhealthy foods – just like a list of recalled products, there should be a database of foods that can be classified as unhealthy based on clear standards. Consumers should be able to report as well as search for products before making a purchase decision.
• Monitor and take aggressive action against misleading claims in food marketing – the problem is that functional claims are allowed and marketers use confusing language to convince customers into buying their products. It takes a lot of knowledge and savvy to cut through the confusion. This is where I see regulators playing a very important role.
• Launch a massive public awareness campaign – get on the offensive and launch a public awareness campaign. The argument I have heard is that it is too expensive and there is no way to beat the food marketers with huge budgets. We need to get creative – why not incent business majors to build and launch a public service messages as a part of their marketing class? Harness the power of social media and encourage key influencers in each community to fight this battle. There can be many low-cost creative ways of doing this.
• Empower parents to build their family’s personal brand – food brands are powerful, no doubt, but parents are the ultimate gatekeepers of their children’s nutrition and eating habits. The problem is that they are overwhelmed by information from different sources which may appear to be very confusing and even intimidating at times. With a little help, I think parents can develop their own brand which defines their unique approach to food and nutrition. It gives them a tool to evaluate food advertising and allows them to reject messages that are inconsistent with their brand. It is kind of an abstract idea but if companies can do it, why not individuals and families?

These are only a few different ideas, and by no means, I can claim to have all the answers. My hope is to start a conversation from a slightly different perspective. When it comes to the politics of food, a lot of focus is on the supply side of the equation. I would love to shift the conversation to the demand side for a change.

Will you join me in this conversation? Share your ideas in comments below.

Enjoy your weekend!

©2010 Littlesotmaks.com

By how much would limiting TV food advertising reduce childhood obesity?

This is the question researchers from Netherlands and Australia asked in their recent article published in the European Journal of Public Health. TV food advertising has attracted considerable public scrutiny, especially from experts in nutrition and public health. There is a popular belief that food advertising plays a big role in influencing food choices and brand awareness among young kids. As a result, kids get hooked on processed food and snacks full of fat, salt and sugar. Clearly, this could be one reason why we have a rapidly rising rate of childhood obesity believe most experts.

Beliefs and opinions are common, but thoughtful scientific inquiry to support them is rare. That is why I found this article interesting because it tackles this tricky problem through a good scientific approach. The researchers candidly acknowledge that the effect of advertising is difficult to study in a direct way. In fact they did not find a single study which quantified the effect of advertising and body weight in a realistic setting. Instead, they looked at changes in the total energy intake due to TV advertising based on a single study from 1983, which concluded that an extra 25 minutes/week of exposure to TV advertisements would cause a child to eat one extra snack which would increase his energy intake by 1.4%.

This is a very small effect. The researchers then decided to set up an expert panel of academics and asked them to complete a questionnaire to estimate the effect of TV advertising on energy intake and effect of energy intake on BMI. Surprisingly, they got a very poor response rate – only 8 out of 33 completed their questionnaires. As a result, there was considerable bias and uncertainty in the data.

Bottom line, they came to the following conclusions:

1. If all TV advertising (about 80 minutes/week) was stopped, the prevalence of obesity will drop by 2.7% in boys and by 2.4% in girls
2. Based on the “expert panel” response, they estimated these numbers to be a reduction of 6.8% in boys and 6% in girls
3. They estimated that about 1 in 7, or as many as 1 in 3 children would not be obese if there were no TV advertising

Overall, these numbers have a very large amount of uncertainty. The evidence against the effect of TV advertising is weak and calls to ban or limit TV advertising are largely based on personal opinions.

Personally, we have not experienced the effect of TV food advertising in our household because we hardly watch any TV. Mostly our twins watch animated shows on demand where we completely bypass the advertisements.

I am not a supporter of cheap junk food. But I also do not support the idea of banning TV advertising. I continue to believe that the best protection against such advertising is to build the wall of your family’s own personal brand which defines your approach to food and nutrition.

Parents: what is your opinion? Do you think that your family’s food choices are strongly affected by TV advertising? Would you support a complete ban on food advertising to kids?

©2010 Littlestomaks.com

The Dietary Guidelines Advisory Committee established jointly by the US Department of Agriculture (USDA) and Department of Health and Human Services (HHS) came out with a report this week. It is a lengthy report based on a lot of data. Most of their conclusions and recommendations are not really unexpected or surprising – cut down on fat, sugar and salt; manage total energy intake; engage in physical activity etc. We have heard them all one way or another.

What caught my interest was data on top 5 dietary sources of energy for children and adolescents, and in particular, for children 2-3 years old and 4-8 years old. Here is a portion of this table for these two age groups:

Grain based desserts include cakes, cookies, doughnuts, pies, crips, cobblers and granola bars. 100% fruit juice does not include orange or grapefruit juice.

Nearly 30% of the average daily caloric intake for the two age groups is delivered by these top 5 food groups. A quick look at these food groups confirms the carb-rich diet of today’s children (and adults alike).

Another troubling fact is that 35% of calories in a typical American diet (both kids and adults) comes from added sugar and solid fats. This is more than double the amount recommended by different agencies.

There is no shortage of data to prove that our diets and eating behaviors are not so healthy. There is also no shortage of blame being passed around – profit-hungry food industry, aggressive food marketing to children, poor quality of school nutrition, lack of physical activity and high cost of healthful foods. Again we have heard them all one way or another!

The report recognizes the challenges in changing this pattern of unhealthy eating, but does little to emphasize the importance of personal responsibility. It seems to imply a command-and-control, top-down type of an approach rather than empowering individuals and parents to make small changes on a daily basis. Individuals can make a difference, but they seem to think that the system is far stronger than the individual.

What do you think? What small changes can you make to make sure your family and children do not fall into the average category?

Have a great weekend!

©2010 Littlestomaks.com

News about childhood obesity is everywhere these days. Hardly a day goes by without a screaming headline in the media about this issue. Jamie Oliver has further popularized it by his TV show and even Mrs Obama has taken up this cause via her Let’s Move campaign. There is no doubt that we must address childhood obesity, but what about the problem of underweight and short stature? How worried should a parent be if their toddler falls under the 5th percentile in weight and height?

Recently, registered dietitian Teresa Wagner tackled a reader question in our Ask the Expert column about a toddler not gaining weight. I received a follow up email from another reader who was worried that her 8 month old child was below the 5th percentile and not eating much. The tone of her message reflected her extreme worry and frustration at not knowing what to do.

There is a reason why our media does not focus on this problem. The numbers, when taken as a whole nationwide are not that high. See below a chart based on the 2008 data CDC’s Pediatric Nutrition Surveillance System (PedNSS) on growth indicators. The PedNSS system is a public health surveillance system which monitors the nutritional status of children from low income families under Federal programs. Data comes from public health clinics where these children are seen for routine care, nutrition education and supplemental food.

Percentage of children 2-5 years old who are underweight or of short stature is between 3-5% for Whites, Blacks and Hispanics. These numbers are even smaller for American Indians and Alaskan Natives. Compared to the 20-30% obesity rates, these numbers are too low to capture the attention of mainstream media and policy makers. Besides, the media loves to show extreme images of either very fat kids or severely malnourished starving kids from the third world countries. Anything else does not make the cut for prime time!

As a parent, it is natural to worry. It becomes a personal issue and fancy nationwide statistics do not make a difference. The frustrating part is that it is not always possible to get enough credible information to make informed decisions. The result is that each day becomes a battle to force feed a child in the hope that she will put on some weight. Since children have a natural ability to regulate their food intake based on their current needs, it may seem like they are not eating enough. Anger, frustration and despair are the emotions most parents feel under these circumstances.

Here are 5 questions you can consider to assess the situation and take appropriate actions

Is there a trend in my child’s growth chart numbers?

A single data point on the growth chart, although important, should not cause concern. Take time to understand growth charts and their limitations so you can use them to evaluate the general growth pattern of your child. Another thing to keep in mind is that your child may not be in the normal range for both weight and height. For example, our twins are tall for their age group but lag behind in weight. From this perspective, I like the BMI for age chart because it takes into account both weight and height at the same time. You can use this online calculator for BMI chart or ask your doctor about it.

Is there a medical reason for slow growth?

This is where keeping a close eye on your child’s growth pattern will help you find medical issues that may be affecting her growth. There may be known birth defects or undiagnosed metabolic or digestive disorders. Severe case of reflux like GERD is also a concern. Detecting them early and working with a specialist for corrective action is very important.

Is there a specific reason for poor appetite?

Nearly all toddlers are picky eaters and it is natural for them to frequently show poor appetite. But if it persists over a long period of time, you will need to be extra vigilant so you can find the root cause. Are there food allergies? Special environmental or seasonal triggers? Does a change in menu or feeding schedule help? The important thing is to pay attention to the unique needs of your child so each feeding is most effective. Siblings around the same age, twins or multiples need different treatments based on their individual personalities. Clearly a challenge for most parents, but there is no perfect answer. Practicing the principles of attachment parenting and nutrition can help.

Does my child seem different than his siblings or other family members?

Although it is not always a good idea to compare your children, you have to take into account your family history and genetic makeup. In some ways, a consideration of these factors is probably more important than the growth charts which are based on population averages. If your family ethnicity is not one of mainstream population, it is unlikely that the growth chart standards will be accurate for your child. Evaluate your child’s height, weight and BMI through the lens of your family’s history to determine if there are differences you should be concerned about.

Are there any special circumstances in my family?

Every family goes through ups and downs – financial, emotional or health-related – often over an extended period of time. Assess if you have certain stresses in your personal life or your family situation at the moment. Even toddlers pick on them easily even if they cannot articulate it. If these problems persists over a long period, there may be slow weight gain or even a loss in weight. Recognize these problems early and seek help from family, friends or your doctor to manage them.

One last thing to remember – early childhood height and weight is often a poor predictor of adult height and weight, except in the case of overweight or obesity. You may be surprised how fast your child can grow upon reaching puberty. Keep a close eye on the growth charts, spot the problems early and take appropriate action. No need for excessive worry just because of a couple of low points on the charts!

Most importantly, focus on building healthy eating habits. Offer a variety of foods in healthy balance and moderation.

Are you concerned about an underweight child? Please share your personal story in a comment below.

©2010 Littlestomaks.com

Greetings! I am on business travel this week. That is why I have decided to pull out a few noteworthy reader comments from my archives this week instead of the usual Five for Fridays.

I am constantly inspired by your comments and I learn a lot from them. I want to say thanks to those who spend time reading my posts and leave a comment behind with some advice, helpful tips or a question for further research. Some of them have their own blogs, which I highly recommend you to visit whenever you get a chance.

Enjoy, and feel free to leave a comment of your own.

1. When a reader asked about food sources of vitamin D, Dr. Joanna Dolgoff listed these on her Ask the Expert post about Vitamin D deficiency
   

Foods that contain Vitamin D include fortified milk, fortified yogurt, fortified breakfast cereals, wild salmon, canned tuna, cod liver oil, sun-dried shitake mushrooms and egg yolks. I think the fortified milk, yogurt and breakfast cereals will work best for a toddler!

2. Nona Nita reminded us that dollars and sense is not everything in response to a Five for Fridays entry on home gardens:

Even if growing my own tomatoes will cost more, I like the idea that I am going to use heirloom seeds that have not been hybridized. I will be able to keep the seeds from my produce to grow more next year. Not only will I get tomatoes like they used to taste when I was a kid, but saving the seeds from the tomatoes to use next year will be a great lesson in the cycle of life for my grandchild. Hooray to the Obamas for being great role models! Hooray to you for a great blog!

3. Reiza was concerned about mercury in tuna when she read dietitian Janet Helms’s Ask the Expert article on sushi for toddlers

My kids have all eaten sushi since infancy. You raised some issues I never even considered. I don’t think we’ll stop (my twins are over 5, but not my son), but we’ll definitely be asking more questions.

One thing I want to know, though, is how much sushi with tuna would a child need to consume to be worried about mercury? I’ve always limited canned tuna, but I never thought mercury would be an issue with such small pieces like you find in sushi.

In response, Janet Helm added:

Thanks for your message. You’re right. The small amount of tuna in sushi should not be such a problem, since the recommended limit is 12 ounces per week. A 3-ounce portion is about the size of a deck of cards, so you can estimate the number of ounces your kids may be consuming.
So if you’re not eating tuna more than once a week, you’re probably well within the “safe” range for mercury.

4. Dr. Ayala offered her perspectives on healthy snacks and indulgences in response to a Five for Fridays entry on childhood obesity

I don’t particularly like the term “snack”, as it can mean a small meal, which could be very healthy, or, more commonly, a highly processed packaged food you can eat on the go anytime and anywhere.

I therefore don’t use “snacks”. No matter the name, I make the small meals between the other bigger meals healthy–fruits, vegetables, nuts, leftover food from yesterdays’ dinner. That’s what I serve my kids when they come home from school quite hungry and in between meals.

As for the indulgences that I do think should not be denied–I call them dessert, and my kids call them “junk”. A good time to eat them is after the meal. I think there’s a place for ice-cream, chocolate, cake or whatever indulgence one fancies, but the key to really enjoying those and eating healthily is moderation and great quality. A small dessert (when a kid isn’t too hungry) made of high quality ingredients is a pleasure. Snacking on chips, cookies and donuts (even if low-fat)is not particularly satisfying, doesn’t hit the spot, and is just a bad habit.

5. Alina shared her concern and hoped for better nutrition at schools in response to Ask the Expert article on managing concerns about daycare food

I like the idea of bringing food to daycare but unfortunately many daycares do not allow found to be brought in. Also, a toddler wants to eat what everyone else is eating since the kids all eat together. Improving the nutrition of daycare (and all school food in general) is a very important topic. It would be nice for policy-makers and law-makers to embrace the need for this change!!

Photo source: Robert Whitehead on Flickr
©2010 Littlestomaks.com

Greetings! The twins are turning 4 this weekend and we are having a birthday party! Should be a lot of fun.

Here are 5 nutrition related stories that caught my eye this week. Enjoy and let me know what’s on your mind.

Beware of this high tech coke vending machine

Called the Freestyle, a high tech Coke vending machine will soon allow you to make your own personalized beverage by selecting a combination of flavors injected on demand into carbonated water. In light of falling soda sales over the last 5 years, and an actual drop of about 2% in 2009, Coke is betting that by getting you to play with these machines, you will drink more soda! I say, watch out and don’t fall for it even if it seems free at your favorite fast food restaurant.

I am all for technology – and believe me, this new machine is really high tech – but this kind of innovation is misguided and reflects linear thinking. The logic is simple – get people to drink more soda so you can make a few more dollars (actually a lot more!) each year. And why worry about a soda tax when you can get the restaurant owners to pay up for these fancy gadgets!

If Coke wants to reinvigorate its brand and re-engage consumers, in the words of its Vice President in-charge of Freestyle, why not do something that actually makes them healthy? Surely they have no shortage of smart engineers and brilliant marketers. How long do they want to keep going with the same Open Happiness message?

Skip the soda fountain. Ask for water. Vote with your wallet and don’t fall for these gimmicks.

Consumers link food to health and expect food companies to do more

Nearly 1 in 4 consumers look at food as a means of health and about 1 in 5 consider it a way to connecting with friends and family. This according to a farm-to-fork survey by StrategyOne which randomly asked 1000 US adults 3 simple questions to understand their attitudes and opinions about food.

About 90% of these consumers expect supermarkets to focus on health, wellness and nutrition, but only 68% found it important for fast food companies. Over 90% want food companies to offer healthy products which also taste good, and offer more healthy food choices. They also expect these companies to help solve community problems such as childhood obesity and malnutrition.

The data is encouraging. Although the sample size is small, the message is clear.  When will the food companies begin to pay attention?

Choose organic to reduce risk of chemical exposure and cancer

The President’s Cancer Panel is raising a red flag on chemical exposure as a potential cause for cancer, which is becoming a growing concern especially in children. According to an Op-Ed in the New York Times, the cancer panel is about to release a 200-page report recommending better oversight, and possibly new regulation, to manage our exposure to chemicals. “Only a few hundred of the more than 80,000 chemicals used in America have been tested for safety”, and “many known or suspected carcinogens are completely regulated”, says the report.

Although, it is important to be careful about chemicals, there is no reason to panic. I think a lot of has to do with the notion what you don’t know can hurt you, because of the very poor public awareness about chemicals. Modern life, and its conveniences, is a direct result of our success with using chemicals. Based on my personal experience I can say that the chemical industry takes its responsibility about chemical safety extremely seriously. Exercising caution is prudent, but there is no need to panic.

Since young children are most susceptible to the risks of chemicals, one easy action you can take is to rely more on organic foods, especially fruits, vegetables, dairy and meats. Organic certification on a food product means that it is produced without the use of pesticides, chemical fertilizers and hormones. It may cost you extra, but there are ways you can buy organic on a budget.

Solving the problem of childhood obesity within a generation

The White House task force on childhood obesity has a plan to solve this problem within a generation. They have issued a 120-page report with 70 recommendations for the federal, state and local governments as well as the private sector so we can get back to a 5% childhood obesity rates of the early 1970′s. Today we are at close to 20% and if these recommendations are acted upon, the task force believes that we can reach this goal by 2030.

I like the comprehensive research and the holistic perspective outlined in this report. This problem cannot be solved by a mandate from the government. Everyone has a role to play – parents, schools, community service organizations, food companies should take responsibility. I also like clearly defined benchmarks for metrics for success.

I plan to take a closer look at the report and write about it in future. Feel free to share your opinion on how this problem can be solved in our lifetime!

Make veggies interesting to eat, not just nutritious

Don’t sell the idea of health and the same old good for you when trying to encourage your kids to eat more veggies. Make it fun and exciting, suggests Dr Susan Robin, a holistic nutritionist, in her article Getting Kids to Eat More Veggies is More Fun Than You Think. I couldn’t agree more!

Coke does not sell nutrition in a bottle, they sell happiness. Food marketing is not much different, although a lot of health related claims are often mixed with the idea of fun, satisfaction and excitement. Take a page out of the food marketers playbook and turn it around! That is what I liked about Dr Robin’s article – they used a cool music video about making hummus to encourage kids to eat more chickpeas at a summer camp.

A word of caution though – I think it is ok to learn from the food marketers playbook, but don’t just copy it. Twist it around because there is no way you can win by doing what they do. They have more money to buy more star power. I have been thinking about the idea of creating your family’s personal brand about food and nutrition as you try to counter the overwhelming influence of major food brands. Not an easy task, but it is a very different approach and will surely take time. I plan to build on this idea in future. In the meantime, feel free to share your ideas.

Have a great weekend!

Photo: adactio on Flickr
©2010 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, Family Physician Dr. Michelle May offers a few tips to help you raise a healthy child by providing unconditional love, encouraging physical activity and promoting healthy eating habits.

Question: How can I encourage my kids to eat well and follow a healthy lifestyle?

Answer:

With the launch of Michelle Obama’s Let’s Move campaign, unprecedented attention has been paid to healthy eating and physical activity in children. There’s a huge potential for benefit but two potential pitfalls that parents need to be aware of.

First, the focus really shouldn’t be on childhood obesity. All children (and adults!) benefit from increased awareness about their lifestyle choices. Singling out overweight children contributes to the stigma and shame they already face—and may cause parents, doctors, and others to mistakenly believe that the information doesn’t apply to normal weight children.

Second, restrictive diets haven’t worked in adults and they don’t work in children. Studies have shown that children who are restricted from certain foods at home and are exposed to those foods elsewhere are more likely to choose the food, overeat it, and feel guilty afterward. Sounds just like the last diet you were on doesn’t it!

Let’s look at the keys to the development of lifetime healthy eating and exercise habits:

Build Healthy Attitudes

• Demonstrate your unconditional love for your child. Children—especially overweight children—need support, acceptance, and encouragement from their parents.
• Build self-esteem by focusing on all of your child’s positive qualities, unique talents, and individuality. By developing interests and skills that increase their success and pleasure, they will be less likely to turn to food for fulfillment.
• Help your child develop good communication skills, encourage them to express their feelings, and teach them effective coping skills to decrease the chance that food will serve that purpose.
• Emphasize the importance of good health, not ideal weight.
• Never tease or criticize a child or adolescent about their weight. Such comments are hurtful and can stick with a person for a lifetime.
• Be a positive role model. When your child observes you enjoying healthful foods and physical activity, they are more likely to do the same.
• Most importantly, sit down and eat together as a family. Family mealtimes are a wonderful way to reconnect with one another and share your day. Mrs. Obama talks about playing “Roses and Thorns” – taking turns telling about the best and worst part of your day.

Enjoy an Active Lifestyle

• Help your child build a lifetime exercise habit by making consistent physical activity a high priority in your family.
• Reduce the amount of time your family spends in sedentary activities like TV and video games. Instead, plan fun family activities that provide everyone with exercise and enjoyment.
• For children who have been relatively sedentary, physical activity should be initiated gradually to avoid injury and discouragement.
• Encourage active play like biking, swimming, and playing ball.
• Participation in individual and team sports can be a great way to build coordination, athletic skills, and self-confidence.

Develop Healthy Eating Habits

• Children have the instinctive ability to regulate their intake to meet their needs. Respect these internal cues of hunger and satisfaction.
• Do not force children to clean their plates or bribe them with dessert for finishing their meal.
• Never use food as a reward. Reward desired behavior with praise, extra attention, and privileges.
• Do not comfort your child with food. Hug them and listen to them instead.
• Do not impose stringent food rules since this may lead to rebellious eating when the child is away from parental control.
• Don’t say or imply that some foods are good while others are bad. Instead, teach children that some foods are healthier than others. This will help them learn to balance eating for nourishment with eating for enjoyment.
• Provide a variety of delicious healthy choices for snacks and mealtimes. Suggestions include fresh or dried fruits, vegetables with tasty low fat dips, reduced fat cheese or peanut butter and whole grain crackers, yogurt, fruit smoothies, whole fruit ice pops, granola bars, turkey roll-ups, or snack mixes made of cereal, dried fruit, and nuts.
• A healthy breakfast is a great way to start the day and is important for optimal performance in school. Include protein and whole grains for energy and nourishment.
• Encourage children to drink water and fat free or low fat milk instead of sugary sodas, fruit drinks, and sports drinks.
• Promote a high fiber diet by giving your child whole wheat breads and pastas, brown rice, and five servings of fruits and vegetables daily. They will prefer these types of foods if that is what they’re used to.
• Since children (and adults!) have a natural preference for sweet and high fat foods, it’s reasonable to limit the amount of sugary and fatty foods that are readily available to encourage intake of more nutrient rich foods.
• Involve children in shopping, meal planning, and preparation. This is a great opportunity to teach them about nutrition—and they will be more likely to try new foods if they helped make them.

Download Keys to Raising Healthy Children flyer by Dr. Michelle May.

©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.

Greetings! It is Friday again, which means it is time for our weekly Five for Fridays where I usually highlight interesting food and nutrition articles of the week. But this week I want to highlight 5 interesting comments from readers of this blog which they wrote last year on different articles. Your comments inspire me and add so much value to my articles that it would be a shame to keep them buried in the archives! Plus, this is a good way to recognize those who take the time to leave a thoughtful comment. Many of them have blogs of their own, which I highly recommend you to visit via the links in each of the titles below.

I will be highlighting more comments in future posts; for now, enjoy these 5 insightful comments. If I did not pick your comment, just hang in there and look out for another post in future. And of course, feel free to share your opinions in a comment!

In response to my review of popular toddler multivitamins,  Tommy’s Mommy recommended paying attention to the recommended dosage

What a good guide to vitamins! My 11-yr-old has been taking Centrum Kids for years because he is my picky eater. I just tried it with my toddler because he has had a bad cold and hasn’t been eating like his normal self the last few days. A couple of observations…

I think you’ve addressed this, but parents need to make sure they check the dosage of vitamins. I cut one Centrum in half for my toddler as per instructions. Secondly, he loved the sweet, tasty vitamin so much he cried when I didn’t give him another. I don’t think I’ll give him any more when he’s eating well again.

Jenna of KidAppeal shared her enthusiasm for leeks and offered these interesting tips when she read my recipe for leeks with olive oil

I love leeks! thx for sharing this recipe. i tell the boys they are “ginormous” onions. eating super huge food is fun for kids. if your recipe doesn’t use all all your leeks, wash them, slice them and put in a zip lock back and store in freezer. take out a handful when you need them to saute and flavor sauces, soups, etc.

members of the onion family are also anti-bacterial by making the body inhospitable to bad bacteria that causes illness. eat onions/leeks to stay free from illness.

TTD-you could make a larger recipe and freeze half for a quick supper that only requires re-heating the next week!

When a reader asked about healthy superfoods for a 12 month old, registered dietitian Milton Stokes offered these additional details to his expert article about retooling your toddler’s diet effortlessly

Nothing beats breastfeeding. So good for you and your baby! Weaning may take place during the 6 – 12 month range.

For the one-year mark, it’s time for solids. At this point your child should eat during normal meal times and eat with the family where the family eats. Texture should be soft, chopped and/or easily gummed depending upon dentition. Avoid making separate, special meals just for your child. Some variation of the family’s meal is preferred. In other words, don’t create a routine of being a short-order cook.

An introduction of up to 20 times may seem excessive, but it’s not. As I said before, what a parent eats–how she models food consumption–is far superior to anything else. I discourage emphasizing certain foods as “good” or “bad,” or using food for any purpose other than nourishment. (For example, refrain from rewarding with food.)

Now, to actually answer your question: nothing is more “super” than fruits and veggies and whole grains. You may need to present them differently and call them different names. Instead of apples, call them “apple smiles” or “smiley fruit.” Or you could cook the apple in the microwave and fill the center with oats, a little brown sugar, and a sprinkle of cinnamon. Call it the “apple cave.” Additionally, you can slice bananas and call them “wheels” or “flying saucers.” Another common one is “trees” for broccoli. (Cook and/or chop tough foods to prevent choking.)

Do you have a garden. Let your daughter help you. “Help” may mean play in the dirt, but at least it’s some exposure. Little by little her diet will change/improve. Just note: her stomach only holds a tiny bit of food compared to an adult’s, so you don’t have to worry if she only eats a couple cooked carrot sticks.

Kayris offered this simple recipe for a greek-style salad with quinoa when she read my review article quinoa – the unrecognized superfood

We love quinoa, and it IS so eay to prepare.

My favorite way to make it is in this Greek-style salad:
One cup quinoa, cooked as directed (or you can sub any other grain, I have made this with bulgur and also with couscous)
1 cucumber, chopped (peel it if you like)
1 large tomato, chopped
1 can chickpeas, rinsed and drained
Italian or Greek salad dressing until saturated (I usually use homemade Italian dressing)

Alina shared her success with herb tea instead of sugary drinks in response to shaking off a sweet addiction

I introduced herbal teas to my daughter who is now 16 months old. I wanted to offer her something different than just water and milk. And I didn’t want to go with juice which is so sweet, even when diluted. So I have offered her some basic, caffeine-free herbal teas such as chamomile. You can add ice as a refreshing cool drink or serve warm or at room temperature.

Like any new foods, I had to offer it to her many many times before she actually drank it. I think that’s where some parents go wrong with juice — it’s sweet so the child will drink it right away. But I have found my toddlers will eat non-sweet foods (or drinks), it just may take longer for them to like the taste. Also it really helps when they can see you drinking the same thing. And with tea, there is the fun part of preparing the tea…. adding the tea bag, waiting for it to steep, adding some ice, etc!

To any parents who would like to try offering tea in a sippy cup, make sure to read the label carefully because some herbal teas do contain caffeine or other “odd” ingredients.

Enjoy and let me know what is on your mind.

Photo Source: Just chaos on Flickr via everystockphoto

©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 Caryn Roll advises against trying weight loss for overweight or obese children. Instead she recommends that you help them grow into their current weight through healthy eating and physical activity.

Question: My child is obese. What can I do to help him lose weight?

Answer:

Weight loss is generally not recommended for children. The goal in helping an obese child is to have them grow into their current weight. This can be achieved through healthy eating and regular physical activity.

Here a few nutrition tips that might help:

• Parents are in control of what they purchase and prepare for meals and snacks. If it becomes difficult saying no to your child about a particular food then consider keeping it out of the house.
• Give your child the choice. When they are hungry, offer something healthy. If they ask for something junky you need to hold firm and tell you child they can have the healthy choice or nothing. It sounds harsh but it is our job as parents to make sure our kids eat properly. Save treats for special occasions and for once a week family time (ice cream parlor, Sunday night desserts, family game night etc…)
• Children need to be aware of their hunger and satiety cues. If they continue to eat after they are full they will put on weight. As a parent, it is important to understand that children can be hungry anytime and not necessarily at designated meals and snacks. Consequently, ask your child if they feel full before serving second helpings.
• Make sure your children’s portion sizes and food choices meet the recommendations for Canada’s Food Guide or the USDA Food Guide Pyramid. Remember, if the food in question is not on your food guide then it should be considered a sometimes food.

©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.

Greetings! This month, the American Dietetic Association is running its National Nutrition Month® campaign. It is a public awareness program designed to focus attention on the importance of making informed food choices and developing sound eating and physical activity habits. This objective is very much aligned with the focus of Littlestomaks because we are all about helping parents of toddlers make smart choices about their child’s nutrition and lifelong healthy eating habits.  That is why I will be supporting this campaign by writing articles along this year’s theme of Nutrition From The Ground Up. I would like to call upon my fellow nutrition and food bloggers to do the same! I am also open to ideas if you want to collaborate!

It is Friday again, which means it is time for the usual Five for Fridays! Here are 5 nutrition related articles that caught my eye. Enjoy and do share your opinion in the comments below.

Link between childhood obesity and heart disease gains strength

30% of obese 3-5 year old children show higher levels of C-reactive protein (CRP), which is linked to inflammation and is known to predict heart disease and stroke. This is nearly twice the rate at which high levels of CRP are seen in children with healthy weight. This data is based on a recent study of 16,000 children between the ages of 1-17 published in the journal Pediatrics and cited in this week’s Wall Street Journal.

It does not mean that children who show high levels of CRP will definitely develop heart disease when they become adults. This is because CRP can be elevated due to a lot of other reasons. Still, this is a strong link between obesity and heart disease and suggests that early childhood obesity needs our immediate attention. The question I would like to get answered is if these high levels of CRP can be reversed in obese children if their weight is managed as they grow. If I find out, I will write about it!

Flooded by snacks, kids are becoming constant eaters

Kids get 27% of their daily calories from salty, fatty and sugary snacks and constant nibbling starts as early as 2! This is what a recent snacking study found from surveys of over 31,000 kids. Clearly, this is becoming a big challenge for most parents who are trying hard to encourage their kids to develop healthy eating habits. Availability of all kinds of snacks combined with our culture of bringing something to eat for every event means that kids are constantly munching.

I think the main problem is that there is no separation anymore between a regular meal and snacks – which are supposed to manage our hunger level between meals and not act as a substitute. To that end, it is important to drive an understanding – and acceptance – of this notion of separating meals from snacks at an early age. And of course, we as parents have to be a role model by consistently showing the desired behavior.

It is not about healthy snacks, although a lot of products claim to be just that. It is about healthy choices which kids should be empowered to make right from the start. If they recognize their hunger cues, and are in the habit of eating full, wholesome meals at regular times, I am sure they will be able to manage snacks on their own.

If you are facing this situation, check out these handy tips on managing snacks and treats by one of our experts.

Confused about which diet to pick? Get your genes checked!

We have all heard about low-carb and low-fat diets, and you have probably tried them all! If nothing seems to work, check out this new technology of a genetic test for diet. It may just point you to the right direction!

It is yet another weapon in our fight against overweight and obesity. Now you can find out if you are genetically predisposed to lose weight on a low carb diet or on a low fat diet. In a study of 133 overweight women, a substantially higher weight loss was reported when their diet was matched with their genetic predisposition. A separate study shows that 45% of white women have the low carb genotype while 39% have the low fat genotype. The test looks at variations in 3 genes known to affect metabolism of fat and carbohydrates.

Don’t run out to get this test yet because these results are far from conclusive. More research is needed especially with a larger group of men and women across different racial demographics. It is an important trend however, we are finally in the era of personalized medicine and nutrition!

FDA issues warning letters to rein in food labels

This week the FDA issued several warning letters to 18 food companies including high profile names such as Nestle, POM Wonderful and Beech-nut. The big guns are out to shoot down the front-of-box claims, which according to some, are getting out of control these days. There are some, including the prominent Marion Nestle, who are suggesting an outright ban on these front-of-box labels.

If you look closely at the reasons for most of these warning letters you will notice something interesting. FDA is complaining that labels like “low sodium”, “low fiber”, “plus vitamins and minerals” are not allowed on products intended for children 2 years or younger because appropriate dietary levels have not been established for children in this age range. Now whose fault is that? Clearly, inaction from the FDA has created a vacuum which is being filled by savvy marketers. It is also clear that there is a need for front-of-the box labels. Busy consumers do not have time to read and absorb the Nutrition Facts and ingredients list on the back or side panels. They want something quick that helps them decide whether they should buy a certain product or not.

The rest of the world is already moving ahead with standardizing front-of-box labels, an example of which is the traffic light food labeling system. There is no perfect answer, but we need something that works. I hope the FDA takes this on and not simply try to appear like they are doing something by issuing warning letters!

Big Words from Little Foodies

Finally a shout out for my blogger friend Jenna of KidAppeal, who is running a weekly column on her blog called Big Words from Little Foodies. She is inviting toddler parents to share mealtime funny comments they hear from their kids in response to the food on the table. We have had a lot of fun lately with our twins as we try to engage them with funny stories and watch their response! Check out stories from other parents and recipes they have shared as part of this column. We too have contributed to it with articles like diesel food for a diesel engine and eating salad like a giraffe! Share your stories of mealtime fun in comments below.

Enjoy and let me know what is on your mind.

Photo Source: just jane on Flickr via everystockphoto
©2010 Littlestomaks.com

Greetings! I thought of doing something different for this week’s Five for Fridays. Here are 5 videos which caught my eye as I looked for food and nutrition related news. Let me know what you think!

Bode Miller the “ski champ” farmer

Did you know that Bode Miller grew up a vegetarian? I didn’t, until found this video on Phd in Parenting blog! I was so fascinated by it that I decided to dig up the original source. I finally tracked it down on Stonyfield yogurt’s website under their “Yotube” video channel. It makes a perfect pitch for Stonyfield – after all, Bode Miller is no ordinary champion. One unintended message out of this video may be that organic is for crazies only! I think the positioning needs to be a little more mainstream. In any case, this video has a great message aimed to inspire the younger generation.

Watch out! Jamie Oliver is bringing his food revolution to America

It’s official folks! We are a country of fat people. If you have doubts, just check out the statistics on Huntington West Virgina – half the adults are considered obese and rates of diabetes and heart disease lead the nation! Jamie has supposedly the secret formula that can change the mindset: we don’t wanna sit around and eat lettuce all day! It is hilarious and I think it is sure to get good viewership when the show airs on ABC in March. I think it will make great TV, and although I hope it makes a real difference, I am not holding my breath for it! Good luck Jamie anyway.

Tom Vilsack on child nutrition act

Secretary Tom Vilsack answers 5 questions about his plans to expand the child nutrition program. I am all for it; I continue to believe that hunger and obesity are two sides of the same coin. Improving access to nutritious food, including fruits and vegetables, and not just focusing on low salt, sugar and fat is a good idea. Childhood obesity is a serious problem we must address now.

Michelle Obama takes on childhood obesity

If you haven’t yet seen this video by the first lady, you have got to check it out. Even though I think her Let’s Move campaign is destined to disappoint, I do admire her initiative to improve the health of our nation. She has a great personality and her message is clear and in many ways quite inspiring.

Help! My baby is fat – are you serious?

Chubby babies are cute, but is there a thing called a “fat” baby? Well, according to some researchers, people who turn obese when they grow up, begin to show a sign as early as 3 months of age! I find that unbelievable and I think this is going to send a risky signals to new parents. Babies need healthy fat, which if they are exclusively breastfed, is very easy to accomplish. Don’t be afraid of fat; the key is to work towards developing healthy eating habits during toddler years. This is yet another example of how catchy headlines can create a sense of unnecessary anxiety. The video does have some good tips from Dr. Sanjay Gupta, so check it out!

Happy Valentine’s Day! The big news this week was the Let’s Move campaign launched by the First Lady Mrs. Obama to fight the problem of childhood obesity in America. I think it is a worthwhile and timely initiative and I am glad that someone of her status is taking it on to give it the visibility it needs. While the cause is noble, the intentions are genuine and the star power is undeniable, I believe that the approach taken by her campaign is fundamentally flawed. I have serious doubts that it would create a change at the scale needed to make any real impact in the long term health of our nation.

I don’t normally consider myself a glass-half-empty-kinda guy. Yet, today I find myself compelled to give you 5 reasons why this initiative is destined to disappoint. I do sincerely hope I am wrong!

It will not change the demand for cheap fast food in any significant way

I admire Mrs. Obama’s candor in her acknowledgment that she found it hard to balance her family’s need for a healthful diet and demands of hers and Mr. Obama’s careers. Just too busy, not enough time…being unable to cook a good meal for my kids…going to fast food…ordering pizza. She certainly reflects the feelings of many Americans; however the ideas proposed under her first pillar, Healthy Choices, are simply too stale. Here is why:

• Empower customers by front-of-box labeling – interesting idea; already much talked about and being practiced, although not in a standardized way. I believe food marketers will eventually find a way around whatever regulations are introduced and customers will tune out the front-of-the-box information just the way they have tuned out the detailed and really informative nutrition facts label at the back.
• Prescription for healthier living – doctors and nurses will be encouraged to track body mass index and offer counseling for healthy eating early on. Nice thought – every time I go to the dentist, they tell me to floss daily. I don’t, even though I want to. I don’t even feel guilty about it anymore. I realize, they are just doing their job.
• Next generation food pyramid – Guess what, the USDA wants to revamp the food pyramid and online interactive tools! Great news for the academics. A busy parent is probably already overwhelmed; besides if they don’t find time to cook a good meal, do you really believe they will tinker around with online tools?
• Empowering change – very novel idea of a food atlas to show you food deserts around the country. If you live in one, watch out your property value may decline! Just kidding. Again, I think this is a gadget for the academic in us!
• Let’s move start up tools – so you need to stop watching TV and get out there and get some exercise! We all know that and no new tools are needed to convince us or help us out. There are plenty of them out there already.

The fundamentals remain unchanged – we live busy lives; we are always on-the-go; cheap fast food is readily available; it makes us feel good and solves a real problem. None of these ideas will change consumer habits in a fundamental way. At best, they will make people feel guilty, temporarily at least, but don’t expect them to change their habits.

It will not change how we farm and what we grow

What we grow is corn and beans – lots of them.  We practice industrial agriculture which is dependent on fertilizers, pesticides, genetic modifications and consumes an unbelievable amount of natural resources. If you have doubts, pick up a book by Michael Pollan. We process meat in feedlots virtually shut-off to the outside world and raise cattle on a diet of corn. Chickens are no better and quality of seafood is getting worse; what with mercury contamination and salmon being raised on corn! We are constantly battling risks with food safety because of loopholes in inspections.

The wheel of supply and demand turns day and night, getting faster with each turn as the population grows and our appetite explodes. If demand does not change in a fundamental way, how can we expect supply to change? The so called organic movement and sustainable farming are like toddlers in the face of industrial farming.

Granted that one should not expect the First Lady to address such political hot buttons. But one should also not get too enamored by the marketing of this campaign to forget that our problems really arise out of the farm driven by consumer demand.

It offers no incentives for the food industry to innovate

I was excited to read:

Let’s Move is building communities by bringing together families, schools, private industry and government to make healthy living easier

I kept looking for what is expected of the private industry and the only example I found was how the beverage industry is answering the FDA’s call to post calorie information on the bottle! This is no innovation, only a marketing gimmick to appear responsible. There are no real drivers for the industry to innovate to produce healthful products. And believe me, the so called soda tax or twinkie tax is unlikely to effect this desired behavior.

Now you could argue about the definition of a healthful product. Surely, reducing sodium, trans fat and sugar is a step in the right direction. But the fact remains that these products do nothing to reduce the share of processed food in a typical American diet. In fact, this notion is contrary to the business model – after all, the food industry stays in business by selling more of their products, not less. I would love to see food companies create products (and services) that actually increase the share of home-cooked food in an average family. That would be real innovation.

It creates another food bureaucracy

A new Healthy Food Financing Initiative through a partnership between the departments of Treasury, Agriculture and Health & Human Services will invest $400 million each year to provide innovative financing to bring grocery stores to underserved areas. The idea is to increase access to healthy food, fruits and vegetables and to get rid of food deserts across the country. To me it smells like a new bureaucracy, unsustainable in the long run and at the risk of another budget cut. It addresses the issue of supply assuming that the demand will naturally be there. Really? Why not utilize the network of food banks and offer incentives to buy healthful products on food stamps? Do we really need a new system?

It will encourage schools to game the system

School administrators now have a new goal to accomplish – try to fit the mold of a healthier school with the Healthier Schools Challenge. The scorecard is simple – reduce salt, fat and sugar and increase whole grains. This is nutritionism at its best. It is probably not difficult to meet the standards – whatever they might be – over the 5-10 year-long time frame of the program. Does it mean that kids will start eating healthy? Maybe, but not a guarantee. With no real carrots and no sticks, my guess is that schools will simply game the system to generate a hype of healthfulness. And maybe they will figure out a way to correlate small drops in average body mass index with their efforts in the cafeteria! That will make it look really convincing – yeah, right!

I know, you are probably thinking that it is easy to be critical without offering an alternative. I agree – that is why I plan to write about a few out-of-the box ideas in future and invite a discussion on them. Stay tuned!

Enjoy and let me know what is on your mind.

Photo Source: baronsquirrel via flickr
©2010 Littlestomaks.com