Last weekend, I had an opportunity to talk to several parents of young children at a local cultural event. I did a short survey with them to learn more about their issues and concerns. One of the questions was designed to find out which sources of information they rely on for advice on child nutrition. I did a similar survey last year and I reported the results in this article. I have now added the new data for this update.

This data set now has  a total of 202 picks from 97 respondents from the blog, Global Toddlers and the recent cultural event.

Here is how the question was posed:

Where do you go for advice on toddler nutrition? Pick 3

1. Your pediatrician
2. Nutritionist or Registered Dietitian
3. Internet
4. Trusted friend/family
5. Books or Magazines
6. Networking group
7. Other

And here is chart showing the results:

Top 3 sources of child nutrition advice for most parents are Internet, Pediatrician and Books/Magazines.

I think that there is a tremendous opportunity for registered dietitians to connect with parents and offer them credible, science-based, actionable information. They get extensive training in all aspects of nutrition and many of them have graduate degrees. I believe they can bridge the gap between the pediatrician, who is unlikely to spend a lot of time addressing nutrition needs of a child, and the internet, where nutrition information tends to be largely fragmented across websites of dubious credibility. I have had a wonderful experience working with over 30 registered dietitians who have answered reader questions in my Ask the Expert column.

What do you think? Are you surprised by these results?

I would love to hear your opinion on the results of this poll. If you did not get a chance to vote in this survey, please feel free to leave a comment with your picks.

©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, Registered Dietitian Emma Stirling offers a few handy tips on how to get enough protein in your child’s diet.

Question: What is the best way to get protein into a diet with a child who’s fussy?

Answer:

Air and water.  Well, so the saying goes that toddlers seem to survive on air and water, as their food intake appears so minimal at times.  But when it comes to optimal growth and development, it’s important to keep an eye on key growth nutrients including the powerhouse protein.  Let’s take a closer look at where you find protein, how much kids’ need and what you can do to help them power up.

What is it?

Protein is made up of chains of smaller components called amino acids, also known as the building blocks of our bodies.  Muscles, skin, hair and blood cells as well as hormones, enzymes and antibodies, are all made up of a combo of amino acids.

There are about 20 different amino acids that, in different combinations, make up the countless millions of proteins available in nature.   And there are two broad classes of amino acids: those that can be made by the human body (non-essential amino acids) and those that can only be supplied by food (essential amino acids).   A protein’s nutritional value is judged by how many of the essential amino acids it provides and in what quantity.

Where do you get it?

Different foods contain different combos and amounts of amino acids as proteins. Generally speaking, animal protein contains all of the essential amino acids.  Plant proteins usually lack at least one amino acid. There are exceptions to this like soy products and the seed of a leafy green called amaranth (consumed in Asia and the Mediterranean).

Nutritious sources of protein include: Meat, poultry and fish, eggs, dairy products, seeds and nuts, beans and lentils, soy products, grains especially wheat and less so rice, barley and corn.

In line with dietary guidelines it’s important to choose lean cuts of meat, trim the fat and go easy on processed meats like sausages and sliced ham as these are also high in saturated fat, sodium and artificial additives.

How much is enough?

Protein needs differ by age, weight, gender and life stage.  The US Recommended Dietary Allowance for children 1-3years is 13g/day of protein. In my country Australia, the NHMRC Recommended Dietary Intakes for 1-3 year olds is 14g/day of protein.  To put this in perspective, two large eggs provide 12.7g of protein or close to a toddlers total daily protein requirements.  So it’s no surprise to hear that nutrition surveys show that protein is not generally an at risk nutrient.  It is also possible for a toddler to consume enough protein for proper growth and development by following a vegan or vegetarian style of eating.  Make sure you speak with your health professional about balancing your child’s diet and seek expert advice from a Registered or Accredited Practising Dietitian.

Top toddler tips to slip in more protein:

Keep it coming – aim to include small serves of protein at each main meal and slip in extras at snack time.  Try:
Breakfast

• Wake up to a poached or hard-boiled egg with wholegrain toast fingers
• Whip up fruit smoothies with reduced fat milk and natural, Greek style yogurt

Snacks

• Spread nut butters on celery sticks for home snacking, away from nut-free zones
• Blend up a quick hummus with canned chickpeas

Lunch

• Make a baked bean toasted sandwich for lunch
• Mix up a tiny tuna mornay with cheese sauce

Dinner

• Toss some small cubes of tofu with bite-sized veggie stir-fry
• Make mini-meat balls for homemade cheeseburgers on round dinner rolls

Chew on this – overtired toddlers can find chewing meat at dinner time challenging, so make sure you use slow cooking methods to tenderize meat or cook with a sauce like a casserole style or mince bolognaise.
Petite is sweet – don’t overwhelm your child with a huge serve of meat.  As a rule of thumb adults should stick to a portion-controlled palm size serve of steak and little kids…well, just a thumb size may do!
Add flavor – experiment with different flavours too. Your three year old may soon learn to love curry, especially if they have been exposed to the cooking aromas as a baby.
Maximize variety – if your toddler wants mince meat all the time, extend their variety by branching out into different recipes….that still look like mince.  Think tacos, spaghetti, meatloaf, shepherd’s pie or your own masterpiece.

As a general guide aim to clock up 3-4 serves of lean red meat per week for valuable iron and zinc and 2-3 serves of fish for brain boosting omega 3 fatty acids.  And remember, research shows us that young children are naturally wary of new foods (known as neophobia) so the key is to try and try and try and try again.  One of the best health head starts you can give your young child is exposure to a huge variety of different nutritious foods and dishes.

Play your protein cards right and before you know it, your toddler that lived on air and water, will become the “I just don’t know where he puts it” ravenous teenager.

©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.

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.

It is natural for parents to be concerned about slow weight gain in their children when they see the weight percentile number on the growth charts. They try to then force feed their child in the hope that he will gain more weight. In this article, registered dietitian Teresa Wagner explains why this approach may not work in the long run. Instead, she suggests you try to implement the notion of division of responsibility in feeding.

Question:I am worried that my 4 year old is not gaining enough weight although he is growing tall. What should I be feeding him so he can put on some weight?

Answer:

As a registered dietitian who worked for almost 10 years with pediatric clients, I have met many parents who are concerned with their children’s either abundance of or lack of weight gain. Weight status is a result of many factors including but not limited to heredity, metabolism, growth, environment and activity level.

Healthy children are born with an innate ability to regulate their own food intake due to hormones in the body that control the rise and fall of blood glucose levels and appetite. When left to one’s own devices, children will naturally eat when they are hungry and stop when they are full. Take for example, my own daughter who has surpassed me in height at the age of 14. When she was a child, she hovered around the 25th% for weight vs. height and was so tiny that you could have wrapped your fingers around her legs. However, when she was eating, she might stop in the middle of a bowl of ice cream, a baggie of grapes or a slice of pizza and be done. Once she went through puberty, she blossomed out into a curvy teen, now hovering around the 50th% of weight for height and still enjoys the foods she eats but innately monitors her own appetite.

The main concepts we should be concentrating on as parents to teach our children involving eating are balance, variety and moderation. Enjoying a variety of nutrient rich foods that will maximize the nutrients we obtain while moderating our calories and balancing those calories with appropriate physical activity or active play. When I taught college, the first statement I would make to my students was that if they learned nothing in my class but the definition and application of the three words balance, variety and moderation, I would be happy.

As a young dietitian, I learned all of my basic information on child feeding and actually worked for years in eating therapy for children who were born without the innate ability to either eat by mouth or sense hunger, fullness and satiety. The guru of child feeding in my book has always been Ellyn Satter.

Ellyn’s division of responsibility in eating tells us that parents are responsible for serving nutritious foods in a positive and supportive atmosphere while the child is responsible for how much and whether or not they will eat. In doing so on both parts, the child can develop successful skills in balance, variety and moderation and carry forth these skills into adulthood in developing a healthy lifestyle that includes physical activity, adequate sleep and weight maintenance. Teaching these concepts at a young age decreases your child’s risk of developing chronic disease as an adult. By becoming overly concerned or forceful with children’s eating and weight, we disrupt this natural balance by creating a negative atmosphere or forcing unneeded calories and our child may lose  that inborn ability, as many of us have, to balance their own weight and monitor their own food intake. In the mean time, they will grow normally based on their own unique make-up of weight status factors. Thus, Ellyn says don’t try to control the amount of food or calories that your child eats; that is the child’s job.

Instead:

• Maintain a division of responsibility in feeding; you providing/child monitoring.
• Do family-friendly feeding and maintain a supportive atmosphere.
• Offer nutrient rich snacks between meals and encourage active play.
• Let your child grow up to get the strong, healthy body that is right for them.

©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.

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 Kerry Robinson clarifies the difference between milk allergy and lactose intolerance and offers advice on how to deal with both.

Kerry Robinson, RD B.S. Virginia Tech – Human Nutrition, Foods and Exercise with concentration in Dietetics Dietetic internship at Virginia Tech Expertise in food and health communication at IFIC Analyzes trends in food and health issues on traditional and social media Twitter – @IFICmedia Contact via email – robinson@ific.org

Question: How can I be sure if my child has milk allergy or lactose intolerance?

Lactose intolerance is an inability to digest and absorb the sugar in milk (lactose) that results in gastrointestinal symptoms such as nausea, vomiting and diarrhea when milk or milk-containing products are consumed.

Unlike lactose intolerance, a milk allergy is caused by an immune system response in which milk proteins (casein and whey) are mistakenly identified as being dangerous and antibodies are created to fight them off in an effort to protect the body.

For example, a child with a lactose intolerance, can consume  lactaid (lactose –free milk) or yogurt without symptoms but a child with milk allergy can not. The difference between milk allergy and lactose intolerance is not only the cause, but also the severity of the symptoms.  While a child with a milk allergy can display similar gastrointestinal symptoms as one who suffers from lactose intolerance, it is important to understand that the symptoms of an allergic reaction can be much more severe, and even life threatening at times.

The following are the most common signs and symptoms of a reaction to a food allergen, like milk

• Skin rashes, itching, swelling or hives
• Vomiting or other gastrointestinal symptoms
• Respiratory distress, such as wheezing or breathing difficulties
• Anaphylaxis, which is a systemic allergic reaction that can involve multiple symptoms at once and can range from mild to fatal

Once you suspect that your child or loved one has a reaction or intolerance to milk you should consult your health care provider, pediatrician and/or a board-certified allergist.  He or she may ask you detailed questions about signs and symptoms, perform a physical exam, request a detailed food diary, and perform a combination of skin prick or blood sample tests to confirm an allergy or intolerance.

Should a milk allergy be confirmed, you will need to eliminate all milk and milk-containing products from your child’s diet.   While this can seem like a daunting task, a registered dietitian can provide expertise in helping to ensure your child receives adequate nutrition, especially calcium to foster proper growth and development.  Since strict avoidance of the offending food allergen (in this case, milk) is the only way to prevent a food-allergic reaction, a registered dietitian can work as part of the healthcare team to:

• Review how to avoid specific food allergens
• Ensure nutrient adequacy (especially calcium and Vitamin D)and add variety to your child’s diet
• Provide suggestions for meals and snacks and strategies to enjoy dining out
• Assist in label reading
• Monitor growth and development
• Share resources related to food allergies

Whether your child is lactose intolerant or allergic to milk, it is important to engage your healthcare team, especially a registered dietitian to help guide you in making sure your child eats and stays healthy.

For more information on allergies, join IFIC and Food Allergy and Anaphylaxis Network for a Twitter chat on Tuesday May 11, 2010 at 8 p.m EST using hashtags #foodinsight and #FAAW

©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.

Through the month of March, I posted a series of articles on this year’s National Nutrition Month theme Nutrition from the Ground Up! It has been very interesting for me to read and compile a broad range of diverse opinions on the question What does Nutrition from the Ground Up mean to you? Hope you have had a chance to read this series; if not, I have posted the links at the bottom of this post.

Here are a few final thoughts….

Jodi Greebel, a registered dietitian and co-founder of DinDins toddler food wrote:

I think Nutrition from the Ground Up can have many different meanings including starting with the basics of nutrition. To me, it means helping children build a healthy foundation of eating habits. The habits we learn as a child stay with us. It’s much easier to teach good eating habits to children than to try to undo bad ones in adults. For parents to teach “Nutrition from the Ground Up” to their children, they may need to examine their own eating habits. Do I eat at least 7 servings of fruits and vegetables each day? Do I choose healthy fats? It can be a great time for parents and kids to start eating healthier by slowly working on these goals. Maybe start by incorporating a fruit at breakfast each day.

Milton Stokes, registered dietitian and owner of One Source Nutrition offered a very interesting perspective and suggested we stay grounded in the present as we consider our health and nutrition:

In the work I do, I see a lot of individuals with eating disorders and negative food relationships. The theme Nutrition from the Ground Up is most applicable to my clients. I counsel them to keep their heads where their feet are–right on the ground, right there in the room with me . . . instead of worrying about what happened food-wise yesterday or last week. They only can deal with the present meal and then do a little planning for meals to come. Excessive worry never promotes health. It’s like sitting in a rocking chair, rocking incessantly, and expecting to arrive at a new destination. So with that I say start where you are; take it one meal at a time. And enjoy!

Here are the links to other opinions on this topic:

Nutrition from the Ground Up means “Back to Basics”

Nutrition from the Ground Up means “Food from the Ground”

Nutrition from the Ground Up means “Real Food”

Expert tips for Nutrition from the Ground Up

What do you think? What does this notion of Nutrition from the Ground Up mean to you? What small changes have you made to your family’s diet recently?

Please share in your comments below. I would love to hear from you!

©2010 Littlestomaks.com

I have been getting very interesting responses to my question What does Nutrition from the Ground Up mean to you?! Instead of compiling all of them in one single article – as I had originally planned – I will highlight a couple of them at a time and write a series of articles during this National Nutrition Month.

Here is one from registered dietitian Elisa Zied:

To me, Nutrition From the Ground Up means getting back to basics in terms of diet, nutrition, and health–choosing as many whole, fresh, and minimally processed foods as possible and making them the foundation for a healthy diet. We all live busy, harried lives and have too much on our plates (literally and figuratively!), but if we take a moment to step back, look at our diet and lifestyle patterns, and take small, simple steps to choose and eat more of the foods that are lacking in our diet–like fruits, vegetables, whole grains, and lean sources of protein in particular– that alone can help us get more key nutrients our bodies need not to mention leave less room for high calorie, nutrient poor foods. Each and every one of us has the power to start eating more healthfully. If we take small steps to achieve that by tackling one meal at a time, one day at a time, we can rebuild a diet that’s more nutritious and still delicious. Eating a diet that’s heavy in real foods that are healthfully prepared can help us fill up on fewer calories, and feel more energized. It can also increase the quality of life, help ward off diet-related diseases and conditions, and put us in a better position both mentally and physically to tackle all the obstacles and challenges we face each and every day.

Here is another from registered dietitian Caryn Roll, who also advises taking small steps as you take control of what you eat:

To me, nutrition from the ground up means cooking your own food and staying away from processed junk. I think people should just stick to ingredients that even grandma can understand.  Now that is nutrition from the ground up!

Make small changes and build on those changes like drink more water and then maybe try dropping one meat meal in favor of a vegetarian meal. Experiment with unsaturated fat like olive oil, nuts and avocados.  Switch to whole wheat pasta.

These are excellent comments and very actionable advice. I also think that the message of going back to basics reflects the current mood where a lot of us are becoming more aware of the pitfalls of relying on nutrition out of a box!

What do you think? What does this notion of Nutrition from the Ground Up mean to you? What small changes have you made to your family’s diet recently?

Please share in your comments below. I would love to hear from you!

©2010 Littlestomaks.com

March is the National Nutrition Month! Sponsored by the American Dietetic Association, this year’s theme is Nutrition from the Ground Up. It is a very interesting theme, one that evokes a lot of ideas about nutrition. Here is one image that came to my mind when I first heard about it!

So, dear readers! I would love to hear about what this notion of Nutrition from the Ground Up means to you.

Please share your thoughts in your comments below. I will compile your response in a blog post, along with a few comments from my registered dietitian friends.

Photo source: antanask on Flickr via everystockphoto
©2010 Littlestomaks.com

As part of the National Nutrition Month®, March 10th this month was celebrated as the National Registered Dietitian (RD) Day. I have a lot of respect for registered dietitians – many have answered questions from readers in Ask the Expert column on this blog. I think this recognition is well deserved!

It is Friday again, which means it is time for the usual Five for Fridays! This week, I want to highlight 5 informative posts by registered dietitians who contributed to a recent blogfest. RD’s in this blogfest were asked a simple question – If you could give only one message, what would that be? There is a wide range of ideas from RD’s in response to this question! Check them out and leave a comment to share your opinions.

Get your kids interested in cooking

That is the message from Robin Plotkin in her post Give a kid a fish, feed him for a day. Teach a kid to fish, feed him for life! The idea is simple, yet quite powerful; one that has the potential to totally change our relationship with food and eating. Instead of relying on carry-outs, drive-thrus and ready-to-eat meals, you could get your kids involved in the whole process of putting food on the table. Get their input in meal planning, take them out for grocery shopping, and do a cooking project in the kitchen with them.

We have sort of getting started on it with simple projects like making chicken quesadillas! Try it out, it’s a lot of fun, although it takes a little planning.

Don’t label food as good or bad, enjoy it

In her post Enjoy food, Heather reminds us that food should not be labeled as good or bad; rather we should take a look at our behaviors and environment to find solutions to our diet and health related problems. We have become so separated from how our food is grown and where it comes from, that all we can rely upon is the nutrition facts panel on the box. The quality of food is determined by calories, fat, sugar, salt, protein, vitamins and minerals. Not by how it is made, how it is eaten and how it is shared with friends and family. There is a cultural aspect to food and eating which has gone completely missing from modern life.

Heather’s message is a simple reminder to enjoy food without guilt while still being mindful of what your body tells you. Get to know your food and choose natural or minimally processed foods. Her message resonated with me a lot especially after I read Michelle May’s book Eat what you love, love what you eat! The risk here is that if you don’t exercise mindful eating and don’t listen to your body, you can take this guiltless eating along a negative spiral. That works only in food advertising, not in real life!

Eating healthy at home is super easy, give it a shot

You don’t have to be a high-profile chef to prepare simple, wholesome, nutritious meal! Or go out of your way to find ways to include fruits and veggies in your daily diet. Simple, but creative, changes can help you eat healthy everyday according to these eat well tips from Janel. I like her simple approach and ideas for getting fruits and veggies at every meal. She also points out that just by keeping a small inventory of whole grains and proteins in your pantry, lean meats and frozen vegetables in your refrigerator, you can make a variety of combo meals simply by boiling water, heating an oven or opening a can of beans!

Once you get in the habit of preparing your meals at home from simple recipes, it becomes a part of daily routine and doesn’t seem like a big task. Getting your kids involved, as suggested by other bloggers, is also a good idea!

Formula for a healthy diet – 90% plants, 10% animal foods

You don’t need one diet for cancer prevention, one diet for diabetes and one diet for heart disease, says Diane Perves on her blog as she makes a case for a mainly vegetarian diet in her article Only one message. Simply increase the amount of plant based foods such as vegetables, fruits, nuts and seeds and reduce the amount of animal based foods like meats and dairy. That is the core of dietary guidelines and a variety of diets. The sad fact of the Standard American Diet (SAD) is that the food triangle has been flipped on its head with vegetables at the bottom and animal products providing 70% of the daily calories.

Of course this does not mean that you need to go cold turkey on meat and dairy completely. What it means is that you can start out by making small changes as you work toward getting your food triangle sitting on its broad base rather than its pointy head!

To D or not to D, is no longer the question

Dietitian Debra is clear and emphatic in her recommendation that you take vitamin D supplements during pregnancy and also give it to your children. Food sources of vitamin D are rare and hours of sunshine limited during the winter. Recent data suggests a broad deficiency of vitamin D and recommendations are pouring in from experts about using a supplement and even taking more than the current daily recommendation of400 IU.

I do agree that vitamin D is very important for growing children. However, I am not convinced that there is widespread vitamin D deficiency and that it is very hard to get enough vitamin D in kids via food. All milk is fortified with vitamin D. So is several brands of orange juice. Kids cereals typically have vitamin D fortification. Eating fish even once a week can provide a lot of vitamin D. There is considerable disagreement about what can be considered as deficiency, especially in kids. And there is no real evidence to suggest that the daily dose should be increased beyond the current recommendation.

Having said that, there is no harm in using a supplement within the suggested dose if that offers you a peace of mind. There are always special situations where your child may definitely benefit. Here is how you can tell if your child may have a vitamin D problem. If you suspect that your child may be in this situation, consult with your doctor first.

Enjoy and let me know what is on your mind.

Photo Source: noahg on Flickr via everystockphoto

©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, Registered Dietitian Rebecca Subbiah offers advice on how to get your little one to develop a taste for multinational ethnic foods at an early age.

Question: How can I introduce my child to ethnic foods?

Answer:

First let me introduce myself, I am Rebecca of Chow and Chatter. I am a Brit married to an Indian living in America. We have a one-year-old daughter, and as a family we love to travel and try new foods. In fact every time we visit a big city like New York we look up new cuisines to try. I am a dietitian and love picking up healthy cooking tips and recipes from around the globe.  So it would only be natural to introduce our daughter to all the amazing food from different countries and broaden her horizons.

When she was 7 months old we went on a trip to Europe, the first week we were in the UK visiting my family where she got to try Great Grandmas chocolate cake and ground Sunday roast. Then we went to France for a week where she chewed on fresh French bread, petit flors yogurts and tried small amounts of food off our plates.

Then during our last week of vacation we visited Italy where she ate pasta, I was truly amazed at how at such a young age she managed spaghetti eagerly sucking it up. She also had fresh fruits and gelato. We purchased the local baby foods from each country and I even found pastini pasta for babies in Italy. She adores pasta now maybe this early introduction and being spoilt in Italy with good food set the scene.

But you don’t have to travel to offer multinational cuisines, simply adapt the dish you are cooking to have less salt and spice and to be the correct texture depending on the age of the baby.
Here are some examples:

1. If you are making Indian dal, add the lentils, tomato, onion and garlic and a vegetable – I often use spinach – pressure cook then set aside for baby. With the remainder add the desired spices for Mom and Dad.
2. For homemade soups make your own broth or use low sodium version from the market.
3. For Chinese or Vietnamese stir-fries add onion, garlic, and a splash of soy sauce with veggies for baby then add spices for Mom and Dad.
4. If your making meat curry have a separate pan for baby with the meat, onion, garlic, and tomato. The two dishes can easily be cooked at the same time.
5. Pasta’s and polenta dishes can be the same for baby and parents.
6. Poached fish with mashed potato and vegetables are a great family meal

Don’t be afraid to offer cuisines from different countries and ask people from those places for suggestions. The more varied and adventurous your little ones diet is at a young age the better it is for life. On a final note have fun and lead by example.

©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.

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 Liz Marr offers a few practical tips for feeding a very active child.

Question: Can you give a few suggestions on feeding a very active child?

Answer:

Many parents of busy toddlers wonder if their child will sit still long enough to actually eat anything substantial. And I know from first-hand experience that can be a particular challenge with very active toddlers. Several points to keep in mind: Children will eat when they are hungry and it may not always be at a prescribed mealtime. Keep in mind, if a child doesn’t want to eat, he or she is probably not hungry. If you are presenting a variety of nutritious foods, try not to worry too much. One way young children express their independence through food, so allow them to make choices. Serve smaller, more frequent meals and snacks for active toddlers, if you know they won’t sit still. Or try letting them eat their meal in stages, if it seems they need an activity break. Allow flexibility to reduce stress at feeding time. In the long run, you’re helping your child develop a healthy relationship with food, which means not responding to prescribed external rules, like eating everything on the plate and specific meal times, but rather creating a solid connection with internal hunger cues and fueling the for health.

©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.

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 Laurie Beebe recommends a simple method to stop your child from overeating and develop long-term healthy eating habits.

Question: How can I model healthy eating behavior for my kids without emphasizing ‘dieting’ at this young age?

Answer:

Recently, a client of mine asked me this question:

“My husband and I are both active and in good shape, but sometimes I eat a bit too much, especially in the evening, and go to bed feeling bloated.  I notice that my 3 year old and 5 year old also want second helpings sometimes and afterwards there are times they complain of a stomach ache.  How can I model healthy eating behavior for them without emphasizing ‘dieting’ at this young age?”

In my opinion, one of the best things you can do for your children is to teach them healthy eating habits while they are growing up.  They don’t need to have any information about what eating too much will do to their future health at this age; only that it might give them a tummy ache!  Just as you need to discover that the signal “you are full” does not reach your brain for 15 minutes after you really have had enough, this is something you can teach them, too.  Show them that you are setting a timer for 10 minutes when they ask for second helpings (especially if you allow them extra portions of foods that are low in nutrient-density, like desserts).  Let them know that their body needs time to realize they are full and if they keep on eating their only signal is a tummy ache when it is too late.  Assure them that if they still want more food in ten minutes then it is theirs, but you want to be sure they don’t get sick from eating too much.  (You don’t need to remind them in ten minutes by asking, “Did you still want more macaroni and cheese?” but do give them a small amount if they come to you for more when the timer goes off.)  Chances are, they will be distracted by some games or toys and forget about the desire for more of the tasty food when the impulse passes.

This is a healthy lesson they will learn for life and they will grow up, not with an idea that “food that tastes good is bad and makes us fat and sick”, but merely “I need to stop and think whether or not my body feels hungry before I take an extra helping”.

©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.

Happy Friday! This photo touched my heart and reminded me the value of nutrition and care for our growing children. Sometimes, a picture really is worth a thousand words!

That said, here are the 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.

Eco-Atkins diet

A low carbohydrate, high protein Atkins diet is popular for weight loss, but carries the risk of increasing LDL (“bad”) cholesterol. Now some researchers are suggesting that a vegan diet rich in protein from plants and nuts reduces weight and lowers cholesterol, by as much as 20%. In a study published in the Archives of Internal Medicine, they concluded that a  plant-based low carbohydrate “eco-Atkins” diet resulted in about the same weight loss as a high-carbohydrate, dairy and whole grain vegetarian diet, but reduced the LDL cholesterol by a larger amount. Although the size of the study was small, it proves again the many benefits of a plant-based diet. Cutting down on meats which are rich in saturated fats and cholesterol is a good idea even though the specific results cited by this study may not be seen for everybody.

New FDA chief focuses on food safety

In an interview with the Associated Press, the newly confirmed FDA chief Dr. Margaret Hamburg put a high priority on restoring FDA’s credibility by using science-based information to drive decisions, and by implementing risk-based controls for early detection of food contamination in the farm-to-store supply chain. I don’t think there is anything earth-shattering here; this is precisely what the FDA is expected to do anyway. Also, this is what the public wants to hear in light of the peanut, pistachio, spinach, lettuce and tomato outbreaks. The public confidence in the nation’s food supply is shaken up, so naturally this is high on FDA’s agenda. What I would like to know is how she plans to fix the management system, improve visibility of problems and bring in a sense of accountability in the public office. Till then, these are simply nice sounding words and we will continue to remain one more outbreak away from another massive recall and public health scare.

Consumers want healthy food but unwilling or unable to pay more

According to the United Soybean Board’s 16th Annual Consumer Attitudes About Nutrition report, nearly 9 out of 10 consumers report wanting to buy nutritious and healthy food but only about half are willing to pay more. Of the remaining, about half say they want to but can’t afford nutritious food right now. A fairly large number of them also say that the food they buy is already healthy, and that the healthier version would not taste as good. There is a certain bias in this survey towards processed foods since that is clearly of interest to the soy industry. I don’t think they even considered asking questions about fresh vegetables and fruits and cutting down on meats. My guess is that the definition of healthfulness was limited to the nutrition facts label – the usual calories, fats, carbohydrates, sugars, proteins, vitamins and minerals etc. And the interesting fact about these labels is that even though most people do review them before buying, about half find the nutritional information confusing. With a limited definition of “healthfulness” and confusing nutritional information, how can we expect consumers to make the right trade-offs between buying healthy food and cost?

Challenges of reducing sugar in (processed) foods

I certainly cannot relate to the “challenges” faced by the food technologists in formulating foods with artificial sweeteners. Nor do I want to! But I found this podcast interview with the manager of sweetener technology at Tate & Lyle posted on the FoodNavigator site quite interesting. Turns out that sugar not only provides sweetness, it also affects the texture and feeling of the food. That is why, a simple substitution of natural sugar with artificial sweetener doesn’t work so well except in beverages. In ice cream, for example, reducing sugar or adding artificial sweetener can change its freezing point, and as a result, the consistency. In baked goods, sugar affects the color, taste, bulk and shelf life, which makes it difficult to reproduce with artificial sweeteners. So I guess they make these food technologists earn their paycheck after all! Anyway, this manager also commented that consumers want taste and choice, and for those wanting healthy foods with low sugar, it is a challenge to offer them all three. Tells me that her interpretation of what consumers want is incredibly – though understandably – quite narrow. What happened to fresh, natural, locally sourced, green, organic and wholesome? Guess they have decided not to listen to those customers since they will probably not be helping Tate & Lyle’s bottom line anyway!

Simplicity is the new message for “affordable” healthy food

My blogger friend and registered dietitian Janet Helm was recently interviewed by ABC News (Go Janet!) on the recent trend of going “back to basics” when it comes to food advertising. Janet has written about these trends on her blog Nutrition Unplugged in a couple of very interesting articles. So check out her blog and the ABC interview via her post Simplicity Sells in Tough Economic Times. Janet is also a contributor to my Ask the Expert where she recently wrote a very informative post about sushi and toddlers.

Enjoy your weekend! And let me know what you think.

Photo source – Thiru Murugan on Flickr
©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 Janet Helm offers a few suggestions on how to introduce your toddler to sushi. She is also a Mom of twins and writes a very informative blog called  Nutrition Unplugged.

Janet Helm, MS RD B.S. in Mass Communications and Nutrition M.S. in Dietetics, Registered Dietitian 15 years in Nutrition Communications Freelance writer, nutrition consultant, blogger Website:Nutrition Unplugged Twitter:@JanetHelm Contact: via website

Question: I am thinking about introducing my toddler to sushi. What should I be concerned about?

Answer:

If sushi is something you enjoy, then no doubt you’d like to share it with your child.  I think it’s great to introduce children to a wide variety of foods early in life.  I’m a big proponent of developing the preschool palate and getting out of the chicken-nuggets rut. However, you’re right that there are a few things to keep in mind.

First, the official food safety stuff.  Raw fish can harbor bacteria and children under age 5 are considered to be especially susceptible to foodborne illness.  Young children — along with pregnant women, older adults and people with compromised immune systems – are advised by FDA’s Center for Food Safety and Applied Nutrition to avoid raw fish or shellfish. So I would wait until at least age 5 before introducing raw-fish sushi.

You also need to think about mercury, especially in tuna sushi.  It’s best to limit tuna and other higher mercury fish like swordfish, shark, tilefish and king mackerel to no more than 12 ounces a week.  A group called KidSafe Seafood, a coalition of chefs, pediatricians and sustainable seafood experts, is a great resource for parents.  They’ve identified the best seafood choices for children ages 3 and up that contain acceptable levels of mercury and other contaminants:  Wild Alaskan Salmon, Tilapia, Farmed Blue Mussels, Northern U.S. and Canadian Shrimp, U.S. Farmed Crayfish and Farmed Bay Scallops. You’ll even find recipes for kid-friendly “safe” sushi, such as California rolls with imitation crab meat and salmon rolls made with smoked salmon.

One last concern is the potential of parasites in raw fish, which can be particularly troublesome to small bodies.  One precaution is to eat only fish that has been previously frozen, which can help kill any parasites that might be hiding inside.

Yet with all of these caveats, it comes down to doing what you’re comfortable with and only going to sushi restaurants you trust.  I know a lot of parents who have been giving their children sushi at a fairly young age (almost always over age 2) and there’s never been any problem.  Afterall, children in Japan begin eating raw-fish sushi at a young age — although the Japanese do not eat as much raw fish as we think they do.

My twins are 5 and we haven’t been out for sushi yet, but that won’t stop us from going to a Japanese restaurant.  For now, I think I’ll start with vegetable rolls, tempura and rolls made with cooked fish.

Fortunately, they love fish that I make at home and I’m beginning to introduce new varieties.  Just be sure you talk with your pediatrician if your child has never eaten shellfish to discuss potential allergies.

Even if you decide to hold off giving your toddler sushi, perhaps you can have fun with this Sushi for Kids book or sushi toys.

©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.

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 Preethi Rahul explains how you can ensure a complete nutrition for your child on a vegetarian diet.

Preethi Rahul Registered Dietitian, Diploma in Clinical Nutrition & Dietetics, Graduation in Nutrition, Food Service Management and Dietetics. Two years of rich experience in the field of nutrition, currently working with a Multinational Corporation Expertise in the field of Child nutrition and Diabetes LinkedIn Profile Contact: via email

Question: My child is on a 100% vegetarian diet. How do I ensure he gets a complete nutrition?

Answer:

Many people globally are certainly getting converted as vegetarians because of the many virtues a vegetarian diet has.

A vegetarian diet by itself is balanced as it has the cereals and sugars that provide the carbohydrates; pulses, milk and milk products that provide the proteins; Vegetables and fruits that provide the vitamins and minerals; Oil, ghee and butter that provide the fats. However, it is important that you give a balanced vegetarian diet to your child which on average, for a 4 – 9 year old child, would be around:

*1 serving is 30 g raw weight
*1 glass is 150 ml
*1 cup is 100 g

However the quality of vegetarian proteins is lesser than that of the non vegetarian sources. Thus, as a parent you need to ensure that you give good quality vegetarian proteins to your child. In order to improve the protein quality you can also make cereal-pulse combination recipes like Idlis, dhoklas, khichdi etc. Sources of good quality vegetarian proteins are soya, tofu, milk, curd, skimmed milk powder, paneer (cottage cheese), lentils, sprouts etc.

Highlight of a vegetarian diet are the vegetables and fruits! They make the food preparations colorful which is very essential for a child. Children love color and variety in their food. Vegetables and fruits contain vitamins and minerals which are needed in small amounts but have very specific actions in the system. For E.g. Vitamin D is needed for bone development; iron is needed for hemoglobin formation. This group also contains fibers- both soluble and insoluble that are needed to improve the bowel health, keep the digestive system healthy and functioning properly.

A colorful diet not only looks good on your plate but also provides all the necessary nutrients that help the body in its growth. For eg: Anthocyanines that cause the purple color regulate the blood circulation; They are richly present in berries. Quercetin that causes yellow color as well as anthocyanines helps to maintain good health of the retina. They are present in corn, apples and leafy vegetables such as spinach. The antioxidant Beta Cyanine present in beets causes the scarlet color in vegetables.

Thus, by having a vegetarian diet your child is getting a complete and a balanced nutrition and has a lesser chance of getting long-term health problems.

©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.

Recently I posed this question on my blog because I have been interested in learning from toddler parents about their most preferred sources of information on nutrition. This is one of the questions in my weekly Global Toddlers survey, but I also wanted to open it up to everybody else. I collected a total of 147 picks from 51 voters on the blog and 18 Global Toddlers respondents.

Here is the original question:

Where do you go for advice on toddler nutrition? Pick 3

1. Your pediatrician
2. Nutritionist or Registered Dietitian
3. Internet
4. Trusted friend/family
5. Books or Magazines
6. Networking group
7. Other

And here is  chart showing the results:

These results may seem surprising – after all, it would be quite reasonable to expect that most parents would pick either the Pediatrician or Trusted friend/family since they would give the most credible advice. In fact, only 29 parents picked Pediatrician (42% of 69 parents who responded). The number for Trusted friend/family was even lower at just 20 out of a total of 69.

But if you give this question a little thought, these results are hardly a surprise. After all, you see your pediatrician usually when your child is sick or if you are going there for a routine exam. There isn’t much time during those visits to get all of your nutrition questions answered in detail. At least that’s what we have experienced. Things seem so rushed when visiting the doctor’s office. We seem to spend more time waiting than talking with the doctor!

And as far as trusted family and friends are concerned, sure they can provide sound, well-meaning advice based on their own experiences, but it is unlikely that they would truly understand your unique situation. We all live busy lives, and just like our doctors, it might not be possible to talk to them often enough to get nutrition related information. I also have a hunch that when you ask for their advice, there is a part of you which feels kind of “pressured” to act on it since you want to be able to “report” the results when you talk to them again. I would love to hear your feelings about this.

From this point of view, it is not surprising that a lot of toddler parents rely on indirect sources of information like the internet and books or magazines. There surely is a lot of nutrition information on the internet, but in my experience it is fragmented across many different websites, some of which may not be completely reliable. On top of that, the topic of toddler nutrition rarely is the main topic on these websites, and as such, does not receive the attention it deserves.

To address this gap, I recently launched a weekly column called Ask the Expert. It is my sincere hope that this column can provide highly credible nutrition information in a simple question-answer format to toddler parents. In the coming weeks, you will hear from several experts (pediatricians, registered dietitians). Please post your questions so I can continue to bring their professional advice to you through this blog.

I would love to hear your opinion on the results of this poll. If you did not get a chance to vote in this survey, please feel free to leave a comment with your picks.

©2009 Littlestomaks.com