There are days when feeding twins can be a difficult challenge.  Then there are days when there is twice the laughter at the table!

We haven’t quite figured it all out, but we have indeed picked up a few tricks along the way.

Recently, I had a chance to share our experience and a few tips in a guest article for InspiredRD, a fabulous blog by registered dietitian Alysa Bajenaru.

Check it out here and share your comments.

©2011 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.

Nearly all parents of toddlers struggle to feed their little ones. But when it comes to feeding twins, it may be the ultimate extreme sport!  This week, Registered Dietitian Aaron Flores, who is also a dad of twins, shares his experience and a couple of successful strategies of feeding kids.

Aaron Flores, RD Bachelors in Family and Consumer Sciences and RD Experience – 4 years experience as a clinical RD specializing in weight management Expertise — General Nutrition, Weight Loss, Nutrition news, Sustainable eating Website: Balance-Variety-Moderation Blog: Balance-Variety-Moderation Blog Twitter: @Afjamp Contact: via email Aaron@bvmrd.com

Question: How can I get my twins to eat well and develop healthy habits?

Answer:

You would think that a dietitian would have an easy time when it comes to feeding their own children right? After all, we do consider ourselves the nutrition experts.  I find it is quite the contrary.  Knowledge does not always equal 100% success when it comes to feeding your kids.  Along with being a dietitian, I am also the proud father of not-quite 3-year-old twins, Reuben and Shira.  Being a father of twins and a registered dietitian, I think I’ve gained some unique perspective on feeding children.

Before being father, I remember sitting in school earning my bachelor’s degree, and learning about Ellyn Satter.  I found out she was a dietitian who had very interesting insights into feeding children.  I knew she wrote many books on the subject I never was motivated to read them until I found out my wife was pregnant.  Until you have children of your own, you never really know what kind of parent you will be or how you will handle any given situation.  You think you will handle it one way but until that actual moment is there, you never really know. Feeding my children was a perfect example of this.

What I loved about Satter’s theory is that focuses on responsibilities.  She believes that a parent’s job is to provide healthy, balanced meals to their children.  Then it is the child’s responsibility to eat the meal.  A parent is not a short order cook and should not run to the kitchen to make a whole new meal just because he/she doesn’t like what is being served.  Sounds simple?  In theory it is but until you experience the five-minute tantrum that your son is having because he doesn’t want pasta with vegetables, you don’t know how hard that is.

Having twins adds another complexity to all of this.  Some think that twins (no matter if they are identical or fraternal) should be similar since they have the same birthday, are raised together and share most of their experiences.  Wrong!  Twins are really just siblings who share a birthday and can be as different as night and day, especially when it comes to food.  My kids eat the same meals as each other but how they react during a meal is totally different.  One is more likely to get upset and the other is more likely to lose attention quickly and eat only one or two bites of food before asking to leave the table.  We learned that there were differences very early on.  Our daughter was colicky for the first four months of her life.  We tried everything to relieve the symptoms.  There was one point when she had different bottles, nipples and formula than our son.  It was our first lesson that what applied to one would not necessarily apply to the other.

If you want some insight into chaos theory, come over for dinner one night.  It is a bit of a circus but despite all of this, my wife and I have two kids that are actually very good eaters.

So how did we do it? They key is that with most things behavioral, there is no quick fix.  It takes time and consistency but pays off in the end.  Here’s what’s worked for us and maybe it can work for you too.

1. Everyone sits down at the dining room table with the TV off for dinner. (Unless there is a big football game on!)  This gives us structure at night and allows us to connect with each other
2. Have regular snack times.  If one child doesn’t eat at dinner for any reason (mood or not hungry) my wife and I know that they won’t starve.  They will have a balanced and nutritious snack in a couple hours that will satisfy them
3. As your children get older, involve them in the meals.  I made falafels at home for the first time last month and the kids helped by adding the ingredients in the food processor.  Since they were apart of the process they were more interested in trying this new food.
4. Grow some vegetables with your kids.  They will love watching the plants grow and be excited to see how a cucumber started from a seed to the long green vegetable that is now on their plate.
5. As they get older, give them a choice between two things for dinner.  Every night I ask, “Ok, do you want this or that for dinner tonight,” and that’s it.  I don’t give them more choices and I try not to get into a negotiation.

©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.

Nearly all toddlers are picky eaters. As if that is not enough of a challenge for parents, they also show irregular eating patterns. One day they might eat a lot, while another day it is only a few nibbles. This week, Registered Dietitian Alysa Bajenaru offers a few tips to help your little one develop regular eating habits.

Alysa Bajenaru, RD, CPT B.S. in Nutritional Sciences, University of Oklahoma Registered Dietitian, Certified Personal Trainer and Group Fitness Instructor Experience: clinical dietetics, personal training, former owner/current instructor Baby Boot Camp Expertise: Family nutrition, weight management, new mom fitness, nutrition education Contributor and instructor for Baby Boot Camp Nutrition Solutions program Mom to two toddlers (1 and 3) Website: Inspired RD Twitter: @InspiredRD Facebook: Inspired Results Contact: via email InspiredRD@gmail.com

Question: Sometimes my son won’t eat for days, except nibbles – and other days he will eat like crazy. Is this normal and healthy? Should I enforce more regular eating patterns?

Answer:

It is totally normal for a toddler’s eating habits to vary.  With that being said, here are some tips that may help bring more consistency to your toddler’s diet.

Plan Snack Times.  Many toddlers tend to “graze” all day on crackers, cereal and other snacks.  Make “snack time” an actual time when your son sits at the table and eats a quality snack.  Combining carbohydrates, protein and fat will help keep him satisfied until the next meal.  Examples are string cheese and applesauce, peanut butter and celery with raisins on top, cheese and crackers with some grapes, plain yogurt with strawberries and granola.

Watch Liquid Calories.  Offer milk (low-fat or fat-free after age 2) only at meal times.  Toddlers who drink juice or milk all day may be drinking too many calories to be hungry at meal times.  Offer water throughout the day and fresh fruit as part of meals and snacks instead of juice.

Involve your Toddler in Cooking and Meal Planning.  If you have the space to grow a garden, I highly recommend gardening with your kids.  From personal experience, my son will try anything that we have grown ourselves because he has a connection to the food.  If I brought the same item home from the grocery store, he might wrinkle his nose at it.  If you can’t plant a garden, involve your toddler in the grocery shopping by asking him to pick out fruits and vegetables that he wants to try.  Make it fun and exciting!  Invite your toddler to stand on a chair or sit on the counter while you prepare meals.  Let him help with age-appropriate tasks.  When kids are involved in the process, they feel a sense of accomplishment and are much more excited to eat.

Don’t Stress.  Toddlers are always changing.  Week to week, day by day, moment by moment.  If you are setting up healthy eating patterns for your son, there’s a good chance that he will still have days when he doesn’t eat well.  Don’t stress too much about it.  He will most likely make up for it the next day.

©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.

Our little monkeys have recently picked up the expression I am horrified from somewhere, and once in a while, they play the horrified game with each other! Usually, it involves making a throaty “Aww” sound followed by a pause and and a shocked, surprised face like this:

And then they burst into laughter! It is a hilarious sight to watch.

Today, it turned out to be a great way to get them to sit down at the table and eat their lunch. We had some leftover cheese ravioli, which they like to eat with a sprinkle of organic cheese (their word for grated Parmesan cheese) without any sauce. They were tired after playing hard in the morning sun and were in no mood to sit down and eat! After a little thought, and in a flash of sudden inspiration, I got them into the horrified game in exchange for a few bites of different things on the table!

“If you eat this ravioli, I will be horrified, I said as I demonstrated their familiar horrified expression”.

It caught on, because they were soon going at each other popping a piece of ravioli in their mouth and playing the game.

Son: Baba, if I eat this ravioli, you will be horrified, right?

Me: Yes, absolutely! As I played horrified in return for his effort. He giggled as he saw my frozen face!

Meanwhile, I was eating some leftover pizza and I threw the challenge out to them -

Me: If I eat this pizza, you will be horrified!

It was my daughter who made the face this time in response:

It was incredibly funny! We went around several times, taking turns playing the horrified game. Soon the ravioli was gone, the glass of milk was empty and everybody was feeling happy.

It was now time to turn to the pieces of cantaloupe and honey dew melon waiting patiently in a bowl.

Me: (confident that the formula was working) If you eat this orange melon, I will be horrified..

It worked as both of them grabbed a piece each and popped it in their mouths, waiting for me to do the horrified face. And then some more giggling and laughter…and then we went around, taking turns playing the game.

Soon that was gone too and it was time to clean up before settling down for a nap.

Not bad for a half-hour of fun, I thought,  where fussiness was replaced by laughter as they finished their lunch.

Bottom line: Getting toddlers to sit down and eat as a family is a challenge for most parents, us included! We try to do something silly and make up interesting stories to keep their interest. Sometimes it is the Diesel Food For a Diesel Engine while at another time it might be something like Eating Salad Like a Giraffe! Recently, it was to get them to ask their little stomach about what it wanted to eat!. Sometimes it works, sometimes it doesn’t, but when it does, it is a great way of capturing their imagination while stretching your own.

Share your story. What has worked for you in getting your little ones to sit down and eat with you?

Greetings! In this week’s Five for Fridays, I will highlight a few interesting videos and articles related to toddlers and restaurant manners. I started the week with 7 ways to handle bad manners when eating out with kids, so this seems like an appropriate way to reinforce the message! Let me know what you think and share your favorite tips.

How dinosaurs eat their food

This video is sure to catch the attention of your little one because of the dinosaurs who show really bad table manners like burping,  belching, making loud and rude noises, throwing food etc. In a funny way, it can teach your child what not to do!

Needs first, manners second

A very interesting perspective is offered by Dionna in her article Mind Your Manners, where she suggests that we pay attention to the child’s underlying need behind the behavior that shows bad manners. It may be a physical reason such as hunger, fatigue or sleepiness. Or it may be psychological reason such as frustration, jealousy, anger or need for attention. Adults have these needs too – and if you think about it – they too do not show good manners and friendly behavior if they are feeling that way. In those moments, it is not helpful to lecture about good manners with a don’t do that, or a do this. Rather, you have to pay attention to the underlying need and find a way to fix it before a meltdown!

Toddlers and mealtime manners

Excellent tips on mealtime manners from the Better Health Channel of the Victorian Department of Health from Australia! A range of mealtime topics such as sitting down to eat, making a mess, wasting food, table manners and reward systems are covered and several practical suggestions are provided under each. I really liked their perspective on why getting angry or worrying whether your child has had enough to eat is not useful. Kids are very perceptive and usually reflect back your anger and anxiety through unruly behavior. Keeping your emotions in check is the key. Have realistic expectations which are appropriate for age and development level. Keep your cool, stay firm and be consistent. And by the way, persuading children to clean up their plate because there are hungry children in the world does not work!

Parents speak out on teaching children to behave at restaurants

I liked this discussion about teaching restaurant manners to children because of a range of opinions and tips from parents based on real life experience. Consensus opinions seem to be training at home, family meals, early exposure to restaurants, and being ready to leave when things get out of hand. One parent advises good luck, patience and understanding, while another suggests involving them in food selection and engaging in a conversation. Another interesting suggestion is to go out in a group with other friends and their kids. Lots of interesting comments here!

Can you teach my alligator manners?

This is a funny series on Playhouse Disney which features a young boy named Mikey and his alligator pal Al, who is fun and cute but has no manners at all! The music is catchy and animation fast paced to capture the short attention of young kids. The great thing about it is that it asks the kids to recognize when Al is being polite and when he is not by picking one of the two color-coded squares which show these behaviors. Very good reinforcement indeed!

In this particular clip about restaurant manners, kids learn about eating with a fork and not their fingers, eat without making faces or noises, and not burp!

The alligator series is one of our favorites; have you seen it?

Enjoy and let me know what is on your mind.

©2010 Littlestomaks.com

Eating out with kids is not necessarily a stress-free experience for most toddler parents, us included. Not only do we have to worry about selecting nutritious foods from the menu, we also have to keep an eye on misbehavior and less-than-ideal table manners. Sure, kids are kids and a certain amount of mischief is only to be expected, but it is hard as a parent to ignore the looks of pity, annoyance and sometimes even hostility from others. Suddenly, the spotlight is on us and it feels like we are the worst parents in whole world!

Last week, I reviewed a wonderful children’s book called Wiggens Learns His Manners at the Four Seasons Restaurant and also invited comments from readers about their dining-out experience with kids. I asked the following two questions -

• What is your most difficult restaurant manners problem with your toddler?
• Share a difficult dining out experience with your toddler where you had to manage a bad manners situation and how you handled it

Here are a few common manners problems people shared in response to my questions -

• Feeling bored, not able to sit still
• Throwing food on the floor, making a mess
• Running around, jumping on chairs
• Talking loudly or being rude to others

I think we can all relate to them one way or another. It also happens at home I am sure, not just when you go out to eat. From that point of view, this kind of behavior is probably normal from 2-5 year olds because they are full of energy and curiosity and constantly trying to push the limits as they learn to exercise their independence. They don’t know that their behavior can be labeled as misbehavior and that it can cause a lot of embarrassment to their parents in public!

That is why, I believe that the issue of bad manners is not a problem of the child, rather it is a problem of the parents.

Having said that, clearly we have to teach children about good manners and acceptable behavior. It will prepare them to be socially responsible and be able to get along with others. However, I fully agree with Dr. Spock who writes in his bestseller book on baby and child care:

Good manners come naturally – teaching children to say please or thank you is not really the first step. The most important thing is to have them like people and feel good about their own worth as a person. If they don’t, it will be hard to teach them even surface manners.

The important word here is naturally, they cannot be forced based on a schedule and should be treated like any other developmental milestone. There can be many ways to teach them manners and good behavior; you should adopt a style that is consistent with your personal style and attitude.

As far as behavior in a restaurant is concerned, here are a few tips you may want to consider -

Be consistent at home and outside: if you get your child in the habit of sitting down for a family meal at home, she is more likely to find the idea of a sit-down meal at a restaurant familiar and comforting. Consistency in family meals is key to not only good nutrition, quality family time and good habits, but also positive behavior when eating out. Do not have one set of rules at home and another for outside.

No rewards or punishments: promise of a reward or threat of a punishment works only for a short time. Kids will figure it out very quickly and pretty soon you will have to offer a bigger reward or a bigger punishment to get the same result. What you can do instead is consistently show your approval for behaviors you want to encourage and disapproval for behaviors you want to avoid. This approach, when combined with consistent role model behavior by you and others in the family is more likely to work in the long run.

Know the limits and enforce them no matter what: although I just talked about not using a reward or punishment, it is a good idea to set a few limits, especially when it comes to safety. Kids are unpredictable, and no matter how much you plan, it is possible that their behavior may create an unsafe situation for them or others around you. Running, jumping and throwing food or sliverware can fall in this category. Calmly explain to your child that it is not safe to do those things because someone can get hurt and that is not nice. If the softer approach does not work, be prepared to get your food-to-go and leave. In these situations, it is very important for both parents to be on the same page. There might be differences in parenting styles between the two of you, but you have to agree on a common plan when dealing with difficult parenting situations

Timing is everything: If you arrive at a restaurant when your child is too hungry or when he has just had an energy boosting snack, you are more likely to have a manners problem. Keep a healthful snack at hand just in case she is starving when you arrive. You can also minimize waiting time at the restaurant by ordering ahead, especially if it happens to be a place you frequently visit. We like to keep a few of our favorite restaurant menus in the car just for this purpose.

Be a role model: just like any parenting situation, the importance of being a role model when eating out can hardly be over emphasized. Children learn by imitating their parents and others they come in contact with. They will simply reflect your behavior because they admire you and want to gain your love and affirmation. It does not mean you have to be perfect at all times, but you do have to be consistent overall on average. Everyone can have a bad day, you don’t have to feel guilty or apologetic when you occasionally slip! In those moments, rely on your partner to do the heavy lifting.

Plan to entertain: even adults get bored and restless if they have to wait too long to get a highly anticipated meal or drink! Children have even a shorter attention span! Keeping their favorite toy or a book handy is a good idea. We like to make up stories and engage them in all kind of silly conversations a the table to keep their interest. We also keep a basket full of toys and books ready in the car just in case!

Keep your cool: parenting is an extreme sport and there are times when things don’t go your way. We also feel under pressure in public because these days everyone is quick to judge and have their own ideas about what it means to be a good parent. I say, just ignore it! You don’t have to be a perfect parent – if there is anything like that in the first place! Keep your cool and laugh it off. If your children aren’t behaving perfectly, it won’t help to yell or scream at them or try to shush them! Enjoy as much as possible, and if everyone is having a bad day, just walk away and try another day!

How have you managed a difficult parenting moment when eating out with your little ones? Leave a comment, I would love to hear from you!

In response to my question about the power of brands last week, I heard many interesting opinions and comments! We are routinely bombarded by powerful messages from food brands everyday. As a toddler parent, you probably feel like you are constantly at war with these messages as you try to encourage your child to eat healthy.

No doubt, food brands have enormous power. Name recognition for Coca Cola, McDonalds, Frito Lay chips (Doritos, Cheetos, Lays etc.) is so strong even 3 year olds know about them! Not only that, their impressions about the core message of these brands form early; exactly what every savvy food marketer hopes to accomplish. Fast food is fun and exciting and soda brands are fun because bubbles are fun and people like them. Once these impressions are formed, they are constantly reinforced by clever advertising and pretty soon there is no escape.

So how do you manage the influence of popular food brands on your kids?

This is the question I asked last week. Here are some of the key points and tips I gathered from reader comments:

• Limit TV and exposure to kids commercials
• Explain to kids that foods shown on commercials are not healthy
• Teach kids to choose healthful foods
• Allow limited portions of “treats”
• Avoid mainstream media and associate with like-minded families
• Be a role model and exercise moderation in using heavily advertised foods
• Be a gatekeeper and control what foods are brought inside the house
• Home is the “sanctuary of healthy eating”

I think all of them are excellent tips for you to use in your battle against the irresistible appeal of food brands. One problem all parents face is that they are constantly having to react to the popular brand message and images. These tips, although useful, fall in the category of managing your reactive response to these brands. Unfortunately, you will never win the battle because the other side spends millions of dollars defending and reinforcing their brand message. They will find a way to break through your defense.

We need to play both defense and offense in this battle!

I have been thinking of an idea I want to share with you. It will allow you to not only have a defensive strategy but also an offensive strategy. I would love to hear your comments because I have not yet fully developed this idea and it remains in a conceptual phase right now.

By an offensive strategy, what I mean is that you need to build your family’s personal brand to clearly define your approach to food and nutrition. I don’t mean to suggest that you don’t have one already, but perhaps it could use some definition and clarity. I say this because not only do we face strong brand messages that try to pull us in one direction, we also face a large amount of nutrition advice from various sources. It can be simply too overwhelming at times!

How do you go about building your family’s brand on food and nutrition?

Brands are developed by highly paid professionals, so it is natural to be a little apprehensive about doing it on your own. Still, there are a few basic techniques anyone can follow! They can be perfected over time with enough practice. Here is a very high level conceptual framework you can use as a first step:

Core Values – the foundation for every brand

This is by far the most important step. It is also the first step!

Brainstorm with your family about what is most important to each member. At this stage, it does not need to be limited to food and nutrition; rather take a big picture point of view and identify about 10 things that are at the core of your family. It could be: being happy, being healthy, being together, helping others, being spiritual, being wealthy, having fun, being adventurous, learning and exploring, being part of a community, being environmentally responsible etc. Think broadly and remember what brings peace and joy to your family; what holds you all together.

Next, select your top 3 based on your current family situation. It may be that your personal top 3 are different from your spouse’s. But I can bet that there is at least one which will be common to both. For example, no matter how we do it, being healthy comes out a common value in our family. If you don’t find anything common in your top 3, you will need to sit down and work together until you find one. Remember, it going to be a family brand, not an individual brand!

Main Message – the core idea behind every brand

Once you have a short list of core values, brainstorm on how your family’s eating habits relate to them. Ask if what you eat, and how you eat, supports those values or if it weakens them. Focus not on the day-to-day details, but the general pattern over a sufficiently long period of time. Chances are that your family’s current pattern of feeding is more or less consistent with your core values. If not, you probably find yourself feeling guilty at times! Looking at your current eating habits through the lens of your core values will help you to clearly identify both the positives and the negatives features.

The goal is to keep the positives and get rid of the negatives. It is important to note that they are your positives and negatives based on your core values. Not because someone else is telling you so. Also note that they are not good or bad, they are simply positives if they strengthen your core values, or negatives if they weaken them.

The main message of your family’s brand on food and nutrition will be based on these positives consistent with your core values. It will be at the core of your marketing strategy!

Logo and Slogan – the marketing tools of every brand

Every brand has a logo and a slogan, which communicate its core idea. This is also something real, something tangible, that the brand owner uses to prevent others from copying the brand. This is where the rubber hits the road!

Why not have something similar for your family? This is how you can communicate with others, seek their support or prevent them from derailing your ideas. This is how you will protect yourself from every little nutrition fad that is made popular by the media. This is what will prevent you from impulse buying just because you saw a commercial somewhere.

Sounds weird? Well, next time your child joins a team notice how they immediately try to come up with a name and a jingle to go along with it. Then someone designs a T-shirt and before you know it, you have a nice, well-established identity for the team. It keeps them together and helps them win against other teams.

Why not have something similar for your personal food and nutrition brand?

Promote with Friends and Family – this is your sales force!

You don’t have the luxury of a strong army of sales professionals and a huge advertising budget to promote your brand. What you do have is the support of your friends and extended family. Help them do the same exercise. Don’t get stuck on minor details – for example, they may not be that much into organic foods as you may be. Rather try to find common connecting points based on common core values.

Think of this as a collection of microbrands all teaming up to be a significant force. Use Facebook or other social media to network with other like-minded people. Before you know it, you will have a collective brand at a much bigger scale!

Protect and Defend – every brand needs a good defense

Big business is fanatic about protecting their brands. They have an army of lawyers to go after anybody who tries to misuse their brands, logos and other copyright or trademark materials. They control how their brands are used and strive for an incredible consistency wherever they do business. They do not encourage use of competing brands by their employees and affiliates. They build multiple layers of defense, both externally and internally, to protect their brand equity. It is simply too valuable to give up.

This is what you fight every day. And this is where you have to make some rules. The list of tips in the beginning of this post is a good start, but you have to make your own rules. Too many rules can backfire, and also difficult to enforce, so try to pick a few and be consistent about them.

Notice how this conceptual framework shows these 4 strategies in a circle with core values in the center. Core values do not change but everything else can be refined and tweaked over time as your family enters a different life stage.

What do you think? I would love to hear your ideas!

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

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 Nour El-Zibdeh emphasizes the power of family meals and offers some handy tips on how to seat your child when eating or drinking.

Question: Could you offer some advice regarding where a child should be seated when eating/drinking…Is it acceptable to let a toddler walk around with a sippy cup of water? Also, how do the experts feel about eating in the carseat?

Answer:

Seating a child:
Gathering around the table for a family meal is the best place for eating. Studies, over and over, show that children of families who eat meals together almost every day have healthier diets (more fiber, vitamins, and minerals and less fat) compared to children of families who don’t.

Aside from nutrition, family meals teach young children table manners, improve social and motor skills, enrich language, and boost self-esteem. They promote a sense of togetherness in the family and are associated with happier marriages.

For older kids, meals frequently with families are associated with less drug use and smoking. It’s a good idea to start when they are young!

Tips for making family meals reality:

• Plan ahead and build in enough time for preparation. But even if you’re taking out, bring the family together to the table.
• Remove distractions: turn off the TV or computer, put video games, toys, and cell phones away, and let the answering machine pick up calls.
• Get them involved by setting the table and cleaning up—as safe as possible for their age.
• Be a role model. Eat your vegetables and they will too.
• Start a good conversation. Avoid arguments or discussions that promote tension.
• Take your time. Eat slowly to match their speed, which helps you conquer mindless eating as well, and enjoy quality time.

If your child sits in a highchair, make sure it’s positioned close to the table or the rest of the family, not in the corner.

Letting a toddler walk around with a sippy cup:
It depends. If your toddler eats well and drinks at least 18 oz of milk, then that’s fine. However, if she doesn’t, especially if she’s small for her age, she might be getting full from all the water she’s drinking.

Drinking juice or milk is more problematic because a constant supply of sugar around the toddler’s teeth might lead to decay. Plus, juice and milk supply extra calories and sugar your child might not need.

If a toddler drinks calorie-containing beverages continuously, they can lose their ability to tell how “hungry” feels different from “full.” Instead, structure meals and snacks; just like naps, bedtime, and other activities. That gives them a sense of security that food will eventually come.

Eating in the car seat:
Other than the missed opportunity of a family meal and its benefits, eating in the car usually promotes mindless eating of less nutritious foods, such as processed snacks. If a child accidentally chokes while you’re driving, the consequence can be disastrous.

As a mom; however, I understand that “never” eating in the car is impossible. On the occasional road trips, or on days when you’re running late for school, eating in the car might be acceptable. But don’t make it a habit. Wake up a little earlier for breakfast and build in time to sit down for lunch and dinner.

©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.

The author of this book Michelle May, M.D., is a contributor to my Ask the Expert column. That is why when she told me that she had published this book, I was immediately interested even though it did not directly apply to toddlers. I think Dr. May has a very interesting thesis here which flies in the face of typical advice on diet and weight loss. Her own personal and professional experience make it all the more credible. No wonder, it was hardly a surprise to me when she told me that this book was recently selected by TIME.com as one of the Top 10 Notable New Diet Books of 2010 and won the National Book Award for Best Health Book! I am so happy for her and wish her continued success.

Overview

Dr. May’s main message in this book is for you to answer a simple question Am I Hungry? It is amazing that children know this notion very well and eat only when they are hungry. Yet, adults no longer have that sense because they tend to eat in response to their emotional needs, not necessarily the sensation of hunger. In this book, she teaches the notion of the Eating Cycle and explains what it means in the case of overeating, restrictive eating (diets) and instinctive eating (eat when hungry and stop when full). The eating cycle is based on 6 fundamental questions – Why, When, What, How, How Much and Where – which will help you determine your eating patterns and underlying drivers.

In short, she wants you to develop a clear understanding of your own personal eating cycle, and not simply obsess over what you eat and how much you eat.

That is why the title of her book is so powerful. Once you understand your own eating cycle, you can pretty much eat what you love without feeling guilty. Balance, variety and moderation along with awareness of where you are on the Hunger-Fullness scale will help you get to the weight you desire and, more importantly, stay there.

Here are a few practical tips I really liked in this book -

• Great point of view on mindful eating – it means eat with intention and eat with attention
• A very practical and intuitive Hunger and Fullness scale to help you judge when you need to eat. I also liked the balloon analogy. Bottom line, eat when you are hungry, don’t wait until you are starving and stop eating when you feel full and not stuffed!
• Each chapter ends with a list of strategies you can immediately apply.
• The FEAST method to understand why you feel like eating when you are not hungry (Focus-Explore-Accept-Strategize-Take Action)
• Strategies to deal with difficult emotions, particularly anger, and not let them lead to overeating.
• Triggers for overeating and how to recognize them.
• Provides a tool to understand feelings and how they drive actions – TFAR (Thoughts-Feelings-Actions-Results)
• Very good overview of the fundamentals of nutrition in common sense language – carbs, fats, proteins, vitamins, metabolism etc.
• The whole book is sprinkled with nuggets of wisdom called Mindful Moments – very practical, scientifically balanced nutrition advice.
• Personal stories from clients and Dr. May’s analysis and advice based on principles of mindful eating.
• Collection of healthy recipes with practical suggestions under Chef’s Notes, Doctor’s Notes and Family Notes.

10 things I learned from this book I did not know before

1. High-fat, high-sugar processed carbohydrates can temporarily activate the pleasure centers in the brain by triggering the release of serotonin and beta-endorphins. No wonder, they are so addictive!
2. Hormones produced when you feel stressed actually accelerate storage of fat.
3. Your taste buds are most sensitive when you are hungry and when you start eating. That is a great tip for fully enjoying the food – eat when you are hungry!
4. Medical research has proven that even a 5% weight loss can significantly improve your health! Small is indeed beautiful!
5. Many people are chronically dehydrated and don’t even know it!
6. Excessive salt can lead to more water retention.
7. The more you weigh, the more fluid your body needs.
8. Basal metabolism consumes the largest portion of energy. Basal metabolism is the amount of energy (calories) your body needs to support vital bodily functions like heartbeat, breathing, brain function, even eating and digesting.
9. Muscle cells burn more energy than any other type in your body. They also require more energy for maintenance.
10. The American Heart Association recommends that you limit your intake of saturated fat to less than 7% and trans fat to less than 1% of your total daily calories.

What I did not like so much

• I think a 10-point scale for assessing the sensation of hunger or fullness may be a little difficult for most people to fully internalize because it is hard to tell a 1 – 2  point difference. For me, the balloon analogy for your stomach of 1 being empty, 5 being a gentle natural shape and 6-10 being overstretched works better. The scale could be simpler with only a 4-5 levels.
• There are a lot of tables and sometimes the information tends to be repetitive.
• I would have loved to see a chapter on how you can apply these principles not only to yourself but to your whole family including children.
• I love pictures, so it would have been nice to see pictures of the recipes.

Recommendation

I think Dr. May’s book is based on a very powerful idea, one that asks you to be first in tune with your inner self instead of prescribing a miracle diet. This book is a great resource for anyone trying to not simply lose weight, but change their entire outlook on food and eating! I think this book can be very effective if you:

• fully understand the fundamental principles of mindful eating first
• make an effort to apply the tools – Hunger/Fullness scale, FEAST, TFAR etc
• practice strategies for mindful eating
• keep a journal to track your progress

This is not a quick read rather a handy reference that should occupy a prominent and rather permanent place on your bookshelf.

Overall, I give it a big thumbs up! Visit Eat What You Love, Love What You Eat to download the first chapter, read other reviews, listen to an interview and learn how to order.

Leave me a comment if you found this review useful.

©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, Dr. Dina Rose offers a few handy tips on what to do if your child has a snacking habit and if he wants to eat snacks even at regular mealtimes.

Question: My child wants to munch on snacks all the time. How can I manage it so he can still sit with us for dinner and eat a regular meal?

Answer:

Lots of kids want to snack all day long and with all the tempting stuff out there, can you really blame them? But snacking, as I’m sure you know, is a problem on many fronts. For starters, most snack foods are nutritiously inferior, so when snacking replaces regular meals, kids end up missing out on a lot of important nutrients. More importantly, though, kids who constantly snack develop a snacking habit and snacking, experts agree, is one of the main causes of obesity in America.

If you want to cut back on your child’s snacking you have to figure out why he prefers to eat in-between, rather than at, meals. Is he stuck in a cycle where he doesn’t eat enough at breakfast so he over-snacks before lunch, so he isn’t hungry for lunch and then over-snacks …? In this case, simply cut out (or cut back) the mid-morning snack. Lunch should improve, which will reduce your child’s need for an afternoon snack so dinner…

Alternatively, is your child reluctant to eat at mealtime because snacktime is on-the-go? Lots of kids go through a stage where they’d rather play than eat, particularly if they’re not that interested in food to begin with. If this is the root of your problem, try letting your child eat (at least some of) his meals while he’s playing. After all, it’s not a hard and fast rule that all meals must be eaten at the table. You also could start serving snacks at the table. That would reduce the time your on-the-go-eater spends eating them.

Finally, if your child prefers to hold out for snack time because that’s when the fun items are served — crackers, sweetened yogurt, cookies — change the kinds of foods available for snacking. After all, if your child was eating his daily allotment of fruits and veggies for snacktime, you would probably be less worried about mealtime.

Of course, no matter which path you pick, be prepared for a meltdown. Changing the game might be necessary but don’t expect your child to see it that way.

Good luck and let me know how it goes.

©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, Dr. Dina Rose offers a few handy tips on what to do if your child drinks too much milk.

Question: My toddler refuses to drink anything but milk, and it’s causing her to fill up on milk and not eat as much food. If I take the cup away and only offer it at certain times, she will cry (hysterically) until the next meal time when she gets her cup again. How do I get her to drink less milk and eat more food?

Answer:

Lots of kids get attached to their milk, so you’re not alone, but you’re right to be concerned.  Not only can too much milk fill your daughter up and impact her interest in eating, but too much milk can also lead to an iron deficiency.  So no matter how you divvy up the milk during the day, give your daughter no more than 16 ounces.

So how do you wean your daughter off the moo?  Here are some steps to take:

Identify whether your daughter is attached to the milk or to the cup.  It sounds crazy, but some kids really have a thing about their cup. To find out whether the milk or the cup is the source of your struggle put the milk in a different cup and see what your daughter does.  If it’s the milk she’s after, your daughter will drink it no matter what.  If it’s the cup your daughter loves, expect a meltdown, then rejoice because there’s an easy fix to your problem: put something else in the cup!

Make morning and evening your main milk times.  Then during the day either (1) gradually reduce the amount of milk you give your daughter at each meal and snack or (2) slowly dilute the milk with water. Eventually, the daily drink will be only a few sips of milk or mostly water.  And that point you can eliminate the daytime milk altogether.

Think of milk time as dessert. Instead of giving your daughter her milk before or during the meal, give it to her at the end as a way of topping her up.  Accomplish this shift by telling your daughter that her milk is coming after the meal and then: (1) give her an extremely small meal so she gets to her milk quickly and over time, increase the size of the meal.  Or, if she prefers (2) split the mealtime milk into two (unequal) portions and give your daughter the smaller amount before the meal and the larger portion after she’s eaten.

Be very clear with your daughter about when she will have her milk.  Since young kids can’t tell time, you need to use events that will help them know when the milk is coming.  For instance, tell your daughter she will have milk when she wakes up, after her nap, after she comes back from the playground, or after dinner.  That way she won’t think the milk is gone forever.

Prepare your daughter for the change that is coming.  Even if you think your child is too young to understand, I recommend that you talk to your daughter about the changes you are making.  She’ll get more than you expect and it will help YOU commit to the transition.

Expect a backlash.  Recognize that your daughter may not like the new milk arrangement and she’ll probably let you know.  Be prepared, but don’t give in to whatever plan you’ve picked.  If you make a change and your daughter cries and wins you have only taught her to cry it out some more.  So don’t make any changes you aren’t prepared to carry through.

Remember, it’s not so much what you feed, as what you teach that matters. So forget about the milk and focus on the interactions you have with your daughter around the milk.  Good luck and let me know how it goes.

©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.

I have a guest post today on challenges of feeding our two little monkeys as we try to apply Ellyn Satter’s division of responsibility.

Simply put, division of responsibility means parents are responsible for what, when and where and the child is responsible for how much and whether.

Check it out at Dr. Kathleen Cuneo’s Dinner Together blog. Feel free to share your challenges and tips in trying to feed your little one!

Photo: Littlestomaks.com All rights reserved
©2009 Littlestomaks.com

This is the National School Lunch Week. Improving the quality of school nutrition is one of the ways to address the problem of childhood obesity. It is encouraging to see that the USDA has established the HealthierUS School Challenge to recognize schools that promote good nutrition and physical activity. This week, Secretary Tom Vilsack is recognizing schools who have achieved the “Gold” status in this program. My question is: how come more schools are not participating in this program? The Secretary should address the barriers to his program’s adoption and measure performance in a transparent way. Only then he can hope to achieve the scale needed to truly address childhood obesity.

Here are the 5 nutrition related news that caught my eye this week. Enjoy and drop me a comment to share your thoughts.

Honey! I shrunk the food ingredient list

In a positive trend, Registered Dietitian Janet Helm (@JanetHelm) points out that packaged food producers are scrambling to simplify and shrink the list of ingredients on their products. Michael Pollan should feel happy – after all, he is the one who has been telling people not to buy foods that contain more than 5 ingredients or difficult to pronounce ingredients! Actually, I agree with him and welcome this trend. Even though all these ingredients including additives, colorants and preservatives are considered to be safe, it just doesn’t make sense to me when I pick up a product which has over 20 ingredients. Why process the food so much?

Some of the new products – Haagen-Dazs five ice cream for example – now claim to be made just like the way you would make at home with only a handful of ingredients. Hmmm…I wonder if they cost more than the regular products! That would be a brilliant marketing idea – make more money with less!

Rice eaters have healthier diets – really?

A new study based on national food consumption surveys finds that rice eaters in general tend to have healthier diets because they eat more grains, more vegetables and dietary fiber, less added fat, less saturated fat and less added sugar. Rice is cheap and provides a rich source of carbohydrates.

I was intrigued by this news, not because we eat a lot of rice in hour household, but because the correlation implied that people should switch to rice! But then upon a closer look at the story I found that this research was sponsored by the USA Rice Federation. There is nothing wrong in urging people to eat more rice, but then the study should also point to the risks of eating too much rice. White rice is a refined grain and even when enriched with added vitamins and minerals, it is nutritionally inferior to brown rice. It also has a high glycemic index which will make your blood sugar rise rapidly. On the other hand, brown rice comes with an expiration date, may be more expensive, takes longer to cook and you may not like its chewy texture.

Just because someone eats rice, does not mean their diet is healthy on its own.

Home remedies for the common cold not backed by science

No doubt, eating warm chicken soup when you are down with the cold and flu is very comforting. But is there any scientific evidence that home remedies like the chicken soup, drinking plenty of fluids, vitamin C, zinc, echinacea, honey and garlic can treat or prevent your sickness? In an extremely well-researched article, Dr Ayala (@DrAyala) concludes that there is no solid scientific evidence on food, nutrients and relief from the common cold. Her advice – you can try these home remedies for comfort, and they don’t hurt except that you need to be careful about supplements.

I do take vitamin C every day, but I am under no illusion that it is the magic bullet for preventing cold and flu. The best way to prevent cold and flu is to avoid contact with sick people and frequently wash your hands. Vitamin C is an immunity booster, not an immunity builder. Proper nutrition, healthy lifestyle, good hygiene are the building blocks for good health. Not an isolated supplement!

New York City bans bake sales in schools

Would banning bake sales from schools solve the childhood obesity problem? New York City regulators seem to think so! They seem to be on a roll because in their zeal to impose a wellness policy, they are going after everything they can find which can be labeled as nutritionally evil for the health of our children. This is nutritionism at its best without regard to the cultural norms.

You might be wondering why it bothers me so much! After all, I don’t live in New York City and my children are too young to go to school.

What I find troublesome is that regulators and policy makers feel that simply by making new rules and demonstrating their power, they can change unhealthy behaviors. It is only the stick, never the carrot! In this case, everybody is rightly upset that they will lose a very traditional way of raising funds for school activities. But are the regulators providing any alternative? A few exceptions to the new rules are provided, but they are practically useless in terms of fundraising.

They should try to focus on encouraging children to make the right choices about their eating habits in the long run. Not simply ban stuff without providing alternatives.

Parents magazine offers tips for turning your baby into a veggie lover

Dr Greene, the author of Feeding Baby Green, has a nice article in the November issue of the Parents magazine. He advises to build on your child’s curiosity about colorful things by introducing him to colorful fruits and veggies. Start early, keep trying,  and introduce variety right from the very beginning. A lot of parents are concerned about allergies, so they do not introduce new foods quickly. He disagrees with this approach and offers scientific data which suggests that babies learn to love new flavors best when they are introduced to new foods in rapid succession. He gives you a nice list of 21 plant families you should sample with your child before he reaches the age of 1.

It may work, or it may not work – and of course, all bets are off in the toddler years! That is when they get picky and nothing seems to work anymore. Here are a few articles we have published to help you with fruits and veggies:

Ask the Expert – Developing a Taste for Fruits and Veggies
Help! My Kids Don’t Eat Enough Fruits and Veggies
Ask the Expert – Getting Complete Nutrition on a Vegetarian Diet
Help Your Child with Autism Have Fun with Food

Enjoy and do let me know you think. I would love to have you share your best tips in comments below.

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

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

This week, Family Physician Dr. Michelle May offers a few tips on helping your toddler develop a taste for fruits and veggies.

Question:My 2-year-old dislikes fruits and vegetables, but I want her to get these important nutrients—and learn to like them. How can I help her develop a taste for them?

Answer:

Congratulations for recognizing the importance of a healthy diet. Only 2% of all children eat the recommended number of servings from all of the food groups. It is common for children to have strong food preferences so it can be a challenge – just don’t make it a battle. Here are ten practical tips:

1. Relax- having a positive, low-key attitude about eating makes meal time more pleasant and therefore feeding more successful.
2. Follow the leader – make family meals a high priority and be a great role model by serving and eating a variety of fruits and veggies.
3. Don’t be a short order cook – fix one balanced meal for everyone in the family. Remember, it is your responsibility to decide what you will offer but it is up to them whether they will eat it.
4. Make it fun – when my kids were small, we played Guess the Color. They closed their eyes and tried to guess the color of the food I put in their mouth. They were having too much fun to realize that the most colorful foods happen to be vegetables.
5. Serve the vegetables first – they are more likely to eat them when they are hungry.
6. Don’t bribe or reward children for eating certain foods -they quickly realize that those foods must be yucky if you have to bribe them to eat them. They also learn to hold out until the reward is offered.
7. Involve your child in shopping for, preparing and serving food – they are more likely to eat it because they participated in the process. At two, my son’s job was to tear up the lettuce and drop it in the bowl. The first time he helped, we made the mistake of telling him to tear it into “bite-sized pieces.” You guessed it…he bit off pieces of the lettuce and spit them into the bowl!
8. Be creative – add carrots to spaghetti sauce, spinach to meat loaf, tomatoes to toasted cheese and bananas to peanut butter sandwiches. Keep fresh fruit and cut up vegetables handy for snack time and offer fruit-based desserts.
9. Easy on the juice and “fruit drinks” – they don’t pack much of a nutritional punch and may just add unnecessary sugar to your child’s diet.
10. Don’t give up!It can take up to ten exposures to a particular food before a child will accept it. Maybe she doesn’t like steamed broccoli and cauliflower but will have fun dipping fresh Trees and Clouds into a little ranch dressing.

©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.