photo credit: sebilden

Salt is in the news these days! A typical American diet is rich in salt because of excessive processed foods and junk foods. Most Americans consume a lot more salt each day than the recommended 2300 mg of sodium (about a teaspoon of salt). Some estimates suggest that adults get an average of 4000 – 6000 mg of sodium while school age children average 3000 – 4000 mg per day. That is clearly a lot!

Do you ever wonder why your child wants to drink a lot more water when they eat salty snacks? Although salt is very important for normal body functions, too much of it forces our body to demand more water so it can be diluted. Our kidneys work overtime to remove excess salt from our body, but they need water to carry it out. That is why sodium content inside our body is directly linked to water balance. A complex system of hormones in our body tries to keep the overall amount of liquid in balance, but consuming too much salt throws it out of balance. What is more of a problem is that our heart has to work against all this liquid which causes our blood pressure to rise. Done too frequently, this can lead to chronic high blood pressure and heart disease.

So what can you do? Here are a few tips:

• First, be aware of sodium requirements in children – estimated minimum requirement for sodium in healthy children ranges from about 200 mg per day for 1 year old to about 500 mg per day in  children 6 and up.
• Read the nutrition facts label on processed foods – we try to stay away from products that contain more than 15% of daily sodium per serving. Unfortunately, hot dogs and french fries fall in this category!
• Get your kids interested in eating a home-cooked meal – this is probably a lot more difficult in practice. All I can say is that you got to keep trying and set a standard of family meals as a daily ritual.
• Get rid of the salt shaker – a teaspoon of salt is really not a whole lot. Resist the urge to reach for the salt shaker on your table. If your kids don’t see you using it, they are less likely to reach for it.
• Say NO to processed meats – salt is a natural preservative and most processed meat is prepared with a lot of salt. Reducing your meat consumption is a good idea, and when you do, get fresh and uncooked meat which you can prepare at home.
• Eat more veggies, either steamed, grilled or raw – vegetables and other plant based foods are the best choice when you are trying to control your family’s salt intake. Nothing wrong in enjoying your favorite recipe that calls for salt, but they are most healthy when eaten raw, steamed or grilled. Saute in olive oil with onions and tomato paste if you want to add a little bit of flavor.

Both salt and water are critical for our survival and growth. We can’t live without them. Like everything else, too much of a good thing is not good either. With a little planning and preparation you can ensure a healthy balance.

Here are a few good resources on salt and managing it in your family’s diet

Shake your salt habit – American Heart Association
What can I use instead of salt – American Heart Association
5 ways to cut back on salt – WebMD
Salt: The Spice of Life or the Taste of Doom – The Yale Guide to Children’s Nutrition

Parents: what has worked for you in reducing your family’s salt intake? Share your tips below in comments.

©2010 Littlestomaks.com

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

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

Link between childhood obesity and heart disease gains strength

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

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

Flooded by snacks, kids are becoming constant eaters

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

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

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

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

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

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

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

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

FDA issues warning letters to rein in food labels

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

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

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

Big Words from Little Foodies

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

Enjoy and let me know what is on your mind.

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

Greetings! Hope you all are having a great week so far. We are getting ready for Thanksgiving, which happens to be my favorite Holiday. I am looking forward to it next week. What are your plans?

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

Vitamin D deficiency linked to heart disease

Vitamin D deficiency is in the news again! The American Heart Association had its annual conference in Orlando this week where a study presented a link between low levels of vitamin D and increased risk of heart disease and stroke. This study looked at tens of thousands of adults 50 years or older, a majority of whom had lower than healthy levels of vitamin D. Within 2 years, those who had extremely low levels of vitamin D were twice as likely to die or suffer a stroke compared to those who had normal levels. They were also more likely to develop coronary artery disease and heart failure.

The unanswered question is whether a lack of vitamin D increases the risk of heart disease, or it just happens to be a condition of people with such diseases. If it is not a cause, then the risk of such diseases cannot be lowered simply by increasing the vitamin D levels from sun exposure, diet or supplements. Most of these studies have an underlying implication that current recommendations for daily intake of vitamin D be increased to improve public health. I still remain unconvinced that a sweeping policy change is necessary at the moment.

I do agree that it is important to maintain healthy vitamin D levels especially in growing children. The focus should be on balanced nutrition from a variety of food sources, plenty of physical activity – out in the sun if possible, and reduction of sugar, salt and fat (saturated and trans).

Interesting food trends to watch in 2010

Yet another great article from Registered Dietitian Janet Helm on her Nutrition Unplugged blog this week highlights several predictions for food products in 2010. Based on a report from Mintel, the prediction is that next year’s food products will focus on health, wellness, convenience, sustainability and affordability. Sodium reduction, simple ingredient list, locally sourced, eco-friendly, multipurpose, private label, functional packaging, simplified labeling are likely to be the features that will dominate the store shelves next year.

I think that no one should underestimate the Marketing skills of the major food companies. They clearly know how to play the game and they keep a sharp eye on consumer trends. I fully expect them to bundle their products to not only capitalize on these trends, but also make sure they continue to up-sell across various consumer groups. Private labels will grow for sure, but I don’t think they will overwhelm the giants anytime soon.

I think there is a place for packaged foods in lives of busy parents. Just don’t fall for the fluff, read the labels and mix these products with fresh foods, especially fruits and vegetables. As a consumer, you have enormous power because the food companies are quite good at listening to you.

Low sodium sea salt promises the gift of health and flavor

Using a mixture of salts from the Dead Sea and the Red Sea, Nutrasalt is a new product which claims to contain 66% less sodium than common table salt while providing a healthy balance of sodium and potassium. The target, of course, is the food industry desperate to claim a lower sodium content in their products without giving up on taste. Claims of heart health, natural, perfect balance of sodium and potassium should be very appealing to the food industry.

The nutritional facts label for Nutrasalt shows that it contains sodium chloride, potassium chloride and natural flavors. It is one of the simplest tricks to lower sodium by replacing it with potassium chloride. I reviewed the latest in salt reduction technologies in Can Salt be Any Saltier? article recently. The problem with potassium chloride is that it gives a bitter after-taste, which needs to masked by flavors or bitterness blockers. I do not know what kind of “natural flavors” this salt contains to maintain the natural salty taste. But I do think that their high volume natural claim is not that credible.

Also, this salt is not iodized. Bottom line – reduce your intake of table salt and processed foods even if they claim to be made from this so called healthy salt.

A new survey of Americans shows strong support for investment in prevention related programs and strategies as part of the new Health Care reform. The Robert Wood Johnson Foundation and The Trust for America’s Health sponsored this survey which polled about 1000 registered voters about their opinions on various priorities. 71% favor more funding for prevention programs while only 23% do not support any more extra funding.

Although it sounds good, I don’t think there is enough awareness and support for nutrition and physical activity, especially in schools. Out of all the prevention proposals, it ranked third by a large margin compared to the top 2. There is more emphasis on public health workers and their resources when it comes to prevention.

Also, only $34 billion out of the total of about $900 billion are allocated for prevention programs. That is not even 5% of the total! I do not believe that prevention is top of mind among our lawmakers. Public support will need to be much stronger and much broader than this survey data. I think we have a long way to go before we truly embrace the notion that prevention is better than cure!

Food allergy among US children rising

A recent paper in the journal Pediatrics reports that nearly 4 in 100 children under 18 years old reported some kind of food allergy in 2007. This was an increase of 18% over the 10 year period between 1997 – 2007. The researchers, however, are not sure if this increase is real from a clinical point of view or simply a result of better tracking and awareness among parents and healthcare providers.

Although troubling, I am not surprised by the recent results. In my article Good Nutrition is Key to Managing Food Allergy, I presented similar statistics. Some experts believe that poor quality of early childhood nutrition is to blame. Also, it is easy to confuse food intolerance with food allergy and most parents may not know the difference. Good nutrition builds a strong immune system, although it probably cannot help if there is a genetic reason for food allergy.

Whatever the reason, living with food allergy is challenging. I cannot claim to have first hand experience of that. But ify you do, I would love to hear from you.

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

Photo source – Paul Davidson on Flickr  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 and Registered Dietitian Dr. Shelley Meyer recommends you consider switching to 2% milk as long as your toddler is growing appropriately. Whole milk is recommended for children between 1-2 years old.

Question: How much whole milk is necessary? Should my nearly-17-month-old be drinking whole milk all the time? I worry about her fat intake a lot because there is heart disease and hypertension in our family in a BIG way – I want to get her started correctly down a road that will help her to avoid those issues.

Answer:

This is a great question that comes up quite a bit with parents of infants that are making their transition into toddlerhood.  Previously, the AAP recommended that any child between one and two years old have only whole milk.  The premise behind this idea was that the additional fat in whole milk was needed for appropriate development of the brain, as 80% of brain development occurs in the first two years.  In addition fat has more than twice as many calories per gram as carbohydrates and proteins, and is thus a great way to ensure adequate energy intake for the early toddler years.

However, due to the rising rate of childhood obesity and the increasing prevalence of cardiovascular disease in the general population, in 2008 the AAP revised their recommendations.  So, in your case, where there is a strong family history of heart disease, you may opt to use 2% milk as long as your child is growing appropriately.  In the case of an obese child 2% may also be the best option.   Remember, though, that fat is needed for brain development so be sure your young toddler is getting 45-50 grams of fat per day.

©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.

Hello everyone! It has taken us a while to get back to normal (whatever that means!) after our week-long Disney vacation. Hope you all have been doing good. Here is this week’s 5 for Fridays where I am once again focusing on the idea of a soda tax. Feel free to share your opinion in comments below.

Calls for soda tax are getting louder

Looks like the pundits have spoken again, this time in a louder, high pitched, unified voice! In a recent health policy report titled The Public Health and Economic Benefits of Taxing Sugar-Sweetened Beverages published in the prestigious New England Journal of Medicine, several “experts” have proposed that a 1 cent tax be imposed for every oz. of a sugar-sweetened soda. They estimate that such a tax will generate about $15 billion in the first year in addition to the state-level revenues. They have even setup an online tax calculator for different states and major cities! They propose that these extra dollars can be used for childhood nutrition programs, obesity prevention programs or healthcare for the uninsured.

Now I am sure that such talk is music to the ears of many people, especially those in the government trying to figure out how to pay for the healthcare reform. It might be appealing to those at the state and local levels also as their budgets are under severe stress. It is not a surprise that this idea has attracted the attention of most of the prominent mass media in recent weeks. Watch out, they are trying to build a mass hysteria!

I think this is a very misguided proposition. I have written about it in a recent post explaining why I don’t believe in a twinkie tax or a soda tax. And just to be clear, my arguments have nothing to do with the politics of the situation, rather they are based on an understanding of how business works.

For this week’s 5 for Fridays, I thought of compiling a summary of various viewpoints I have read on the web lately in response to this idea. Check them out and let me know what you think!

1. An interesting commentary in the New York Times explains why sodas are a tempting tax target. It is quite clear that there is a link between caloric imbalance and obesity. It is also known that soda consumption has skyrocketed over the last few decades. Put the two together and it is easy to see why the sugar-laden soda with its empty calories is the prime suspect for our obesity problem. Let us tax it to reduce its consumption; after all it has worked for tobacco. It is not a basic need anyway and even Adam Smith justified taxing such unnecessary which have become objects of almost universal consumption!

What I did like about this article is that it tries to address the bigger problem and talks about a broader Pigovian approach to get rid of the subsidies for corn syrup. Much more difficult to accomplish politically I am sure.

2. Another commentary on Forbes.com shows a serious skepticism about the effect of a soda tax on obesity and makes its case using numbers. Data suggests that even a 58% tax on soda, which is equivalent to the combined federal and state taxes on cigarettes, could at most lead to a mean BMI reduction of 0.16 points. Moderate decrease in consumption is expected in response to taxes, however there is a belief that people will simply switch to the diet option or other drinks. The return on these tax dollars in other words is not expected to be significant.

Let us leave the numbers aside for a minute – people can argue over them endlessly in my opinion. But I agree that the soda tax does not change the demand in any fundamental way.

3. In an excellent review Dr Ayala digs deeper into why these health experts favor taxing sugary drinks and offers her opinions on why such a tax should be supported. What I liked the most about her review is that she actually takes the time to explain why excessive consumption of sugary drinks leads to obesity and serious health problems.

Dr. Ayala is a pediatrician and an outspoken supporter of obesity prevention, healthy lifestyle and good nutrition choices. I respect her a lot, but on this matter we have a difference of opinion. I am personally no fan of soda anymore, but that is by choice not because of price. I do agree with her that a public debate on the ills of sugary drinks regardless of whether a tax is imposed on them or not will be good for everybody.

4. The Health Blog on the Wall Street Journal presents an interesting calculation to show that even when the penny an ounce tax is imposed on the soda and it is completely passed on to the customer, it will still be cheaper to buy soda than orange juice. The main idea is to show that the tax will have to be much higher in order to bring the price of soda in line with other so-called healthy options.

One observant reader left a comment that the box of orange juice also shows a lot of sugar per serving, so probably not a good example. Great point, and I agree because there is a lot of added sugar in these ready-to-serve orange juices. The underlying point however is that consumers should really read the labels and decide for themselves if they should be buying a particular food item or not. When consumers make healthy choices they are truly empowered and demand will change in a fundamental way.

5. Fooducate blog, which I read regularly, suggests we consider a calorie offset instead of the soda tax. Here is how it will work – for every ton of added sweetener, a company would contribute $3000 to a government program aimed at obesity reduction. This is equivalent to the penny an ounce tax on the finished product.

Interesting idea because it directly affects the cost of production rather than price of the product. It also encourages the manufacturer to reduce the sugar content or switch to healthier products. I also suggested several other ideas that can affect the cost of production in my post on twinkie tax.

This is a good debate. However we should focus on the big picture and not try to put a band-aid on it by using taxes. I think the experts have their heart in the right place because they are worried about our health problems and lack of effective policy. But they need to get more creative and offer something better than a soda tax!

Enjoy your weekend!

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

There is a certain perception, especially outside the US, that Americans are fat and lazy. Even our own media bombards us with stories of poor eating habits (think cheeseburgers and fries) and inactive lifestyle (think couch potatoes). Then there are alarming statistics on rising rates of obesity, diabetes and heart disease. And you really begin to pay attention, and raise the volume on the TV, if the story is focused on weight problems in children. After all, who would want their children to grow up in poor health?

But is it really that bad? Is it simply an American issue?

Check this out..

This came from a report issued by the WHO Regional Office for Europe following a November 2006 Ministerial Conference held in Istanbul, Turkey.

What’s wrong with this picture? Our media shows us images of slim, healthy-looking Europeans biking to work, eating healthy-looking food and living a stress-free life. On the other hand, the Americans are shown eating junk food, driving to work in gas-guzzling SUV’s and living a hectic stressed-out life. And all this is supported by “facts” and “numbers” with fancy charts and interviews with “experts”.

Now, let us not stop there…here is another interesting fact:

I don’t have anything against the Europeans or the Aussies. In fact, I have many good (and very healthy) friends from both of these continents. And before you get the urge to say that “you got your head in the sand“, let me say that we do need to pay attention to the numbers and make smart nutrition choices for ourselves and our children. After all, that is why I am writing this blog!

As a parent, it is natural to be concerned. Concern leads to caring; caring leads to action; and action leads to results. All I am trying to say is that it is not useful to be alarmed by the so called news in the mainstream media. In this age of short attention spans and low ratings, the media needs a big horn to get the message across. It is up to us to filter the noise, take a deep breath, and look at the data in a calm manner so we can make our own decisions.

It is my intention to help you do exactly that through this blog. Let me know how I am doing.