photo credit: DesertNana aka majamom

Chances are you have not had a whole lot of opportunity to ask your family physician or pediatrician about a few rules of thumb for your child’s nutrition. After all, there is hardly any time to talk about nutrition even on a routine wellness visit. Our experience has been no different as the doctor always seems to be in such a big rush to get you out of there!

That is why, I read with great interest an article written by a physician and a registered dietitian published in the American Family Physician, which is a peer reviewed journal of the American Academy of Family Physicians. The title of this article is Nutrition in Toddlers and it contains a nice table of 7 consensus recommendations you can use to manage your child’s nutrition. I wanted to share them with you in this article.

A toddler diet should include 2-3 servings of milk or other dairy products  per day

Not a problem in most cases unless your child has a milk allergy or intolerance. Milk is a great way to meet your growing child’s calcium and vitamin D needs.

Toddlers older than 2 years old should get 30% of daily calories from fat

Not all fat is bad, even though we live in a world where low fat seems to be the golden rule. What you need to limit is saturated fat or trans fat and watch dietary cholesterol. Very easy to do if you reduce processed foods and rely more on home-cooked meals. Polyunsaturated or monounsaturated fats and fatty acids are among the healthy fats you must include in your child’s diet.

Limit fruit juices to no more than 4-6 oz per day and emphasize whole fruits and veggies

It is easy to get comfortable with the no-sugar 100% pure fruit juice label on the box, but fruit juices are no replacement for real fruit. Getting your child to love fruits and veggies takes effort and patience, but don’t give up!

Vitamin supplementation is unnecessary except in undernourished or chronically ill children

I could not agree more! It is natural to worry as a parent, and sometimes feel the pressure to start using a vitamin supplement just to be safe. There days we hear so much about vitamin D deficiency but a supplement is not needed unless your child doesn’t get enough sun exposure or if he does not or cannot drink at least 2 cups of milk. There are situations where you may consider a multivitamin for your toddler, but the general advice is to manage your child’s vitamins and minerals needs through diet and healthy lifestyle.

Good nutritional habits should be fostered by sitting at the table, turning off the television and interacting socially

Sometimes we get so focused on the what of eating, that we forget about the how of feeding! Having a family meal without the distraction of TV or video games is a very powerful way of building lifelong healthy eating habits. Dr Kathleen Cuneo of Dinner Together is an expert in this matter whose opinion I respect a lot. I really like her approach and belief that feeding is parenting. That is what matters in the long run, not the nutritional facts on the label!

Parents should offer children a variety of foods, expose them repeatedly to healthy foods and model healthy eating behaviors

Like it or not, you are a role model for your young child. And when it comes to building lifelong healthy eating habits, your attitude towards food and eating is the most important factor. Being a role model is not difficult; just be consistent and completely natural with your child.

To reassure parents and detect undernourished children, physicians should monitor growth patterns including body mass index

While it is natural to worry if your child falls below the 50th percentile on weight and height growth charts, body mass index is a better tool to assess if your child is overweight or underweight. Body mass index uses both height and weight. It is very easy and you can use an online calculator if you don’t want to wait until your next wellness check appointment.

I think these recommendations pretty much sum up the latest thinking in child nutrition. They are based on sound evidence and practical experience of doctors and dietitians. You don’t have to try to follow all of them on a daily basis. You can try to make them a part of your child’s overall eating habits in the long run. It is also a good idea to tailor your approach to your child’s individual personality without getting hung up on a certain best way to practice them.

Good luck!

©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 Preethi Rahul addresses concerns about soy milk and suggests a few alternatives.

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: I have heard that soy foods, especially milk, can be bad for kids because of a high estrogen content. IS this true and what is my alternative?

Answer:

The American Academy of Pediatrics (AAP) recommends that parents give soy formula only to infants who cannot digest cow’s milk or to those whose parents wish them to follow a vegan diet. For the majority of infants, the AAP says cow’s milk formula is still the next best thing to breast milk.

The main concern about soymilk is that it contains high levels of phytoestrogens — estrogen-like substances found in some plants. Soybeans are a significant source of mammalian lignan precursor secoisolariciresinol containing 13–273 µg/100 g dry weight. Another phytoestrogen in the human diet with estrogen activity is coumestans, which are found in beans, split-peas, with the best sources being alfalfa, clover, and soybean sprouts.

People who are worried about soy formula fear that these substances could interfere with a child’s development and even cause early puberty, thyroid problems, breast development in male children, or other difficulties. However, most of the research on soy has been carried out in animals and not in people. Soy may cause some endocrine disruptions in animals but humans metabolize soy differently. According to British Medical Journal there is virtually no data on the effects of phytoestrogens on children. However, the long-term effects of soy are still not known. So, use soy milk in moderation as research is still being carried out and it is highly controversial.

Other alternatives to soy milk are almond milk and rice milk unless of course you do not plan to use cow’s milk. Almond milk is rich in magnesium, potassium, manganese, copper, the antioxidants vitamin E and selenium, and calcium. Almond milk, then, may be one of the more nutritious milk alternatives on the market but it is expensive. Rice milk is processed from brown rice and usually contains rice syrup, evaporated cane juice or some other natural sweetener. It is typically fortified with calcium or vitamin D. Rice milk is largely a source of carbohydrates, so it’s important not to look at it (or either of the other two milk substitutes) as a nutritional replacement for milk (cow’s milk is a source of protein, fat and carbs).

Below is table comparing various milks:

©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.

Most toddlers are picky eaters and getting them to build lifelong healthy eating habits is a challenge for most parents. It is not unusual for a child to fill herself with drinks and only nibble on a few foods occasionally. This week, Registered Dietitian Ashley Rosales offers a few tips to bring variety in your child’s diet and encourage healthy eating habits.

Ashley Rosales, RD B.S. in Clinical Nutrition from UC Davis, Dietetic Internship completed at Napa State Hospital Project Manager Dairy Council of California Past Experience: Clinical nutrition, nutrition communications, senior nutrition and food service management Expertise: Registered Dietitian with a focus on effective nutrition education, providing parents with realistic approaches to raising healthy eaters, and blog writer for MealsMatter.org Twitter: @Ashley_RD Contact via email – arosales@dairycouncilofca.org

Question: My little one drinks and drinks and drinks but only nibbles on food here or there. Is this okay or should I try to make her eat actual food? Or maybe a nutrition shake?

Answer:

Many parents of young children question if their child is getting enough nutrients through food. It is important to remember that although they’re no longer babies, young children aren’t ready for adult-sized portions. Their little stomachs just aren’t big enough. Although it is true that they need the same nutrients as adults, the amounts do differ greatly. It is also very common for your child to show day-to-day appetite fluctuations. If your child is occasionally “picking” at a meal, chances are that he or she will make up for it later. If your child is growing normally, seems healthy, and has energy to play, then he or she is probably getting enough to eat. Despite this, it is still normal for parents to feel insecure about “what” or “how much” their child is eating.

One of the hardest things for a parent to do is trust in their child’s hunger and satiety cues. This is a critical time when your child is learning how to make food choices and is establishing patterns of healthy eating that they will take with them the rest of their life. If you are doing all you can as a parent to set your child up for feeding success, then you can feel confident that they will eventually make the right choices and that they will get enough nutrients in the process. Here are a few guidelines to consider to give you some peace of mind.

Establish a routine. Children do best with a routine, so try serving meals and snacks at about the same time every day. Limit snacks that are served as a “pacifier”, such as in the line at the grocery store or while running errands in the car, as these types of snacks can interfere with mealtime. Plan snack and meal times to coincide with your families schedule in order to ensure you have adequate time to prepare a healthy snack and eat meals together as a family when possible. When children don’t feel rushed, or when they eat with others, they tend to eat better.

Serve smart snacks. In addition to meals, young children need 2 to 3 snacks each day. Plan snacks that include something from at least one of the food groups. An example would be sliced apples with string cheese or whole grain crackers with hummus. If your child likes to sip on beverages for a snack try serving up a delicious and nutritious smoothie by blending fruit, ice and milk together. Snacks should be a nutritional complement to meals, so try offering snacks two hours before meals so that your little one is hungry again by mealtime.

Beware of beverages that compete with nutrients. Beverages are important for many reasons, with the highest being that they ensure your child is getting enough fluids for hydration. However, many beverages consumed by children today are loaded with calories yet provide no essential nutrients. These beverages, like soda, fruit and sport drinks, often replace nutrient-rich beverages like milk, which provides the calcium, vitamin D and potassium that children need each day. On the other hand, although your child needs nutrient-rich beverages, don’t be so quick to reach for those child “supplement shakes” unless directed by your pediatrician, as these really can interfere with your child’s hunger at mealtimes. So what should you serve your child to drink? The best rule is thumb is to serve milk with meals, provide 100% fruit juice in moderation (around 4-6 oz per day) and offer water throughout the day when your child is thirsty.

Be a good role model. What are your eating and drinking habits? Do you snack on nutritious foods and eat a balanced meal with your children? Do you drink milk at meals and choose water when you are thirsty? Children are observant and they rely on you to learn their habits, attitudes and beliefs around food. Role modeling is one of the most powerful and effective ways to help your child eat healthier.

©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.

Calcium is very important for growing children as it helps them build and maintain healthy bones.  This week, Registered Dietitian Karen Kafer talks about calcium requirements for children and different sources of calcium.

Karen Kafer, RD B.S. Oklahoma State University VP Health Partnerships at National Dairy Council Past experience: VP, Communications for Kellogg Company Website: The Dairy Report Contact via email – karen.kafer@rosedmi.com

Question: There are several calcium choices I could provide for my child—which one(s) should I choose?

Answer:

Since children are often picky about what they eat, parents are challenged to find foods kids like that also provide the nutrients they need.  The Food and Nutrition Board of the National Academy of Sciences recommends children consume adequate calcium in their diets.  This means:

• 500 mg of calcium a day for kids who are 1 to 3 years old;
• 800 mg of calcium a day for kids who are 4 to 8 years old; and
• 1,300 mg of calcium a day for kids who are 9 to 18 years old 2 .

To reach these recommended calcium levels, there are several options parents can provide for their children.  Calcium can be found in dairy foods such as milk, cheese and yogurt, vegetables like broccoli, kale and spinach, as well as salmon, red beans and fortified juices and cereals.  However, different calcium sources provide various levels of calcium and also vary in how easily they are absorbed in the body.

To compare, a one cup serving of milk or yogurt or 1.5 ounces of natural cheddar cheese contains about 300 mg of calcium on average.  However, to obtain the same amount of calcium in one cup of milk, a child would have to eat 10 cups of raw spinach, nearly 4 ¾ cups of canned red kidney beans or 4 ¾ cups of cooked broccoli.  As for foods fortified with calcium, they vary in both their calcium content and quality, so be sure to read food labels to determine how much calcium these products contain.  Check the ingredient section of the food label to determine the type of calcium (such as calcium carbonate, calcium citrate, calcium malate, etc.) used during fortification.

Another option for children is calcium supplements or supplements containing calcium; however, it’s recommended that parents always consult a pediatrician before giving children supplements of any kind.  According to the National Institute of Health, “the two main forms of calcium in supplements are carbonate and citrate. Calcium carbonate is more commonly available and is both inexpensive and convenient. Both the carbonate and citrate forms are similarly well absorbed, but individuals with reduced levels of stomach acid can absorb calcium citrate more easily. Calcium citrate malate is a well-absorbed form of calcium found in some fortified juices. The body absorbs calcium carbonate most efficiently when the supplement is consumed with food, whereas the body can absorb calcium citrate equally effectively when the supplement is taken with or without food.”  Unless a child has a dairy allergy and must avoid dairy, it’s important to remember foods naturally containing calcium, such as milk and milk products, rather than supplements, are the preferred source of calcium for both you and your child.

Vitamin D helps promote the absorption of calcium and enhances bone mineralization.  In fact, a glass of milk fortified with vitamin D provides about 25 percent of the Daily Value for vitamin D, and aids in this calcium absorption and bone mineralization enhancement.  Milk is one of the few dietary sources of this important nutrient so it’s important for children to have their recommended amount of low-fat and fat-free milk and milk products every day.

Resources:

Milk’s unique nutrient package from National Dairy Council

Calcium content of select foods – USDA national nutrient database for standard reference

©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.

We just came back from another wonderful visit to the Magic Kingdom at Disney World! No doubt, the magic continues to delight and amaze thousands of visitors every day even though the lines are long and there is always something you don’t get to do before it is all over. We enjoyed the Halloween decorations everywhere in the park. The parade at night was absolutely fantastic; or shall we say “magical”!

There was, however, no magic in the kids menu which had the usual hot dogs, chicken nuggets, mac ‘ n cheese and french fries. In one of the restaurants, we found a packaged peanut butter jelly sandwich. Packaged apple slices, carrots and grapes were available as side items. Not surprisingly, soda was everywhere, although I am glad milk and bottled water were included in the dining plan! No shortage of sugary treats and salty snacks either.

If Disney wants to stay ahead of the curve, they must bring magic to the kids menu.

What do you think?

photo credit: Aaron T. Goodman

The word protein brings images of strength, muscle and high stature to mind. As such, there is a common notion that children need to eat a lot of protein to grow strong. Although, it is definitely important to include foods rich in protein, there is no need to overdo it. Chances are your child is already getting sufficient protein from a variety of foods  including dairy, meat, fish, eggs and vegetarian sources of protein.

Here are a few handy facts to know about protein:

1. Chemically speaking, proteins are made up of amino acids joined together to make a chain like structure.
2. Human proteins are made up of 22 different amino acids. 13 of these can be produced by the body. The remaining 9 are called essential amino acids which we must get from food.
3. 1 g of protein equals 4 calories.
4. The daily amount of protein your child needs depends on age, weight and activity level. In general, children 1-3 years old need 0.5 g per pound of body weight, which comes to about 13-16 g per day. Children 4-6 years old also need about the same amount per pound, but since they weigh a little more, the daily amount is about 22 g. The Institute of Medicine has a good resource for recommended daily amounts (RDA) of macro-nutrients such as fat, proteins and carbs.
5. Foods that provide all 9 essential amino acids are called complete protein foods. Animal food sources such as meat, fish, poultry, eggs, milk and cheese fall in this category.
6. Proteins from plant sources are deficient in one or more of the essential amino acids; that is why they are called incomplete proteins.
7. It has been a common belief that vegetarians need to combine various foods to get all the essential proteins. For example, beans should be eaten with rice. Most experts now agree that there is no evidence to support this belief. As long as you are eating a broad range of foods in balance and moderation, you don’t need to worry about such rules!
8. The quality of proteins is measured by many different types of indicators which relate to how effectively the body is able to utilize the protein. Biological value is one of these indicators – egg whites are considered a standard with a biological value of 100. It means that nearly all of the nitrogen from its amino acids can be utilized by the body.
9. The body cannot store excess protein. Eating more protein than necessary will actually result in more fat!
10. Food allergies is a response to specific proteins in different foods. For example, milk allergy is a response to caesin and whey proteins in milk. Another problem protein for a lot of people is gluten, which is found in wheat and causes celiac disease.

©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 and contributing editor of Parents magazine Sally Kuzemchak offers tips for creating a healthy food environment at home to foster lifelong healthy eating habits and preventing childhood obesity.

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

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

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

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

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

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

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

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

©2010 Littlestomaks.com. All Rights Reserved

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

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.

Growing children need both calcium and iron in their early years. This week, Registered Dietitian Cindy Williams explains why you need to balance milk and meat for your toddler so he doesn’t miss out on these critical minerals.

Question: How much milk and meat should I feed my child?

Answer:

Milk

Milk is an excellent source of calcium. Children need plenty of calcium to build strong bones and teeth. Up until 12 months a baby should not drink cows’ milk because the protein is too large for the baby’s immature digestive system. After 7-8 months babies can have a little cooked cow’s milk as part of a milk pudding or custard. Yogurt and cheese are also fine for this age group – and a great source of calcium. Babies who drink cows’ milk before 12 months are at greater risk of iron deficiency.

Up to the age of two children should have full fat cows’ milk. They need the extra energy from the fat for growth. After the age of two toddlers can drink reduced fat milk so long as they are eating a good variety of food.

Up until the age of five, health authorities recommend children should drink about two cups of milk a day. Some toddlers love milk and would be happy to drink it all the time. Stick to two cups a day otherwise they will fill up on milk and have no room to eat their meat and vegetables. Toddlers who regularly drink more than two cups of milk a day are at greater risk of iron deficiency.

In a day they could have milk on cereal for breakfast, a small glass of milk sometime during the day, a little cheese and perhaps a milk pudding or half a carton of yogurt. The amounts will vary according to the child’s appetite. Remember the parent decides the quality and the child decides quantity.

Meat

Meat, especially beef and lamb, is the best source of iron and zinc for a child. The type of iron found in meat is called heme iron and it is easily absorbed. Children can also get iron from non meat foods such as iron fortified cereal, legumes (split peas, dried beans, lentils) and green leafy vegetables. Only about 5% of this iron is absorbed but having vitamin C with the food will increase absorption. Give your child some vitamin C rich fruit such as orange or kiwifruit with their breakfast cereal and they will absorb about four times more iron from the food.

Research has found that children who eat fruit with their meals are less likely to be iron deficient than those who eat fruit between meals.

Babies are born with enough iron stores to last about six months. Premature babies have lower iron stores because iron is mostly stored in the last three months of pregnancy so it is especially important for these babies to start eating iron rich foods sooner rather than later.

At six or seven months a baby can eat cooked, pureed meat, chicken or fish. It provides essential iron for brain development but at this young age is still a top-up after the usual milk feed. By 7-8 months a baby should be eating two or three small meals a day with 2 tablespoons to 1/2 a cup per meal. Increase the amount gradually before increasing the number of meals. Include some cooked minced meat with mashed vegetables most days.

A one year old needs more iron than his or her dad. It is vitally important that toddlers get enough iron from their food. This is when their brain is developing the most rapidly. If they miss out on iron at this stage their brain will not develop to its full potential – and they can’t make up for it later. The American Academy of Pediatrics recommends two serves of meat (or protein equivalent) a day for children under six years. A serve is 1oz of meat, fish or poultry or 1 egg or 2 tablespoons peanut butter or 4-5 tablespoons legumes. Remember to give your child an orange or piece of fruit with the egg, peanut butter or legumes to increase iron absorption. Give your child a mixture of meat, chicken, fish and vegetarian meals each week. Variety is good for both their health and training their taste-buds to enjoy different flavours.

KEY POINTS

• Don’t drink cows’ milk before 12 months.
• Toddlers should drink no more than 2 cups milk a day.
• Eat fruit with meals rather than between meals.

©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 Nour El-Zibdeh offers tips for getting enough iron from a vegetarian diet without relying on supplements.

Question: How can I ensure enough iron if my child is on a strict vegetarian diet?

Answer:

Iron is important for health. It is part of hemoglobin, a protein found in red blood cells, and its main role is to transfer oxygen to body tissues and cells.

Too little iron causes fatigue, decreased immunity, and may impair psychomotor development in infants.  Iron deficiency occurs due to three general reasons:

1. increased needs of iron (growth),
2. decreased absorption (iron in the diet comes from sources that are not easily absorbed, such as plant foods),
3. decreased iron intake (low total food intake).

The prevalence of iron deficiency in the United States is low. However, toddlers are at a high risk because they don’t drink or eat iron-fortified formula or cereal anymore, and their intake of iron-containing foods may still be low. Toddlers who are on vegetarian diets, drink more than 24 ounces of milk a day, or suffer from decreased availability of food are at an increased risk.

Type of iron in the diet

There are two types of iron in the diet, heme and non-heme. Heme iron comes from animal sources and is the most easily absorbed. Non-heme iron is the most prevalent in food, found in both animal and plant sources, but its absorption is less efficient and can be influenced by many factors.

When discussing plant sources of iron, two points must be distinguished. First, the amount of iron in plant foods, and second, the amount that is actually absorbed. For example, half cup of soybeans has 4.5 mg of iron, but the fiber and protein in soybeans prevent its absorption. Half cup of tomatoes, on the other hand, has 1 to 2 mg of iron but is easier to absorb.  Vitamin C improves the absorption of iron, while phytates (in bran and whole grains), oxalates (in spinach, rhubarb, strawberries, nuts, chocolate, and wheat bran), polyphenols (in coffee and tea), calcium, and fiber prevent its absorption.

Tips for vegetarian toddlers

1. Offer a variety of plant foods, especially those high in vitamin C. These include guava, lemon, orange, papaya, tomatoes, beetroot, broccoli, cabbage, cauliflower, pumpkin, and turnips.
2. Choose iron-fortified cereals and grains when possible.
3. If you are interested in numbers, toddlers one to three years old need 7 mg or iron a day, and toddlers over four years old need 10 mg a day. Since iron in plant foods is not absorbed entirely, aim for more than the recommended amount from plant foods, not supplements. Here are some foods rich in iron.
4. Don’t give your toddler more than 24 ounces of milk (cow, goat, or soy) a day. Milk is low in iron and high in calcium (prevents iron absorption), and too much can be filling causing your child to be uninterested in other iron-containing foods. Too much cow’s milk can also irritate the gastrointestinal tract and cause bleeding, which will lead to iron losses.
5. Don’t stress about iron deficiency unless your child shows symptoms, which include fatigue and weakness, pale skin, mucous membranes, rapid heartbeat, irritability, decreased appetite, dizziness, or feeling lightheaded.
6. Consult with your pediatrician if you suspect deficiency, and don’t give your child iron supplements on your own. The human body doesn’t have a way to get rid of excess iron, so too much can be toxic and cause organ damage.

©2010 Littlestomaks.com. All Rights Reserved

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

Greetings! There is no doubt that popular food brands have enormous appeal and influence, especially on children who are exposed to heavy marketing. Not a surprise therefore that even 3 year olds can recognize these brands. The bad news is that most of these brands offer sugary, salty and fatty junk foods, to which kids get hooked on early! Parents have to face this challenge as they try to encourage their children to develop healthy eating habits. Sounds familiar?

I started this week by suggesting that we need to have an offensive-defensive strategy for dealing with the attack of popular food brands. The idea is to create your family’s brand of food and nutrition by applying common branding techniques of identifying core values, developing a main message with a logo/slogan, promoting with friends and family and aggressively defending it with a few rules.

Another approach is to identify a few brands and products that resonate with your core values to support your battle against the not-so-healthy-but-otherwise-popular food brands. Association with these brands then becomes an extension of your personal brand.

This week, instead of the usual Five for Fridays, I want to share with you 5 of our favorite brands and why we like them. And no, I have not been paid to highlight them here; the idea here is to offer you a few suggestions as you try to discover what is important to you.

I would love to hear your comments! Feel free to share your favorite food brands and products.

Earth’s Best Organic

Earth’s Best, by far, is our most favorite brand! Our twins grew up on Earth’s Best fruit and vegetable purees, and they continue to love their organic toddler snacks such as Letter of the Day Cookies, Yogurt Rice Crisp Bars and Instant Oatmeal.

In researching Earth’s Best for this article, I found out – much to my surprise – that the company’s founders Ron and Arnie Koss are twins! Their vision of nurturing children with purest foods and growing those foods responsibly to promote a healthier earth resonates with our core values completely.

Earth’s Best brand now belongs to the Hain Celestial Group, Inc. who is responsible for bringing their toddler products to market, and of course, we are very thankful! Their product lineup ranges from infant formulas to baby’s first foods to toddler snacks and meals. They seem to be big on using Seasame Street characters as a marketing tool on their products. Honestly we are not too crazy about it! For us, the appeal is in their promise of organic quality and commitment to the environment.

For a complete list of their products and to learn about their history, visit Earth’s Best website.

Horizon Organic

We are a big fan of Horizon’s organic milk with DHA. We have had our twins on this milk ever since they started cow’s milk. At first, we were looking for an organic milk brand, but when we found Horizon’s milk with added DHA in our local supermarket, it was a no-brainer! DHA is known to support healthy brain and eye development in infants and toddlers. The source of DHA is from algae branded as life’s DHA from Martek Bioscience Corporation.

We believe that milk is an important source of nutrition for a growing child, unless there is the unfortunate situation of milk allergy. Selecting certified organic milk is better because it does not contain any antibiotics or growth hormones.

We are impressed by Horizon’s commitment to organic principles, compassion for their livestock and passion for the land. In my research, I found Horizon’s Standard of Care, which goes in great detail about their beliefs and management practices to support these beliefs. The integrity of this brand is impressive.

For a complete list of their products and company facts, visit Horizon Dairy website and Horizon Organic Facts.

Campbell’s Kids Soups

Campbell’s soups are a household name, no doubt, as you can tell by the prominent place they occupy in any grocery store. Our daughter enjoys Campbell’s kids soups with her favorite characters like Dora and Disney Princess. She loves to help Mom open a can and pour its contents in a saucepan for a quick meal. On a busy day, these ready-to-eat soups come in very handy! We are careful to read the labels because these soups can be high in salt, although Campbell’s is ahead of the curve in reducing the sodium content from its products.

We like Campbell’s as a brand, because they seem to really listen to their consumers while being sensitive to the economic difficulties. Clearly, their brand is positioned for the masses. Although their approach to healthful nutrition and environmental sustainability is incremental in our opinion, we do like their focus on affordable nutrition and continuous improvement. They have also figured out a great way to encourage consumers to prepare home cooked meals using their soups and recipes on the label. From that point of view,  we believe that Campbell’s has the potential to enable a move away from fast food and restaurant food toward home cooking at a very large scale.

Here is an interesting piece of trivia I found while researching their brand – they also produce their own seeds for tomato and peppers!

For a complete list of their products, visit Campbell’s Condensed Soups.

Cheerios

Although our twins are no longer that crazy about Cheerios, this cereal is a family favorite and occupies almost a permanent place on our cereal shelf. When they were younger, it was one of their favorite finger foods, especially when they needed to munch on something in the car!

Although there are many different types of products in the Cheerios family, we go for the plain standard Cheerios and Honey Nut Cheerios. We like the whole grain oats, low sugar and vitamins (particularly vitamin D) in this cereal. Recently, there has been some recent controversy about their claims around cholesterol and heart health, but we think it is more of a legal issue for them rather than a real concern with the product.

For a complete list of their products, visit Cheerios.

Green Giant Frozen Vegetables

We usually keep our freezer stocked with several packages of Green Giant frozen vegetables. Although fresh produce is the best choice, the convenience of packaged frozen vegetable -  some ready to serve with a sauce – makes it easy to add veggies in your daily diet. We like the affordable diversity of different frozen vegetables from Green Giant. But we also try to limit our selection to some of their simpler products like peas, cauliflower, broccoli and mixed vegetables. Their rice pilaf is also one of our favorites.

As a brand, which is now a part of the giant General Mills, they seem to be able to retain their identity and maintain a connection with their roots in the Minnesota River Valley. We are also impressed by their commitment to sustainability. They are sponsoring an innovative project with The Nature Conservancy. It involves using a combination of native vegetation in infiltration ponds to collect the water runoff from the fields. It is then diverted to a bioreactor (trenches filled with woodchips) where the excess nitrogen is removed and land erosion controlled. This system will also create a habitat for wildlife. Sounds like an interesting idea; although it may take up to 10 years to see the results.

For a complete list of their products, visit The Green Giant.

Enjoy and share with us your favorite brands and products.

©2010 Littlestomaks.com

Disclaimer: We have not received any sponsorship or free products from these brands and companies for our review. Our opinions are based on personal use and publicly available information.

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

Snacks are in, Meals are out

That is our eating culture today according to this story in the recent New York Times. Research conducted by the Department of Agriculture and the Department of Health and Human Services between 1997 and 2002 found that fewer children ate 3 meals a day while the percentage of those who had a snack instead went up by 40%. This should hardly be a surprise since snacks are now available everywhere. And parents are asked to bring snacks to sporting events or other extracurricular activities. It is no wonder that the traditional family meal is no longer a tradition now except around the Holidays!

Right now, we are experiencing this problem first hand. It takes a lot of effort to create a distinction between mealtime and snack time. Healthy snacks have a place in a child’s diet, but when they begin to demand their favorite snacks at regular mealtimes, you have to draw the line. Snacks are meant to keep them from getting too hungry between meals. Not as a substitute for regular wholesome family meals. So we are trying to be gentle, yet firm in our approach to having our twins understand this difference. Share your tips for getting your child to eat regular meals and not demand snacks and mealtimes.

Obesity rates are flat, but that’s no reason to celebrate

New data from CDC suggests that obesity rates among US adults have reached a plateau, which means they are not rising anymore. But the bad news is that the number is quite high – nearly 34% of the US adults are obese, which is nearly double the number about 30 years ago. Although the number of obese children is at about 17%, this number as tripled over the same time frame. Some may see this as “halting the obesity epidemic”, but I think that attitude does nothing to solve the problem at hand.

This graph in the New York Times is interesting. It shows that Hispanic and African American children 2-5 year old have a higher rates of obesity (BMI is >95% of children in this age group) compared to White children of the same age. Same conclusion can be drawn for adults 20 and older. There is a clear correlation between race and, more importantly, the socioeconomic status, and obesity. And I don’t think there is any coherent strategy to target this group of people to solve this problem. There is no reason we should get complacent about “flat” rates of obesity in the US. This problem is deep and quite severe.

Fuel Up to Play 60

This is an interesting program sponsored by the National Dairy Council and the NFL to encourage kids to eat healthy, play at least 60 minutes a day and do fun activities in and out of school. Kids and Schools can enroll in a competition of sorts where they score points by tracking their food choices and activities. Even the USDA has joined in as a partner.

I think this is a great project. More than anything else, it will get kids to pay attention to what they are eating on a daily basis. I strongly believe in the power of measurement – you get better only when you measure. That is why tracking the food choices and physical activity is a good idea. And of course if they win, they get to hang out with NFL players, which is also very cool!

The only thing to watch out for is that undoubtedly dairy products including flavored milk will be pushed into schools and kids will be encouraged to grab them so they can “score” points. Milk is a far better option than soda or other sugary drinks in schools, but too much flavored milk is also not good. The reason is that it has added sugar in addition to the natural sugar found in plain milk.

Bottom line – stick to plain milk, eat fruits and veggies and give up on soda and junk food. But do bring this program to the attention of your child’s school if they don’t know about it. 60,000 schools have already signed up!

Here are 2 neat recipe ideas for you this week

Take the beef out of your burger and (still) enjoy the experience

Who doesn’t love to sink their teeth in a thick, juicy burger?! But with so many scary stories of E. coli contaminated beef recently, even the most devoted burger fan is probably looking for safer options. This article in the Well column of the New York Times offers 5 ways of enjoying a beef-less burger! You can make burger-like patties by combining fish, chicken, turkey, vegetables, beans  and mushrooms. Sounds like a good idea, certainly worth trying.

Cold quinoa salad with feta cheese

We like quinoa and we love feta cheese! That is why this simple recipe on The Nourished Kitchen caught my eye. First you cook the quinoa and chill it before preparing the whole salad. Aside from the feta cheese it also calls for chicken and pine nuts, both very healthy ingredients. I could also consider experimenting with finely chopped pieces of apple. Overall, it looks very good and worth a try.

Enjoy and let me know what is on your mind.

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

According to the 2nd edition of the PDR for Nutritional Supplements -

The absorption efficiency of calcium varies throughout the life span. It is highest during infancy when it is about 60%. In prepubertal children, it is about 28%. During early puberty, at the time of the growth spurt, it increases to 34% and then drops to 25% two years later.

How you can use this information -

1. Get your kids to drink milk and eat yogurt at an early age. Dairy is the best source of calcium. Unless you have an allergy problem, this should be your first choice. Milk also has vitamin D which is necessary for calcium absorption.
2. Other sources of calcium and vitamin D – fortified orange juice, cereals, collard greens, broccoli, tofu, salmon, spinach. Offering a variety of food sources in addition to, or instead of dairy, is a good way to get calcium in your child’s growing bones early on.
3. Recommended daily value for children 1-3 years is 500 mg (about 2 cups of milk) and for children 4-8 years is 800 mg (2-3 cups of milk).
4. In addition to food sources, physical activity is also important. Both exercise and nutrition help bones to increase their strength.

Building a calcium reserve at an early age is almost like building a bank balance of good health for the rest of your child’s life.

What has worked well for you in providing adequate amount of calcium and vitamin D in your child’s diet?

©2009 Littlestomaks.com
Information provided in this post is not meant to be treated as medical advice

Oh no! It is Friday the 13^th! A coincidence maybe, but I just noticed that this is the 3rd Friday the 13th this year. Maybe that is why we are having a nightmarish year so far – there is simply no good news anymore! Hopefully things will change for the better soon.

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

Toronto conference raises another red flag on vitamin D

If  you want to be heard, scream louder! That seems to have been the strategy of the conference organizers in Toronto who made loud proclamations like “breast cancer risk virtually eradicated by elevated vitamin D levels” and “97% of Canadians are vitamin D deficient and don’t even know it”. I love it when I hear attention grabbing headlines like these! Sounds like the vitamin D enthusiasts are getting desperate because their research so far has not been able to influence policy decisions by health officials.

Interestingly, a non-profit “grassroots” organization called Grassroots Health is leading this fight with their flagship D*Action panel of leading researchers in North America. They recommend 2000 IU of daily vitamin D and blood levels of 100-150 nmol/mL to reduce the risk of all kinds of chronic diseases. Their mission is to promote awareness of the vitamin D problem by educational seminars and encourage people to get their blood levels checked two times a year.

There is no consensus on optimal vitamin D levels, especially for children. Keep in mind that the current recommendation is 400 IU for infants, children and adolescents. Many “experts” believe children need about 10 times the current recommended levels! I am not really convinced of that and I don’t recommend you to fall for this kind of advice without testing and consultation with your pediatrician.

Will you raise your hand for chocolate milk?

The creators of the “Got Milk?” campaign now want you to encourage your children to “raise their hand” for chocolate milk in school. The logic is simple – kids are not drinking enough milk, vitamin D levels are low, chocolate milk is popular so why not let them drink more of it in school? It is not as bad as candy and soda anyway! Check this out:

I am not necessarily against this idea because it seems like a practical solution to a common problem. Some experts have opposed this idea because of extra calories coming from added sugar. Kids are getting enough sugar already so chocolate milk has no place in schools, they say.

What do you think? If you raise your hand for the chocolate milk mustache this time, try to cut those extra calories from somewhere else in your child’s diet.

By the way, I understand why this video would use dietitians to endorse this idea, but what’s up with the actors and models? Does their endorsement carry the same weight? But then, I probably don’t understand Marketing!

Getting the division of responsibility right in feeding toddlers

I was thrilled to read Dr Kathleen Cuneo’s sound advice in response to my guest post on her blog a couple of weeks ago about challenges of feeding toddlers using Ellyn Satter’s division of responsibility idea. 5 challenges that we have faced with our 3 year old twins are – can’t be sure if they are really full, they are not hungry at dinner time, they are distracted by TV, they are too tired and you are just too tired and “give in”.

As she promised, Dr Cuneo followed up with a couple of posts on her blog, which I strongly recommend you to read if you are facing a similar challenge. In her post Are They Really Full? she advises parents to acknowledge their fears and do a realistic assessment of how much their children are eating on average. Probably about what they need because they are naturally programmed to regulate their food intake. So keep your fears in check and use division of responsibility consistently.

Just like getting a workout buddy can keep you on track to burn those extra calories in the gym each week, a community-level program to fight childhood obesity is more likely to work based on recent experience in Europe. Together Let’s Prevent Childhood Obesity is a proven program in France (it goes by the name EPODE), which aims to build healthier habits over a lifetime by using all key stakeholders at the local level. First started in 2003, EPODE now extends to 1.8 million people across 167 French cities, 20 in Spain and 8 in Belgium. Greece and Australia are expected to follow soon. The results, measured by BMI of children have shown reduction in the percentage of overweight and obese children.

Why does it work so well? I think the key is making it a community level issue and not an individual issue. Also encouraging healthy habits, moderation and not stigmatizing certain foods. Mindful eating, peer pressure and involvement of key opinion leaders such as dietitians, chefs and school administrators seem to create a supportive environment for the individual.

Should we wait for our policy makers to wake up and act? Why not get a Mom’s group together and develop a simple action plan to address this problem in your community? What do you think?

Changing the way we eat in 2010 and beyond

Registered Dietitian Janet Helm provides a great preview of what we might expect in the 2010 revision of the Dietary Guidelines for Americans. Looks like the experts are considering the following recommendations – fight obesity, promote nutrient-rich foods, focus on nutrients of concern (vitamin D etc.), emphasize plant-based foods, highlight diversity of vegetables and cut the salt. How the exact guidelines will turn out, no one knows but we can probably expect more emphasis on these points. I think it is quite timely and a clear recognition of a link between what we put in our bodies and our present healthcare challenges.

There is no shortage of advice and guidelines and yet we are facing a public health crisis. I think the gap is in implementation and accountability.

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

Photo source – 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, 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.

News of vitamin D deficiency in children are popular in the media these days. Like all concerned parents, I am sure you have paused to pay attention to these news and wondered if you should get a vitamin D supplement for your toddler. The only way you can be sure whether your child has a vitamin D deficiency is by getting a blood test which screens for a particular form of vitamin D called 25-hydroxyvitamin D. Unfortunately, there are no early warning symptoms which can help you determine if you should take a corrective action.

You don’t need to go rushing for a blood test right away though! By paying attention to your child’s general level of outdoor activity and eating patterns, you can get a few clues. Here are 5 questions you can ask to figure out if there might be a need to get a definitive answer on vitamin D deficiency in your specific situation. However, you should not jump to a conclusion too soon just by observing over a few days. Rather you should try to look for a general pattern over a period of time.

Does he get enough time to play in the sun?

Your child’s body (and yours) is programmed to make its own vitamin D simply by being out in the sun. Even 10-15 minutes of play with arms and legs exposed to the sun can be enough. And best of all, the body is able to self-regulate the amount of vitamin D by storing the excess in fat cells.

The problem is that you may not get enough sunshine during the day, especially during the fall and winter months simply because of where you live. Children with darker skins are also at a disadvantage because of the pigment in their skin which absorbs the UVB rays which would otherwise be used to make vitamin D.

The good news is that the effect of sun is cumulative - that is, it adds up over time. Take advantage of every sunny day, even in the middle of winter to let your child play outside. Getting fresh air and physical exercise is good not only from the point of vitamin D, but also for overall physical and emotional health.

Does she drink at least 4 cups of milk every day?

Milk, by far, is the best source of vitamin D because all milk in the US is now fortified with vitamin D. However you need at least 4 cups to reach the recommended level of daily vitamin D (400 IU for children).

The problem could be milk allergies and just a natural dislike of milk. Also 4 cups is a lot, and even adults don’t usually get to drink that much on a daily basis. Try to mix with vitamin D fortified cereals, most of them generally are these days. You can also get vitamin D fortified orange juice, but be sure to watch out for added sugar.

One good way of increasing milk consumption is to add it to a smoothie. This way you can also get your child to eat some fruits!

Does he eat fish as part of a balanced diet?

Eating fish such as salmon is almost like buying insurance as far as vitamin D is concerned. You don’t have to eat it everyday – even once a week can work its magic. One serving of 3.5 oz (about 100g) or the size of a deck of cards can provide as much 2 times or even higher than the daily recommended level of vitamin D. Other fishes like tuna, mackerel and sardines are also good sources of vitamin D. Mercury contamination is a risk but should not be too much of a concern if you eat them occasionally as part of a varied diet.

The problem again could be allergies. Also your child may not like the taste or smell of fish. Trying new recipes and offering in small portions in combination with some of his other favorites can help you to build a taste for fish.

Does she seem overweight for her age?

Childhood obesity is on the rise and if your child is overweight or obese, you have a challenge in terms of vitamin D as well. That is because the body is not able to pull the vitamin D stored in the fat cells when needed.

Keep a close eye on her Body Mass Index by looking at the age specific growth charts. They are available on the CDC website or you can ask your pediatrician. Again, it is important to look at the trend and not a single point on these charts. If you see a trend creeping over the 85th percentile, you need to take action right away and improve the overall nutrition and eating habits of your child. Unless there is an underlying medical condition, nutrition and lifestyle changes can show good results.

Does he have special medical conditions?

In the most unfortunate situation, your child may have a medical condition such as Crohn’s disease, celiac disease or cystic fibrosis. These diseases cause poor absorption. Since vitamin D is a fat soluble vitamin, its availability is severely reduced in people suffering from these problems.

If this is the case, you are probably already talking to your pediatrician. Discuss the matter of vitamin D deficiency if you have not already done so.

After considering your specific situation, you can consult with your pediatrician about supplements. While I am not a fan of jumping on the vitamin supplements bandwagon, I think it is important to be informed about them. I plan to write about vitamin D supplements in future once I have had a chance to do some research on them.

What do you think? Are you concerned about your child’s vitamin D levels? Are you considering supplements? I would love to hear your comments.

Photo Source: Leo Reynolds on Flickr
©2009 Littlestomaks.com