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

This week, Family Physician Dr. Michelle May offers a few tips to help you raise a healthy child by providing unconditional love, encouraging physical activity and promoting healthy eating habits.

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

Answer:

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

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

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

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

Build Healthy Attitudes

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

Enjoy an Active Lifestyle

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

Develop Healthy Eating Habits

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

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

©2010 Littlestomaks.com. All Rights Reserved
Disclaimer – Information provided in Ask The Expert column on Littlestomaks.com is intended to give you general guidance on a question related to toddler nutrition. It is not meant to be treated as medical advice. You are welcome to contact this expert for a detailed consultation on your specific situation to determine what actions, if any, you should take regarding nutrition and health of your toddlers. We do not recommend you to take any action based solely on the information presented in this column. Experts have agreed to provide their professional opinion on toddler nutrition related questions on a voluntary basis and no compensation is offered to them by Littlestomaks.com.

Greetings! It is Friday again, which means it is time for the usual Five for Fridays! If you are just joining, this is where I highlight some of the recent food and nutrition related stories. This is also my soapbox where I offer my rants and not-so-scientific personal opinions! Sometimes, I also highlight the work of some of my favorite nutrition bloggers. Your comments and personal opinions, especially if you disagree with me, are most welcome and highly valued!

So, here are this Friday’s five! Enjoy and let me know what is on your mind.

Fruits and vegetables do not reduce cancer risk, but that’s no reason to give up on them

It appears that eating fruits and vegetables only slightly reduces your risk of getting cancer according to a recent study analyzed by Dr Ayala in her very insightful article “Another apple-a-day may save more lives than the Toyota recall“. Does it mean that we should ignore the advice of 5 fruits and veggies a day and bypass the produce aisle in the grocery store?

Absolutely not argues Dr Ayala and I agree completely. A diet rich in fruits and veggies has many benefits for your overall health and well-being. If there is anything you should ignore, it is studies like this and the sensational headlines that inevitably follow in the mass media.

I have a real problem with such studies and I am amazed they get funded in the first place! I doubt if they offer any value to the common public, except probably to the media machine hungry for anything that can be labeled as health related.

By the way, check out the long list of authors who wrote the original paper in the Journal of the National Cancer Institute. Granted that everyone has to make a living, but come on, this is crazy! Work on better hypotheses and solve some real problems!

To lose weight, take a cold shower

This may sound totally insane, but new research is suggesting that you can train your body to burn more calories simply by getting used to a cold environment! Turns out that exposure to cold activates brown fat inside your body, which is known to produce heat (which means burning calories) in contrast to the insulating nature of the regular fat. Believe it or not, researchers are discovering that obese mice are able to burn off half of their fat within a week simply by living in a cold environment even if they eat more than 1.5 times their usual diet.

It appears that our bodies have a built-in heat producing mechanism to offer protection against cold. Babies are born with brown fat which helps them keep warm long before they learn how to shiver. Even adults have this brown fat but it is not active. Cold environment activates the brown fat, and so does a special protein discovered by researchers at Harvard. Some are now thinking about developing a drug to encourage production of brown fat to solve our obesity problem!

Don’t get too excited though! Keep in mind, that a healthy weight is a result of achieving and maintaining the right energy balance your body needs. Energy in minus energy out equals weight gain (or loss) – it is that simple. You don’t have to torture yourself by taking a cold shower every day, or wait for a fancy anti-obesity drug!

Don’t fall for the low fat label, you may actually eat more calories

Would you believe that putting a low fat label on snacks causes people, especially those who are overweight,  to underestimate the calories and actually eat more? There is a devilish effect from this health halo, writes registered dietitian Janet Helms on her blog Nutrition Unplugged this week.

I found this research quite fascinating, although, not really surprising. This is the result of clever marketing messages on the package, which are designed to lower the resistance and enhance the urge to eat. This is no different from advertising for other products which often targets the hidden desires and aspirations of consumers. Brand associations are powerful, and once they stick, consumer choice is nearly automatic. Why is it that you always pick the same brand of toothpaste, shampoo and laundry detergent even though other options, including cheaper store brands, are available on the same shelf? It is the job of the marketer to make the product irresistible by serving consumer needs at many different levels. And some of them are very good at what they do!

The problem, I think, is not with the marketing slogans on food products. Although this notion is quite popular among today’s experts who propose imposing limits on food marketing, even to the extent of imposing a twinkie tax! The problem is in a total lack of awareness and self-empowerment on the part of the common consumer.

How can you fight the influence of such powerful marketing? Not by banning these products, but by making smart choices. Consider a mix of an offensive-defensive strategy by building your family’s personal brand. That will be your anchor which can offer some strength against the currents of powerful brand marketing. Also check out Janet’s insightful suggestions on how to enjoy real foods and practice mindful eating.

Many ways to enjoy vegetables, give it a try

More people are trying to include veggies in their diet and that is great news! Even better, there are so many ways to enjoy vegetables whether you like them raw, medium or well done according to the Fooducate blog, which offers helpful tips for making smart choices in the supermarket. There are many useful tips in this particular article, but this one resonated with me the most:

If you are thinking about incorporating more vegetables into meals, worry less about the healthiest preparation method, and figure out the tastiest and most convenient use case for you.

I think this is great advice. A large variety of vegetables are available in a typical supermarket today, whether in the fresh produce section or in the frozen foods aisle. Plus there is no shortage of recipes – you can check out our own simple recipes section for ideas! So go ahead, give it a try and share your vegetable story!

Calling all recovering picky eaters

My blogger friend Jenna of KidAppeal is on a mission! Inspired by Jamie Oliver’s Food Revolution, she wants to register 1000 recovering picky eaters in a month and help them develop a taste for a wide range of wholesome food. Interesting idea; so I am supporting her by spreading the word out. Now, you might be considered a recovering picky eater if:

• there are foods you don’t eat simply because you don’t like them even though they are good for your health; and
• you want to shrink the list of objectionable foods because you want to eat better and set a good example

If this is you, check out her blog and sign up! You got nothing to lose except a few bad habits!

Enjoy and let me know what is on your mind.

Photo Source: robbie jim on Flickr

©2010 Littlestomaks.com

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

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

Get your kids interested in cooking

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Enjoy and let me know what is on your mind.

Photo Source: noahg on Flickr via everystockphoto

©2010 Littlestomaks.com

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

Overview

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

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

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

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

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

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

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

What I did not like so much

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

Recommendation

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

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

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

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

Leave me a comment if you found this review useful.

©2010 Littlestomaks.com