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.

Peer pressure in school can make your child feel insecure about her healthy lunch from home which may not have the poplar processed foods and snacks. This week, Registered Dietitian Katie Heddleston offers a few ideas to help your child feel good about carrying a healthy lunch from home.

Katie Heddleston, MS, RD, LD B.S. in Nutrition from Case Western Reserve University, OH M.S. in Public Health and Nutrition from Case Western Reserve University, OH Expertise: Maternal/child nutrition, Gluten free recipes, Healthy lifestyle Website: Healthy Heddleston Twitter: @KatieHeddleston Contact via email – HealthyHeddleston [at] gmail [dot] com

Question: According to my 1st grader “everyone” except for her packs a lunchable or other convenience foods. I need some suggestions on how to help my kids feel good about eating their healthy lunches packed from home.

Answer:

This is a great question and one parents are faced with more and more as convenience foods and busy lifestyles are becoming the norm. To help your kids gain confidence about eating their healthy lunch packed from home, my suggestions come from answering the following questions:

• What is your child’s relationship with food like at home?
• How appealing and appetizing is the lunch packed from home?

Let’s tackle the first question: What is your child’s relationship with food like at home? Maybe your child just comes to the table when dinner is ready; maybe your child likes to sit at the counter and watch the whole cooking process. Maybe your family doesn’t cook at home often and your child is used to the convenience of a restaurant or take out. Whatever the situation, the facts are simple: Kids are less likely to reject foods if they help make them. Getting your children involved in meal planning not only helps build confidence, but can lead to your child accepting those packed lunch from home (since they helped make them!) There are other benefits from having kids in the kitchen too; your child will:

• Try and like more foods
• Gain confidence, feel important, and proud
• Learn early math and science concepts
• Learn new vocabulary
• Develop small muscle skills
• Learn responsibility with cleanup

Now for an easier question to tackle: How appealing and appetizing is the lunch packed from home? I’m not here to criticize the way anyone packs their child’s lunch, but I am here to tell you children want to eat appealing and appetizing food (they are just like us adults!) This is why the packaging or uniqueness of a lunchable seems appealing to a child. I am also here to suggest ways to make your child’s school lunch more fun, appealing, and appetizing!Try these ideas:

• Let your child choose their lunchbox.
• Pack the lunch with fun, reusable accessories.
• Make food fun.

Here is an example of how you can make it fun to try new foods as you capture your child’s imagination:

Basically, presentation is key. Try to incorporate your child in the kitchen and these suggestions to see how your child starts to feel good about those healthy packed lunches from home!

Useful Resources:

MyPyramid for Kids

Nutrition for Kid and Teens

©2010 Littlestomaks.com. All Rights Reserved

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

The childhood obesity octopus is out to ruin our children’s future! What can we do to stop it?

Share your thoughts in comments below.

Artwork by: Sierra B.
©2010 Littlestomaks.com

Childhood Obesity Awareness Month Blog Carnival

This article was written for inclusion in the blog carnival hosted by Littlestomaks to promote awareness of childhood obesity as part of the National Childhood Obesity Awareness Month. Please read to the end of this article to find a list of links to the other carnival participants.

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Talk about childhood obesity and you are sure to be inundated by all kind of alarming statistics and cries for tax on soda, banning food ads on TV and regulating school nutrition. As a parent, you hardly have any control over any of these so-called solutions. Sure you can try to limit junk foods, encourage fruits and veggies and force your kids to sit down on the dinner table each night. It is a real challenge for nearly all toddler parents and success is not guaranteed, at least in the short term. If your child is already overweight or obese, you may have even a smaller chance of success and a clinical intervention may be needed to reverse the situation.

Is there a solution that can actually nip the problem of childhood obesity in the bud?

In my research, I was surprised to learn that there is indeed such a solution. Even more surprising was the fact that we don’t hear about it at all when solutions to stopping childhood obesity are discussed.

This surprising and simple solution is: Breastfeeding!

photo credit: c r z

The benefits of breastfeeding are well known. It provides all the necessary nutrients for your child’s growth and builds his immune system for a foundation of healthy growth during the toddler years and beyond. But did you know that it also significantly lowers the chances of overweight or obesity? Consider, for example, this conclusion from a CDC report which addresses the question: Does Breastfeeding Reduce the Risk of Pediatric Overweight?

In conclusion, breastfeeding is associated with a reduced odds of pediatric overweight; it also appears to have an inverse dose-response association with overweight (longer duration, less chance of overweight). While more research is needed, exclusive breastfeeding appears to have a stronger effect than combined breast and formula feeding, and the inverse association between breastfeeding and overweight appears to remain with increasing age of the child. The three meta-analyses reported in these review articles suggest a 15% to 30% reduction in odds of overweight from breastfeeding.

This conclusion was based on three different studies which analyzed data from over 50 studies between 1970 and 2004. In case you need more convincing, consider the conclusions of this German study which appeared in the British Medical Journal in 1999:

Prolonged exclusive breast feeding reduced the risk of being obese or overweight among school age children in Bavaria who were born in the early 1990s. This effect is more likely to be related to the composition of breast milk than to lifestyle factors associated with breastfeeding. Preventing childhood obesity and its conse­quences may be an important argument in the drive to encourage breast feeding in industrialized countries.

Now there are purists in the academia who say that such conclusions are not based on randomized trials, which means that it cannot be proven with enough confidence that breastfeeding alone is a cause of reduction in chances of overweight or obesity. Rightly so, because there are confounding factors present in most of these studies. Although, the conclusion about breastfeeding and a reduced risk of overweight does not change even though it becomes a little weaker. From a practical point of view, it does not matter in my opinion and breastfeeding should still be promoted as a solution to preventing childhood obesity.

Although there is considerable debate about why breastfeeding lowers the risk of overweight or obesity, these three reasons are commonly cited:

1. Breastfed babies develop better sense of when they are hungry and when they are full
2. Formula-fed babies have a higher and more prolonged insulin response which stimulates more fat and weight gain
3. Breastfed babies have a higher concentration of leptin, a hormone which regulates their appetite

If breastfeeding, and extended breastfeeding in particular, has such a protective effect on overweight or obesity in later life, why is this message not amplified in public media? How come the revised policy statement on breastfeeding by the American Academy of Pediatrics only casually mentions the benefit of breastfeeding for reducing the risk of obesity? If childhood obesity is such a huge problem, then the benefit of breastfeeding should be prominently highlighted. Why do they recommend exclusive breastfeeding for only 6 months, when extended breastfeeding to 9 or even 12 months of age show a significant risk of childhood obesity?

The rates of breastfeeding in the US are pathetically low. National average rate for exclusive breastfeeding until 6 months is only 11% (2004 data). Married women, older than 30 years with a college degree are more likely to continue breastfeeding until 12 months of age. There is clearly a need to increase the public awareness of this issue and tailor the message for different demographics of women.

During the month of September, which has been declared as the National Childhood Obesity Awareness Month, we will surely hear a lot about junk food, soda, poor quality of school nutrition, too much TV and negligent parents. There will be a lot of focus on alarming numbers and renewed cries for more Government regulation. But where is the voice of reason addressing the need to actually prevent the crisis, rather than react to finding a miracle solution? I hope you will join me in giving support to such voices wherever they are. Promoting and supporting breastfeeding seems like a simple thing to do without having to spend too much money.

©2010 Littlestomaks.com

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Please take time to read the submissions by the other carnival participants:

7 Things Parents Say That Cause Eating and Weight Problems in Kids Michelle May, Physician and author of Eat What You Love Love What You Eat, highlights a few things parents say which can have unintended consequences (@EatWhatYouLove)

Childhood Obesity Kia Robertson of Today I Ate a Rainbow suggests that prevention of childhood obesity should start with education and educating parents about basics of healthy eating by breaking it into achievable parts (@eatingarainbow)

Childhood Obesity: A Reality Check Dr Susan Rubin, founder of BSF, suggests we change our approach to looking at childhood obesity (@DrSuRu)

Childhood Obesity: Prevention Starts in Infancy Nutrition expert Sarah Fennell reminds us that prevention is the best cure and offers a few tips to raise healthy eaters (@FoodFunHealth)

Giving Our Children a Chance at Health Registered dietitian Susan Dopart offers tips to parents for taking charge of their child’s health in the world of over-processed “kid foods” (@smnutritionist)

Healthy School Campaigns Works on Creating Healthy Food Environments A report on Chicago’s Healthy School Campaigns (HFC), a non profit dedicated to creating a healthy food environment in schools

How to Prevent and Manage Childhood Obesity Registered dietitian Jessica Levinson offers practical tips to prevent and manage childhood obesity (@JLevinsonRD)

Lessons I have Learned as a Mom Registered dietitian Alysa Bajenaru shares some of the lessons she has learned that have helped her develop a good understanding of what it takes to feed her kids (@InspiredRD)

Looking for a New Trend in Childhood Obesity? Registered dietitian Elizabeth Rahavi of the IFIC brings the focus back on family in the debate about childhood obesity (@FoodInsight)

Losing Weight: It Starts in Your Head Registered dietitian Cindy Williams reminds us of the power of attitude and mindset in losing weight and controlling obesity (@nutritionchic)

Making the Grade Registered dietitian Sally Kuzemchak evaluates her son’s school programs on healthy eating and physical activity (@RMNutrition)

Obesity and GERD: A Family Affair Jan Gambino, author of Reflux 101, writes about the link between overweight and GERD

Parents, Let’s Take a Positive Approach to Childhood Obesity Registered dietitian Ashley Rosales from the Dairy Council of California encourages parents to take a positive approach in helping their kids build healthy habits

Revolutionize the Way Your Kids Eat in Five Easy Steps Sociologist Dr Dina Rose suggests we shift our focus from nutrition to eating habits if we are serious about solving childhood obesity (@DrDrRose)

Surprising Easy Solution for Preventing Childhood Obesity Research shows benefits of extended breastfeeding in reducing risk of childhood obesity (@TwinToddlersDad)

The Problem Behind Childhood Obesity Ken Whitman, Publisher of Organic Connections, points out that our national priorities concerning childhood obesity are misplaced and calls for a renewed focus on the health of our nations kids.

Yoga Gets Kids Moving Registered dietitian Danielle Omar has an interesting suggestion for solving childhood obesity – get your kids into yoga! (@2eatwellRD)

Greetings! I thought of doing something different for this week’s Five for Fridays. Here are 5 videos which caught my eye as I looked for food and nutrition related news. Let me know what you think!

Bode Miller the “ski champ” farmer

Did you know that Bode Miller grew up a vegetarian? I didn’t, until found this video on Phd in Parenting blog! I was so fascinated by it that I decided to dig up the original source. I finally tracked it down on Stonyfield yogurt’s website under their “Yotube” video channel. It makes a perfect pitch for Stonyfield – after all, Bode Miller is no ordinary champion. One unintended message out of this video may be that organic is for crazies only! I think the positioning needs to be a little more mainstream. In any case, this video has a great message aimed to inspire the younger generation.

Watch out! Jamie Oliver is bringing his food revolution to America

It’s official folks! We are a country of fat people. If you have doubts, just check out the statistics on Huntington West Virgina – half the adults are considered obese and rates of diabetes and heart disease lead the nation! Jamie has supposedly the secret formula that can change the mindset: we don’t wanna sit around and eat lettuce all day! It is hilarious and I think it is sure to get good viewership when the show airs on ABC in March. I think it will make great TV, and although I hope it makes a real difference, I am not holding my breath for it! Good luck Jamie anyway.

Tom Vilsack on child nutrition act

Secretary Tom Vilsack answers 5 questions about his plans to expand the child nutrition program. I am all for it; I continue to believe that hunger and obesity are two sides of the same coin. Improving access to nutritious food, including fruits and vegetables, and not just focusing on low salt, sugar and fat is a good idea. Childhood obesity is a serious problem we must address now.

Michelle Obama takes on childhood obesity

If you haven’t yet seen this video by the first lady, you have got to check it out. Even though I think her Let’s Move campaign is destined to disappoint, I do admire her initiative to improve the health of our nation. She has a great personality and her message is clear and in many ways quite inspiring.

Help! My baby is fat – are you serious?

Chubby babies are cute, but is there a thing called a “fat” baby? Well, according to some researchers, people who turn obese when they grow up, begin to show a sign as early as 3 months of age! I find that unbelievable and I think this is going to send a risky signals to new parents. Babies need healthy fat, which if they are exclusively breastfed, is very easy to accomplish. Don’t be afraid of fat; the key is to work towards developing healthy eating habits during toddler years. This is yet another example of how catchy headlines can create a sense of unnecessary anxiety. The video does have some good tips from Dr. Sanjay Gupta, so check it out!

Happy Valentine’s Day! The big news this week was the Let’s Move campaign launched by the First Lady Mrs. Obama to fight the problem of childhood obesity in America. I think it is a worthwhile and timely initiative and I am glad that someone of her status is taking it on to give it the visibility it needs. While the cause is noble, the intentions are genuine and the star power is undeniable, I believe that the approach taken by her campaign is fundamentally flawed. I have serious doubts that it would create a change at the scale needed to make any real impact in the long term health of our nation.

I don’t normally consider myself a glass-half-empty-kinda guy. Yet, today I find myself compelled to give you 5 reasons why this initiative is destined to disappoint. I do sincerely hope I am wrong!

It will not change the demand for cheap fast food in any significant way

I admire Mrs. Obama’s candor in her acknowledgment that she found it hard to balance her family’s need for a healthful diet and demands of hers and Mr. Obama’s careers. Just too busy, not enough time…being unable to cook a good meal for my kids…going to fast food…ordering pizza. She certainly reflects the feelings of many Americans; however the ideas proposed under her first pillar, Healthy Choices, are simply too stale. Here is why:

• Empower customers by front-of-box labeling – interesting idea; already much talked about and being practiced, although not in a standardized way. I believe food marketers will eventually find a way around whatever regulations are introduced and customers will tune out the front-of-the-box information just the way they have tuned out the detailed and really informative nutrition facts label at the back.
• Prescription for healthier living – doctors and nurses will be encouraged to track body mass index and offer counseling for healthy eating early on. Nice thought – every time I go to the dentist, they tell me to floss daily. I don’t, even though I want to. I don’t even feel guilty about it anymore. I realize, they are just doing their job.
• Next generation food pyramid – Guess what, the USDA wants to revamp the food pyramid and online interactive tools! Great news for the academics. A busy parent is probably already overwhelmed; besides if they don’t find time to cook a good meal, do you really believe they will tinker around with online tools?
• Empowering change – very novel idea of a food atlas to show you food deserts around the country. If you live in one, watch out your property value may decline! Just kidding. Again, I think this is a gadget for the academic in us!
• Let’s move start up tools – so you need to stop watching TV and get out there and get some exercise! We all know that and no new tools are needed to convince us or help us out. There are plenty of them out there already.

The fundamentals remain unchanged – we live busy lives; we are always on-the-go; cheap fast food is readily available; it makes us feel good and solves a real problem. None of these ideas will change consumer habits in a fundamental way. At best, they will make people feel guilty, temporarily at least, but don’t expect them to change their habits.

It will not change how we farm and what we grow

What we grow is corn and beans – lots of them.  We practice industrial agriculture which is dependent on fertilizers, pesticides, genetic modifications and consumes an unbelievable amount of natural resources. If you have doubts, pick up a book by Michael Pollan. We process meat in feedlots virtually shut-off to the outside world and raise cattle on a diet of corn. Chickens are no better and quality of seafood is getting worse; what with mercury contamination and salmon being raised on corn! We are constantly battling risks with food safety because of loopholes in inspections.

The wheel of supply and demand turns day and night, getting faster with each turn as the population grows and our appetite explodes. If demand does not change in a fundamental way, how can we expect supply to change? The so called organic movement and sustainable farming are like toddlers in the face of industrial farming.

Granted that one should not expect the First Lady to address such political hot buttons. But one should also not get too enamored by the marketing of this campaign to forget that our problems really arise out of the farm driven by consumer demand.

It offers no incentives for the food industry to innovate

I was excited to read:

Let’s Move is building communities by bringing together families, schools, private industry and government to make healthy living easier

I kept looking for what is expected of the private industry and the only example I found was how the beverage industry is answering the FDA’s call to post calorie information on the bottle! This is no innovation, only a marketing gimmick to appear responsible. There are no real drivers for the industry to innovate to produce healthful products. And believe me, the so called soda tax or twinkie tax is unlikely to effect this desired behavior.

Now you could argue about the definition of a healthful product. Surely, reducing sodium, trans fat and sugar is a step in the right direction. But the fact remains that these products do nothing to reduce the share of processed food in a typical American diet. In fact, this notion is contrary to the business model – after all, the food industry stays in business by selling more of their products, not less. I would love to see food companies create products (and services) that actually increase the share of home-cooked food in an average family. That would be real innovation.

It creates another food bureaucracy

A new Healthy Food Financing Initiative through a partnership between the departments of Treasury, Agriculture and Health & Human Services will invest $400 million each year to provide innovative financing to bring grocery stores to underserved areas. The idea is to increase access to healthy food, fruits and vegetables and to get rid of food deserts across the country. To me it smells like a new bureaucracy, unsustainable in the long run and at the risk of another budget cut. It addresses the issue of supply assuming that the demand will naturally be there. Really? Why not utilize the network of food banks and offer incentives to buy healthful products on food stamps? Do we really need a new system?

It will encourage schools to game the system

School administrators now have a new goal to accomplish – try to fit the mold of a healthier school with the Healthier Schools Challenge. The scorecard is simple – reduce salt, fat and sugar and increase whole grains. This is nutritionism at its best. It is probably not difficult to meet the standards – whatever they might be – over the 5-10 year-long time frame of the program. Does it mean that kids will start eating healthy? Maybe, but not a guarantee. With no real carrots and no sticks, my guess is that schools will simply game the system to generate a hype of healthfulness. And maybe they will figure out a way to correlate small drops in average body mass index with their efforts in the cafeteria! That will make it look really convincing – yeah, right!

I know, you are probably thinking that it is easy to be critical without offering an alternative. I agree – that is why I plan to write about a few out-of-the box ideas in future and invite a discussion on them. Stay tuned!

Enjoy and let me know what is on your mind.

Photo Source: baronsquirrel via flickr
©2010 Littlestomaks.com

Greetings! Hope you all are enjoying the beautiful days of Fall. I simply love this time of the year. We are getting ready for Trick-or-treat and pumpkin painting, and the twins are excited! They are already dreaming of collecting candy – it is going to be an uphill battle trying to keep them from eating too much. I won’t spoil the fun by telling you their costumes this year yet, but will surely post a photo after Halloween.

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

A new index to help you select affordable nutritious foods

A new food rating system called the Affordable Nutrition Index (ANI) was introduced this week at the American Dietetic Association’s Food and Nutrition Expo in Denver. The idea is to provide a score that takes into account the cost of a certain food item in addition to its nutrition value. A food item with a high score means that it is high in 9 nutrients (protein, fiber, vitamin A, C, E, calcium, iron, potassium and magnesium), low in 3 nutrients (saturated fat, added sugar and sodium) and costs less on a per serving basis. Sweet potato, broccoli, green pepper, orange and banana scored high on the index (over 100) while packaged convenience foods scored lower than 100.

This index has been developed by Dr Adam Drewnowski, Director of the Center for Public Health Nutrition at University of Washington in Seattle. He used the Nutrient Rich Food Index (NFR9.3) which he previously developed and a price per serving information from food prices database, Seattle area supermarkets and industry sources. This research was sponsored by the Campbell Soup Company. Not surprisingly perhaps, many of the condensed soups from Campbell ended up with a high score around 100 compared to many fresh or cooked vegetables and even fresh fruits.

I am intrigued by this idea since we all want to select foods that have high nutritional value at an affordable cost. However, I don’t think that this is the only way to make that choice. I was disappointed to see that vitamin D was not included in the 9 nutrients to promote in the NFR9.3. Plus cost per serving is probably not the right measure of what a customer pays when buying a product. Also, you can manage cost by buying seasonal fruits and vegetables from local sources. Still, I think it is a good idea and I plan to write more about it in future.

Coke’s response to the debate on obesity is lame

Coca-Cola, the icon of sugary drinks is under attack! CEO Muhtar Kent wrote an Op-Ed piece in the Wall Street Journal on October 7th defending his company against proposals of soda tax. Coke Didn’t Make America Fat is what he believes; and quite arrogantly he points the finger to his own customers saying they lead a sedentary lifestyle! Well, Coke did make America fat according to my blogger colleague Dr. Ayala who wrote an excellent piece this week in response to Mr. Kent’s lame arguments.

So far, Coke’s response to the current debate on the role of sugary drinks in our obesity problem is rather lame in my opinion. They have announced that they will add calorie information on the front of Coke cans. They have given a large amount of money to the American Academy of Family Physicians (AAFP) to develop consumer education content as part of their Consumer Alliance Program. They are also a part of the Healthy Weight Commitment Foundation (HWCF), a group of 40 organizations seemingly engaged in a collaborative effort to address obesity. And now in their latest move, Coke has announced that they will introduce a 90-calorie mini soda can so that people can limit their intake of sugary cola.

While I am no fan of the twinkie tax, I do not believe that these actions by one of America’s top brands are of the high caliber needed to solve one of America’s most challenging health problems. Coke needs to do more than just pay lip service and make lame arguments defending their products in public. They need to take a more grass-roots approach – building playgrounds in schools, sponsoring healthy lifestyle events, developing after-school programs, integrating nutrition and physical education, sponsor healthy nutritious school lunches just to name a few examples. They need to measure the effectiveness of these programs in reducing obesity and make the data public.

Coke’ 3Q financial results show that they generated $6.3 billion in cash from operations year-to-date in 2009. They spent $241 million buying back their own shares. A little more of that cash spent on real programs to solve our obesity problem will not make a dent in their profits! What do you have to say about that Mr Kent?

FDA puts the hammer down on front-of-box labeling

The Smart Choice program it seems was the last straw according to Marion Nestle who writes a blog called Food Politics! In a letter to the food industry, the FDA is openly questioning the arbitrary nutrition standards used by companies to develop these labels which end up showing their own products as healthy. FDA wants to develop a set of independent criteria which these labels will need to meet before companies can use them on their products. FDA also wants to understand how these front of the box labels affect consumer choice.

I say, it’s about time. The Nutritional Facts panel, usually at the back or the side of the box, is too complicated for most consumers to read and understand. Consumers are looking for something simple that allows them to quickly make a decision.

We are lagging behind other countries in this area. A traffic light based food labeling system developed by the industry based on government guidelines in UK seems to be working very well. Why can’t we do the same here?

Here is a good background information on different types of front of box labeling systems. What is your opinion? Have you come across a labeling system you really like?

Toddler diets a cause for concern according to the 2008 FITS data

Latest data from the 2008 Nestle Feeding Infants and Toddlers Study (FITS) confirms the sorry state of a typical toddler diet in America. Most toddlers and preschoolers are not eating fruits and vegetables. They are consuming too much saturated fat and sodium. French fries are the most popular vegetable!

Good news is that the diets of infants and older babies are much better compared to the 2002 data. Mothers are breastfeeding their children longer and consumption of sugary drinks is decreasing. There is a risk of iron deficiency in some children.

Looks like parents and caregivers are following the feeding guidelines for infants. So why do things go south during the toddler years? Is it because of picky behavior? Or is it because toddlers eat what their parents eat? Or a combination of the two?

Not much progress has been made in the diet of toddlers since 2002. We need to make a deliberate effort to improve this situation.  Having dinner together, being a role model and encouraging fruits and vegetables is critical to solving the problem of childhood obesity. And in case you are struggling, here are some tips for picky eating.

Let us bring the school nutrition standards to the 21^st century

Can you believe that it was 1995 when the standards for the National School Lunch Program (NSLP) and School Breakfast Program (SBP) were last revised? Yet the NSLP served lunch to over 30 million children and SBP served breakfast to over 10 million children in 2008! If we are serious about fighting the battle of childhood obesity, we need to revise these standards and bring them to the 21st century!

Well, the good news is that the Institute of Medicine (IOM) has now issued its recommendations in a report titled School Meals: Building Blocks for Healthy Children, which the US Department is going to consider as they revise these standards. Recommended meal requirements encourage more fruits & vegetables, whole grains, min and max levels of calories and limit saturated fats  and sodium.

This is good news! I hope they will begin to implement these recommendations by the time our twins start going to school. I think progress may be slow due to cost and bureaucracy, but at least it’s a good start.

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

Photo source -cambodia4kidsorg on Flickr via everystockphoto

©2009 Littlestomaks.com

Greetings! Fall is in the air and I really love this time of the year. There is a cool, crisp freshness in the air, especially in the morning and just before the sunset. We are having a lot of fun with the twins playing outdoors in the yard or going around the block with them on their tricycles. Hopefully you all are having fun too. And yes, the Holidays are not that far off either!

It’s Friday, which means it’s time for another Five for Fridays! Here are 5 interesting nutrition stories of the week that caught my eye. Enjoy and drop a comment to let me know what’s on your mind.

Maximize your child’s nutrition at every stage

Registered Dietitian Maryann Jacobsen has written a very nice and comprehensive guide to help you maximize your child’s nutrition at every stage, from birth to school years. What I liked about her post is that she describes very clearly the recommended levels of different nutrients and offers great feeding tips at every age. For preschoolers, it is important to build healthy eating habits early on by striking a balance between their desire for sugary, fatty and high energy snacks and balanced homemade meals. Eating as a family is highly recommended, although it is no easy feat to accomplish!

For school-age children, watch out for deficiencies in vitamin E, D, calcium, magnesium, potassium and fiber. Get them to eat with you as a family and encourage them to eat more fruits and vegetables.

Most of all, don’t give up, keep trying and fight the battle by being a role model.

Too much marketing hype behind probiotics

There is a lot of buzz around probiotics these days! People have been eating yogurt for a long time, but it is only recently that food marketers have realized they can make it sexier by using the immunity claim on the package. This kind of advertising is hard to resist, especially when it comes to products for kids. Even we fell for the DanActive Immunity Probiotic Drink, which claimed to have a new more absorbable yogurt culture but it contained a lot of sugar and it was super expensive. All kinds of claims are being made to pull customers. I was surprised to lean that Dannon recently settled a class-action lawsuit Activia yogurts and DanActive yogurt drinks.

When it comes to probiotics, not every strain of the bacteria is equally effective. Consumers should be informed about the specific probiotic strain in the product and its scientifically proven benefits. The L. Casei Immunitas^TM strain in DanActive drinks has been shown to reduce illness in children attending daycare. But there is very little evidence of general immunity or resistance to disease from these probiotics. In my opinion, these new products are not worth the extra money and you should watch out for added sugar. In the meantime, plain yogurt with home-made fruit puree is a very decent affordable option!

Schools start cooking fresh food for a healthier lunch

Yes there are a lot of regulations for school kitchens, there is little or no equipment and there aren’t any skilled cooks on the staff. Plus it is simply easier to serve straight out of a package after a quick reheat. No wonder over 80% of the school districts in the country cook less than half of their entrees from scratch according to a 2009 survey by the School Nutrition Association. School lunches have neither appealing nor appetizing for kids!

I was happy to read about one middle school in New York which is trying to do things differently to encourage kids to eat better at lunch. Mostly due to the efforts of its principal and the cafeteria manager, a few new ideas are being implemented. A curry chicken recipe is one such idea especially popular among the students. The bread is whole wheat, pasta is whole grain and milk is low fat. There are salad bars and deli bars. More importantly, these leaders believe that “the children need a little flair in the food, it is good for their brains”. Amen to that!

Omega-3 cheese may soon become available

A new study shows the promise of formulating cheese with fish-derived omega-3 without the fishy smell. Scientists have developed a technique to add omega-3 as an emulsion to the cheese to make it stable and mask the fishy smell. It is still at the research stage but I am sure there will soon be a commercial product given the huge consumer interest in omega-3 fatty acids. I think it is a good innovation even though only a small amount of omega-3 can be added to cheese by this technique.

Omega-3 fatty acids are called essential fatty acids because the human body cannot make them. They are good for growing children because they help in visual and brain function development. Diet and supplements are the only source of these nutrients. Cheese is popular among children, therefore omega-3 fortification of cheese makes sense. When it becomes available, watch out for saturated fats and trans fats before tossing it in your shopping cart!

A fun way to learn about nutrition

Cathy of A Life Less Sweet provided a link to Nourish Interactive, a website which is trying to educate parents and kids about nutrition by using online games. It looks very interesting, and best of all, membership is free. Parents and kids can learn together by trying out these games, puzzles and challenges. You will need to create an account for your child to play free. There are many useful interactive tools such as a healthy meal planner which helps you calculate the daily calories for different foods based on your child’s age. I plan to check it out in detail. If you do try it, let me know what you think.

Enjoy your weekend!

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

It has been a while since I highlighted some of the great comments I have received from all of you. Since this week we are on vacation, I thought of posting a few insightful reader comments instead of my usual Five for Fridays.

I am constantly inspired by your comments and I learn a lot from them. I want to say thanks to those who spend time reading my posts – some on a very regular basis – and leave a comment behind with some advice, helpful tips or a question for further research. Some of them have their own blogs, which I highly recommend you to visit whenever you get a chance.

Enjoy, and feel free to leave a comment of your own.

1. jessyz reaffirmed her belief in breastfeeding in response to Annie’s guest post Attachment Parenting and Toddler Nutrition:

I loved this post, I am planning to breastfeed until my daughter is 2 years and then decide if she is ready for weaning. My sister in law nags me all the time that my daughter is not eating enough but I’ve been watching my daughter and she’s almost one now and is growing steadily and happily. I offer lots of food choices but she’s still more dependent on breast milk. My mother is a nutritionist and always points out that if you don’t worry too much about the quantity of food but about the quality of food offered to toddlers you could be helping them combat life long diseases like diabetes and obesity.

2. In response to Study Suggests Kids Who Get Vitamins Don’tNeed Them, Kayris had this to say:

My kids get a chewable vitamin when I remember to give it to them. A whole one for the 4 1/2 year old and a half tablet for the 2 year old. Our previous pediatrician was very adamant about vitamin use and insisted that if I didn’t give my infant Vitamin D drops, he would get rickets. Strangely, my doctor routinely tests *my* Vitamin D level, and she says I am one of few patients with a normal result. I assume it’s because we eat so many eggs and get morning sun.

We changed pede’s, for a sort of complicated reason, and the new doctor doesn’t seem to care either way. He asked me if I give a vitamin, and when I said, “When I remember,” he just shrugged and went on.

Both my kids eat pretty well and healthfully, but my older child is a little pickier and there are foods neither one eats well. Vitamin C foods, for example, because while both devour their veggies, they don’t really eat a lot of fruit. So I figure a vitamin a couple times per week is extra insurance against anything that might be missing in their diets.

3. Samantha made a very insightful suggestion for Moms struggling to continue breastfeeding upon returning to work when I commented on a survey in Five for Fridays:

I have to comment on the pumping and returning to work. I nursed my daughter for 10 months, which also included pumping at work. (She self weaned, early probably due to her heavy use of the bottle from expressed milk. She got impatient when it came to eating straight from the breast.) I work for fairly large non-profit organization, and while it has been difficult to manage, I have found support. They do not have a set private space for me to pump, but between the executive director and the billing specialist, both have allowed me to use their offices when available. The executive director is even a single man. I think if you can relay how important continuing breastfeeding is, sometimes you can make an impact in the perception of pumping.

I now have my second child and am only working part time with him, and even still my place of employment allows me to clock out and pump as often as necessary, and even lets me schedule appointments around my pumping sessions. I think their flexibility has taken the stress out of pumping, and because I am able to relax about it, the process goes much more quickly and takes less time away from being productive.

I would encourage anyone struggling with pumping to schedule a time to sit down with their supervisor and explain the importance of breastfeeding, and what their needs are in terms of a private space. You’d be suprised how willing people are to work with you. I think sometimes we are just afraid to talk about it, which leads to embaressment, stress, drop in milk production, and early weaning. Thanks for giving us a place to share!

4. Vitamin D deficiency is a popular topic these days. When I commented on this in a Five for Fridays, Dr. Ayala of Herbal Water provided an interesting perspective:

You’re brave to tackle the vitamin D issue. I am both intrigued and confused by the proliferation of studies finding low vitamin D in practically every disease process, from cancer to heart disease to obesity.

The questions are:

• Is the low vitamin D a part of the cause of the disease, or a manifestation of an unhealthy state, i.e. just a marker of disease. It would be similar to blaming a fever for the inflammation of the ear or lungs during an infectious disease. Vitamin D metabolism is complicated, therefore low vitamin D can be a result of both unhealthy lifestyle (engaging in less physical activity, which could be related to less sun exposure and eating an unhealthy diet), but also a sign that some of the many body systems (skin, kidney, liver) that participate in vitamin D production aren’t functioning well.
• Can supplementation with vitamin D improve those conditions associated with low vitamin D? This question needs to be addressed in a large randomized clinical trial of vitamin D supplementation. Other vitamins were thought to be protective against disease and trails proved that not to be the case.

At this point, all we know is that low vitamin D has been correlated with many states of disease. We don’t know it’s a cause. We don’t know if supplementation will lead to a better outcome.

That’s for sure Vitamin D is a hot topic!

5. Susan Gardner shared her dilemma about her daughter’s food choices in response to my post Lunch in School Cafeteria:

This is very interesting to read. My daughter entered kindergarten this year and we allow her to buy her lunch one day a week. She always picks Friday – pizza day! I do know that the school offers vegetables and fruit, but I do not think she eats them and instead opts to buy a cookie or chips (she rarely gets these things in the meals we serve). It is interesting to see what goes on as kids get older and have the opportunity to make their own food choices. I hope that the cashier at my daughter’s school is as helpful as the one you observed.

Photo source: tirong on Flickr via everystockphoto
©2009 Littlestomaks.com

Hello everyone! Seems like I still can’t let go of summer – this picture was so cute, I had to post it this week to remind us of summer fun on the beach. We did manage to get out a few times to the nearby beach, although my daughter refuses to step on the sand! She finds it too yucky – go figure!! Luckily both of our twins love the pool, so that is where we spent most of our summer this year.

It’s Friday, which means it’s time for another Five for Fridays! Here are 5 interesting nutrition stories of the week that caught my eye. Enjoy and drop a comment to let me know what’s on your mind.

Finally some guidance on daily sugar intake for Americans

I almost fell out of my chair when I read that Americans consume a whopping 22 teaspoons of sugar every day. That is about 355 calories, nearly 20% of the 2000 recommended daily caloric intake. I am sure you have noticed that on a typical nutritional facts label, there is no daily percentage for sugar content. This is because a daily limit has not been established, although there is good consensus on limiting the daily intake to less than 25% of total calories. As a result, it is very difficult for consumers to keep track of their daily sugar consumption. A while ago, I wrote about how to take the guesswork out of daily sugar to help set some boundaries and regulate the sugar intake.

Now, for the first time, the American Heart Association has come out with fairly clear guidelines on daily sugar which suggest that most women should limit it to less than 6 teaspoons and most men should limit it to 9 teaspoons. Note that these are still not official USDA recommendations, which I hope will follow soon. I think the breakfast cereal makers will respond first since their products tend to make heart-healthy claims although they contain a lot of sugar per serving. But I hope to see it change other food products as well. It is possible that this will drive the use of zero-calorie sweeteners in food products.

Ideas for packing a healthy lunch your kids will actually eat

My Twitter friend @RelevantMom alerted me to this article by the Associated Press which highlighted a few interesting school lunch box ideas from TV food stars Rachel Ray and Melissa d’Arabian. It is hard to resist the ready-to-go lunchables but they can end up costing a lot without providing good nutrition. Simple ideas like peanut butter, hummus, canned tuna, beans and lentils are good source of protein. You can mix them with breads, pitas and rice to create a quick and easy nutritious item. Add fruits and veggies selected by your child on the last grocery shopping trip to make sure he will actually have an interest in eating them. Get creative on snack ideas and skip the packaged snacks to save money. Their last tip is the best – add a loving note to the lunch box; it costs nothing but it can make your child feel special and loved when out of home in school where they might still not be very comfortable.

Share your tips for the school lunch box this back-to-school season. Here is what @themenumom suggested when I asked this question to my Twitter followers:

What has worked for you so far?

How normal is your eating?

Ever wonder if you practice normal eating? I can see you rolling your eyes and thinking “please, not another diet buzzword to make me feel guilty about my eating behavior”!

I was intrigued by a short note in the Well column of the New York Times by Tara Parker-Pope this week which asked this question. I am sure if you ask different people, they will come up with their own answer, and be quite sure that their eating preferences are perfectly normal. Turns out that the term normal eating was coined by famous dietitian Ellyn Satter. She explained that normal eating is when you “listen” to your body, eat when hungry and stop when full. Sounds simple and common sense. Except that we now seem to listen more to our tongue than to our stomach when it comes to eating. There are some who believe that the food industry has figured out how to rule the tongue by loads of salt, sugar, fat and other taste enhancing chemicals in processed foods. Self-control is lacking, especially when most family meals are consumed in front of the TV. We no longer have a sense of portion control. We try hard when we are motivated to go on a diet, only to give it all up and return to our old ways when things don’t work out the way expect. From this point of view, today’s normal eating is hardly normal the way nature intended it to be. I think it is about time we paid attention to it, especially when it comes to raising healthy children.

Functional food is nothing but dressed up junk food

That seems to be the opinion of many nutrition experts such as New York University’s Marion Nestle as cited by one of my favorite bloggers Dr. Ayala on her recent post “Are functional foods healthy foods?” I liked her article very much because she reminds us that with a little bit of right information, planning and effort you can prepare your own nutritious foods without having to waste money on these so called functional foods. It is easy to slap catchy slogans like low cholesterol, zero trans fats and fortified with brain-boosting omega-3′s without really changing the basic nature of the food inside the box. Sad truth is that such marketing works since such fortified functional foods deliver over $27 billion in sales each growing at up to 20% each year.

I am not personally against all processed foods. To our busy lives, they offer the convenience of immediate consumption although there is a cost to it. I do want to credit the food industry for many innovations that have made the modern life possible. I am not suggesting we turn the clock back by making all of our food from scratch. What I don’t like is that the industry at its heart is no longer concerned about the health of its consumers, rather the profit motive has become the main driver of innovation. Surely there are exceptions, which I hope will become the norm in future.

One Hungry Monkey and a dad committed to raising a healthy eater

I was finally able to finish reading a delightful book by Matthew Amster-Burton called Hungry Monkey! If you did not get a chance yet, check out my review of Hungry Monkey published this week. And let me know what you think.

Enjoy your weekend!

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

Last Friday, I had an opportunity to visit a local Elementary School as a Junior Achievement volunteer. My assignment was to spend half a day teaching 3rd graders about what it takes to build a city and run different types of businesses. It is a great program, and if you have any interest in helping kids in school, I highly recommend it. I had a lot of fun, although dealing with about 16 energetic 3rd graders for 5 hours left me pretty exhausted when I finished!

Anyway, this post is not about teaching or volunteering. I want to share with you my observations about what the kids were eating for snacks and lunch in the school cafeteria. It wasn’t fancy by any means; yet I was pleasantly surprised to see a good combination of reasonably healthy options of cooked entrees, fruits and veggies. I did not see a lot of junk food and sugary beverages.

I am writing this by memory; here is what was on the menu for lunch:

Entrees – choice of cheese pizza, tuna casserole or turkey

2 sides – choice of peas, salad, apple, chocolate chip cookie

Drinks – milk, chocolate milk, bottled water, tea, a few different soda (not too many)

Other (behind the counter) – potato chips, other snacks

Most kids picked milk, pizza, salad and apple. A few grabbed the chocolate chip cookie. Peas were not very popular!

A few of them brought their own lunch; Kraft’s Lunchables seemed to be popular.

What impressed me the most was that the cashier encouraged the kids to pick at least one veggie or fruit if she did not see any on their plate. That was really cool and I congratulated her as I paid just $4 for my meal.

When I asked some of the kids about fruits and veggies, I was impressed to learn that they liked broccoli, carrots, potatoes, apples and oranges.

During the morning session before lunch, kids were given a 10-15 minutes break mid-morning for a quick snack. Most of them brought something from home. I was disappointed to see several junk and sugary snacks. The teacher had a jar of pretzels for those who forgot to bring a snack. What impressed me though is that the teacher had them practice deep breathing, stretching out and a few simple yoga exercises before letting them return to their desks.

As we returned from the lunch, I took another look at the kids walking ahead of me in a single line. They didn’t seem to be overweight or obese. Food choices at the school cafeteria do make a difference. Of course, this is just a single observation and by no means a scientific conclusion.

What are your kids eating at school?

Photo Credit: absolutwade at Flickr
©2009 Littlestomaks.com

TGIF! Here is another installment of 5 interesting nutrition related articles I read this week. I invite your opinions and feedback.

1 in 3 new working Moms gives up breastfeeding within 7 weeks after returning to work

I was personally troubled by the results of this recent survey which brings to light the challenges faced by new working Moms in trying to breastfeed their babies. The situation is worse in the service and retail sector and among younger Moms where the dropout rate is more than half. Lack of private pumping environment and difficulty in scheduling a time for pumping were cited as the two top factors. I can’t believe that it is a matter of resources for most companies. After all, how difficult could it be to find a room and provide some privacy. It is really a matter of attitude and organizational priority about providing a supportive workplace. I would love to hear your comments if you have faced this problem at work or if your company has done something creative to solve this problem.

Regional differences in prices affecting affordability of healthy foods in Canada

Hard to believe, but true; in some parts of Canada, apples may cost 5 times more, and lean ground beef 3 times  more than some other parts. In this post about a recent poll, I was amazed to learn that 47% of Canadians go without fresh fruit, vegetables, dairy products, whole grain products, lean meat or fish because they are too expensive and 68% of Canadians identified price as extremely or very important when choosing what goes into their grocery cart. I think the situation is similar in the United States, although I am not sure if the difference in prices is so large. I find it difficult to believe that there is such a large gap in supply and demand of common foods in different parts of the same country. The author of the post (follow her on Twitter @phdinparenting) wonders if government should regulate the price of basic nutritious food. What do you think?

Yes there is choice, but should you really encourage your child to choose the “competitive foods” at school?

If you have a child in middle or high school, chances are he is getting nearly 200 calories from junk food (low nutrient energy dense if you want to get technical!) at the school vending machine. In another thought provoking post, Dr Ayala discusses the results of a recent study, which makes you wonder how we can accept to have our kids be put into this lose-lose situation! The subsidized school lunch is of low nutrition quality in the first place, and then the so called “competitive foods” do not offer anything better either. Seems like the only choice for the nutrition-minded parents is to pack their child’s lunch each day! I wonder if at least some of the kids would choose healthy alternatives if they were made available to them through vending machines.

Dannon will stop using milk from hormone treated cows

First it was General Mills, and now Dannon has annonced that their products will no longer be made from milk from rBST-treated cows according to this report. rBST (recombinant bovine somatotropin) hormone was approved by the FDA in 1993 for use in cows to sustain milk production at high levels. However, there has been rising opposition to its use by various consumer groups. As a result, the use of this hormone has been very controversial even though it is considered safe since it does not pass through the milk to humans. Still, concerns about the health of cows and extensive use of antibiotics seem to be valid. I wonder if this means they will increase the price of their popular yogurts. There is already a higher price organic option available to consumers, so that would not be really fair.

March is national nutrition month

The theme of this year’s National Nutrition Month® is “Eat Right“. This campaign is organized by the American Dietetic Association to improve the awareness of nutrition and healthy lifestyle. As if not to be left behind (joking! :)), the Dietitians of Canada have their own campaign and their theme is Stay Active. Eat Like a Champion. I am very impressed by both of these initiatives and hope that their message will bring a new focus and attention to the value of good nutrition. If you are a registered dietitian, I would love to hear your plans for this month. If you have a tip or advice for the readers of this blog, please leave a comment. I wish you good luck for your programs this month.

Have a great weekend everybody!

Image source: LaRuth on Flickr
©2009 Littlestomaks.com