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! Hope you all are having a great week so far. Here is another set of 5 nutrition related news and articles from this week that I found interesting. Feel free to share your opinions in the comments section.

Getting out of the salt-fat-sugar trap

No doubt we have become a nation of fast food lovers. Certainly it is a marvel of modern technology which delivers a full meal in 10 minutes or less, costs you 10 dollars or less, and which you can enjoy driving in your car at 60 miles an hour. But the real magical formula behind its success is what Dr. David Kessler calls the trap of sugar-fat-salt  in his recent book “The end of overeating“. In an excellent review of this book, Dr. Ayala explains how we can end overeating and eat healthier by first recognizing what fast food truly is – highly addictive and of poor nutritional value. Develop a taste for simple, wholesome foods made from fresh, quality ingredients and you will actually feel more satisfied and healthier. Encourage your kids to develop this taste, and you can be sure they will make the right choices even when presented with these outwardly appealing foods. I don’t necessarily agree when Kessler draws a parallel between addiction to nicotine and fast food. But I do agree that when consumers begin to change the definition of what is acceptable as food, the food industry will innovate to satisfy that demand.

Recession is shrinking wallets but expanding waistlines

Compared to last year, we now have 5.5 million more people in America who are considered obese based on their BMI (body mass index). Blame it on the recession? That is what some researchers have concluded based on recent Gallup-Healthways data which has prompted the question “Is the recession making Americans fatter“? The theory goes like this – recession causes stress and price of healthy foods has gone up, so people are satisfying their appetites and improving their moods by reaching out for comfort foods, which tend to be high in fat, sugar and calories. There  a trend here as I commented in a recent Five for Fridays that this recession has a sweet tooth and candy sales are on the rise. Whatever the reason might be, the high rates of obesity can no longer be ignored. Four out of the top10 chornic diseases (diabetes, heart disease, stroke and cancer) have clear links to poor nutrition and obesity. Blame recession all you want, but at the end of the day, we need to act and not just point fingers!

Going gluten-free? Be sure to get complete nutrition

Gluten-free diets are quite popular these days. New recipes and products claiming to be gluten-free are being launched almost on a daily basis. Sales of such products have more than tripled since 2004. Whether it is a new diet fad or because more and more people are being diagnosed with the celiac disease or gluten intolerance, no one can tell for sure. If you happen to be following a gluten-free diet, and reaching out for some of these new products, be aware that they may be lacking in dietary fiber and several B vitamins. In a very informative article Getting out the gluten, experts recommend eating foods made from the “super six” nutritionally balanced ingredients namely amaranth, buckwheat, millet, quinoa, sorghum and teff. These are rich in fiber, proteins and vitamins and do not contain gluten. I am not familiar with most of them except quinoa, which has become a regular substitute for basmati rice in our diet. Chicken with quinoa is one of our favorite recipes if you need ideas! Share your favorite gluten-free food or recipe if you are on a gluten-free diet.

No grapes, no nuts and now no place in the market for this jaw crusher

Amused as I was to read about the decline in market share of Grape Nuts, the news that this venerable cereal is facing crunchtime didn’t really break my heart! I have never been a fan of this brand, even though it has existed in the market for over 100 years. What I found intriguing about this story was not the changing fortunes of this product, but how processed foods are marketed to consumers. Grape nuts is people eating advertising is how one brand manager puts it as if to indicate a certain sense of pride in having fulfilled the requirements of the job description. Clever language can be used to convince consumers of almost anything it seems. But the fact remains that processed food can hardly be considered “food”, even though it is considred fit for human consumption. So far removed it is from the natural existence of its ingredients that it can be made to look, feel and taste almost anything the food scientist or the imagiative marketer desires. My guess is that the package costs more than the “food” inside it, which means that we are really eating advertising after all!

Teaching nutrition to children improves health behavior knowledge

Sounds logical;  if you include nutrition in the school curriculum, you should expect that it would improve their knowledge of healthy behavior. Reading Across My Pyramid is a nutrition literacy program targeting lower elementary school children of low income families in California. In a recent evaluation of its effectiveness, researchers found significant evidence that it increased the importance of exercise in the minds of children, knowledge that the heart pumps blood through the body, and knowledge that computer use and television watching are not exercise. Correlations were also observed between a child’s knowledge of healthy foods and parent reported soda consumption. Although on a lot of other items related to health behavior, no significant change was seen after implementing the program, these few positive results are encouraging in my opinion. Development of healthy eating habits is equally dependent on availability of information and healthy food in schools, and we seem to have neither of the two in our current education system. Is it a surprise then childhood obesity is on the rise and that Type 2 diabetes is now reported in children as young as 4 years old? How many studies will it take before we begin to see real change in our schools?

Enjoy your weekend!

Photo source – Eggz on Flickr
©2009 Littlestomaks.com

Children love sweet treats like desserts, candies and sugary snacks. If you are struggling to find ways to reduce sugar in your child’s daily diet, you are not alone. In a recent Ask the Expert feature, registered dietitian Dina Lindquist offered a few great tips to tame your child’s sweet tooth. These are really good practical tips and I am sure you have tried most of them already. Still, sometimes you wonder if you are just fighting nature and whether your child is simply hardwired to have a sweet tooth.

It is the nature vs. nurture question all over again!

My son definitely has a sweet tooth while his twin sister is not that crazy about sweets. He has an almost unstoppable craving and appetite for cookies, cake, ice-cream, raisins, chocolate and fruit yogurt – in short, anything sweet. But she doesn’t care about them as much and asks only when she is trying to imitate him or competing for our attention. Give my son anything sweet and he will do whatever you want him to do – for a while at least! “Raisins and lentil soup together”, is  one of our most effective tricks with him as we encourage him to try a healthy alternative at dinner. I am certainly not very proud of using this trick on him, but we do not want to use the promise of a sweet treat either as a reward or as a punishment when we ask him to try other foods.

The nature vs. nurture question has been on my mind for quite sometime now as I have noticed these differences in the food preferences of our twins. Over the weekend I stumbled upon a research paper “Genetic and environmental determinants of children’s  food preferences“, which provided a few interesting facts about the effect of genetic and environmental factors that affect the food preference by children:

1. In general, humans have a natural preference for sweet taste and a dislike for anything sour or bitter. Sweetness means sugar which provides quick calories for body function and growth. Bitter and sour tasting foods may contain harmful toxins and bacteria. As a result, we have evolved to favor sweet foods over bitter and sour foods.
2. Taste perception and food sensitivity is affected by genetic factors. Some people can sense a broad range of tastes and can tolerate a broad range of foods, while others have a limited range.
3. Differences between identical and fraternal twins can be studied to estimate the relative importance of genetic vs. environmental factors, not only for food preference, but also for a lot of other health and behavior related issues. A recent study found high heritability for protein foods, moderate heritability for fruits and vegetables, and low heritability for dessert foods. Heritability is a number between 0 and 1; heritability of 1 for a trait in a child means that that particular trait is inherited from the parents , while a heritability of 0 means that it is acquired from the environment.
4. In general, there is a strong link between genes and neophobia - meaning a natural tendency to dislike novel and unfamiliar foods. However, it is also natural for both children and adults to “learn” to develop a taste for new foods through experience. A personal example of this is how I have recently developed a taste for sushi in the last 4-5 years.
5. Overall, the food choices can be controlled and shaped by familiarity to different types of foods and parental role modeling.

In short, the answer to the original question whether your child is hardwired to have a sweet tooth is a big NO! It is very natural for him to want to eat sweet stuff, but it is up to you as a parent to shape this want so that it does not get out of control. Here are a few quick tips you can try – and by all means, feel free to share your own tips that have worked for you.

Recognize the caloric needs of an active child

An active, rapidly growing child needs more calories. Not only their rapidly growing bodies but also their growing brains demand a lot of energy. The only energy type the brain can use comes from glucose, which of course comes from sugar. So it is quite natural that a growing child will crave for quick calories from sugar when hungry or after a bout of intense physical activity or mental concentration. It is important to recognize the signs of a caloric deficit before it actually happens and provide a quick, healthy snack just in time.

Introduce a wide variety of new foods

The best insurance against too much sugar is to increase the range of new foods including fruits and vegetables which your child can accept willingly. That way, sweet foods become one of the many items he will reach out for when hungry.  It will take a lot of effort and repeated attempts in small amounts at first so he can gradually develop a taste for new foods. Resist the urge to force feed or build an expectation of a reward, because in the long run such tactics do not stick.

Be a role model

A wide variety of foods in your own diet and overall healthy eating habits will have the most impact on your child as she learns to try these foods by imitation. Many studies have shown a direct relationship between food preferences of parents and their children. Like it or not, you are the first role model for your children. This does not mean that you should completely change your habits or behavior in front of children. Here are a few easy actions you can take to promote healthy eating habits without having to make big changes in your own habits. Small positive changes sustained over a long period of time will have a bigger, more permanent effect than big changes made overnight without a sustained follow up.

Save sweet treats for special occasions

There is nothing wrong with enjoying a nice dessert after a special meal. After all, there should be joy in eating and a good dessert completes the feeling of satisfaction in both the tongue and the stomach. Pleasures of food and dining are as important as the healthiness of good nutrition. Enjoying a sweet treat in this way teaches children that sweets are not “bad for you”, rather they should be reserved for special occasions. The goal is to help them learn how to regulate their cravings and not label food as “good” or “bad”.

What do you think? What has worked for you as you try to tame your child’s sweet tooth?

Photo source: Ká on Flickr
©2009 Littlestomaks.com

We are all aware of the growing problems of obesity, diabetes and heart disease. Eating too much junk food, sugary drinks and lack of physical activity is to blame. But how to tell if you or your child is consuming too much sugar each day, which in the long run adds up to cause these problems?

In this week’s Ask the Expert, Registered Dietitian Dina Lindquist offered several tips on how to “tame your child’s sweet tooth“.  As a parent, it is natural to worry about too much sugar, but exactly how much is too much?

Interestingly, it is not possible to find the answer to this question from the Nutrition Facts label on food packages. How could it be that there is a percentage daily value (%DV) for fats, carbohydrates, cholesterol, sodium, proteins and all kinds of vitamins and minerals, but not for sugar? All you can find for sugar is the amount per serving in grams. Without a total daily amount, it is not possible to assess if that 13 g sugar per serving of Fruit Loops or 22 g in a glass of Orange Juice is “way too much”.

In the 2005 Dietary Guidelines for Americans, the USDA recommends a maximum of about 8 tsp (~32 grams) of added sugars each day on a 2000 calorie diet. It still does not tell you anything about the total sugars, part of which comes naturally – for example in fruits or juices – and part from added sugar. So it remains a guessing game, and as a concerned parent you find yourself agonizing over a cookie or a piece of candy wondering if you are turning your child into a sugar junkie!

Well, guess no more! After researching several sources, I have put together this estimate which you can use as a guide -

1. No more than 25% of the daily calories should come from total sugars
2. Each gram of sugar is about 4 calories
3. This comes to a daily maximum of 125 g for a 2000 calorie diet. Remember that toddlers need only about 1200 – 1600 calories based on their activity level. So the maximum amount for them is 100 g.
4. Any food item which contains more than 20% of this maximum (about 20 g) in a single serving is definitely a red flag. This is because it is very hard to control the serving size at one time unless each serving is individually packaged.
5. Fruit juices, even without added sugar, should be used in moderation. Try the fruit instead – at least their sugar comes with fiber, vitamins and minerals! Another option is to water the juice down or reduce the quantity.

How do you keep track of how much sugar your child (or you for that matter) is consuming each day?

Photo source: squacco on Flickr
©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, Registered Dietitian Dina Lindquist offers a few suggestions on how you can tame your child’s sweet tooth.

Dina Lindquist, RD BA in Psychology from Oakland University, BS in Dietetics from Madonna University Oakland County Health Department Dietetic Internship, Individual nutrition counseling for weight loss, Medical Nutrition Therapy for Diabetes, IBD, Renal Disease, etc Website:Nutritious Feast Twitter:@NutritiousFeast LinkedIn Profile Contact: via email from website

Question: How can I tame my child’s sweet tooth?

Answer:

Being a role model to your child is one of the most important things you can do. Children learn by watching their parents and other family members. Spend time with your kids and set a good example by eating a variety of foods with them. If children have a well rounded, nutrient dense diet, then offering them a few sweet treats is fine. The most important thing to remember is portion control. Keep the sweet treats small.

I’ve found that labeling food choices as “good” or “bad” can put an inappropriate significance on food. Instead, help your child see how any food can fit into a healthy eating plan. Some parents have admitted to me that once they label a food as “forbidden” or “bad,” their children start focusing on the particular food and ask for it. Children are curious! Also, I’ve talked to some parents who have never offered sweets to their children. That can be easy until your child enters daycare, goes to a friend’s house or even to grandma’s house. Once they try that “forbidden” treat, they may want it more than anything. If children are already aware of sweet treats and are used to eating in moderation, it won’t have as much of an impact. I’ve found that this topic can be controversial at times, so I always leave the final decision to parents.
Now for some tips on how you can tame your child’s sweet tooth:

1. Offer sweet treats as a dessert after a meal rather than as a snack. Snacks are an important part of a child’s diet and should be full of nutrients. Healthy snacks like celery with peanut butter, low fat yogurt with fruit, popcorn, dried fruit, hummus with veggies and whole wheat crackers with low fat cheese will keep your child focused and full of energy.
2. Limit the amount of sugary treats you buy so that you won’t have too many options available. Instead, buy fresh fruit and leave a bowl on the table. Put a few small boxes of raisins or dried fruit there as well. If children have easy access to it, they will eventually grab a banana or apple to tame their sweet tooth. Also, introduce your children to exotic fruits like mangoes, kiwi and clementines. They are sweet and satisfying! Make sure your children brush their teeth regularly! Even healthy treats like raisins can cause cavities.
3. If your child likes to drink sugary beverages such as soda, replace some of it with a healthier alternative like low fat milk, soy milk, water with lemon and sparkling water with a little 100% fruit juice. Just make sure to start with small, easy to achieve changes.
4. If your child likes breakfast cereal that is high in sugar, try slowly replacing it with a whole grain cereal with at least 5 grams of fiber and no more than 25% of calories from sugar. Mix a little of the new, healthier cereal into the sugary cereal. After a while, they should get used to the new cereal.
5. Many parents have told me that their children are more likely to eat foods they help prepare. Even toddlers can help out with food preparation! Have them wash fruit and veggies or put together small cracker sandwiches. They will feel accomplished and enjoy their healthy snacks even more. It’s like an adventure for them. Some may even forget about that bag of M&M’s in the cupboard.
6. Reward your children with affection and attention, not food. Some studies show that using food as a reward or punishment may result in unhealthy food attitudes. Next time your child cries, offer them their favorite board game or read them a chapter from their favorite book.

Remember that all foods can be part of your child’s healthy eating plan, even sweet treats!
Here is an interesting article that discusses children and why they may love sweet-tasting foods:

©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.