Happy New Year! Hope you all had a wonderful time with your loved ones over the Holidays.

I took a little break from blogging but now it feels great to be back! I am looking forward to continuing our journey in child nutrition in 2011, but first I would like to invite you to check out these top 10 posts of 2010 in terms of page views and comments. Some of them were written in 2009 and made the list then, but continued to attract interest in 2010. Science driven, yet practical, nutrition knowledge indeed can be timeless in some ways! Thank you for interest and support over these years.

Whether you are a brand new visitor – or a regular reader of this blog – I hope you will find them interesting and useful as you try to manage your growing child’s nutrition needs. Share your own experience, offer advice, or simply ask a question in your comments below. I would love to hear from you!

	Simple Recipes – Chicken with Quinoa   This is a very easy recipe to make! Quinoa, in my opinion, is the unrecognized superfood because it is a good source of protein and low glycemic index carbs. It also provides a good mix of vitamins and minerals.
	Milk Allergy and Ear Infections   Dairy allergy can be one of the underlying causes of recurring ear infections. This article by Jasmine Jafferali, MPH, explores this issue in a simple, yet practical, Q&A format.
	Ask the Expert – Sushi and Toddlers  If you are a sushi lover and you are thinking about introducing your toddler to sushi, you have got to read this informative piece from registered dietitian Janet Helm. She writes a great blog at Nutrition Unplugged with tons of excellent information about nutrition and food trends.
	All Natural Toddler Multivitamin   My review of Floradix Kinder Love Children’s Multivitamin Liquid Extract Formula attracted a lot of attention because it is based on herbal extracts and fruit juices. It claims to be easy on the child’s digestive system while providing vitamins A, B, C, D and E. It is not a good source of minerals.
	Looking for a Multivitamin Supplement?  This is a “mini” guide to toddler vitamin supplements on the market. If you are considering a supplement for your child, you can use a simple comparison chart in this post. Centrum Kids and Flintstones Complete offer a good balance of complete vitamins and minerals. But the most important advice is to rely on a balanced diet with plenty of fruits and vegetables.
	Product Reviews – Buddy Fruits  This is a simple fruit puree and makes a healthy snack when you are on the go. When we found it in our local supermarket early last year, it wasn’t as commonly available as it is now. Can be a little messy for small children, but overall not a bad choice for a quick snack.
	Basmati Rice: It is Very Easy to Cook and You Will Love It’s Flavor and Fragrance  We love basmati rice! It is an excellent source of low glycemic index carbohydrates. Try my simple recipe to cook it as a separate side dish. You can also try some of the links in this post for other great recipes.
	Simple Recipes – Pasta with Spinach and Mushrooms  This is a simple variation of our recipe Chicken with Pasta and Vegetables. It hardly takes any time to prepare and we save it for those hectic days when we have to quickly put something together for dinner.
	Traffic Light and Food Labeling  Clearly, consumers want simple and easy to understand front of the box food labels. FDA is worried about accuracy and manipulation by the food industry. A traffic light based food labeling system is gaining popularity in UK and Australia. It is not perfect, but clearly a step in the right direction.
	Milk Choices for Toddlers   Registered dietitian Jill Castle offers an overview of several different milk choices for toddlers in case cow’s milk is a concern. Jill blogs about child nutrition at Just the Right Byte.

Web statistics are surely important, but here are a few of my personal favorites. I hope you will check them out and leave me a comment with your opinion!

1. Surprising easy solution for preventing childhood obesity
2. How worried should you be about your underweight child?
3. Do children need more vitamin D?
4. Nutrition trivia – 10 facts to know about protein
5. Resting metabolic rate and weight management

©2011 Littlestomaks.com

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

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

Link between childhood obesity and heart disease gains strength

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

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

Flooded by snacks, kids are becoming constant eaters

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

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

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

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

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

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

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

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

FDA issues warning letters to rein in food labels

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

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

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

Big Words from Little Foodies

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

Enjoy and let me know what is on your mind.

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

It has been an excellent year blogging about toddler nutrition! When I started writing back in the Fall of 2008, I did not realize how exciting it could be to learn and write about all aspects of a young child’s nutrition and growth. Blogging has also given me an opportunity to connect with both experts and moms in a unique way!

As we close on 2009, I would like to reflect upon the more than 220 posts I have published on this blog. Whether you are a brand new visitor, or a regular reader of this blog, I invite you to check out these top 10 posts of 2009 in terms of page views and comments.

Enjoy and let me know what is on your mind!

	Attachment Parenting and Toddler Nutrition This post by Annie of PhD In Parenting explains what it means to feed your child with love and respect. It is one of the 8 guiding principles of Attachment Parenting.
	All Natural Toddler Multivitamin My review of Floradix Kinder Love Children’s Multivitamin Liquid Extract Formula attracted a lot of attention because it is based on herbal extracts and fruit juices. It claims to be easy on the child’s digestive system while providing vitamins A, B, C, D and E. It is not a good source of minerals.
	Simple Recipes – Chicken with Quinoa This is a very easy recipe to make! Quinoa, in my opinion, is the unrecognized superfood because it is a good source of protein and low glycemic index carbs. It also provides a good mix of vitamins and minerals.
	Ask the Expert – Sushi and Toddlers If you are a sushi lover and you are thinking about introducing your toddler to sushi, you have got to read this informative piece from registered dietitian Janet Helm. She writes a great blog at Nutrition Unplugged with tons of excellent information about nutrition and food trends.
	Looking for a Multivitamin Supplement? This is a “mini” guide to toddler vitamin supplements on the market. If you are considering a supplement for your child, you can use a simple comparison chart in this post. Centrum Kids and Flintstones Complete offer a good balance of complete vitamins and minerals. But the most important advice is to rely on a balanced diet with plenty of fruits and vegetables.
	5 Reasons to Consider a Multivitamin Supplement I heard a variety of opinions from Moms who took my Global Toddler survey about use of multivitamins. In this post, I highlight 5 main reasons why you might consider it for your child. Vitamins should not be used to “fix” nutrition and eating issues; rather you should rely on them to supplement a balanced diet.
	Basmati Rice: It is Very Easy to Cook and You Will Love It’s Flavor and Fragrance We love basmati rice! It is an excellent source of low glycemic index carbohydrates. Try my simple recipe to cook it as a separate side dish. You can also try some of the links in this post for other great recipes.
	Help! My Kids Don’t Eat Enough Fruits and Veggies! This is a very common concern of most toddler parents. In this article, pediatrician Dr Ayala Laufer-Cahana offers a few practical tips to get your kids interested in fruits and veggies. Check out her blog at Ayala’s Herbal Water.
	Traffic Light and Food Labeling Clearly, consumers want simple and easy to understand front of the box food labels. FDA is worried about accuracy and manipulation by the food industry. A traffic light based food labeling system is gaining popularity in UK and Australia. It is not perfect, but clearly a step in the right direction.
	Think Play-Nutrition-Rest for Long Term Health of Your Children Play is an important part of your child’s physical, mental and emotional growth. Combine it with good nutrition and enough rest for long term health of your toddler.

Web statistics are surely important, but there are a lot of other articles which I am particularly very passionate about. Here are a few of my favorites. I hope you will check them out and leave me a comment with your opinion!

1. Twinkie tax will do nothing to reduce the sweetness
2. Shaking off a sweet addiction
3. Why we must address childhood obesity NOW
4. Good nutrition key to managing food allergy
5. Healthy fats for children

©2009 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

Imagine driving through a busy intersection that has no traffic lights. Instead there are boards showing the driving rules in large print that you must read and quickly understand so you can pass through safely. And to make things worse, every intersection has different rules even though the boards look pretty much the same from a distance. It would be a disaster!

I think this is exactly the case with food labels. They all look the same but they pack a lot of information that you are supposed to digest (pun intended!) so you can make a healthy choice. And remember, all the bad stuff is usually hidden in the fine print on the label! Let us say your grocery cart on your weekly shopping trip has about 50 different items. Even if you spend just 1 minute trying to figure out the food label, it would take you almost an hour just to read and understand the information. Add to that all the walking through the aisles you need to do to get everything on your list, and you can be sure to spend your entire Saturday afternoon in the store. And if you have a screaming toddler trying to jump out of the cart, then simply forget it! You will likely look for the same items and brands every week without even looking at the label.

Traffic lights work because they are simple and easy to understand. The red-yellow-green lights have become a part of our nature. This leads to automatic action, which by habit and practice, is the correct action (in most cases, unless you are drunk!). So why not use the same idea and make the decision-making simple when it comes to food shopping?

I was really excited to learn that this is exactly what many supermarkets in the UK have started doing for their store brands. The standard nutrition label has not gone away, rather there is a simple color chart on the front panel of the package showing in red-amber-green, the levels of fat, saturated fat, salt and total sugars. We know that if we want to eat a healthy diet, one of the key things we should be doing is trying to cut down on fat (especially saturated fat), salt and added sugars. The message from the traffic light label is simple and clear – choose foods that show more “greens” than “reds” if you are trying to decide between two similar products.

One of the early adopters of the traffic light labeling system recommended by UK’s Food Standards Agency (similar to our FDA) was the Sainsbury supermarket chain, which now has nearly 5000 of its own branded food products showing this front-of-pack multiple traffic light (MTL) nutritional labeling. Even better, they have now developed a new ‘Just for Kids’ multiple traffic light labelingspecifically for the nutritional requirements of children.  This is based on Guideline Daily Amounts (GDA) for 4-6 year olds. Not surprisingly, the consumer response has been overwhelmingly positive. In a recent survey, 92% of the customers found the MTL labeling easy to understand and 54% felt that MTL labeling, rather than the corresponding GDA approach, gave the“best at-a-glance indication of the healthiness of the food”. In another survey, they found that out of those aware of the MTL labeling, 57% said the symbol has helped them eat more healthy, with 17% saying it helped them eat ‘a lot more’ healthy. Clearly, the system works for most consumers.

Not everyone is equally excited of course. I was browsing through the comments on a blog post by Andrew Wadge of the FSA on this topic. Some find it too simplistic and arbitrary. Others see it as a tool to pressure the food industry to adopt a new labeling requirement. One particularly interesting criticism was that the color coding system does not work for color blind people!

Surely, this cannot be a substitute for the detailed nutrition information label. In addition to avoiding the bad stuff, we need to also look for the good stuff like proteins, vitamins and minerals. Still, I think that such a system, if adopted by the food companies here at home, could make life easier for us busy people. What do you think?

Here are a few links if you want to learn more:

1. A detailed overview on Netmums.com
2. An article on food labels from FSA
3. Sainsbury’s traffic light labeling system
4. Traffic light label adopters in UK