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

Hello everyone! It has taken us a while to get back to normal (whatever that means!) after our week-long Disney vacation. Hope you all have been doing good. Here is this week’s 5 for Fridays where I am once again focusing on the idea of a soda tax. Feel free to share your opinion in comments below.

Calls for soda tax are getting louder

Looks like the pundits have spoken again, this time in a louder, high pitched, unified voice! In a recent health policy report titled The Public Health and Economic Benefits of Taxing Sugar-Sweetened Beverages published in the prestigious New England Journal of Medicine, several “experts” have proposed that a 1 cent tax be imposed for every oz. of a sugar-sweetened soda. They estimate that such a tax will generate about $15 billion in the first year in addition to the state-level revenues. They have even setup an online tax calculator for different states and major cities! They propose that these extra dollars can be used for childhood nutrition programs, obesity prevention programs or healthcare for the uninsured.

Now I am sure that such talk is music to the ears of many people, especially those in the government trying to figure out how to pay for the healthcare reform. It might be appealing to those at the state and local levels also as their budgets are under severe stress. It is not a surprise that this idea has attracted the attention of most of the prominent mass media in recent weeks. Watch out, they are trying to build a mass hysteria!

I think this is a very misguided proposition. I have written about it in a recent post explaining why I don’t believe in a twinkie tax or a soda tax. And just to be clear, my arguments have nothing to do with the politics of the situation, rather they are based on an understanding of how business works.

For this week’s 5 for Fridays, I thought of compiling a summary of various viewpoints I have read on the web lately in response to this idea. Check them out and let me know what you think!

1. An interesting commentary in the New York Times explains why sodas are a tempting tax target. It is quite clear that there is a link between caloric imbalance and obesity. It is also known that soda consumption has skyrocketed over the last few decades. Put the two together and it is easy to see why the sugar-laden soda with its empty calories is the prime suspect for our obesity problem. Let us tax it to reduce its consumption; after all it has worked for tobacco. It is not a basic need anyway and even Adam Smith justified taxing such unnecessary which have become objects of almost universal consumption!

What I did like about this article is that it tries to address the bigger problem and talks about a broader Pigovian approach to get rid of the subsidies for corn syrup. Much more difficult to accomplish politically I am sure.

2. Another commentary on Forbes.com shows a serious skepticism about the effect of a soda tax on obesity and makes its case using numbers. Data suggests that even a 58% tax on soda, which is equivalent to the combined federal and state taxes on cigarettes, could at most lead to a mean BMI reduction of 0.16 points. Moderate decrease in consumption is expected in response to taxes, however there is a belief that people will simply switch to the diet option or other drinks. The return on these tax dollars in other words is not expected to be significant.

Let us leave the numbers aside for a minute – people can argue over them endlessly in my opinion. But I agree that the soda tax does not change the demand in any fundamental way.

3. In an excellent review Dr Ayala digs deeper into why these health experts favor taxing sugary drinks and offers her opinions on why such a tax should be supported. What I liked the most about her review is that she actually takes the time to explain why excessive consumption of sugary drinks leads to obesity and serious health problems.

Dr. Ayala is a pediatrician and an outspoken supporter of obesity prevention, healthy lifestyle and good nutrition choices. I respect her a lot, but on this matter we have a difference of opinion. I am personally no fan of soda anymore, but that is by choice not because of price. I do agree with her that a public debate on the ills of sugary drinks regardless of whether a tax is imposed on them or not will be good for everybody.

4. The Health Blog on the Wall Street Journal presents an interesting calculation to show that even when the penny an ounce tax is imposed on the soda and it is completely passed on to the customer, it will still be cheaper to buy soda than orange juice. The main idea is to show that the tax will have to be much higher in order to bring the price of soda in line with other so-called healthy options.

One observant reader left a comment that the box of orange juice also shows a lot of sugar per serving, so probably not a good example. Great point, and I agree because there is a lot of added sugar in these ready-to-serve orange juices. The underlying point however is that consumers should really read the labels and decide for themselves if they should be buying a particular food item or not. When consumers make healthy choices they are truly empowered and demand will change in a fundamental way.

5. Fooducate blog, which I read regularly, suggests we consider a calorie offset instead of the soda tax. Here is how it will work – for every ton of added sweetener, a company would contribute $3000 to a government program aimed at obesity reduction. This is equivalent to the penny an ounce tax on the finished product.

Interesting idea because it directly affects the cost of production rather than price of the product. It also encourages the manufacturer to reduce the sugar content or switch to healthier products. I also suggested several other ideas that can affect the cost of production in my post on twinkie tax.

This is a good debate. However we should focus on the big picture and not try to put a band-aid on it by using taxes. I think the experts have their heart in the right place because they are worried about our health problems and lack of effective policy. But they need to get more creative and offer something better than a soda tax!

Enjoy your weekend!

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

Greetings! It is Friday again. We are getting ready for a week-long trip to the Disney World with our kids. This is the first time for them and I can tell they are excited. My daughter keeps saying “next week we will go to Mickey Mouse Clubhouse!” It should be fun and we are looking forward to this little time off!

I am taking a slightly different approach to my regular Five for Fridays this week. Instead of writing about 5 nutrition news of the week, I am going to cover just one news in more detail and try to look at it from 5 different ways.

The big news this week was a report issued by the Institute of Medicine (IOM) which urges local governments to take a decisive action in controlling childhood obesity. Reading the report brief, it is hard not to be impressed by many of the suggested recommendations from the committee. The media, however, picked on one of the most provocative idea that a “twinkie tax” be imposed on junk foods and sugary drinks to limit their consumption. A 10% tax on sugary beverages could reduce their consumption by 8-10% according to some experts.

To these experts, I say a better way would be to simply ban all junk food and sugary drinks. Seize the products from the stores, treat them as controlled substances and shut the manufacturers down! It has a better chance of working if that is the culprit behind childhood obesity.

Obviously no one will stand up for it because this would be considered so un-American.

Here are 5 reasons why I believe a “twinkie tax” will have no real effect on the obesity problem:

1. Tax is like using a spigot when a dam is needed- let us face it; consumers love sugary foods and drinks. There is a huge demand for them and as a result, there is a huge supply. Imposing a small tax will be like trying to control the flow of a river by a spigot when we need to build a dam. The real question is, how high the taxes should be before the resulting prices are simply prohibitive for most consumers to give up on these products?
2. Tax does nothing to the production cost – manufacturing junk food is cheap! Cheap raw materials and large scale production keeps unit cost at a very low level. What is not cheap is packaging, marketing and distribution of these products. It would be very easy to keep the same sticker price by simply reducing these costs by a small amount. It will take a lot to cut them to a level which can affect their availability on the shelves.
3. Tax will actually increase the desire for these foods – let us say the price does go up to a point that these products become out of reach for some consumers. Do you really believe that their desire for these foods will diminish? In fact, if they can’t have them as often as they would like, they will actually want more of them. They will find some other way to get them anyway.
4. Tax will do nothing to the consumption of healthy foods – those who favor taxes on junk foods justify their idea by suggesting that the money could be used to promote awareness of healthy options. This is absurd! It makes the assumption that those who will give up junk food because of high prices will actually be able to afford healthy foods if they become aware of them. Not true at all in my opinion. As long as the availability of healthy foods remains limited, the current demand from consumers with higher income will continue to keep their prices high. A lot of people eat junk food not because they don’t know it is unhealthy, rather because it is cheap, readily available and tastes good.
5. Tax will encourage producers to develop bad habits – dealing with taxes is like dealing with a strict teacher in school. You try to find a way around him rather than developing a desire for learning. This is particularly true if the producer is confident that the demand for his product is not going to be changed in a fundamental way. You can expect more lobbying, more promotion and even more products at a lower price point. Is this what we want?

By now, you might be tempted to believe that I am not a tax-and-spend kind of a guy! Let me clarify – this is not a political discussion for me. I am looking at this situation purely from a business perspective. In fact, if you are a proponent of taxes, I suggest the following ideas might work better:

1. Tax the raw materials, or lift the subsidies that result in low commodity prices. Now that is a touchy political issue, isn’t it?
2. Tax the machines that make these products. The trickle down effect on the manufacturing sector would be tremendous!
3. Tax the utilities used by producers of these products. Make their electricity, water and gas more expensive. I bet the utility companies will be delighted!
4. Tax the transporters of these foods by making them pay more for gas and use of highways and railroads. Maybe they will consider going after producers of healthy foods then!
5. Tax the retailers who stack their shelves with these products. Make them pay more for healthcare and unemployment taxes. Perhaps that will persuade them to opt for healthy foods instead!

No matter how you look at it, taxing these products is not a sustainable solution. In my opinion, we should rather focus on finding ways to make healthy foods cheaper and more readily available to consumers of all socio-economic backgrounds.

Another approach would be to change the demand patterns in a fundamental way. Businesses innovate in response to consumer demand, not necessarily in response to legislation. For example, the demand for soda in our household is zero. It is as if the soda aisle does not exist in the store. Not even offers like buy-one-get-one-free tempt us anymore. I am not saying that this has had an impact in the bottom line for Coke and Pepsi. But imagine, if just 1 in 5 shoppers bypassed the soda aisle in every store in America. That would certainly force them to find out what consumers like me want and develop products to satisfy this need. That is what drives innovation. Not taxes.

I hope the “experts” can exercise their brain cells to think about that for a while!

What is your opinion? I would love to hear your comments.

©2009 Littlestomaks.com