Monday, September 8th, 2014
A recent study published in Annals of Internal Medicine found that, at least in adults, a low-carbohydrate (<40 grams/day) diet led to greater weight loss and more beneficial improvements in blood cholesterol and triglyceride levels than a low-fat (<30% of daily energy intake from total fat) diet. Researchers concluded that restricting carbohydrates may be an option for those who want to lose weight and reduce cardiovascular risk factors.
The study, highlighted on Good Morning America, in The New York Times, and in countless other outlets will likely have many parents, in their efforts to manage their own weight, continue with their low carb ways. And if parents are eating low carb, should they encourage kids—especially if overweight—to do the same? I hope not!
For one, carbohydrates provide the basic fuel needed by the brain, red blood cells, and entire central nervous system. Carbohydrates also supply the body with serotonin, a brain chemical that helps regulate mood, appetite and sleep. Too few carbohydrates—and serotonin—can very well make kids feel sleepy and irritable. And what parent in their right mind wants to do anything to encourage that?!
According to current Dietary Guidelines for Americans, about half of kids’ calories should come from carbohydrates. More precisely, the range suggested is 45 to 65% of total calories. Based on What We Eat in America, kids fall into that range, and get an average of 53 to 56% of their total calories from carbohydrates. But while many kids can certainly afford to curb their intake of carbohydrate by at least a little bit, especially with obesity rates as they are, it’s wise for them to reduce intake of sugary snacks and drinks that provide empty calories rather than forgo grains (even if refined, like pasta or white bread) and other carbohydrate-rich, nutrient-packed foods.
That doesn’t mean kids should OD on white bread, pasta, white rice, sugary cereal, French fries, cookies, and donuts to get their carbs. Going overboard on such foods, especially when served in bloated portions at fast food and other restaurants (not to mention ballparks), will most definitely leave less room for other nutrient-rich foods to help them optimally grow and develop.
Currently, kids consume most grains in their refined rather than whole form. So one key way to improve (if not slightly reduce) kids’ carbohydrate intake is to help them replace some of the refined carbs in their diet with whole grains. Current Dietary Guidelines for Americans urge three to six grains daily, with at least half as whole grains, for kids who consume 1,000 to 2,400 calories. (For reference (see page 16), two to five-year-olds require at least 1,000 to 1,200 calories; six- to 10-year-olds require at least 1,200 to 1,600 calories; 11- to 14-year-olds 1,600 to 2,000 calories; and 15- to 18-year-olds require at least 1,800 to 2,400 calories daily.)
Although they tend to get a bad rap (or is it wrap?!) because they’re carbohydrate-rich, whole grains are sources of nutrients such as iron, magnesium, selenium, B vitamins, and dietary fiber. Whole grain intake has also been linked with reduced heart disease risk. It may also help reduce constipation, and promote healthy weight.
Some whole grains that kids enjoy include popcorn, air-popped, with canola or vegetable oil; cooked oats or whole grain, high fiber cereal (eg low fat granola or another crunchy cereal mixed with fresh fruit, nuts and/or seeds, or low fat yogurt); and brown rice mixed with stir-fried poultry or beef and vegetables.
For ideas on how to enhance the taste and flavor of whole grains and to serve them and other carbohydrate-rich foods in appealing ways, check out the Meal Makeover Moms website. Also, there’s evidence that nudging your kids toward whole grains by making them more fun can also help. A recent study published in BMC Public Health found that presenting kids with whole wheat bread in fun shapes can help increase their intake.
When it comes to kids and carbs, it’s also important to remember that carbohydrates aren’t just found in grains. Fruits and vegetables (which kids don’t get enough of, anyway), beans, nuts and seeds, and milk are also sources of carbohydrates and can create the foundation for a healthful dietary pattern for most children. Depending on their individual calorie needs, current guidelines recommend that kids aim for one to two cups fruit (whole fruit preferable to juice), one to three cups vegetables (including dark green, red and orange, legumes, and starchy vegetables), and 2 to 3 cups dairy foods including low-fat or nonfat milk/yogurt.
I’m all for encouraging kids to have fewer carbohydrate-rich foods like French fries, potato chips, cookies, candy, and soda. But it’s essential that they not throw out of their diets fruits (despite their natural sugar content) and other foods that provide quality carbohydrates and other important nutrients to keep them healthy. Such foods are also vital for kids who are very active or athletic since carbohydrates are the main fuel for their working muscles.
If your child is overweight, you may think that it’s perfectly fine to forget about any possible benefits carbs provide and to simply cut them from their diet. If you mean cutting many of the extras like cookies and cupcakes, I’m all for that. But if you mean cutting all pasta, rice, bread, or crackers, whether or not they’re whole grain, I say that sticking to small portions of those foods is better than not including any of them. Even refined grains provide nutrients (though not as much as whole grains). There’s also proof that cutting portions rather than carbs may be enough to promote healthy weight management.
A recent year-long study published in Journal of Pediatrics of more than 100 obese 7- to 12-year-olds found that lowering carbohydrate intake was just as effective as a standard portion-controlled diet (an energy-reduced, low fat diet) for weight management. However, the researchers also found that the low carbohydrate diet was more difficult for the kids to follow, especially over the long-term. They concluded that either diet can effectively help kids lose weight.
When it comes to kids and carbs, my bottom line is this: choose smart carbs in smaller portions rather than cutting them altogether. That way, kids can reap their many nutritional and other benefits carbohydrate-rich foods provide while still consuming a healthful and still edible diet.
Image of healthy cereal rings via shutterstock.
What’s your take on carbs and kids?
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Diet, Health, Must Read, Nutrition, Obesity
Monday, September 1st, 2014
In her recent article in the Washington Post, Casey Seidenberg described the back-to-school mindful eating reboot she had planned for her kids after a summer filled with too many sweets and too much TV. Her story is something so many of us—even health experts—can relate to.
While my kids spent much of their summer at overnight camp, I know that their usual eating and lifestyle routines were altered. (Full disclosure: so were mine.) On most days, my kids ate at different times of day than usual, ate and were exposed to different foods, and had a far different routine (especially when it came to sleep) than the one they typically have during the school year.
But while I know my kids got more than enough daily physical activity and ate enough—but not too much—to meet their calorie needs, like Seidenberg’s kids and so many others, they too could benefit from a food reboot. Getting in touch with the taste, texture, and flavors of food and being mindful of eating rather than doing it automatically as so many of us tend to do not only can help them enjoy their food more, but it can help them feel more satisfied on less food and protect them from unhealthy weight gain. It potentially can also help them incorporate more nutritious foods into their diets to meet their nutrient needs for growth and development.
In addition to the tips provided in the Washington Post article that include encouraging children to thoroughly chew food (chewing contributes to satiety, which can prevent overeating) and teaching children to put their fork down between bites to encourage slower eating, here are eight from mindful eating expert and author Susan Albers, PsyD:
1). Teach kids Dr. Albers’ S-S-S Model. Encourage them to SIT down while they eat, SLOW down, and SAVOR their food. Too often, kids run around while they eat. The S-S-S model teaches them to pay close attention to what they eat and to break out of autopilot in which they scoop food and eat it.
2). Research indicates that location, location, location matters when it comes to snacking. Both children and adults will eat foods that are easy to grab. That’s why it’s important to place healthy food in a highly visible location such as on the counter or on a shelf kids can reach. It’s okay to have treats as well—just keep them out of sight.
3. Make a table rule: have snacks, but only at a table. Too often kids eat in front of the TV, the number one trigger for mindless eating.
4. Proportion snacks into small bags. That enables kids to come home from school and grab portions that are truly snack sized. Put snacks in baggies or make up brown paper sacks that you keep in the fridge.
5. Consider bento boxes. In a bento box, food is artistically arranged to look like bugs, animals, and faces. These boxes are popular among kids in Japan and make food fun to eat. And making food fun is a great way to help kids enjoy eating and slow down. Google ‘bento box recipes’ to learn more.
6. Encourage kids to get involved in making their own lunch or reviewing their lunch menu each week before it begins. If they know Thursday is chicken nugget day and they don’t like that, you can brainstorm other appealing ideas.
7. Hydration is also a key to mindful eating. When we are thirsty, we often think it is hunger. Make a water bottle a staple item that kids carry around. Buy fun bottles (preferably BPA-free) and make it routine to fill them before you leave the house.
8. It’s a great teachable moment to help your kids compare two different cereal labels while food shopping. See if you can find the cereal with the least amount of ingredients, the least sugar, and the most fiber. It’s a fun game that even little kids can play. This sets them up for caring about what’s in the food they eat.
How do you help your kids practice mindful eating?
Image of mother and daughter shopping in supermarket via shutterstock.
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Monday, August 18th, 2014
A public service announcement (PSA) called “Rewind the Future,” launched as part of the Children’s Healthcare of Atlanta’s Strong4Life campaign, has garnered a lot of media attention—and considerable criticism—from health experts and parents alike. Although the PSA first surfaced in April 2012, it recently blew up on the internet, garnering an estimated six million views so far.
The PSA begins with a 32-year-old man named Jim who at 5’9” and 300 pounds is wheeled into a hospital while having a heart attack. After the doctor asks, “How the hell does this happen,” the video flashes backwards through the man’s life, attempting to illustrate how he got there. At various stages of Jim’s life, he’s shown eating ice cream and pancakes, being out of breath while playing with his kids or walking on a treadmill, hiding food in his room, playing video games, being rewarded candy by a teacher for earning good grades, being exposed to fast food by his parents (his dad orders pizza and his mom goes through a drive-thru), and acting up at meal time—and being pacified with French fries by his mother. The video ends with the message, “There’s still time to reverse the unhealthy habits our kids take into adulthood” and a link to the Strong4Life website.
While the PSA has certainly sparked conversation, I was surprised when a Good Morning America poll inspired by the PSA revealed that eighty-one percent of viewers believe parents are to blame if their kids are obese. Only nineteen percent believe they are not. Although parents certainly play a major role in their children’s eating habits, I don’t believe pointing fingers and playing the blame game are the way to inspire meaningful change and better physical or psychological health in children. And while I appreciate the idea of prevention of obesity and its consequences, I don’t feel that blame and shame as suggested in this video are the answer.
Several experts have also spoken out against the PSA. In his recent blog post about the PSA, Yoni Freedhoff, MD, a family doctor and Assistant Professor at the University of Ottawa refers to the PSA as “…everything that’s ugly about society’s attitudes towards weight boiled into a two-minute video treatise on how gluttony and sloth are to blame for obesity….oh, and add in lazy parents.” Although he agrees that parents have a role to play in all of this, he believes that fear and shame aren’t likely to get them there. He writes, “If guilt or shame had any lasting impact on weight or behavior, the world would be skinny, as guilt and shame are the two things that the world bends over backwards to ensure that people with weight never run short of.” Freedhoff also says that shaming the symptom without tackling the cause is likely only to add to the belief that fat shaming has a role to play in fixing the environment.
In another blog post, California-based registered dietitian nutritionist Aaron Flores wrote, “Just like many other ads, the sensational tone shames both parents and kids. It says nothing of the fact that health comes in different shapes and sizes. It makes it seem as if a parent makes one mistake feeding a child at an early age, they’ve doomed their child to an early death. Nothing could be further from the truth. It’s this black and white thinking that leads us to think of foods as “good” or “bad” and lead to a life of dieting and binging.” Flores goes on to suggest that what parents need is to learn how to help children feel comfortable with all different kinds of foods and to nurture children’s self confidence with food and their body. He adds, “The last thing we need is to create environment that leads our children to hate their bodies, seek diets and (develop) unhealthy relationships with food.” Terrific points, no?
Although obesity, especially among children, is certainly something we all need to be concerned about and address, the findings of a recent study from the Rudd Center for Food Policy and Obesity at Yale University and published in American Journal of Preventive Medicine suggest that this video and others like it may not be the answer. The study found that stigmatizing obesity-related public health campaigns were no more likely to instill motivation for improving lifestyle behaviors among participants than campaigns that were more neutral.
As someone who always thinks you can attract more bees with honey, I, too, believe that rather than shocking or shaming parents, emphasizing what they can do more of—for example, offering more produce and cooking more at home, and choosing choose smaller portions while dining out—can empower them to feed their children better and help children actually eat better. It can also have a wonderful side effect of helping kids develop more healthful food, fitness and lifestyle behaviors they’ll carry with them as they increasingly make more decisions about what and how much to eat and move. Over time, this can help prevent many of the diet-related diseases many children, including those who are overweight, can develop as adults.
When asked about the rationale for the PSA, Stephanie Walsh, M.D., Medical Director, Strong4Life at Children’s Healthcare of Atlanta wrote in an email, “The video was designed as part of a larger movement to empower parents” and to “remind parents of the power they have to influence their child’s health and help them to consider making small steps towards lifestyle change.” In response to criticisms that the video unfairly blames and shames parents, Dr. Walsh added, “This video was not designed to place the blame on parents or make people change; it was designed to make people consider making a change.” She also suggests that people must first realize the importance of changing a behavior before they actually make a change. Although she concedes that the video dramatizes the problem, she notes that the scenes depicting unhealthy habits are real examples of the struggles many of their patients and families face— reigning in screen time, motivating kids to be active and decreasing the amount of sugar their kids drink. She adds, “The video was designed to focus on behaviors that we, as parents, can control.”
What are your thoughts? Does this video go too far, or do you think it will inspire parents to help their kids eat and live better?
Image of mother and kids having a snack at a fast food restaurant via shutterstock.
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Diet, Health, Meals, Must Read, Nutrition, Obesity
Sunday, August 10th, 2014
Do you send your kids to school with a brown bag lunch, thinking it’s a more nutritious option than what they’ll otherwise find at school? You might be surprised to find out that might not be the case.
A recent study published in the Journal of the Academy of Nutrition and Dietetics (JAND) found that among 626 elementary schoolchildren, nearly half brought lunch from home to school on any given day. The most common lunch foods included sandwiches, snack foods, fruit, and desserts. Leftovers, dairy foods, and vegetables were also included, though to a lesser extent.
Of the lunches children brought from home to school, only about one in four met at least three of five National School Lunch Program standards. And that means most fell short of the standards created back in 2012.
Researchers also found that while 97%—or just about all the lunches brought from home to school—included a snack, only about 4% of snacks met at least two of four Child and Adult Care Food Program (CACFP) requirements.
According to the researchers, previous studies suggest that children who bring lunch from home consume less produce, consume more calories and less fiber, and are more likely to consume sugar sweetened beverages and snacks high in added sugars and fats while at school compared with children who rely on the NSLP for lunch. Studies also suggest that those who eat school lunch are also more likely to consume milk, fruit, and vegetables during lunch than those who brown bag it.
My children go to a school that requires them to eat lunches that are provided by their school. But when they were younger, I used to love to send them lunch—not in a brown bag, but in an insulated lunch bag with ice to keep it at a safe temperature until lunchtime rolled around. If you are able and choose to send your child to school with their lunch in hand, below you’ll find some great ideas from top registered dietitian nutritionists. These lunches provide a balance of nutrients to meet their needs for growth, development, and sustained energy—and a side of deliciousness—so that they’re less likely to make a trade!
From Melissa Halas-Liang, MA, RDN, CDE
Mango-Orange Smoothie made with 1.5 cups frozen mango, 1/2 cup coconut milk, and 1/2 cup orange juice; string cheese; and a 100% whole wheat cracker-wafer.
My third grader doesn’t have much time to eat at school. Drinking her fruit ensures that she has time to fuel up and helps boost her fiber intake, which is so important for kids. I include string cheese to give her some protein, and a whole wheat cracker-wafer that is 100% whole grain made with healthy fats for sustained energy and no added sugars.
Whole wheat flat bread with pesto and shredded melted mozzarella plus a smoothie.
My daughter eats the flat bread with pesto and mozzarella cold. Sometimes we even add a few olives or artichokes to our homemade pesto. I vary the smoothies by color, sometimes adding frozen blueberries, fresh kiwi, pineapple and a little parsley, baby spinach leaves or kale. This is a good, balanced lunch that packs in plenty of protein, fiber, and healthy fats.
From Holley Grainger, MS, RD:
One small whole wheat flour tortilla spread with seed or nut butter, topped with sliced banana, rolled up and cut into spirals; plain Greek yogurt with mashed blueberries stirred in; carrot and red bell pepper sticks with hummus; and a glass of nonfat milk or water.
My three-year-old daughter’s lunches vary day-to-day but always follow the same simple formula to keep her meals interesting while exposing her to a broad range of foods for a balance of nutrients and flavors. The breakdown is simple, and includes at least one food from each of the five food groups listed below with examples for each:
lean protein: grilled chicken, low-sodium turkey, sliced pork tenderloin
vegetables: green beans, red bell pepper strips, or carrots
fruit: pineapple, apple slices, banana, mandarin orange segments, or berries
dairy: milk, yogurt or cheese
whole grains: popcorn, whole wheat pretzels, whole wheat flour tortilla
From Jill Castle, MS, RD, LDN, author of Fearless Feeding:
A sandwich with hummus or turkey, leftover mixed salad (or shredded carrots, purple cabbage and lettuce) on a whole grain wrap/tortilla or bread; a large serving of fruit; a small packet of nuts and dark chocolate (trader Joe’s); and a large water bottle.
The sandwich wrap is easy to make, utilizes my dinner leftovers and highlights a good protein source, whole grain and vegetables. In one meal, I am able to hit most of the food groups: protein, grain, fruit, vegetables and healthy fat. Since my girls (ages 12-17) are athletes, they usually eat the nut/dark chocolate mix before practice and I send in a separate chocolate milk box (dairy) for after practice.
From Toby Amidor, MS, RD, CDN author of The Greek Yogurt Kitchen:
Brown rice vegetable rolls, an apple, and low fat milk.
I like to buy vegetable rolls for my daughters, ages nine and seven, to bring to school about twice a month. This helps break the boredom of everyday sandwiches. The brown rice provides fiber, the apple has vitamin C and the antioxidant beta-carotene. The low fat milk provides nine essential nutrients like calcium, vitamin D, and protein.
What’s your favorite lunch to send with your kids to school?
Image of school lunch via shutterstock.
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Diet, Health, Meals, Must Read, Nutrition
Monday, August 4th, 2014
If you have or are otherwise involved in feeding children between the ages of 2 and 11, help is on the way. Just this month, the Academy of Nutrition and Dietetics (AND) released a new position paper to provide nutrition guidance to parents, pediatricians, educators and anyone who feeds 2- to 11-year-old children. According to the paper, children “should achieve optimal physical and cognitive development, maintain healthy weights, enjoy food, and reduce the risk of chronic disease through appropriate eating habits and participation in regular physical activity.”
Although AND acknowledges that obesity rates among children appear to be leveling off, it suggests that we still need to learn more to help children achieve and maintain healthy body weights, reduce the prevalence of food insecurity, help children consume more nutrients they tend to fall short on (including fiber, calcium, vitamin D, and potassium), and reduce diet-related risk factors that can develop early and make them more likely to develop chronic diseases such as cardiovascular disease, type 2 diabetes, cancer, obesity, and osteoporosis.
Reviewing children’s eating habits, AND highlights some positive childhood nutrition trends that emerged between 1999-2000 and 2009-2010. For example, average intakes of calories, fat, sodium, and sugar* have gone down, whereas intakes of calcium and fiber went up. Despite these improvements, AND concludes that many American children ages 2 to 11 years fail to meet recommendations for fruit, vegetable, grain, or dairy groups; they also tend to exceed recommended intakes for total fat and saturated fat. To help reverse these trends, AND recommends that those who feed children receive education about mealtime behaviors that promote the adoption of healthier eating behaviors early in life. It also suggests working with, when possible, credible nutrition professionals including registered dietitian nutritionists (RDNs) and dietetic technicians, registered (DTRs) who are well-versed in child nutrition.
Although there are many factors that influence children’s eating habits—these include marketing food (such as fast food) and beverages generally and specifically to children, screen time, physical activity and exercise, sleep, and coping skills—parents can play a key role in helping children get off on the right foot when it comes to eating well and meeting nutrient needs. Here are some suggestions outlined in the AND position paper to help you get started:
- Using a responsive feeding approach by which a parent or caregiver recognizes and responds to the child’s hunger and satiety cues;
- Enjoying family meals—these may benefit children’s beliefs and attitudes about nutrition and reduce the risk of overweight;
- Repeatedly exposing children to nutritious foods—offering children a variety of nutrient-rich foods often, even if they reject them at first, can encourage children to try and even learn to like new or previously disliked foods;
- Modeling healthful eating habits—for example, eating fruits and vegetables in front of children can encourage them to do the same;
- Offering a variety of nutritious foods without forcing children to eat them—this allows children to determine whether and how much to eat from what is offered.
For more information about how to help your children eat better, visit AND’s website here. The U.S. Department of Agriculture’s MyPlate can also help.
How do you help your 2 to 11-year-olds eat better?
Image of kid eating an apple via shutterstock.
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