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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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Monday, July 28th, 2014
A new review published in the British Journal of Nutrition and covered in a recent New York Times article suggests that organically grown crops may have an edge over their conventionally produced counterparts.
In their analysis of 343 peer-reviewed studies published all over the world—70% in Europe—researchers found that, on average, organic crops/crop-based foods had higher levels of antioxidants, lower concentrations of cadmium, and a lower incidence of pesticide residues.
The review found that organically grown crops had an average of 17% more antioxidants (including polyphenolics) than those produced conventionally. In their review, the researchers cited several dietary studies that suggested consuming more foods rich in antioxidants—especially fruits, vegetables and whole grains—may protect against a variety of chronic diseases including cardiovascular disease, certain cancers and neurodegenerative diseases. Antioxidants are believed to protect the body against cell damage caused by free radicals—substances in the body and in the environment (especially in smoke or pollution). When produced in the body in excessive amounts, free radicals can increase inflammation in the body and contribute to the development of disease.
Cadmium is a highly toxic metal that accumulates in the body (especially in the liver and kidneys). According to the U.S. Food and Drug Administration (FDA), cadmium is found in foods naturally and due to air pollution. Although the exact health benefits of lowering dietary intake of cadmium are unknown, the British Journal of Nutrition review found that, on average, organic crops had 48% less cadmium than non-organic crops. The researchers urge keeping cadmium levels in the diet as low as possible. They also note that the European Commission has set maximum residue levels in foods for cadmium as well as lead and mercury, also toxic metals.
Although the FDA acknowledges there are no regulatory limits for toxic elements like cadmium or lead in food, foods that are found to have higher than normal levels of such metals are brought to the attention of the Center for Food Safety and Applied Nutrition (CFSAN), who then assesses the potential hazards associated with cadmium intake at such levels.
The British Journal of Nutrition review also revealed that the frequency of occurrence of detectable pesticide residues was four times higher in conventional crops than in organic crops. According to the American Academy of Pediatrics (AAP), pesticides are chemicals intended to kill unwanted insects, plants, molds, and rodents. The AAP believes that even low-level exposure to pesticides among children is concerning, especially because “they encounter pesticides daily and have unique susceptibilities to their potential toxicity.” In fact, in its policy statement on pesticide exposure in children, the AAP cites evidence associating early life exposure to pesticides with pediatric cancers, decreased cognitive function, and behavioral problems.
Even though the British Journal of Nutrition review has gotten a lot of positive press, not everyone agrees (as evidenced in this article by AG professional) that its conclusions are definitive or that such results should ultimately dictate people’s perceptions or purchases when it comes to organic versus conventional food. Eating and buying food is very personal, and it’s up to parents to decide what’s best for their families based on personal preferences, nutrient needs, budgetary and time considerations and other factors.
In the meantime, kids should at very least be encouraged to meet current Dietary Guidelines for Americans, especially when it comes to foods that many fall short on including nutrient-rich vegetables, fruit and whole grains. Until we know more, focusing more on helping kids get closer to meeting current recommended intakes for produce and whole grains rather than pitting organic and conventional foods against one another is a great first step towards helping them meet their nutrient needs that support optimal growth and development. MyPlate recommends 1 to 2 cups fruit, 1 to 3 cups vegetables and 1.5 to 4-ounce equivalents whole grains daily, depending on your child’s age and gender.
Still, if you can afford and choose to provide your family with mostly organic foods, you’ll likely reap at least some benefits (eg lowering pesticide intake) by doing so.
To learn more about organic food, check out my Scoop on Food post, Should You Buy Organic Food?
Do you buy organic foods?
Image of a variety of fresh healthy foods via shutterstock.
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Diet, Health, Must Read, Nutrition
Monday, July 21st, 2014
If you’re like most parents, you wouldn’t dream of getting through the day without some kind of caffeine pick-me-up first thing in the morning or midday. Not only can a cup or two of iced or hot coffee or tea, soda or other caffeinated beverage stimulate your brain and nervous system—and keep you awake for that early morning meeting, feeding or workout—it may also make you feel just a little bit happier! And what sleep-deprived parent of an infant or young child wouldn’t appreciate the perks caffeine can provide?
Unfortunately, it’s likely our caffeine-centric ways coupled with the widespread availability and marketing of caffeine-containing beverages and other products may prompt our children to seek out caffeine and possibly harm their health.
Although the U.S. Food and Drug Administration (FDA) has yet to determine a safe level of caffeine for children, the agency—concerned about the proliferation of caffeine-infused products including chewing gum, jelly beans, bottled water and waffles—announced last year its plan to investigate the safety of caffeine in food products and the effects of caffeine on children and adolescents. And just last week, the FDA issued a warning to consumers to avoid powdered pure caffeine, sold on the internet. The substance is believed to have caused a caffeine overdose and subsequent untimely death of an 18-year-old high school wrestler in Ohio.
According to a recent ABC News report, the boy had 70 micrograms of caffeine per milliliter of blood in his system, an amount that far exceeds the 3 to 5 micrograms you’d find in a typical coffee drinker.
Even a tiny amount of pure caffeine powder, which isn’t regulated by the FDA, can be harmful. For example, a mere teaspoon provides just about the same amount of caffeine as 25 cups of coffee.
As a moderate caffeine consumer, registered dietitian and mother of two (my older son just turned 16, and my younger son is 12), the use of caffeine by children concerns me. Because children typically weigh less than adults, they’re much more vulnerable to caffeine’s effects. And although few studies have examined the effects of caffeine in children, a recent review published in the Journal of Hypertension found that the caffeine concentration in so-called energy drinks is high and their over consumption could contribute to insomnia, agitation, tremors and cardiovascular complications like sudden death.
Although I don’t mind if my sons have an occasional caffeinated soda at a party, I’ve tried to encourage them to play it safe by simply avoiding caffeine-containing beverages—at least until they’re older and until caffeine amounts are required to be posted on labels. But until the FDA provides guidance on how much caffeine is safe for children to consume, it’s wise for parents to heed the advice of the American Academy of Pediatrics or Center for Science in the Public Interest and to encourage kids to avoid caffeinated soda, energy drinks, and for most kids (except extremely athletic ones), sports drinks—at least most of the time.
According to the National Institutes of Health (NIH), caffeine may dial down a child’s appetite—a problem if a child is underweight or already has limited food or nutrient intake. The NIH also discourages caffeinated beverage intake in children who are hyperactive since it can potentially exacerbate their behavior.
Caffeine can also exacerbate anxiety and depression or interfere with sleep. In large amounts, it can reduce calcium absorption and thin bones. None of these effects are desirable, especially in growing children.
At the very least, it’s prudent to follow Health Canada’s daily guidelines for caffeine use in children aged 4 and above:
- Age 4 to 6: 45 milligrams (~one 12-ounce can of cola)
- Age 7 to 9: 62.5 mg (~one and a half cans cola)
- Age 10 to 12: 85 mg (~two cans cola)
- Age 13 and older: no more than 2.5 milligrams of caffeine per kilogram of body weight
To see how much caffeine various beverages and foods contain, check out MedlinePlus or CSPI’s Caffeine Content of Food & Drugs.
It’s also critical to monitor children’s online purchases and to protect them from potentially harmful products like powdered pure caffeine and caffeine-loaded energy drinks that are easily available to virtually anyone online.
Image of family having breakfast in bed via shutterstock.
Do you let your kids consume caffeine?
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Diet, Health, Must Read, Nutrition
Sunday, July 13th, 2014
If you and your kids frequent fast food restaurants—especially while traveling over the summer—Consumer Reports just released its latest fast food survey. In an update to its 2011 survey, Consumer Reports had more than half of its 32,405 subscribers rate 96,208 meals at 65 fast-food chains in America on variables including food quality and freshness and value. One of the key findings of the survey was that while consumers talk thin, they eat fat.
According to Consumer Reports, despite the fact that some fast food restaurants have made some strides when it comes to nutritious offerings, many aren’t biting. It’s true that many chains now offer nutritious options like salads and soups, have reduced sodium in their offerings (for example, Subway reports it has reduced sodium in some core menu items including low-fat sandwiches and subs by 15 to 28%), have added grilled choices, and now offer fruit and yogurt (instead of French fries and cookies) in kids’ meals. Some chains including Chipotle, Culver’s, and Panera have even begun to offer poultry raised without antibiotics. But despite an increase in nutritious fast food fare—64% of those surveyed said that the restaurant they ate at most recently offered enough healthy alternatives—only 1 in 5 said they think about the availability of healthy menu options when choosing a restaurant. That’s no real surprise, but troubling nonetheless since higher fast food intake seems to be associated with higher calorie intake and a less nutritious diet overall. And according to Consumer Reports, Americans spend more than more ever before—in excess of $680 billion—dining out.
But there’s some good news: while only 19% of those surveyed reported ordering a healthy meal during their most recent dining experience, 42% of women and 28% of men reported they ordered lower calorie fare when calorie and nutrition information was conspicuous at such restaurants.
While I agree that some healthy steps have been taken in recent years to improve the nutritional and overall quality of fast-food, healthy pickings remain slim. And unless parents and their children who frequent such restaurants demand or at the very least buy more healthful fare when it’s made available, little is likely to change. So as I inferred in a previous Scoop on Food post, fast food probably won’t be considered health food any time soon.
If you know fast food is and will continue to be part of your family’s diet, I’m not going to be the food police and tell you to forgo it altogether. But if you and your kids have fast food more than once-in-a-while, it’s important to at least become familiar with the menus at some of your favorite fast food outlets (fortunately, many are available online). Planning ahead and making mindful choices in moderate portions can help you and your kids fit in fast food without derailing an otherwise healthful diet.
Here are some tips adapted from Consumer Reports to help you move in a more healthful direction when you eat fast food:
- If eating healthfully is a priority when you eat out, choose more often from sandwich shops, Asian, and Mexican restaurants instead of from pizza and burger chains.
- Have it your way. Many chains will hold the mayonnaise or cheese, go easy on sauces, substitute skim milk for whole milk, or serve dressings on the side. This is especially true at sandwich shops.
- Beware of certain words. Instead of buying foods that are battered, creamy, crispy, crusted, sautéed, or stuffed, choose items that are roasted, broiled, baked, grilled, charbroiled, steamed, poached, or blackened.
- Don’t supersize unless you plan to feed your whole family. For example, choose a single patty instead of a double or triple, and choose small instead of medium or large items (especially for high calorie items like French fries).
- Drink smart. Instead of soda, choose plain water or low- or nonfat milk.
How do you help your family fit in fast food without sabotaging your diets?
Image of cheeseburger and french fries via shutterstock.
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Sunday, July 6th, 2014
As a registered dietitian nutritionist, I always tout the perks of protein in the context of a nutritious diet. A satiating and satisfying nutrient, protein is found in a wide variety of animal and plant foods. Children need it because it provides their bodies with energy to support growth, development and maintenance of muscles, bones, organs and all body cells. But despite its many virtues, many children—and their parents—OD on protein.
The popularity of Atkins’ type diets coupled with concern over carbohydrate and added sugar intake have led many of us parents to consume more of our daily calories from protein. That has likely lead many kids to also eat more protein-rich foods. The emergence of more and more foods pumped up with protein—everything from granola bars to pasta, Cheerios with protein, high protein pretzels and even pancake mix made with extra protein as described in a recent segment on Good Morning America—is likely to make even more adults and children consume protein in amounts that can greatly exceed their daily needs.
For infants up to age 6 months, the adequate intake (AI) for protein is 9.1 grams daily. For older children, Recommended Dietary Allowances for protein range from 11 grams daily for 7- to 12-month-olds to 13 to 46 grams daily for 1- to 18-year-olds. To put these protein recommendations in perspective, the following foods and beverages each pack in about 8 grams of protein: 1 ounce roasted turkey, 1 ounce broiled sirloin, 1 cup milk, 1 ounce Swiss cheese, 4 ounces firm tofu; and ~1/2 cup chickpeas.
Although it’s a challenge to know just how much protein infants and older children consume, the most recent What We Eat in America report reveals that boys aged 2- to 5-years-old, 6- to 11-years-old, and 12- to 19-years-old consume an average of 56, 68 and 95 grams of protein, respectively, each day. The survey also shows that girls aged 2- to 5-years-old, 6- to 11-years-old, and 12- to 19-years-old consume an average of 56, 63, and 64 grams of protein, respectively, each day. grams. Essentially, the report suggests that children can easily consume 3 to 4 times the amount of protein recommended for them daily.
Although it’s not yet clear how excess protein affects children’s health over the long term, a recent review in Food & Nutrition Research concludes that a high intake of protein (15 to 20% of total calorie intake) in infancy and young childhood increases the risk of obesity later in life. The researchers recommend an average of 15% of total calorie intake for protein as the upper limit at 12 months of age. (However, current Dietary Guidelines for Americans recommend a range of 10- to 35% of total calories from protein for Americans aged 2 and older.) To reduce protein intake in an infants’ diet, the researchers recommend breastfeeding for the first year of life since breast milk has less protein than formula, and to avoid excessive intakes of protein-rich foods like cow’s milk.
Besides its link to weight gain, too much protein can strain kidneys and cause bones to excrete calcium. It can also lead to excess calorie and saturated fat intake—and increase the risk of unhealthy weight gain, cardiovascular disease, high blood cholesterol and high blood pressure. This is especially true if the protein foods children eat include big portions of fried, skinned chicken, fatty meats and full-fat dairy products.
While it’s much more important to focus on children’s overall diet and the foods they are offered and actually eat rather than specifically how much protein they consume, we parents can help them achieve more dietary balance. When it comes to protein, we need to provide—but not push—protein foods that are in their lowest fat forms and are prepared in healthful ways. Examples include low- and nonfat milk, yogurt and cheese; lean beef; skinless poultry; fish; eggs; beans and peas; and nuts and seeds. We need to offer these foods in amounts based on children’s unique needs (check out the Daily Food Planner based on MyPlate here).
Although few children are deficient in protein, those who for whatever reason consume fewer calories than they need for growth and those who follow vegetarian or vegan diets may fall short on protein. In such cases, it’s important to offer and encourage intake of protein-rich plant foods including soybeans and tofu (like animal proteins, these contain all the essential amino acids the body needs and cannot make itself) to meet calorie and energy needs. Adding such foods to other dishes your child already likes can help. And while foods touted as having extra protein can help some children meet their baseline protein needs, most can afford to bypass such foods and instead rely on foods that are naturally protein-rich.
Image of meat and dairy foods via shutterfly.
Do you pay attention to your child’s protein intake?
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