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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.
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Diet, Health, Must Read, Nutrition
Thursday, February 6th, 2014
We all know that sweetened beverage intake in kids can be a problem. Sugary sodas, energy drinks, fruit drinks and other sweetened beverages often provide extra calories with few nutrients. Drinking them is linked with poor oral health and cavities. They’re also easy to over consume, especially since they tend to come in large portions (12 to 24 fluid ounce servings are typical) and aren’t filling the way solid foods are. Sugar-sweetened beverages can also displace or leave less room in the diet for more nutritious foods and beverages.
There’s also evidence that higher sugar-sweetened beverage intake is linked with a higher risk of overweight and obesity among children and that reducing intake can reduce weight gain associated with their consumption. Initiatives to drink more water and to remove soda from kids’ meals will likely help to create an environment in which kids and their parents can make better beverage choices.
Two new studies underscore the importance of helping kids develop healthful habits when they’re young to prevent obesity and optimize health. One study published in the New England Journal of Medicine found that children who were overweight at age five were four times as likely as normal-weight children to become obese by the age of 14.
Another study published in the Journal of School Health found that a lot of young children drank sugar-sweetened beverages and that the older they got, the more they drank. Compared with an infant less than one year-old, a child between the ages of one and two-years-old was 35 times as likely to consume fruity drinks, 17 times as likely to consume sodas, six-and-a-half times as likely to consume sweet tea, and about 53 times as likely to consume sweetened milk products. As compared with an infant less than one-year-old, a three to five-year-old was nearly 263 times as likely to consume fruity drinks, 30 times as likely to consume sodas, nearly 11 times as likely to consume sweet tea, and 375 times as likely to consume sweetened milk products. Led by University of Alabama researcher Jen Nickelson, the study concluded that interventions designed to prevent sugar-sweetened beverage consumption should occur early in life, ideally before children reach preschool age.
According to Nickelson, “To avoid the problems associated with sugar-sweetened beverage intake and to help ensure children have the nutrients they need for proper growth and development, its best to keep kids from drinking them to begin with. If children learn to love beverages such as water and milk early in life, they have a better chance of maintaining these healthier habits as they mature.”
Here are six tips from Nickelson to help you raise healthier drinkers:
1. Keep only healthful beverages in the house. For example, providing only water or milk in the home provides structure and helps kids know what to expect, at least when they’re home.
2. Be a good role model. If the kids see you drink water, they know you’re not asking them to do anything you wouldn’t do yourself.
3. Give them choices. Allow your children to choose healthier beverages in the form they enjoy. For example, they can choose plain water or water with lemon or other fresh fruit slices.
4. Encourage children to finish their milk at their own pace. Children resent being forced to do something, so if they haven’t finished their milk during a mealtime, you can save it in the refrigerator and offer it later when they’re thirsty.
5. Plan ahead. When you know you’ll be out and about, plan beverages ahead of time. Carry a sippy cup of water for toddlers and a trendy sports bottle for older kids. Water never goes bad; and if it spills, it won’t make a smelly, sticky mess.
6. Offer to bring drinks to your kids’ sporting events or parties. Bring bottled water (sugar-free squirtable flavorings can also make these more fun; I know my grandchildren love to squeeze the flavorings into the bottles and shake them up). Also bring permanent markers to label drink bottles to avoid mix-ups.
As a registered dietitian nutritionist and mother of two, I believe it’s perfectly fine to also offer 100% fruit juice to children. Of course whole fruit packs in fiber and is more filling than juice. But if you do offer fruit juice, limit portions to no more than four to six ounces daily for children between the ages of one and six-years-old, and to no more than eight to 12 ounces daily for older children as recommended by the American Academy of Pediatrics. Low fat flavored milk is also OK, though it’s wise for kids to cut back on their added sugar intake that day (eg have one small cookie instead of the usual two cookies for dessert) when they consume flavored milk.
How do you help your kids drink more healthful beverages?
Full disclosure: I’m a current spokesperson for the Got Milk? campaign.
For more ideas on where you can substitute healthier foods into your everyday routines, download our free guide.
Image of child drinking water from a glass via shutterstock.
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Monday, January 27th, 2014
After a decade of working toward revising 20-year-old nutrition facts labels, the Associated Press (AP) reports that the U.S. Food and Drug Administration (FDA) has sent guidelines for the new labels to the White House for review.
Although we don’t yet know exactly what will change on labels and when manufacturers will have to implement such changes, calorie listings will likely be more prominent. As noted by Time, serving size information may change as well.
The AP article outlines a few desired changes that health and nutrition advocates’ hope for. These include adding a line for sugars and syrups that are not naturally occurring in foods and drinks and added when processed and prepared; adding the percentage of whole wheat to the label (currently, a product can say it’s “whole wheat” even if there’s only a small percentage of it in the food); using more clear measurements (eg for added sugars, using teaspoons instead of, or alongside, grams); using serving sizes that make sense (eg basing them on portions one might or should eat in one sitting); and providing labels that highlight certain nutrients on the front of packages.
I, too, hope that the new labels make calories more prominent. Although I don’t necessarily recommend that parents and children start counting calories, it is important—especially for children—to meet, and not exceed, daily calorie needs to achieve and maintain a healthy body weight as they grow. Using calorie information can be especially useful when comparing items that don’t fit neatly into food groups or that tend to have lots of empty calories and are easy to overeat such as condiments, snacks and desserts.
Besides listing total sugars that include both naturally occurring sugars like fructose in fruit or lactose in milk and added sugars—sugars (like white sugar, brown sugar, honey) and syrups (like high fructose corn syrup) that are added when foods or beverages are processed or prepared), I really hope labels will specify how much of the total sugar comes from added sugars. Listing them not just in grams but also in teaspoons would also be helpful, especially when the American Heart Association and dietitians’ recommendations for sugar intake are often in calories or teaspoons. Having information like this can be especially helpful when choosing foods that can have added sugars including canned or frozen fruit, flavored milk and yogurt, cereals, baked goods, ice cream, condiments and beverages.
I’d also love to see standardized serving sizes for similar foods such as ready-to-eat cereals. Standardizing serving sizes for cereal to 1 cup—a portion many people (including kids) consume—will make it that much easier to make comparisons and hopefully choose those with the least calories, most fiber and least sugar.
I also agree with my colleague Wendy Jo Peterson who told me on Facebook that she’d like to see Daily Value percentages removed since they’re confusing and don’t apply to everyone.
As soon as labels are officially updated, you—my loyal Scoop on Food readers—will be the first to know. Of course I’ll also share with you ideas for how to use them to feed your children well. In the meantime, you can use this guide from the Academy of Nutrition and Dietetics to understand current Nutrition Facts Panels.
What information would you like to see on the new food labels? And what information would you like to see removed from labels?
Need some inspiration in the kitchen? Click here for our recipe guide.
Image of nutrition information being studied under a magnifying glass via shutterstock.
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Thursday, January 23rd, 2014
A new study by Consumer Reports reveals concerning levels of a potentially carcinogenic chemical—4-methylimidazole (4-MEI)—in soft drinks. In the study, researchers looked at levels of the chemical, formed during the production of some types of caramel color (an artificial coloring commonly found in foods and drinks) in 81 cans and bottles of popular soft drinks purchased in California and New York between April and September 2013. In December 2013, 29 new samples of brands that initially tested above 29 micrograms of 4-MEI were purchased from the same areas and retested.
Both rounds of testing found 4-MEI levels in Pepsi One and Malta Goya samples exceeded 29 micrograms per can or bottle. In the initial round of testing, some of the other brands purchased in California had average levels around or below 29 micrograms per can, although New York samples of those same brands tested much higher. In the second round of testing, the levels in the New York samples had come down. As stated in a Consumer Reports article, “…regular Pepsi from the New York area averaged 174 micrograms in the first test and 32 micrograms in the second.” The article also says that the drop in amounts of 4-MEI from the first round of testing to the second suggests that some manufacturers may have taken steps to reduce levels in their products.
The Consumer Reports analysis also found that the products purchased in California didn’t have a cancer-risk warning label. That’s surprising since as of January 7, 2012, manufacturers have been required to put such a warning on the label of a product sold in the state if it exposes consumers to more than 29 micrograms of 4-MEI per day.
According to a 2007 report by the National Toxicology Program (NTP), a 2-year mouse study showed an increased incidence of certain lung tumors caused by consuming levels of 4-MeI that far exceed current estimates of human exposure. And in a 2010 report by the International Agency for Research on Cancer (IARC), 4-MEI was deemed as “possibly carcinogenic to humans.”
In its assessments in 2011 and 2012 of 4-MEI in caramel colors, the European Food Safety Authority (EFSA) concluded that they have no concerns about Europeans being exposed to 4-MEI from the use of caramel coloring in food.
According to an NBC News article, while the U.S. Food and Drug Administration (FDA) says there’s no evidence 4-MEI is unsafe, an FDA spokesperson said the agency will take a closer look after Consumer Reports complaints. Currently, there are no federal limits for 4-MEI levels in foods and beverages.
We all know soda is a popular beverage among children and adults alike. We also know that for many reasons, kids (and all of us) should drink less—if any—soda. Besides being a source of empty calories (mostly from sugar), soda has been linked with everything from obesity to aggressive behavior in children. The fact that caramel color found in soda may promote cancer adds even more incentive for kids to sip less soda and more water and other nutritious beverages. I also agree with the Center for Science in the Public Interest statement that says, in an article about 4-MEI, that “soda drinkers should be much more concerned about the high-fructose corn syrup or other sugars used in soft drinks” and that “soda drinkers are much more likely than non-soda drinkers to develop weight gain, obesity, diabetes, and other health problems.”
If we want to limit our family’s exposure to the potentially cancer-causing 4-MEI, we need to look beyond soda since other foods and beverages are sources. According to the FDA, the chemical can form as a byproduct in some foods and beverages when cooked—for example, when coffee beans are roasted and when meats are roasted or grilled. According to the Office of Environmental Health Hazard Assessment (OEHHA), other potential sources of 4-MEI include include beer, soy sauces, breads and other products can also be sources.
Until we know more, a great way to protect kids—and ourselves—from overexposure to potentially harmful ingredients like 4-MEI is to read ingredients lists on food labels. Not all potentially harmful ingredients will be listed, and at times you’ll need a figurative magnifying glass. For example, although you won’t see 4-MEI listed on an ingredients list, you will see caramel color—and some caramel color will contain 4-MEI. We can also use safer cooking methods when preparing foods including meats. For example, when cooking meats, we can limit the creation of potential cancer-causing chemicals by using smaller pieces, trimming visible fat, using certain herbs and/or marinades, precooking meat in a microwave and cooking it at a lower temperature or for less time. We can also mix up the foods and beverages we feed our kids week to week to maximize nutrient intake and minimize exposure to substances that can potentially cause harm.
For more on food additives, check out CSPI’s Chemical Cuisine here.
Image of little girl drinking a soft drink via shutterstock.
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Wednesday, August 21st, 2013
In my last parents.com post, I shared my thoughts on whether or not soda could—or should—be a part of kids’ diets. While I certainly don’t think of sugary or artificially sweetened sodas as good-for-you beverages, I also don’t think of them as poison. Although I don’t give or encourage my kids to drink soda or other sweetened, nutrient-poor beverages, they drink it on occasion—just like they have candy or cookies or ice cream once-in-a-while. They know the difference between nutrient-rich and nutrient-poor foods, and I teach them the best I can from my example and from education and experience to choose mostly nutritious options and to keep portions of nutrient-poor options small and to consume such foods infrequently.
It’s always a challenge for parents to feed kids well. But I don’t believe there’s only one way for parents to raise their children to eat well and nutritiously. Each family should find what works for them to help raise healthful eaters who are active and fit and who feel good about food and their bodies. Ultimately, it is up to parents to decide what messages about food and eating they want to pass on to their children and to create an environment that supports those messages. It is also parents’ prerogative to decide what (if any) role different foods and beverages—soda, or other empty-calorie foods—should play in their kids’ diets.
Because I don’t consider my personal opinion about feeding children to be the only—or right—opinion all must share, I queried several dietitians, a physician, and a health advocate to share their thoughts about the soda issue. Here’s what they had to say.
When I was a child, soda was a special treat–it was reserved for family picnics and rare dinners out. We drank water when we were thirsty. Now, children find water boring–they want it flavored with something–primarily sugar and artificial flavorings. While I don’t think it’s effective to demonize sodas, we need to get back to our roots. There is a strong relationship with soda consumption and childhood obesity. Let soda be for special occasions, dinners out, parties, picnics. Don’t bring it home and stock it in the house as a regular part of the diet. Let children drink water–straight out of the tap–when they’re thirsty. It will be better for their health, and it’s better for the environment.
~Sharon Palmer, RD, author, The Plant-Powered Diet
I have adult daughters, but when they were small, soda was not allowed in the house. They could have their choice of soda on their birthdays and I know they had it when at a friend’s house. As my daughters went through their teen years and college, the both said that while they did drink soda once-in-a-while, it wasn’t something they craved. Instead, both chose mostly water and homemade smoothies. I believe parents control what foods and beverages are in the home. If you don’t purchase soda, then children don’t have access to it. And that makes it much easier for them to enjoy the most natural hydrator—water.
~Debra King, MS, RDN, LD, CEO, Crown Consulting
As a registered dietitian nutritionist and mom of an active five-year-old, I believe that moderate soda intake is acceptable for my child. We live in the hot and sunny south, and my child plays outside all day. He drinks a variety of drinks, and milk is his favorite. However, when it is hot outside, and he is playing and sweating, he also drinks water, and sometimes a regular or diet soda. I do not allow him to have soda that contains caffeine as he already so full of energy. My child is lean and eats a diet based on fruits and vegetables, low fat dairy, whole grains and lean protein. He does not like or ask for cakes, cookies, pies etc. Labeling a food or beverage as “good” or “bad” doesn’t make sense to me, because if a child is not allowed soda, but is allowed high sugar treats throughout the day, what is the difference? I understand the AAP’s position on eliminating soda in children’s diets, but I think that education would be a better tactic. An occasional soda, regular or diet, in the context of an otherwise healthy low fat diet is not the enemy. This is especially true in active children of normal weight.
~Melissa Herrmann Dierks, RDN, LDN, CDE, Eat Smart Nutrition Co.
(Disclaimer: Melissa is also a consultant to the food and beverage industry, including Coca-Cola.)
We rarely had soda in our house and consequently, my kids didn’t develop a taste for it. However, once my kids went to school, it was a different story. My son (who is now 29, I might add) was given FREE soda at his middle school as part of a soft drink promotion. It was widely available in school and sports settings. Schools today also have fundraising McTeacher nights or Pizza Hut coupons for rewards for reading which promotes fast food and soft drink consumption. This creates a tough situation for parents because it put us up against a very powerful and savvy marketing and media machine. When it comes to diet soda, I absolutely do not support diet soft drink intake because of metabolic issues we don’t fully understand. If I had to choose between regular or diet soda, I would rather dilute a regular soda with plenty of carbonated water and ice to create a fizzy, refreshing taste, than give kids or adults diet soda. Parents should also know that most commercial soft drinks contain GMO sweeteners, and the cans may be lined with BPA.
~Melinda Hemmelgarn, MS, RD, Host, Food Sleuth Radio
As the mom of two school aged children, this is always a challenge. There are peer influences, as well as a desire for that extreme sweet taste, that sometimes override sensibilities. I am opposed to children drinking soda as there’s no good that comes from it. Soda provides empty calories and excess sugar, not to mention chemicals that affect children’s insides (though we’re not yet sure how). My gut reaction is for kids to avoid soda altogether. We never keep soda in our house, but what our kids drink when at their friends’ houses or when dining out might be another story…
~Victoria Shanta Retelny, RDN, LDN, author of The Essential Guide to Healthy Healing Foods (Alpha Books/Penguin)
Low-calorie sweeteners, including those in diet soda, are some of the most thoroughly studied food ingredients on record and numerous robust scientific studies show they are safe for people of all ages. The American Heart Association, American Diabetes Association, and the Academy of Nutrition and Dietetics all agree that low-calorie sweeteners can help safely control blood sugar and achieve health goals.
~Theresa Hedrick, MS, RD, LD, Nutrition and Scientific Affairs Specialist, Calorie Control Council
I tell my adolescent patients to avoid soda as much as possible. It’s an empty-calorie beverage that can do more harm than good! The American Heart Association recommends that children have no more than six added teaspoons of sugar daily. One 12-ounce bottle has nine teaspoons. I would rather have my clients drink beverages sweetened with a little stevia or one to two teaspoons of sugar than sip diet sodas as I feel it is an unhealthy beverage. Artificial sweeteners have zero nutritional benefit. And there are so many healthy drink options: water, seltzer, herbal teas, seltzer with a little fruit juice. Eating/ drinking real whole foods is a better choice than consuming products with artificial ingredients.
~Lisa Stollman, MA, RDN, CDE, CDN, author of The Teen Eating Manifesto: The Ten Essential Steps to Losing Weight, Looking Great and Getting Healthy
We recently were on vacation in Atlanta, Georgia. Our friends and family were after us to visit the Coca-Cola Factory. I just said ‘NO’ because I would have been more critical about the whole process and how the factory worked rather than enjoy myself. I thought, why bother tasting soda flavors from so many countries when it’s not doing anything good for us. But even after hearing about the factory from their friends and checking out the factory’s website, reading about the tour and all the fun things they’d do and see on the tour, they still said NO even though they were given the freedom to make a choice. I was amazed! I am a strong believer of not having soda at home or offering to others when entertaining. I think this has rubbed off on my children. I do allow them to have soda if they wish when they’re at a birthday party. My 10-year-old son sometimes drinks Fanta, but my six-year-old daughter still chooses water over soda. One thing I constantly do is to remind them if something is good for them, and why soda is not good for them. I teach them not to succumb to peer pressure by drinking soda. I also teach them that they are responsible for their own health and that they actually have the power to influence other kids just by making a better choice for themselves.
~Shivani Sharma RD, LD, CLT, author, speaker and nutrition educator
I think it absolutely depends on the family and the child. The worst thing I could ever do with my oldest son who became obese during adolescence and who had oppositional tendencies (his story appears in my book, Weight Loss Confidential - he’s now 29 and manages his weight reasonably well) was to not allow something in the house. It only made him want it all the more.
~Anne M. Fletcher, MS, RD, LD, Anne M. Fletcher Communications, Inc.
I personally feel that nothing has to be completely avoided, especially for children. If you categorize foods or beverages as “never” or “forbidden” items, it may contribute to an unhealthy relationship with food. However, parents and caregivers should promote healthier options (like water or low- or nonfat milk ) on most occasions. and offer soda or juice less frequently. That can teach children that, over time, drinking too much soda—regular or diet—does not benefit health and may, down the road, add to health problems many of us adults face today.
~Melissa Mitri, RD, CDN
Should kids drink soda? No, except for on the rare occasion. If we teach our kids that food and drink are fuel for our bodies, soda is definitely not high octane!
~Jennifer Ashton, MD, ABC News Senior medical contributor and author of The Body Scoop for Girls
I think soda and diet soda are harmful to the body and should not be consumed by parents or children. There are no benefits to having it as a part of your life or healthy lifestyle, and there are risks associated with drinking it. For one, aspartame—the artificial sweetener found in Diet Coke—is made of three chemicals: aspartic acid, phenylalanine, and methanol. Aspartame consumption has been linked with various diseases including cancer, muscular sclerosis, and diabetes and may contribute to weight gain, headaches, or fatigue. People need to realize they can still enjoy their lives and prevent disease by eating real food and drinking beverages. Once we start taking responsibility for what we put in our bodies, and make better choices that help us have healthier hearts, good eyesight, energy, mental clarity, strong bones, and clear skin, we will become a healthy nation instead of a sick one.
~Sarah Stanley, health advocate and endurance athlete
What’s your opinion? Are you yes, no, or somewhere in the middle when it comes to your kids and soda intake?
Image of little girl drinking water with young mother via Shutterstock.
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