Digestive Issues: How to Help with Diet

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Digestive issues are extremely common among kids and adults in our country. So common, in fact, that we often don’t give these issues much thought and accept these feelings as being sort of normal. As a registered dietitian, I can tell you that digestive issues are your body’s way of telling you that some changes need to be made to feel better.

Here are common digestive problems, along with causes and dietary cures:

Acid Reflux

Causes:  Overeating, making the stomach too full and as a result, the stomach contents push up into the esophagus. Reflux can also be caused by food sensitivities or allergies, especially in infants.
Diet Cures:  Eat smaller meals at regular intervals each day (3 meals and 2 snacks). Your stomach is about the size of your two hands cupped together (with two more hands on top to make a sphere), so try eating about this much at meals. Eliminate fried foods. Eat plenty of fruits, vegetables, whole grains and lean meats. Eliminate trigger foods such as caffeine, dairy, and other high fat foods (such as sausage pizza or “loaded” nachos). In infants, rule out food sensitivity or food allergy; common culprits related to reflux in infants are cow’s milk protein (dairy), soy, eggs, and wheat.

General Indigestion

Causes:  Overeating, poor quality of diet, chronic constipation, inflamed enterocytes (cells that line the gastrointestinal tract).
Diet Cures:  Eat smaller meals at regular intervals (see above). Reduce processed foods and focus on whole foods such as legumes, fruits, vegetables, whole grains and lean meats. Drink plenty of water (2+ liters/day). Vary your grain intake (often we eat some form of wheat at all meals and snacks throughout the day). Consume probiotics through quality food sources such as organic yogurt, fermented vegetables (sauerkraut, kimchi, etc), and kefir.

Chronic Constipation

Causes:  A diet that is high in refined carbs, low in fiber, and inadequate in fluids. Constipation worsens with inadequate physical activity and long sedentary periods. Kids may be constipated if they consume too much dairy.
Diet Cures:  Eat fresh fruit at least twice per day and vegetables at least 2-3 times per day. Replace refined grains with whole grains. Other foods high in fiber include legumes, nuts and seeds. Drink 2+ liters of water per day. Limit dairy to 12-24 oz per day. Engage in physical activity throughout the day; even walking and doing house chores are helpful.

Frequent Loose Stools

Causes:  Excessive intake of sugary beverages, including juice, as well as excessive intake of “diet sugars”. Can also be caused by food sensitivity/food allergy. Another cause may be imbalanced gut flora, which can occur after taking antibiotics or with prolonged poor quality of diet.
Diet Cures:  Eliminate sugary beverages and replace with water or milk (given dairy is tolerated). Limit diet beverages to 8 oz per day or less. Trial an elimination diet of common food allergens for two weeks to see if symptoms improve (dairy, wheat, soy, eggs, nuts, fish, shellfish). Consume quality probiotic food sources (see above), as well as soluble fiber which is found in foods such as bananas, oatmeal, applesauce, dried peas as in pea soup, carrots, cucumbers.

Stomach Pain, with Gas and Bloating

Causes:  Food intolerance, sensitivity or allergy. Also these symptoms occur with general overeating of unhealthy food choices.
Diet Cures:  Trial elimination of common culprits for two weeks, including lactose (in dairy), wheat, legumes including beans and nuts, eggs, and soy. Eliminate sugary beverages as well. If symptoms do not improve, investigate fructose intolerance by working with a registered dietitian. Eat smaller meals and regular intervals throughout the day reflecting the Healthy Plate Model.

If you didn’t see your digestive issues listed above, or for more specific questions, leave a comment in the section below. For more guidance on helping your family overcome digestive issues, make an appointment with a registered dietitian at North Shore Pediatric Therapy.

Get the Family Healthy in 2014, Part 2 of 2

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Last week, I discussed three New Year’s resolutions to help get your family healthier in 2014. Here are some more ideas. Like I said in last week’s post, adopt as many of these as you think are realistic for your family. Or pick one change to implement each month as the year goes on. By summer, you will see some real changes!

More Fixes for Healthy Family Eating:

1. Eliminate sugary beverages, including juice. This change is pretty simple and can have a huge impact. Sugary beverages are problematic because it’s easy to quickly consume a lot of calories without feeling full. Juice and sports drinks are not ideal drink choices either, as they are just as calorie-dense as other sugary beverages like soda. It is better to get the vitamin C and electrolytes from healthy food choices. Kids rarely need sports drinks to replace electrolytes during or after physical activity unless they are involved in multiple hours of continuous physical activity and are sweating a lot. Chocolate milk is also considered a sugary beverage, and should be replaced with plain milk. If you are wondering how much sugar is in some of your family’s favorite drinks, measure out one teaspoon of table sugar for every 4 grams of sugar in the “Total Sugar” content on the Nutrition Facts Label. Be sure to look at what the serving size is and how many servings your family member is consuming. I have done this experiment with many families, and they are always shocked since no one (not even the kids) would consider drinking that heap of table sugar.

2. Do something active for at least 60 minutes, every day. Encourage your child to be active by having plenty of outlets for physical activity all year round. For days the weather is not conducive for outdoor play, have a bin filled with things like jump ropes, hula hoops, balls, and other toys. Encourage your child to participate in sports or other hobbies that involve physical activity. Be a good example. Find ways to be physically active as a family, such as walking places within a mile or so instead of driving. This is possible even in cold winter months as long as you dress warmly. If your child is resistant to doing fun physical activities, then offer another option— house chores.

3. Limit screen time to less than 2 hours per day. When you think about how many hours your child spends sitting at school, then how many hours they spend sitting doing homework, then how many hours they spend sitting watching TV or playing on the computer—it adds up to a pretty sedentary lifestyle. This is one of the biggest implications of childhood obesity in our culture today. We have transitioned from a society that relied on physical labor to complete daily tasks, to a society that relies on convenience. Kids used to play outdoor games and sports for fun, and now they play video games. I have had some school-age kids tell me that they just don’t know how to play. Set boundaries around screen time. One idea is to have the kids earn screen time by doing 60+ minutes of physical activity and completing homework.

Any of these New Year’s resolutions will make a healthy impact on your family, especially if the whole family is on-board and participating together. The resolutions described are all simple changes, but can be challenging to implement and sustain without commitment. For more personalized planning and troubleshooting, make an appointment with a registered dietitian at North Shore Pediatric Therapy.

Click here if you missed part 1 of this series, Get Your Family Healthy in 2014.

Get the Family Healthy in 2014, Part 1 of 2

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The New Year is here, and it’s a great time to make a resolution to get healthy. In order to stick to that New Year’s resolution, be specific about what changes to make. This can help your family execute a plan to ensure positive outcomes. Here are some specific changes that you as a parent can implement to bring about real change for your family’s health this year. I recommend choosing as many of these as you think are realistic to do in your household. Even one real change is better than a handful of half attempts that fail. Good luck!

Easy New Year Health Swaps for the Family:

  1. Replace the refined grains with whole grains. This advice might sound like a broken record, but based on the wide range of clientele I work with, this healthy change is not actually happening in real families. Whole grains maintain the natural fiber, vitamins and minerals that have been stripped from their refined counterparts. Whole grains include whole grain bread, oatmeal, whole grain pancakes, whole grain pasta, brown rice, quinoa, millet, and whole grain cereals. Refined grains are the “white” carbs, such as white bread, white pasta, and the wide variety of processed foods that are made from refined flours. Sometimes it is harder for parents to make this change than it is for the kids, since our generation was raised on refined flours. Trust me, you will get used to it and soon the refined stuff will taste bland and leave you hungry an hour or so after eating. Because whole grains have fiber, they take longer to digest (making you full sooner and longer). Whole grain fiber also plays an important role in binding and excreting fat, both in digestion and circulating lipids in the bloodstream. From the very beginning of feeding your kids as infants and toddlers, remember- kids do not need “kid food”, and they can enjoy whole grain pancakes and whole grain pasta just as much as the white stuff. Be a good example for your kids.
  2. Replace snack foods with fruits or vegetables. And while you’re at it, limit snacks to two per day (one mid-morning or before bed, and one mid-afternoon). This might be the most effective change you can make if you or your family members are big snackers and grazers. Your job is to make sure there are always plenty of fresh, colorful fruits and vegetables available to your kids. When it comes to produce, quality matters. Kids will more readily accept things that look and taste fresh, so choose wisely. Local and organic produce is usually more fresh and flavorful than something that may have traveled half way around the world and then sat frozen in a warehouse for months. Enforce this change by telling the kids what their snack options are, then encouraging them to go play or do homework before the next meal (or bedtime).
  3. Limit eating out to once per week or less. Although it is possible to eat healthy when eating out, often it is easier to make unhealthy choices and overeat when eating at restaurants. It may be even more difficult for your kids to eat healthy when eating out as many kids’ menus are limited to foods high in fat and sodium and low in fiber. This may be a challenge for the busy parent who is not used to cooking. If you choose this resolution, be prepared to plan, grocery shop, and cook. Cut corners by using time-saving and healthy cooking methods such as the slow-cooker and stir-frying lean meats and veggies. It may be a difficult change to implement, but it will be very rewarding from a health perspective (and on your budget).

Check the blog next week for more healthy New Year’s resolutions for your family!

Click here for more advice on how to set achievable goals for the new year.

How I Plan to Eat this Holiday Season without the Guilt Trip

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Christmas and New Year celebrations are just around the corner and we’re bound to meet old friends, families, and enjoy good food. Yes, the holidays, especially Christmas and New Year is all about home-cooked meals—those scrumptious delights we’ve been hoping for throughout the year. But, we also feel guilty after eating these foods. So, how can we have fun, eat heartily, and live healthy? In this article, I’m sharing my plans to enjoy eating during the holidays, while also keeping lean.
tips to stay healthy for the holidays

Healthy Holiday Eating Plan:

Plan #1: Always Check Ingredients

Most people think that the food that they eat is what makes them fat. However, this isn’t entirely true: there are certain substances or “hidden ingredients” that can make you fat.  In an article for Save Our Bones; writer Vivian Goldschimdt, MA, warns people of these hidden ingredients:
  • Soybean Oil
  • Yellow # 5 (a food dye)
  • Propylene glycol alginate (E405)
  • Monosodium Glutamate (MSG)
  • Butylated Hydroxytoluene (BHT)
These ingredients have been found to cause nausea, heart irregularities, migraine, seizures, and skin rashes. Aside from these side Read more

Infant Feeding Series: Starting Solids

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After the first several months of life, your baby is approaching that age when either of one of two scenarios occurs:

1. Baby is practically grabbing the spoon out of your hand when you’re eating and seems so eager to eat some of that!

2. Friends, family members, and even the pediatrician keep asking when you plan to start solids.

What is the right age, what is the right first food, and how exactly do you go from there? This blog covers a plan that is based on research, professional, and personal experience. The important thing is to follow your baby’s lead. It is up to your baby to learn to eat at his or her own pace, not up to you to make them eat.

What is the right age to start solids?

According to the current recommendations from the American Academy of Pediatrics, the age to consider starting solids is 6 months old. This is later than previous recommendations and probably later than our parents started feeding us foods. There are several reasons why this age is recommended, which include developmental milestones and readiness, digestive system maturity, and long-term studies looking at outcomes of risk for developing issues like food allergies, digestive disorders, obesity, diabetes, etc. In addition to watching the calendar for that 6-month birthday, watch your baby closely for signs of readiness as well.

Here are some things to watch for to make sure your baby is ready to transition to solids (and is more likely to be successful doing so):

  • Baby can sit with minimal support, and has very stable head control. Read more

Make Your Holiday Recipes Healthy for Hanukkah and Christmas

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Potato latkes are a popular food prepared during Hanukkah. This dish combines two typically unhealthy foods- a white starch (potatoes) and oil for frying. To put a healthy spin on your latkes this year, try this recipe, which includes the healthiest oil options and extra vitamins and minerals.

Potato Latkes

Ingredients:
  • 4-5 cups of boiled and grated potatoes (4-6 large potatoes). Choose organic potatoes and do not peel the skin.
  • 2-3 Tablespoons olive oil, walnut oil, or canola oil, with additional 1-2 tablespoons added as needed when the pan dries out.
  • 1 medium onion, diced
  • 1/3 cup whole wheat flour
  • ¼ teaspoon black pepper
  • ½ teaspoon salt
  • 2 eggs Read more

Holiday Cooking for Speech and Language Development

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Ready or not, the holidays are right around the corner! This means family, fun, vacations, and a lot of free time. And let’s face it; you’ll most likely have a lot of cooking to do. So, why not have your kids help you, while you help them by making cooking into a fun speech and language activity!

Recipes are a great way to target a variety of speech and language goals in a fun, unstructured way. There is a lot of planning and processing needed to execute a perfect recipe and let’s face it, even the adults don’t always get it right – I know I’ve made a mistake or two! (Why is that cup of flour still sitting on the counter when my cookies are already in the oven?)

Here’s a list of speech and language activities you can tackle with some fun, kid-friendly Thanksgiving desserts from food.com:

  • Sequencing: Read through the recipe and have your child identify what step is first or last. You can incorporate concepts such as before, after, and next. For example, “What comes after the eggs?” You can also have your child repeat the directions in order – if it’s not too complicated! Feel free to use a visual with this task, draw a simple pictures (i.e. a mixing bowl, spoon, cookie sheet) to support each step. Read more

How to Talk to Your Kids about Weight and Healthy Eating

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We all want our kids to be the healthiest they can be. In recent years, we are seeing serious health problems presenting in young kids and adolescents. An unhealthy diet and lifestyle affects kids’ quality of life, and this is often what hurts them most. Kids with weight issues may get teased at school or start to withdraw from activities that were once a big part of their life, such as sports. This can make the weight issues even worse for them.

If you find yourself in a position of having to talk to your child about his or her weight, consider some of the points below. These tips apply to both overweight and underweight issues.

Explain BMI and the importance of being in a healthy range.

BMI stands for body mass index. Your child’s pediatrician should be measuring your child at well checkups and plotting their BMI on a growth chart. You can explain BMI to kids by saying, “BMI is a measurement of how much weight is on your body for how tall you are.” Read more

Pumpkin: A Nutrition Powerhouse

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It’s that time of year! Pumpkin season is here and we are all heading to the patch to find the best ones. Although pumpkins are most popular for carving and decorating, they should also get attention for being very nutritious. Both the seeds and the flesh are packed with nutrition.

Read on to find out why pumpkins are so nutritious, and enjoy these recipes using pumpkin that your family will love:

Pumpkin Seeds:  In a nutshell (no pun intended), they are a great source of omega 3s. These are the super healthy fats that reduce inflammation and are highly concentrated in brain tissues. Omega 3s are essential fatty acids, which means our body does not make this type of fat, so we have to get it from our diet. Eat up those pumpkin seeds, and reduce your risk for chronic disease while boosting your brain!

Roasted Pumpkin Seeds Recipe:  Save the pumpkin seeds from carving for a healthy snack. Rinse them in a colander to remove all of the flesh, then boil them in salted water for about 10 minutes. Roast in the oven at 400 degrees on a cookie sheet with olive oil for 5-15 minutes or until golden brown. Read more

Understanding Genetically Engineered Foods (GMOs)

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The topic of genetically engineered food is hot right now. There is a debate between food labeling advocacy groups and large food industry producers over the need to label foods that are genetically engineered (GE). The term GMO (genetically modified organism) refers to a food that has been genetically engineered. The following points can help clarify what the debate is about and why it may be important to your family to be informed.

What is a GE or a GMO?

These terms are essentially interchangeable. A genetically engineered food has had foreign DNA bred into the plant (or animal, although at this point GMOs are all crops), which results in DNA that would not otherwise naturally occur in that food. The goal of genetic engineering from an agricultural standpoint is to produce crops that tolerate pesticides or to breed pesticides into the crops. Virtually all genetically engineered seeds contain viral or antibiotic DNA (or both). Read more