Farmer’s Markets in the North Shore

It’s farmer’s market season! If you have ever tried farm-fresh fruits and vegetables, you know that you can taste the difference between them and those that are frozen, canned, or even sitting on produce stands in the grocery store. Going to a farmer’s market is a fun family activity that provides kids with a different way to experience fresh food. Often, farmer’s markets will have live music, arts and crafts, and of course, lots of tasty food to sample.

Mother at a Farmers Market location

I am often surprised at how affordable produce is at farmer’s markets. Taking just $20 out of the weekly food budget will buy a sack full of fruits and vegetables. My toddler loves coming to the farmer’s market with me. She can’t believe all the colorful fruits and vegetables within her reach.  I always let her choose one piece of fruit to munch on as we stroll along. I think there is something fascinating to kids about seeing all of that food outside on display under the sun, with so many people and kids and pets everywhere at the same time. It is really a great opportunity to get kids interested in fresh fruits and vegetables. The other perks are supporting local farmers, enjoying the community, and spending time having a healthy family outing.

Kids can learn so much about food and where it really comes from at a farmer’s market. I will never forget speaking to elementary schools with a basket of vegetables and quizzing kids on each one. Believe it or not, the kids often could not correctly identify a tomato, cauliflower, eggplant, and most surprisingly, a whole carrot with its leafy top. I realized that in today’s world, kids identify carrots as the little 2-inch long oblong orange things in a baggie. And they see tomatoes as ketchup or pizza sauce. And some never see cauliflower or eggplant at all.

Kids will grow up eating the kinds of foods they are exposed to and offered regularly. It is your choice as a parent what foods your kids are exposed to while they are in your care. Make trips to the farmer’s market a part of your summer routine. Maybe by fall, your kid will be asking for you to pack those fruits and veggies in their school lunch!

Some Farmer’s Markets in the North Shore Area:

Deerfield Farmer’s Market. Saturdays 7AM-12:30PM at Deerfield Road and Robert York Avenue.
Evanston Farmer’s Market. Saturdays 7:30AM-1PM at University Place and Oak Avenue.
Glenview Farmer’s Market. Saturdays 8AM-12PM at Wagner Farm, 1510 Wagner Road (Opens June 23rd).
Northfield Farmer’s Market. Saturdays 7:30AM-12PM on Happ Road across from New Trier’s freshman campus.
Ravinia Farmer’s Market. Wednesdays 7AM-1PM on Dean Avenue between Roger Williams and St. James Avenue.
Wilmette French Market. Saturdays 8AM-1PM at the Village Center.

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Healthy Supermarket Shopping for Your Family

The first step to having a healthy diet for your family happens when you make a trip to the grocery store. Choosing what foods you put in the cart actually determines your child’s health, in a lot of ways.

Here are some tips to make grocery trips a healthy success

Make a habit and priority of going to the grocery store at least once a week.
This sounds basic, but what happens when you are low on food in the house? Often this means picking up fast food, random snacks, or making a meal out of chips. Also, cooking food at home is key to a healthy lifestyle. Research supports this, and also shows that families who eat together eat more fruits and vegetables. It’s also wonderful family bonding time and a place for kids to learn healthy eating habits from their parents

Here is a basic list of foods to get weekly for the family

  • Meats, beans, tofu, or seafood for main dishes
  • A variety of fresh fruit for side dishes and snacks, frozen fruit for smoothies, and/or dried fruit for snack.Mother shops for food with child at the supermarket
  • Vegetables to eat raw, like salad greens, carrots, tomatoes, celery. Vegetables to eat cooked like potatoes, onions, garlic, brussell sprouts, zucchini, squash, peas, green beans, broccoli, cauliflower.
  • Eggs (if your family eats them), for breakfast or to cook with.
  • Milk or milk alternative.
  • Cereal and/or oatmeal.
  • A jar of nut butter.
  • “Flavoring and cooking” items like sauces, dressings, olives, seasonings, cheese, olive oil, etc.
  • Whole grain bread.
  • Whole grain side dishes like pasta, quinoa, or brown rice.
  • The rest of your list can be the specialty items needed for new recipes or specific meals.
Make a list based on healthy recipes.

Keep a pen and paper handy for an ongoing list for the next grocery trip. That way if you come across a good recipe in a magazine or online, you can write down the ingredients needed. Some people find it helpful to create a “menu” plan for the week for dinners, and use new recipes throughout the week. A list keeps you focused and organized while you are in the store.

Be sure to gather plenty from the perimeter of the grocery store.

Picture a typical grocery store in your mind and how it is set up. The middle aisles draw you in, but what do you find there? What do you find when you walk the perimeter of the store? It is not random that most grocery stores are set up this way. The middle aisles draw you in, but mostly are filled with processed foods. The outer part of the store is where many whole foods are:  fruits, vegetables, meat and seafood. Don’t skip the produce section.

Organic or on sale? Reduced fat or regular? Local or best buy? 

There are many side by side options of every food product out there, making a grocery trip feel like a “Where’s Waldo” experience. My choice is to buy organic and local as much as possible. Reduced fat or regular depends on what you and your family needs as part of a healthy diet. I choose regular, as many reduced fat foods are loaded with sugar or other chemicals in place of the reduced fat.

Let the kids pick!

If you’re brave enough to bring the kids along to the grocery store (or maybe you don’t have a choice), let them pick from healthy options you have preselected. For example, give them a few breakfast cereal options and let them pick which one they want. Or bring them to the produce section and let them pick one fruit and vegetable each. This gets kids engaged in healthy eating, and if they picked it, they are more likely to be excited about eating it.

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Signs Your Child May Have an Eating Disorder

There are different types of eating disorders which present in both girls and boys, although more commonly in girls. Anorexia nervosa involves restricting eating to induce weight loss. Bulimia nervosa involves purging, which can be in the form of vomiting and/or excessive exercising. anorexia scaleAnother eating disorder is binge eating without purging, which often results in weight gain. Sometimes, there is a combination of these behaviors occurring.

Eating disorders often develop in response to stress in one’s life. In other words, the child may use the eating disorder as a coping mechanism. In other cases, the child develops an eating disorder when they are striving for an extreme body image. In my experience, people with eating disorders are also usually depressed, using the eating disorder to deal with (or distract themselves from) much bigger problems in their lives. They have a very difficult time coming to terms with and truly letting go of the eating disorder behaviors. For these reasons, eating disorders should be treated by a multidisciplinary team to address the medical, nutritional, and psychological/behavioral issues. This approach promotes health and recovery more effectively than any of these treatments alone.

Here are some signs to look for that may indicate your child is struggling with an eating disorder:

  • Rigid rules about foods your child will or will not eat
  • Unwillingness to eat around others
  • Leaving after meals and going to the bathroom
  • Excuses about not wanting to eat
  • Fatigue, irritability, mood swings, and depression
  • Wearing baggy clothing to conceal weight loss
  • Hair starts thinning and becoming brittle
  • Callouses or scabs on the fingers/knuckles from inducing vomiting by sticking fingers down the throat
  • Finding laxatives in their possession that have not been prescribed for a reason
  • Moving food around the plate, cutting it, playing with it, but not actually eating much of it
  • Excuses about not wanting to eat in your presence (other plans, not feeling well, already ate, etc)
  • Making food for others but not eating any of it themselves
  • A covering of fine, short hair over neck and body
  • Feeling cold all the time
  • Drastic weight loss or gain
  • Hiding food
  • Missing periods
  • Eating in the middle of the night
  • Judgments of self, others, or of certain foods as good or bad in terms of eating, weight or body image.
  • Eating large amounts of food but not gaining weight.

Be aware that people with eating disorders usually do not want anyone to know that they are engaging in these behaviors. This is because they may be ashamed and/or not want to give up this coping mechanism. In this way, I have seen eating disorders become almost addictive to those really struggling with recovery. Discuss eating disorder concerns with your child’s pediatrician or schedule a meeting with a professional right away. For more information, refer to the National Eating Disorders Association website: or, the Eating Disorders Resource Center website:

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5 Things to Avoid on Food Labels

As a dietitian and a mom, I believe in whole foods nutrition. This means eating foods that are found growing in nature, and have undergone as little processing as possible. This doesn’t mean I never eat processed foods. It is pretty difficult not to in today’s world.

There are a few things I recommend avoiding:

  1. High Fructose Corn Syrup– This controversial sweetener makes the list for a few reasons. It is found in highly processed foods and beverages that are often high in calories and sugar. Also, fructose requires a “carrier” in the gut for digestion. These carriers get overwhelmed with large amounts of fructose coming through the gut at once (i.e. beverages sweetened with high fructose corn syrup), which results in gut bacteria breaking down fructose with side effects such as gas, bloating, pain, nausea, diarrhea and/or constipation. Furthermore, it is a highly processed food which is created using chemical processes.Mother examining a food label
  2. Partially hydrogenated– These words mean the same thing as “trans fat”. Trans fat is bad for us because of its chemical structure and the way it gets stored in our body (lining blood vessels). It is highly susceptible to oxidation, which is a chemical reaction that breaks the hydrogen bonds of the trans fatty acid chain, releasing free radicals. Free radicals can then break more hydrogen bonds, including in lining of cells, which causes cell damage and releases more free radicals, and the cycle continues.
  3. Artificial sweeteners– These make this list because they are chemicals, and often found in highly processed foods and beverages. Sucralose (aka Splenda) has a similar chemical structure as a sugar molecule, except chlorine atoms replace some carbon groups. Chlorine is not something we typically think of as a good thing to put in our body, in any quantity. In addition, they trick us into thinking we are going to eat something sweet, which arguably makes us crave the real thing.
  4. Artificial Food Coloring– European countries have imposed a voluntary ban onmany artificial food colorings because research indicates they may have harmful effects. There is controversy over whether artificial food coloring exacerbates aggression and/or ADHD symptoms. But the bottom line is, if a food is artificially colored, it is probably not a healthy food.
  5. Any label with a laundry list of unrecognizable, un-pronounce-able ingredients– This should raise a red flag. So many packaged, processed foods have a long list of ingredients that our grandparents and ancestors would never have considered “food”. And the obesity epidemic and cancer rates we have now didn’t exist in their day either.

Can you identify this common food by its ingredient list?


It is “whipped topping”. I will leave the brand name anonymous- but it’s the one we’ve all had on top of birthday cakes, pies, and ice cream.
Some of the healthiest foods in the world do not have food labels with ingredient lists to read at all. Do you have foods in your cupboards or fridge that don’t have food labels? If not, take a serious look at your diet and your overall health. A good rule of thumb is, the shorter the ingredient list, the better; and the more ingredients you recognize, the better. Better yet, get single “ingredient” foods without labels like fruits, vegetables, and farm fresh animal products. For more tips for better nutrition and better health, see a registered dietitian at North Shore Pediatric Therapy.

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6 Tips To Convincing Your Child To Try New Foods Through Meal Prep

Many children are set on eating the same few foods, such as chicken nuggets, macaroni and cheese, and hot dogs. Most parents with children who eat the same few foods over and over again want their children to increase the variety of foods in their diet. The big question is how to introduce new foods into your child’s diet without them refusing to eat. An important component of helping your child eat more foods is allowing them to participate in all aspects of the mealtime process.

6 tips to help increase food variety through meal preparation:

  1. Involve your child in the grocery shopping: Bring your child to the grocery store and allow him to explore some of the food options. Allow your child to pick out a few new foods with the intention of letting him help you prepare and try the foods for dinner. Sometimes children don’t know where their food comes from, but if you give them the opportunity to go with you and pick out something to eat, they may be more willing to try it.
  2. Involve your child in the food-making process: This includes having your child open containers, throw them away, pour the ingredients into a pot or bowl, and stir the contents. It is especially important that you have your child help make the food that she picked out from the LIttle girl eating nutritional foodgrocery store.  This will make the process more fun and help your child understand how her food comes packaged. This will also help your child learn how food feels and smells when it is uncooked too.
  3. Have your child help set the table: This is one more step of the eating process that should be explored. The purpose of this is to have your child go through each step in the mealtime routine so they know everything that goes into preparing a meal.
  4. Allow your child to play with his food at the dinner table: You may have been taught that playing with your food is a “no-no,” but allowing your child to play with his food will let him explore before trying it. Research shows that a child must develop an idea in their mind about how a food will taste and what it will do in his mouth before accepting it. Therefore, your child needs to know what the food smells, feels, and looks like before putting it in their mouth. This helps your child “warm-up” to the food and understand all of its properties before finally eating it. If you force your child to try something new by shoving it in their mouth, they may instantly reject it if it is different than they expect. Then, they will likely not accept that food into their diet. They may also be less trusting of you when you make a new food, for fear that it will be forced upon them.
  5. Eat family style at the table: By having everyone pass around and eat the same food, you will be providing an opportunity to model good eating habits for your child.
  6. Involve your child in the cleanup process: Have your child help take the dishes to the sink, put leftovers in containers, and throw away any scraps to conclude the mealtime process.

By engaging your child in each step of the mealtime routine, they will understand where food comes from and how it is prepared. This will eventually lead to your child’s acceptance of new foods and feeling of accomplishment from helping make dinner. Your child may not initially try all the new foods that are presented, but with repetition they may become more open to trying new foods.

It is important to note, however, that some children have more severe sensitivities or oral-motor issues that may be impacting their eating habits. If they are extremely limited in the number and variety of foods they will eat, a consultation with a feeding specialist (occupational therapist or speech therapist) may be indicated. Signs that your child may need further intervention include gagging at the sight of food or while eating or exclusion of an entire food group or certain textures.

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I found this article from the New York Times (published 5/14/12) to be very interesting. It is an interview with Carson Chow, an applied mathematician from the National Institute of Diabetes and Digestive and Kidney Diseases, who used mathematical equations to analyze the etiology of the rise in obesity rates over the past 20-30 years. Through his applied mathematical analysis, Chow reports that his results indicate that a surplus of food supply, starting from the 1970s when the government began encouraging farmers to grow as much food as possible, is one culprit in rising obesity rates since then. He argues that in general, the amount of physical activity Americans do really hasn’t changed in the past 20-30 years. He further explains that with this surplus of food, came cheaper food prices and more marketing from food retailers and restaurants, which in turn encourages people to eat more. Since it is affordable and convenient, fast food is even more appealing to today’s busy American consumer.

Even more interesting, he found through mathematical analysis that the more overweight a person is, the easier it is for them to gain weight. Also Chow states, “huge variations in your daily food intake will not cause variations in weight, as long as your average food intake over a year is about the same. This is because a person’s body will respond slowly to the food intake.” This insight rings especially true for those “yo-yo dieters” or others who do dramatic diets that only produce temporary results. In addition, he touches on the idea that our body has a “set point” of body weight, which is a weight that our body tends to hover around despite variations in eating day to day. This set point can be “reset” though, both in a negative way (in the case of excessive intake over time resulting in overweight status that becomes the new set point), or a positive way (in the case of weight loss). However, it takes time for our body to reset, so when weight is lost, it must be maintained for a long time, 1-3 years, before that new point is set.

To me, Chow’s findings demonstrate two things:

  1. We have to be smarter food consumers and aware of what the human body actually needs in terms of nutrition to sustain normal growth and health. This includes listening to our hunger and satiety cues, knowing what is a healthy body weight for stature (i.e. normal BMI), and knowing how to put together healthy meals.
  2. Weight management is a long term journey. It is a lifestyle change that really involves changes in all areas of life. It may mean cooking more at home, grocery shopping differently, adjusting the family budget, incorporating more physical activity into your day, and making food and health a priority in life. These are not easy changes, but if it is important to you or your family member to achieve weight management goals, meet with a registered dietitian to make a plan.

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Rising Development of Prediabetes and Diabetes in Teens, According to Recent Pediatrics Study

A new study published in the May 21 issue of Pediatrics shows a rise in prevalence of a number of risk factors for cardiovascular disease among teens based on NHANES data from 1999-2008. One risk factor that was examined was pre-diabetes and diabetes, Diabetes diagramwhich had a prevalence of 23% in 2007-2008 data, based on 8 hour fasting blood glucose tests of teens ages 12-19. This is up from 9% in 1999-2000 data. The study warns that the result should be interpreted with caution as single blood glucose tests in children can be inaccurate. In any case, the upward trend of prevalence of diabetes is alarming, as this medical condition has serious consequences.

There are two types of diabetes seen in children and teens, which have different etiologies. Type 1 Diabetes is a genetic, autoimmune disorder in which a child’s pancreas cannot produce insulin. Type 2 Diabetes involves insufficient insulin production and/or insulin resistance at the cells related to overweight status, poor quality of diet, and inadequate physical activity.

Overview of Physiology of Type 2 Diabetes:

In human physiology and digestion, carbohydrates are consumed, digested and broken down to simple sugar molecules. These are then absorbed from the gut to the blood stream, and circulated throughout the entire body to all the organs and tissues, to be used as a primary source of energy. In response to sugar in the bloodstream, the pancreas releases insulin. Insulin is the critical hormone needed to “open” all cells in the body so that the cells can uptake and utilize sugar from the blood stream for energy.

In Type 2 Diabetes, either the pancreas is no longer able to produce enough insulin to manage all of the sugar in the bloodstream, and/or the cells throughout the body are no longer responding to the insulin knocking at the door. In both cases, sugar is not being utilized properly by the cells and is circulating in higher than normal levels in the bloodstream. This elevated blood sugar level is how diabetes is diagnosed, and is what causes the complications of diabetes. High levels of blood sugar can cause damage to the lining of the blood vessels, or cause “congestion” in the blood vessels. If blood is not flowing properly, then tissues are not being nourished or oxygenated well. If these tissues are in the brain or heart, this can cause stroke or heart attack. In the feet or hands, this causes poor circulation which can cause neuropathy, or tingling and numbness, and eventually circulation can be so poor that amputation is necessary.

Diet and exercise are directly related to both the development and treatment of Type 2 Diabetes

Over time, the pancreas cannot produce enough insulin to keep up with the body’s demands of chronically high blood sugar levels. In addition, cells in the body stop responding to the insulin accompanying high blood sugar levels, also known as “insulin resistance”. Type 2 Diabetes used to be called “adult-onset” diabetes, as it was formerly diagnosed later in life, when metabolism slowed and organ function declined with age. The fact that it is now seen in kids and teenagers is a huge indicator of poor quality of diet and lack of exercise, as seen in the NHANES population sample of the Pediatrics study. It is also directly correlated with the rise of obesity and overweight in kids and teens.


The bigger message of this study is that overweight teenagers may face a difficult road of health problems, if changes to their diet and lifestyle are not made today. Type 2 Diabetes is preventable and often can be managed with diet and lifestyle changes, under medical supervision. Studies have shown that even 10% weight loss (of total body weight) lowers blood sugar levels. Also, exercise directly stimulates the cells to uptake sugar from the blood stream, improving the issue of insulin resistance. If your child or teen is overweight, obese, or has been diagnosed with pre-diabetes or diabetes, do not delay addressing the issue. Meet with a registered dietitian to make a plan to prevent or manage diabetes.

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Why Meet with a Registered Dietitian?

At North Shore Pediatric Therapy, our registered dietitian, Stephanie Wells, MS RD LD, specializes in pediatric nutrition, and works with kids of all ages- preemies through adolescents. She is passionate about kids’ nutrition, and aims to alleviate parents’ concerns for their child’s nutrition status. Her background includes working in the pediatric ICU as well as a pediatric outpatient gastrointestinal clinic. Stephanie’s areas of expertise include food allergies, underweight or difficulty gaining weight, feeding difficulties, picky eating issues, specialized diets, constipation and diarrhea, gastroesophageal reflux disease, ulcerative colitis, Crohn’s disease, Celiac disease, overweight or obesity, nutrition for children with special healthcare needs, and managing gastrostomy tube feedings.Registered dietitian

Nutrition Facts:

As stated on the Academy of Nutrition and Dietetics’ website (, “Registered dietitians are food and nutrition experts, translating the science of nutrition into practical solutions for healthy living. The expertise, training and credentials that back a registered dietitian are vital for promoting positive lifestyle choices. Registered dietitians draw on their experience to develop a personalized nutrition plan for individuals of all ages.”

Stephanie will spend quality time listening to what your family’s unique needs are, and then together, will create a nutrition plan that works for you. She can provide meal ideas, handouts, special diet materials, samples, and any tools or resources you need for you and your child to be successful in moving toward health.

Nutrition is a hot topic these days, especially childhood obesity. In an article published by USA Today on May 7, 2012, researchers report the country’s obesity rate will reach 42% by the year 2030 if current trends continue. Even more compelling- “ ‘If the obesity rate stays at 2010 levels instead of rising to 42% as predicted, then the country could save more than $549.5 billion in weight-related medical expenditures from now till 2030,’ says study co-author Trogdon.”* Of course, the monetary costs are not the only costs at stake with children dealing with obesity. There are also serious health consequences that can arise such as diabetes and high blood pressure, as well as the emotional effects.
Nutrition-related health issues such as obesity are often a result of daily habits over time. You may think, “My family’s diet isn’t perfect. But we are just too busy right now. Maybe next week we will make a change.” Make this week the week you meet with a registered dietitian to help make a change in your family’s diet.
*To read the full article on obesity in USA Today, go to


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Food Allergies in Children

This week is Food Allergy Awareness week (May 13-19). For many of us adults, it is surprising how many children these days have food allergies. We peanut butter allergyremember bringing birthday treats to school, and all eating at the same table in the school lunchroom. Today, many schools have banned edible birthday treats altogether, and have designated “allergen free” tables at lunchtime. The grade school my mom teaches at has signs posted on the classroom doors that read “Nut-Free Classroom.”

The answer to the question “why have food allergies become more prevalent?” is still being investigated. A food allergy involves an IgE-mediated immune response in which the immune system reacts to protein fractions in foods, producing a variety of symptoms for different people. A food intolerance does not actually involve the IgE immune response, but still produces symptoms. In either case, strictly avoiding the particular food is the best treatment.

There are eight common food allergens, which the Food Allergy and Anaphylaxis Network estimates account for 90% of all food-allergic reactions:

8 Common Food Allergies:

  1. Wheat
  2. Soy
  3. Dairy
  4. Eggs
  5. Peanuts
  6. Treenuts
  7. Fish
  8. Shellfish

Diagnosing Food Allergies:

Diagnosing food allergies can be somewhat tricky, as blood tests that look for elevated IgE markers in response to certain foods can produce false positives and false negatives. Symptoms present differently depending on the individual, and can be severe as in the case of anaphylaxis. Other signs and symptoms are less obvious, and may be overlooked as a possible food allergy. Some I have seen in the clinical pediatric setting include:

Signs of a Food Allergy:

  • Rhinitis (aka “runny nose”) or general congestion
  • Chronic ear aches (resulting from congestion)
  • “Allergic shiners” which are dark and/or swollen circles under the eyes
  • Asthma
  • Eczema
  • Diarrhea
  • Blood or mucus in the stool
  • Vomiting or reflux
  • Suboptimal growth or a slowing of growth

A definitive way to determine food allergies or intolerances is through an elimination diet. A registered dietitian can educate parents and children on how to do an elimination diet successfully, which can provide clear answers and a path to better health. The elimination diet is also useful for breastfeeding mothers whose infants are showing signs of possible food allergy or intolerance.  A registered dietitian can also provide education and alternatives for infants who are formula fed and not tolerating standard infant formulas.

Once a food allergy or intolerance has been identified, a registered dietitian can also provide education and guidance for families on how to eliminate the food (and all forms of it), as well as alternatives that can be consumed.  At North Shore Pediatric Therapy,  an experienced pediatric registered dietitian can help your child feel the best he or she can, food-allergy free.

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