Recipe of the Month: Nutrition Powerhouse Smoothies for Parents and Kids

in , , , , ,

Smoothies are a great way to pack a lot of nutrition into something that tastes like a treat. They can be part of a meal or a post-workout snack. These recipes include four of the five components of The Healthy Plate Model:  protein (yogurt), calcium (yogurt), fruits, and vegetables. All of these smoothies promote healthy digestion since they contain fiber (fruits and spinach) and probiotics (yogurt). Kids love drinking something that is colorful and comes with a straw. Plus these are so tasty, they won’t believe how healthy they are! Smoothies are also a healthy option to eat while on the go. Hope you enjoy these!

Berry Blast

1 cup frozen mixed berries
½ banana
¾ cup plain, organic, whole milk yogurt
1 cup loose baby spinach leaves

Put all ingredients in a blender and blend until smooth. If desired, allow berries to sit at room temperature for 20 minutes for easier blending.

Recipe makes 1 serving. Provides approx 245 calories, 8 grams protein, 6 grams fiber, 277 mg calcium.

Green Monster

1 cup frozen mangoes
½ banana
¾ cup plain, organic, whole milk yogurt
1 cup loose baby spinach leaves

Put all ingredients in a blender and blend until smooth. If desired, allow mangoes to sit at room temperature for 20 minutes for easier blending. This smoothie will be green, and giving it a fun name like “Green Monster Smoothie” makes kids more likely to want to try it (it worked with my kid!).

Recipe makes 1 serving. Provides approx 285 calories, 8 grams protein, 4.7 grams fiber, 277 mg calcium.

Immune Booster Digestive Aid

1 cup frozen pineapple chunks
1 clementine orange, broken into individual pieces
¾ cup plain, organic, whole milk yogurt
1 cup loose baby spinach leaves

Put all ingredients in a blender and blend until smooth. If desired, allow pineapple chunks to sit at room temperature for 20 minutes for easier blending. Pineapples and oranges both provide vitamin C. Pineapple also contains a natural enzyme called bromelain that aids in digestion.

Recipe makes 1 serving. Provides approx 242 calories, 9 grams protein, 4.7 grams fiber, 274 mg calcium, 116 mg vitamin C.

Click here for healthy twists on your child’s favorite foods.

Are Eggs Good for You?

in , , , ,

Eggs seem to conjure quite a nutrition debate-the white, the yolk, the cholesterol, the omega-3s, the protein, cage-free, brown, white…  This simple, whole food has been put on the “bad” list as much as it’s on others’ “good” list. Whole eggs have been dissected and rearranged into liquid and powdered egg products. Brown eggs have been bleached white. And some eggs have been fortified. Which are healthiest?

As with many nutrition-related questions, I advocate for food in its whole, most natural form. When it comes to eggs, here are my nutrition bites:

Whole eggs are part of a healthy diet, in moderation.

Eggs are comprised of two things: protein and fat. Eggs are a great source of protein, containing approximately 7 grams per egg. All of the protein is in the egg white. All of the fat is in the egg yolk. If we learned anything from the fat-free craze of the 90s, it’s that not all fat is bad for you. In fact, some fat is essential for health (i.e. omega-3 fatty acids), and eliminating all fat does not result in sustainable health changes.

Regarding egg yolks…

The yolk of the egg contains many vital nutrients that would be used to nourish a new life (a baby chick, that is). In this way, it is one of nature’s perfect foods. Yes, there is cholesterol in the egg yolk, so eating more than two eggs every single day may inch up your blood cholesterol level (although exercise and fiber will inch it down, too).

Eggs are actually low in calories and very filling.

One large egg has only about 70 calories, including the yolk that gets such a bad rap. The reason why eggs are filling is because both protein and fat take longer to digest, and help moderate sugar absorption and blood sugar levels. In other words, having an egg with a typical carbohydrate breakfast food will hold you over longer than if you were to eat just cereal, toast, or pancakes alone.

How the egg is produced and where it comes from matters.

When it comes to animal products, quality matters. A hen’s diet will dictate the nutrition quality of the eggs she produces. The better and healthier her diet and lifestyle are, the better and healthier her eggs will be. Chickens’ natural diet and environment includes roaming around pecking grass, seeds and bugs. Chickens who live and eat this way are often termed “free range” or “cage free”. Modern agriculture practices have tweaked chickens’ natural diet and environment to maximize production and revenue. These chickens live in very close quarters in cages and eat a diet of grain and corn. As you might expect, the yolks of free range-produced eggs have healthier fatty acid content, and these yolks naturally contain omega 3 fatty acids. Furthermore, organic eggs come from chickens that have not been given hormones, antibiotics, and who have been fed an organic diet. In my professional opinion, free-range, organic eggs are the best quality.

Brown vs white

Brown eggs come from brown hens and white eggs come from white hens. Given that all other production factors are equal (see above), brown and white eggs are no different in taste or quality.

I hope this was helpful in deciphering all the ideas out there about eggs. What are your opinions of eggs? What diet myths do you want to investigate further?

Digestive Issues: How to Help with Diet

in , , , , , , ,

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.

Baby Food Pouches: Bad for Baby’s Health?

in , , , , , ,

A recent statement from the American Academy of Pediatric Dentistry warns parents of the possible side effects to prolonged usage of baby food pouches. They compare the squeeze pouches to that of giving babies juice in sippy cups and bottles, and they indicate that tooth decay may develop if babies are given frequent access to the pouches.

What Harm Can Baby Food Pouches Cause?

The squeeze pouches, while convenient for families on the go, often contain sugary fruit blends which can reek havoc on developing teeth. Over time, the constant exposure of the foods directly to the teeth may begin to break down tooth enamel. However, further research will determine if there is a true correlation between the squeeze pouches and cavities in young children. It is indicated that if parents do allow for their children to eat from the pouches, that they continue to follow the recommendation  of brushing their children’s teeth 2x per day and giving them water and milk to drink instead of juice.

Should I Allow My Child to Use Baby Food Pouches?

While the jury is still out on the actual effects of the pouches on little teeth, the old adage of “everything in moderation” holds true. Busy parents should not be discouraged from using the pouches in a pinch, but spoon feedings are still preferred. Feeding your child from a spoon not only contributes to functional oral motor development, but increases the social aspects of mealtimes. Parents are able to connect with their children during meals and if children are allowed access to constant drinking from the pouches, they are missing out on opportunities to practice developmental feeding skills when fed via spoon.

Click here to read more about oral motor and feeding difficulties in children.

ADHD and Picky Eating

in , , , , , , , ,

Attention Deficit Hyperactivity Disorder (ADHD) is a very common diagnosis seen in a pediatric therapy clinic. It is not uncommon for parents to report difficulty with their child with ADHD and picky eating. The most common complaints for parents of children with ADHD who have trouble with mealtimes are distracted eaters, decreased appetites, and picky eaters.

Distracted Eaters

Distracted eaters are attending to external stimuli (e.g., TV, other conversations) or internal stimuli (e.g. lost in own thoughts) during mealtimes. Here are some strategies to help:
  • Decrease the external distractions: Eliminate other distractions like the TV or videogames playing in the background, dogs running around, telephones buzzing, etc. Have your child face other family members and face away from the busy kitchen area to encourage attention in the appropriate direction. Require your child to stay in the room and at the table for the duration of the mealtime.
  • Decrease internal distractions: Use solid placemats, plates, and utensils when eating. Colorful patterns or animated pictures can be distracting. Sometimes having a child engage in motor activities before sitting for a meal can help regulate him to be ready to sit and attend for a period.

Decreased Appetites

An almost universal side effect of stimulant medication used for ADHD is the suppression of appetite. In particular, the dextroamphetamines (e.g., Adderall, Vyvanse) seem to have the highest incidence of suppressing appetite. Here are some tips to manage decreased appetites:

  • Give the morning medication dose after breakfast to ensure an adequate meal is consumed before the side effect of decreased appetite sets in.
  • Provide proteins during lunchtime and small, healthy snacks during the day. Smaller snack-sized portions are often more visually manageable for children than an entire plate of food. Protein shakes are good options during this time.
  • Serve a larger dinner meal at the end of the day when the drug has worn off. Kids will typically make up many of the calories lost during the reduced daytime eating with a larger evening meal.
  • Consider not using the drug on weekends if your child continues to struggle with this side effect. Allowing one or two days of increased calories a week can counteract for a decreased intake during the weekdays.

Picky Eaters

Kids can be picky eaters for a variety of reasons. Evolution dictates children be wary of trying new things in order to survive. They may have a negative association with eating or have sensory issues causing anxiety with certain foods. Cognitive and developmental disorders also may impact the types of food eaten. Similarly, kids with low tone (i.e., decreased strength, coordination, and postural control) may be picky about the foods that are easier for them to eat.

Any of the above issues may co-occur with ADHD.

Here are some strategies to help your picky eaters:

  • Meal Routine: Too much grazing throughout the day may result in a lack of hunger at specific mealtimes. Three meals and two snacks should be offered per day to ensure hormonal balance triggering “hunger”. There should be a beginning, middle, and end to every meal.
  • Exposure: The best role model for food it you! Having family dinners and presenting children to a variety of foods that you, as caregivers, model eating is a critical way to expose your child to the idea that food isn’t scary.
  • Posture: Ideal eating position is hips, knees, and ankles positioned at 90 degree angles. Boosters/chairs should be utilized to ensure the child is at the appropriate table height. If your child has a hard time remaining in a chair, move-and-sit cushions can provide sensory input to help your child stay seated for a longer.
  • Desensitize: For some children, decreasing the sensitivities of the mouth may help with food intake. Using a vibrating tooth brush, a chewy tube or a washcloth tug-o-war are good options to desensitize the child.
  • Get the kids involved: Taking the kids with you when you grocery shop and letting them help pick out the foods will help with compliance. Encourage your child to help with creating the menu, choosing the foods, and preparing the meal are other ways to help your child become involved in mealtimes.

Children with ADHD may have a difficult time with mealtime. Remember to be patient and do the best you can to provide them as many healthy food options as possible. The rest is up to them. For other tips on how to parent a child with ADHD, click here.


Get the Family Healthy in 2014, Part 2 of 2

in , , , , , , , ,

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

in , , , , , , , ,

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.

Infant Feeding: When Your Baby Is Turning One Year Old

in , , , , , ,
Your baby is a year old- what a milestone! At this time, along with many other developmental changes you’re probably witnessing, baby is ready for some advancement at mealtimes as well.  Here are the next steps as toddlerhood begins:

At one year old, transition to cow’s milk or other milk alternative, if your baby meets the following criteria:

  • Your child does not have any growth or nutrition concerns.*Feeding your one year old
  • Your child does not have history of cow’s milk protein allergy.*
  • You are planning on weaning breastfeeding in the foreseeable future. If not, be sure that your child is getting at least 12 oz of breastmilk at scheduled times (preferably immediately after meals) daily, as well as 1-2 servings of calcium foods. Avoid allowing your child to “snack” on breastmilk at this age since it may decrease appetite for food at meals.
*In these cases, it may still be appropriate to trial cow’s milk at one year old; however, this must be under supervision of your child’s physician or dietitian.

Tips for a healthy one year old diet:

  • To transition to cow’s milk, offer 4-6 oz of milk in a cup at mealtimes. If baby is adamantly rejecting it (presumably because of the taste difference from breastmilk or formula), be patient and do not stress. Stay consistent by offering milk in a cup at meals, but fill it with mostly breastmilk or formula (whichever they are used to drinking) and add a small amount of cow’s milk (ratio of 4 oz:2 oz or even 5 oz:1oz). Every day, make the ratio a little more cow’s milk and a little less of the breastmilk or formula.
  • Limit milk to no more than 24 oz per day to ensure baby has a healthy appetite for meals.
  • Offer milk at meals and water at snack time and throughout the day as needed. There is no need for juice, and in fact, juice can fill baby up with empty calories which decreases appetite for more nutrient-dense foods.
  • Begin phasing out the bottle. Stick to cups at meals and snack times. Often the bottle is most difficult to wean when it precedes a Read more

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

in , , , ,
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: How to Transition Your Child from Purees to More Advanced Textures

in , , , , ,
It is generally recommended to feed infants pureed foods starting at 6 months old. After a few months of sampling a variety of pureed introducing finger foodsfoods, your child will be ready for other textures. Around 9 months old, your child will develop a “pincer grasp” where they can pick up small objects with their thumb and forefinger. This fine motor skill is acquired around the same time that babies develop the oral motor skill of up-and-down chewing motions. These two skills are both very important and necessary when you think about what your baby needs to do in order to accomplish eating foods that are not pureed.
Therefore, around 9 months is a good time to introduce little finger foods and other soft textured foods. Here are some tips to make the transition:

First and foremost, a few feeding basics:

  •  Always feed your infant in high chair or other belted seat that is pulled up to the kitchen table. Read more