Tag Archive for: Diet

Food Journaling 101

Food journaling involves writing down everything you (or your child) eat and drink over a certain period of time. I often ask parentsfood journal and children to do this and they are often not thrilled about the “assignment”. The detailed record keeping of foods and beverages consumed may provide a lot of useful information and can be a great tool to direct the nutrition plan of care.

Below are five situations when food journaling may be helpful:

  • For weight management: Writing down everything you eat and drink during weight loss cases provides two benefits: First, you are accountable and aware of everything you are eating and drinking in a new way. You are seeing it listed on paper. Second, you don’t forget about the foods you consumed when asked about it during the visit a few days later.
  • For picky eaters: Again, recording everything a child eats throughout the day serves a few purposes. It helps me to identify the “gaps”- what nutrients are falling short and which nutrients are being met. It may also help you as a parent to reflect on how many things your child is actually consuming, especially if you review it over the course of a week. Finally, seeing the pattern and timing of what your child eats is very important. Adjusting or creating a structure around meals and snacks is very beneficial for picky eaters.
  • For suspected food allergies or sensitivities: If a child is having physical symptoms that I suspect are correlating with food, food journaling is one tool that can decipher whether the symptoms are food-related or not. In these cases, in addition to the foods and beverages consumed, it is also helpful to write down the times of a day. Through the course of the day, it can be difficult to remember every detail of what your child consumed. For example, you notice a rash on your child in the bath tub before bed and are trying to remember if it was the vanilla granola or oatmeal she had for breakfast? Or was it eggs today? Wait, was that yesterday? Did I send lunch to school or did she get hot lunch? Did she trade and eat something else at school? The goal of the food log is to provide clearer information.
  • For underweight kids: Similar to picky eaters, it is beneficial for a parent to keep a food log for the underweight child once in a while. The parent may be able to focus on whether the child is eating well and then troubleshoot with me on how to maximize calories and protein; however, I do not advise children that may be at risk for having an eating disorder to record everything they are eating, nor should parents of these kids keep a food log for them. The reason is because this can easily become a tool to control and restrict the diet further.
  • For general healthy eating goals: Any of us can benefit from doing food journaling every so often. If you find an area of your health that you would like to improve, start with a food journal. Examine what exactly you eat over the course of a few days. Establish where there are gaps, strengths and areas for improvement. Do you need more variety? Are you not actually eating as many fruits and vegetables as you thought? Do you eat more in the evening than in the morning? Is your calcium intake low?

If you would like a registered dietitian to do a food journaling exercise for your child, contact NSPT at 877-486-4140. One of our nutrition professionals can meet with you to create a food log template, guide you through the process and then analyze the nutrition for you.

Staying Healthy on Spring Vacation

Spring break time is here and many families will be getting away for some quality vacation time. Although the purpose of vacation is to family vacation take a break, relax and have fun, it is worthwhile to maintain some healthy habits for the family. First, a drastic change in diet, especially for kids, can lead to some major mood swings. It is also crucial to remember that many people experience digestive issues while traveling, such as diarrhea or constipation. This can put a bit of a damper on having a good time. Lastly, straying from healthy habits during a vacation can carry over and continue when a family arrives at home again after a long trip.

Here are some tips to stay healthy on vacation:

  1. Plan ahead. Research the area and find out what food options are available. By doing this, you can avoid last-minute decisions, such as fast food or vending machines. It is almost always healthier (and more cost-effective) to eat food cooked from home. Take advantage if your accommodations include a kitchen and/or a refrigerator. For example, a simple breakfast such as oatmeal or eggs and cereal are easy to make. They are also healthier than pastries and juice in the lobby. You
    can also buy or bring healthy snacks, such as fruit or granola bars, instead of giving the kids candy and ice cream.
  2. Beware of buffets. These are common in vacation towns and are a hallmark of all-inclusive resorts. All-you-can-eat does not mean that you should eat too much. Overeating will cause stomach aches, diarrhea or constipation. To avoid overeating, limit meals to one plate full. Another tactic would be to have plenty of fruits, vegetables and lean protein first. Once your appetite has been stifled a bit, you can then go back for richer foods.
  3. Parents- caution with alcoholic beverages. It is easy to get carried away with drinking alcohol on vacation. Not only are these drinks very high in calories, but they also impair our ability to make healthy food choices. Of course, alcohol is also dehydrating. Be aware that many typical vacation-inspired alcoholic drinks are loaded with sugar (think margaritas, pina coladas, strawberry daiquiris, etc). Ask if they can be made with less sugar or as “skinny”.
  4. Remember physical activity. Some people think of physical activity as a chore, therefore, it is not a welcome part of a relaxing vacation. If you think of exercise as a stress-reliever that increases your energy and overall vitality, then some physical activity is a perfect addition to your vacation. Hopefully, your kids will stay active while on vacation- playing outdoors, swimming, biking, hiking, etc. Joining them gives you quality time and the benefits of physical activity. Other great vacation activities include walking on the beach, swimming in the ocean, playing a round of golf or joining a tennis or sand volleyball match.
  5. Stay hydrated. If your family is spending long days in the sun, make sure to offer plenty of water throughout the day. Water is the best source of hydration and is always a better choice than sugary beverages. Bring bottled water for the family any time you leave the house. Staying well-hydrated also helps keep digestion regular.

Follow these tips to stay healthy on vacation. Most importantly, have a great time with the kids!

Milk Options: Which is the right one?

There are several milk options available on store shelves today. Many of us grew up drinking regular cow’s milk, but now it seems as if people are choosing alternative milks. When choosing what milk is best for your children, it is important to know what nutritional purpose milk serves in a child’s diet. Not all milks are nutritionally identical, therefore, knowing the nutrition facts of the milk you are buying is key to making the right choice.

Traditionally, cow’s milk has been the most common type of milk that parents choose for their children after age one. The reason is because it is nutritionally comparable to breast milk. Whole cow’s milk has the same calorie content, protein and calcium as breast milk. Protein, calcium and calories are all critical nutritional components for growing kids, which is why milk has been a staple in kids’ diets for years.

Alternative To Cow Milk:

There are a variety of reasons why a parent may not choose cow’s milk for their kids. For example, the child could have a milk protein allergy, lactose intolerance, vegetarianism or other reason. Soy milk seems to be the second-most popular milk choice. It is important to note that soy milk is lower in calories than whole milk (it is more comparable to skim milk), but contains less protein. In addition, many people choose soy milk due to cow’s milk protein allergy. In my experience, it is often that babies and young children with dairy allergies can also develop an allergy to soy. Furthermore, soy contains phytonutrients, called isoflavones, which are estrogen-like compounds that can stimulate estrogen receptors in the body. Research shows various long-term effects of this. In general, it is recommended that soy is consumed in moderation.

For those that are avoiding cow’s milk and soy, the remaining options include almond milk, hemp milk, oat milk and rice milk. Rice milk is actually the least nutrient-dense of all of the choices available, and so it is the one I recommend least for growing kids. On the other hand, some of the lower calorie alternative milks may be good choices for people seeking weight loss. See the nutritional breakdown* of all of these milks in the box below for more information:

[table id=12 /]

*Nutrition data varies by brand.
**Nutrition content of breastmilk is variable

If you are interested in more advice on choosing the right milk for your kids or ways to ensure proper nutrition for your family, contact us to schedule an appointment with a registered dietitian. 877.486.4140.

The Healthy Plate Model

Did you learn the Food Pyramid as a nutrition guide when you were growing up? How about the Four Food Groups? Or was it Five Food Groups? Nutrition models can be quite confusing; however, the Healthy Plate Model is a new tool that is actually very simple to use. It is a way of visualizing how to put together a healthy meal without having to count or measure foods. Kids are now learning this method in schools and it is a model I advocate with families I work with as well.

Here are the basic features of The Healthy Plate Model:

  • Use a dinner plate for older kids and adults. Use a smaller children’s plate for younger kids.
  • Fill half of the plate with fruits and vegetables.
  • The other half of the plate is divided into two sections:
  • 1. ¼ of the plate has whole grains
  • 2. ¼ of the plate has a protein food

Visually, it looks like this:healthy plate model

By including these foods for each meal, and in these proportions, you can ensure a well-rounded diet for both you and your family. Notice that ¾ of the plate is represented by fiber-containing foods, which makes it easy to meet the recommended amounts of daily fiber intake. Although it might seem overwhelming to have that many fruits and vegetables on your plate, this does not always have to be salad. Consider vegetables in pasta sauce, soups, on sandwiches, as coleslaw, in stir fry, etc.

The Healthy Plate Model also promotes satiety, or feeling full and satisfied after eating, which helps prevent overeating. The high-fiber foods and protein moderate the absorption of sugar into the bloodstream. This prevents the sugar “spike” and “crash” that comes with eating too much refined carbohydrates.

Perhaps the most useful aspect of the Healthy Plate Model is that it offers a visual guide that can be applied to every meal, every day. It helps with meal planning, grocery shopping and ensures quality nutrition without having to overthink too many details. Feeding your family meals that represent the Healthy Plate Model will provide good nutrition and promote healthy eating habits. For additional assistance with meal planning using the Healthy Plate Model, or guidance on how this model can improve your family’s health, schedule an appointment with one of our registered dietitians. 877.486.4140.

Omega 3s: Do we need to supplement?

We have all received the message that Omega 3s are really important to one’s personal nutrition. We should eat more fish or include Omega 3fish oil supplements to our diets. Fish oil may be recommended by a doctor in order to help lower cholesterol or reduce inflammation in the body. Why are Omega 3’s lacking in our diet and why do we seem to need so much of it?

What is Omega 3?

To answer these questions, we must first understand what an Omega 3 is. Omega 3s are a type of long chain of fatty acid molecules. These fatty acids serve as important functions to the body. They are used for tissues in the brain, eyes and cell membranes. These fatty acids compose some of the most important parts of the human body. This is why pregnant woman are encouraged to take Omega 3s (or DHA supplements- a type of Omega 3). Similarly, breast milk is naturally high in Omega 3s and infant formulas are now being fortified with DHA and EPA (another type of Omega 3, both found naturally in breast milk).

When Omega 3 fatty acids are broken down in the body, they make Cytokines. Cytokines promote anti-inflammatory cell signals. In contrast, when Omega 6 or Omega 9 fatty acids are broken down, they produce pro-inflammatory cell signals. There are two key things to understand about this process. Firstly, there is an imbalance of the ratio of Omega 3s,Omega 6s and 9s in our modern day food supply. Omega 6s and Omega 9s are found in refined vegetable oils, such as soybean, safflower and corn oil. These oils are used in many processed foods. In addition, because animals are commonly fed corn, their fatty tissues are higher in these pro-inflammatory fats. Animals who are grass-fed and/or eat their natural diet have higher levels of Omega 3s as well as a better ratio of Omega 3s to Omega 6s and 9s. Another important thing to remember is that many chronic diseases and ailments are caused by or exacerbated by inflammation. These include cardiovascular disease, cancer, asthma, allergies, arthritis and more.

How can Omega 3’s benefit us?

Based on this provided information, Omega 3’s can help prevent and/or alleviate many chronic health problems. One way to reap the nutritional benefits of Omega 3’s would be to eat a diet that is low in processed foods and higher in whole foods, including animal products from animals that are fed their natural diet (meat, eggs, dairy products).

These foods are also naturally high in Omega 3’s:

  • Cold water fish, such as salmon, halibut, and sardines
  • Walnuts
  • Chia seeds and flax seeds
  • Dark leafy greens
  • Canola oil

To learn more about an anti-inflammatory diet or how your family’s diet may be impacting their health, schedule an appointment to see one of our registered dietitians. They can help you modify your pantry and kitchen to help prevent or alleviate inflammatory diseases.

Tummy Aches, Abdominal Pain, and Stools: What the signs and symptoms might be telling you about your diet

My professor in grad school spoke about how difficult nausea and abdominal pain is to manage. Think about the last time that your sick childstomach felt extremely upset. Have you ever experienced morning sickness during pregnancy? It is incredibly difficult to function on a daily basis when you are feeling that miserable. In addition, it is nearly impossible when you have to make frequent trips to the bathroom. What if this is how your child feels during the school day?

This is how many people feel almost every day, including children. They suffer from stomach aches, nausea, cramping and irregular bowel movements (diarrhea or constipation). Parents are unsure about what to do about this predicament when there doesn’t seem to be a medical reason for these symptoms.

If this is something that you or your child is experiencing, I would encourage you to speak with your doctor and schedule an appointment to see a registered dietitian. A dietitian can perform a thorough analysis of you or your child’s diet as well as eating patterns throughout the day. Following the analysis, recommendations can be made, symptoms can be tracked and adjustments to the diet can be made.

Here are some dietary factors that may be contributing to digestive issues:

  • Excessive intake of quantities of food
  • Inadequate (and sometimes excessive) fiber
  • Excessive sugary beverages
  • Excessive intake of processed foods
  • Excessive intake of sugar alcohols (found in diet foods and beverages)
  • Eating when stressed
  • Eating too fast
  • High fat diet
  • A diet that is imbalanced
  • Food sensitivities- a negative reaction in the body that manifests in response to certain foods.
  • Food intolerances- result from inadequate enzymes (or enzymes that are overwhelmed with volume) in the gut to digest certain components of foods.
  • Food allergies- an immune response in the body to certain proteins in foods.
  • Imbalanced gut bacteria.

Digestive pain is not normal and it should not be acceptable to suffer with digestive pain or other digestive issues. With the proper guidance, you and your family can be feeling much better while improving the quality of nutrition in your lives life. To schedule an appointment with a registered dietitian at NSPT, click here.

Hop 2 Health : A Pediatric Weight Management Program

Obesity and being overweight are the biggest health issues facing our children today. Not only that, these issues can have serious kids exercisingeffects on kids, in both the short and the long-term.

Obese children report a lower quality of life and are at risk for developing serious health issues during childhood and adolescence, such as:

  • Type 2 diabetes
  • Hypertension (high blood pressure)
  • Hyperlipidemia (high cholesterol and/or high triglycerides)
  • Asthma
  • Sleep apnea
  • Depression
  • And more

With the New Year upon us, and pediatric obesity at the forefront of our nation’s health concerns, North Shore Pediatric Therapy is offering a multidisciplinary, family-based pediatric weight management program:

Hop 2 Health

Hop 2 Health has been developed following the model that research shows to be the most effective treatment for childhood obesity. It is multi-disciplinary, which means your child will work with a registered dietitian, physical therapist and social worker to address and improve all factors that are part of this complicated issue. It is family-based, which means you, as a parent, will be informed and involved in your child’s journey to health since you are so instrumental in their success outside of the program. It is an on-going program that involves weekly group sessions where your child can engage with and lean on other kids that are struggling with the same issues. The learning experiences through which your child will gain information about making healthy choices for life are fun, engaging and totally geared towards kids. Your child will also receive individualized care through periodic one-on-one visits with our team of experts.

All of these key components of the program will give your child one of the best opportunities to make real changes to their life. Our mission is to provide a positive atmosphere, where kids will be given the tools and learn strategies to become healthier, and more importantly, build self-esteem to know that they can do it. For more information about Hop 2 Health, please go to this link on our website: www.Hop2Health.com.

Here, you can register for the program that will be starting soon. Space is limited.
As a parent, your child’s health and well-being is your number-one priority. Register now and start 2013 knowing that your child is on the path to better health.

You can also call 877-486-4140 to speak with one of our Family Child Advocates for additional information about Hop 2 Health. We are offering free screens to help determine if your child may benefit from participating in Hop 2 Health. Contact 877-486-4140 to set up a free screen.       


Eating Healthy when Eating Out

I am an advocate of eating from home or at home, for both kids and parents. I recommend limiting eating meals that are from restaurants to once per week or less. The reality is that many families eat out much more often than once a week. In many cases, restaurant meals are higher in calories, fat, sodium and additives. Even meals that seem to be healthy may not have the nutritional value you are seeking.

Take the quiz below to see how you might navigate choices regarding restaurant menus:

1. Which of these is highest in calories?

A. Chicken Caesar salad from Chili’s.
B. Small chocolate milk shake from Burger King.
C. One Big Mac.

2. Which of these is highest in fat?

A. Lasagna Classico (dinner portion) at Olive Garden.
B. Quesadilla Explosion Salad from Chili’s.
C. Large fry from McDonald’s.

3. Which of these is lowest in sodium?

A. Applebee’s Cajun Shrimp Pasta.
B. Margherita Pizza from California Pizza Kitchen.
C. Large bowl of chili from Wendy’s.


1. A. The grilled chicken Caesar salad from Chili’s has the most calories (640 calories). This salad does provide other quality nutrients and, for an active person, this is not necessarily an excessive amount of calories for one meal.
2. B. The Quesadilla Explosion Salad has 88 grams of fat, 3000 mg of sodium and 1360 calories—in one salad!
3. C. The bowl of chili from Wendy’s includes the lowest amount in sodium with 1330 mg. This amount is still relatively high for one food item, especially considering that the recommended daily limit for an adult is about 2000 mg of sodium.

The point of this quiz is not to imply that I recommend eating Big Macs and milk shakes rather than salads. The point is that it is difficult to know what is a better choice when eating out.

These categories of menu terms should help steer you in the right direction of making healthier decisions when eating at a restaurant:

[table id=11 /]
For more nutritional information about the foods mentioned in the quiz above (and thousands more), go to www.calorieking.com. You should also ask the restaurant staff for a brochure that includes the nutrition information for their menu. If you have Internet access, you can research it yourself (if it is published on the restaurant’s website or a site like calorieking.com). Our registered dietitians are also able to help you select specific meal items at restaurants that fit your family’s dietary needs.


How to Make Your Own Baby Food

Are you interested in creating your own baby food? The good news is that it is actually quite possible and simple to make your own baby foodbaby food!

Supplies to make your own baby food:

  • A manual food mill. I personally used one made by KidCo. It is suitable for any soft or steamed fruits and vegetables, as well as cooked quinoa, oatmeal, millet and amaranth.
  • An electric food mill. I utilized an inexpensive, small electric food mill for more advanced textures of food that I needed to grind down slightly, such as soft-cooked meats and pasta.
  • Other options that you may choose to use include food processors and/or coffee grinders. A food processor is able to puree any food into the texture desired. As a result, this eliminates the need for a manual food mill or smaller electric food mill. A coffee grinder is useful for making your own “infant cereal”, using grains such as quinoa, brown rice, millet, amaranth and oatmeal. To do this, simply grind the whole grains in the coffee grinder and then cook them as you normally would.
  • Storage containers. You may use any refrigerator- or freezer-safe containers. There are containers that are designed specifically for storing baby food that closely resemble ice cube trays with a lid. I found these to be very helpful as I could produce 2-4 “cubes” of baby food to send to the babysitter each day.

Once you have acquired the equipment that you need, the next step will be to determine what food you want to make for your baby. Speak with your pediatrician or registered dietitian if you require guidance.

Below are the categories of infant-appropriate foods as well as general directions on how to prepare them yourself:

  • Vegetables: Try green beans, zucchini, squash, carrots, sweet potatoes, peas, cauliflower, broccoli, etc. The important thing to remember is to steam them or bake them until they are very soft and can be easily pureed in the manual food mill.
  • Infant cereal: Choose hypoallergenic grains such as brown rice, oatmeal, quinoa, millet or amaranth. Grind the uncooked grains in a coffee grinder or cook them and then let the grains cool prior to pureeing in a food processor. Cook the grains as you normally would.
  • Fruit: Try soft-cooked apples, pears, plums, peaches, blueberries, bananas, cherries, mangoes, papaya, etc. You can also purchase frozen fruit that can be thawed and pureed.
  • Beans: Once your baby is age-ready to consume beans (8-9 months), you may not need to puree them completely. You may give them cooked beans that are slightly smashed with a fork. Many babies enjoy eating black beans, lima beans, pinto beans and lentils. Observe them carefully as they eat as the skin of the beans may be difficult for them to manipulate in their mouth.
  • Meat: Cook meats for a significant amount of time (10+ hours) in a slow cooker with plenty of liquid to ensure that they are very soft. Puree the meats in the electric food mill or food processor. Meats can be offered to children that are around 8-9 months of age or when your child has the ability to consume foods with a little more texture.

One tip is to add a small amount of breast milk or formula to the cooked product so that your baby experiences a familiar taste when trying new types of foods for the first time. Making your own baby food is a great way to introduce your child to real foods that they will grow up to become familiar with eating. They will be able to consume texture-appropriate versions of the foods that the rest of the family is eating. As a result, making your own baby food can save you time as well as promote healthy eating habits.

If you are interested in creating homemade baby food, but require more guidance or do not have the time, I am now offering personalized home services. I am able to create weekly menu plans for your child. I can even finish personal grocery shopping for you to purchase whole, organic ingredients for your baby’s food. I am also able to come to your house on a weekly basis to make the baby food for you or to guide you with making the baby food yourself. Click the button below for more information:



What is a Feeding Team?

A feeding difficulty is a complex medical condition. Feeding issues can result in poor growth, nutrient deficiencies as well as developmental delays. Due to the fact that the process of feeding involves numerous systems throughout the body, addressing the issue is multi-faceted. Feeding difficulties can stem from various issues, such as dysphagia, reflux, history of intubation and/or feeding tubes (such as in a NICU stay), food allergies or anxiety.

Feeding difficulties are very challenging for a large majority of families. Parents may become frustrated, overwhelmed and stressed. At North Shore Pediatric Therapy, we have a unique, multi-disciplinary approach to treating feeding difficulties that provides a more effective treatment result.

The feeding team is comprised of four members that represent the following disciplines:

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The following are common reasons for referral to a feeding team for evaluation (1):

  • Limited variety of accepted food/selectivity. See my previous blog on “Problem Feeders”.
  • Limited volume of accepted foods. The child takes very small bites of certain food and then pushes it away.
  • Food refusal, including from the bottle or breast during infancy.
  • Gagging, coughing and/or choking with meals.
  • Difficulty progressing with table food.
  • Aversion to certain food textures.
  • Vomiting with meals.
  • Poor feeding skills or inability to chew and swallow well.
  • Fear or anxiety when eating certain foods or new foods.

If you or your child’s doctor is concerned with feeding issues, please contact a Family Child Advocate at North Shore Pediatric Therapy to schedule a feeding team evaluation for your child. Based on the evaluation, the team will recommend a plan for treatment in which disciplines may need to be involved. Although not all cases will require all disciplines to be involved for treatment, a thorough assessment from a strong multi-disciplinary team will ensure that your child will experience the best possible outcome.

1. Cerezo CS, Lobato DJ, PInkos B, LeLeiko NS. Diagnosis and treatment of pediatric feeding and swallowing disorders: the team approach. Infant, Child, & Adolescent Nutrition. 2011;3(8):321-323.