What and When 4 Kids is proud to welcome nutrition expert Allison J Stowell MS, RD, CDN. Registered Dietitian and mother of two, Allison specializes in balanced nutrition for women, adolescents and children. Allison graduated Cum Laude from the University of New Hampshire with a Bachelors’ in Nutritional Science. She completed her Dietetic Internship and Masters in Nutrition Education at Teachers College, Columbia University.
She has been in private practice with offices in Mahopac, Bedford Hills and Danbury since 2003 and specializes in eating disorders, family dietary makeovers, medical nutrition therapy for heart disease and diabetes and a non-diet approach to weight loss.
Since 2007 she has been the Nutrition Coordinator for Carmel Hannaford, where she provides complementary nutrition classes and tours, community workshops and one-on-one shopping experiences.
Q: Dear Alli,
My daughter is 4 years old and just does not get enough fiber in her diet. The result is often constipation! Is there any fiber powder on the market that I could mix in with her yogurt, cereal, etc that could help remedy this situation? Is there a safe amount for such a young one to have? Also, what foods would be high in fiber that would be a good natural source for her to have?
Thanks.
Anonymous
A: Thank you for your question. Constipation in young children can be very distressing and difficult to manage. I have unfortunately seen this problem many times in my office, as well as in my own children. A few things come to mind. If you haven’t yet seen your pediatrician then I suggest that you schedule an appointment. He or she is likely to refer you to a gastroenterologist or allergist for allergy testing.
It is possible that your daughter has a food sensitivity that causes her constipation. In advance of your appointment if would be helpful to keep a food/symptom diary in which you record all that your daughter eats and when/if she has symptoms.
Many children (and most adults!) don’t consume enough fiber. That said it is very important to also recognize that many of us (adults and children) are also dehydrated, which can worsen symptoms of constipation. It is essential that you make sure your daughter is consuming enough fluids throughout the day both to attempt to avoid constipation and to properly digest the fiber that you are offering her.
Some foods that are high in fiber are raw vegetables, fruit, beans, whole grain breads and pasta and brown rice. There are also products that are designed to be high in fiber such as Light English muffins that contain 8 grams of fiber per serving and similar products.
In addition, you can stir ground flax seed (begin with a ½ tbsp) into yogurt, cereal, oatmeal or other batters to boost the fiber content. Your doctor may also recommend Miralax, which is a tasteless, odorless powder that can be stirred into liquids. Miralax is a mild laxative that is not absorbed into the system but relieves constipation. Please only try Miralax if your doctor recommends it..
Tip of the Week:
Keep your child’s energy up at school through balanced, healthful snacks that are easy to put together and sure to please! Begin by seeking to pair carbohydrate-based foods with foods that contain protein and/or fat. For example pair an apple or banana with peanut butter (or another nut butter) pair crackers or similar snack with a cheese stick. Or, let your child be the chef with a “make-your-own” trail mix. Select “fixings” and put into small bowls. Allow your child to select and create their own snack bag size trail mix. Healthful fixings include low sugar cereal, nuts (unsalted and dry roasted), dried fruit and seeds. If necessary, add a few mini chocolate chips.
Mom-to-mom…Why combine carbohydrate with protein and/or fat? Protein and fat serve to slow the digestion of the sugar in the carbohydrate, which leaves our kids (and us!) feeling fuller longer and sustains our energy to improve our mood and fatigue level.
Allison J Stowell MS, RD, CDN
www.Beyond-Health.com
Q: My teenage son is vegetarian. How can I ensure that he is getting enough protein? What protein sources do you recommend?
Anonymous, Mahopac NY
A: Thank you for your question! To begin, I want to make sure you know that it is fine that your son is vegetarian. Many young people experiment with different diets and vegetarianism is a very popular one. The most important thing is for your son to consider that he is taking on the responsibility of understanding what it means to avoid meat. I assume that he is a lacto-ovo vegetarian, meaning that he continues to consume dairy foods, such as milk, eggs and cheese. This is good, as being vegan (avoiding dairy and meat) is an even greater challenge, though also safe when done correctly.
Teenage boys require approximately 40-50 grams of protein a day. When divided into servings, this looks like around 6-7 servings daily (each offering about 7 grams of protein). Of course, one is left wondering what exactly a serving is! According to the USDA, examples of vegetarian protein servings include: one egg, ½ ounce of nuts (approximately 12 almonds, 24 pistachios or 7 walnut halves), ½ ounce of seeds (pumpkin, sunflower), 1 tbsp nut butter, ½ cup cooked dry peas or beans, ¼ cup tofu, 2 tbsp hummus. To get in two servings, try a cup of split pea, lentil or bean soup or a bean based burger. Another excellent choice is Greek yogurt, which is much higher in protein than other yogurts found on your grocer’s shelf.
I would recommend that he consume any of the above protein choices and that he aims for good variety. The goal for anyone- vegetarian or not- is to try to get at least some protein with every meal and snack. Many vegetarian protein sources are portable and pair well with a variety of foods. If on-the-go foods are needed, then you can also choose from the assortment of energy bars that are available. For more help, please visit me at Hannaford (Putnam Plaza, Carmel NY; 845-225-4151) and I can help you pick out a variety of high protein foods!
Q: Help! There is so much Halloween candy in my house. My kids keep asking for it and I am picking at it too. Any strategies for getting it away from me and my kids? Suzanne, Fishkill NY
A: I am sure there are many reading this that are having the same problem this week! To begin- separate what you want to keep and make a plan to get rid of the rest. While it is acceptable to keep some of it plan to give up most. Of the portion that you keep, put some of it in the freezer (a frozen candy bar is delicious!) and put the rest in a hard-to-reach location that is not in view. Do not let your kids keep it in their room. To get the rest out of your home consider either finding someone that can take it to work. Better yet, try to locate a box that is collecting candy to send to away to our troops. I know that Dr. Benjamin Dancygier of Valley Pediatric Dentistry is accepting candy to donate as well as the New York Sports Club in Danbury and the Melrose School in Brewster.
As we manage the Halloween aftermath and head into the holiday season we need to be careful not to turn our “sometimes” foods into an everyday occurrence. If Halloween was more of a struggle for you then you may want to make a plan for the rest of this holiday season. Begin by monitoring the sweets that come into the house and other “extras”. That being said, please remember that at the end of the day it is calories that matter most. That “fun size” Milky Way is probably fewer calories than you think. Try not to beat yourself up over it! Just do your best to make the rest of your day as balanced as possible.
Hello Anna,
Thank you for your question! I am sure many parents and caregivers relate! Believe it or not we need to try some foods up to ten times before we know we like it! (Unfortunately Oreos are not one of those foods!) Your daughter may need a little more encouragement to try something new. Please just keep offering foods that she has refused in the past and modeling good behavior by eating them yourself. If she likes to dance, do gymnastics or any other activity then remind her that a variety of foods- and especially our proteins- are our “big and strong” foods to make us better at the things we love to do.
Here are a few other suggestions….
Start a taste chart…all she has to do is take a taste- not finish- a food that she is refusing and she will earn a sticker. You can decide how many stickers earn her a prize and what that prize should be (just not sweets or any other food!)
Color Menu…sit with her and make a list of some starches, vegetables, and proteins and then color code each group (ie. Starches= blue, veggies= green, protein= red) and tell her that her meal has to have a food from each color
Hannaford Store Tour…sometimes kids just don’t want to listen to mom (don’t worry, it happens to me too and my daughter is only 3!). Bring her in to see me at Carmel Hannaford (Putnam Plaza, Route 6) and I can introduce her to different foods, tour her around the store and try to make eating new foods exciting…and it is free!
I hope these ideas help! Please stay in touch and let us know!
Dear Alli,
My 2 year old son has been giving me a very hard time eating lately. He loves fruit and can eat apples and blueberries all day long, but when it is time to have breakfast, lunch and dinner he tells me he doesn’t want to eat, and his famous line is “I will have it tomorrow”. I have to take out the bin of cars, or give him my cell phone to entertain him so I can put the food in his mouth, because if I leave it up to him to sit and eat he just won’t do it. He was never like this before, could this be the “terrible 2’s”? Do you have any tips or tricks to get his more engaged with his food?
Anonymous
It can be so frustrating to feed our kids sometimes. I can picture the scene –there you are begging your child to eat all the while hearing your pediatrician’s voice in your head reminding you of the nutrients he needs to be healthy and strong. Please, take a moment to rest and breath. This too shall pass!
Children- especially toddlers- are grazers. This makes sense, as their bellies are not that big and therefore cannot digest too much food at once. Actually, children tend to use food in the way I wish more adults were able to eat, as they seem to genuinely use food as an energy source not for other, less healthful reasons (ie boredom, emotions…because the clock “says” it’s time to eat!)
One of the best ways to feed them is to simply have food available as often as possible and allow them to pick. I realize that this is difficult to balance with “meal time” but it may suit your son better and actually encourage his appetite to grow. One suggestion is to use a divided plate and fill it with different foods and a mix of colors and textures to attract his eye. Then leave it out as he plays and encourage him to try some. If he tries a new food and likes it then he will be more likely to eat it again at meal time.
I also suggest that you use a dip as a medium for trying new foods. For example, if he loves ranch dressing then serve it with anything that fits! This works with any favorite food- pair a food you know he loves with one you are trying to encourage (pizza with broccoli!).
Lastly, you may want to try to engage him in the preparation (as much as you can handle!)…or at least let him pick something out at the store and then get excited about trying it. With my daughter I often let her open something new in the store (yes, I sometimes hand the cashier empty wrappers and open boxes!).
Please know that this is most likely just a stage. Before you know it he will be emptying your kitchen and you will hardly be able to keep up with his appetite!
Question: I am concerned about all of the holiday parties and other things coming up for my son. I generally watch how many sweets he eats but this time of year it seems so hard. Any advice?
Anonymous
Answer:
For many of us the holiday season has us focusing on how to make room for holiday cookies while still balancing our diet and not overeating. We may forget that our children are facing the same struggle and that they probably don’t realize that these “sometimes” foods have become part of their every day diet. If we aren’t careful, our children could ring in the New Year with holiday weight gain.
Depending on the age of your child you may or may not be invited to the parties that are going on for them at school, during extracurricular activities and at friends’ homes. However, whether you will be present or not be sure to know what will be served. Once you know the menu, you can offer to make something healthful (contact me if you need ideas!). Also, use this knowledge to determine what your child is having before and after. For example, make sure that breakfast includes adequate protein, which is often lacking at parties. Likewise, plan a dinner that makes sense as well. For instance, if your child ate pizza at a party that afternoon then ziti isn’t the best choice for dinner. Of course, your child should skip an evening dessert as well if they had one that afternoon.
For older children, the holiday season is a good opportunity to learn about balance and how to incorporate a variety of foods. If appropriate, ask your child to keep a food journal on the days that they have parties or other special events that include food. At the end of the day, sit with them and determine how they did at eating foods from each food group (and did they have significantly more carbohydrates then protein?). If your child likes to cook, teach them how to prepare foods more healthfully by modifying ingredients and showing them why the modification improved their recipe. For example, maybe they could try using whole wheat flour (for whole grain and protein) in cookies and see how it tastes…they may be surprised that it still tastes like a cookie!
Even very young children can understand “sometimes” foods versus “every day” foods. This is a message that I teach in the store all the time to children as young as three. It is important for children (and adults) to realize that our sweets or other higher fat foods are not “bad” foods or always bad for us if eaten correctly. Rather, we want to explain to children that these “sometimes” foods are just that- foods that should be eaten sometimes and not frequently. Most importantly, we don’t want our children to view our “sometimes” foods as something extra special as this may cause a unsafe relationship to develop, which encourages overconsumption of these foods (sometimes in secret).
If you struggle to get a healthful message about food and eating to your children then please call or visit Carmel Hannaford and set up an appointment with me. I can tour your children (or the whole family) around the store, allow them to sample new foods and explain what healthful eating is all about and as always…it’s free!
Question:
I recently found out that my child has Celiac disease and is allergic to gluten. Any ideas of how I can manage upcoming holiday parties? I don’t want her to feel left out. Please help!
Anonymous, Mahopac NY
Answer:
Thank you for submitting your question! Allergies in kids are a considerable concern. Luckily, many teachers, parents and others are quite used to keeping children with allergies safe and are generally aware of foods that may contain unsafe ingredients. That said, an allergy to gluten is more complicated as gluten can be found in many different types of foods from baked goods to salad dressings and sauces. Depending on the age of your child you may need to play a significant role in monitoring their food choices.
Holiday parties and other gatherings this time of year can present a great challenge for anyone with allergies. An allergy to gluten is especially difficult as it will be present in cookies and other baked goods, as well as many of the snacks that are likely to be present at school parties and similar events. I recommend a few things. First, if you haven’t done so already I suggest that you have a conversation with your child’s teacher (and nurse if not done already) and, if appropriate, send a letter home to other class parents explaining the allergy and how to keep your daughter safe. Things to highlight are not just the foods that may contain the allergen but also other necessary steps to avoid cross contamination such as ensuring she has her own paper plate and doesn’t share with friends and that all foods safe for her remain so by offering her a portion first before others (as there is a risk for contamination if a serving spoon makes contact with a food that contains gluten). Also remind others that simply using gluten free pasta doesn’t mean that your daughter is safe unless the pasta is prepared in a gluten free kitchen.
The good news is that there are several products that are easily accessible to you. Not only are there many more gluten free foods found in natural stores (or the natural section of larger grocery stores, Hannaford in Carmel has a great selection) but now Betty Crocker has a gluten free baking line that is affordable and found in the regular baking aisle. Also plan to provide snacks for the party such as gluten free crackers and cheese, corn chips and salsa/guacamole or baby carrots and hummus.
Following a gluten free diet to manage symptoms of Celiac disease is not just a diet but a lifestyle change. If you have not sought support to adjust to your daughter’s new diagnosis then please do so. I have worked with many families that are adjusting to this new way of living and can help to make it a little easier.
A Healthier Holiday
We all look forward to a break from the everyday but when it comes we sometimes actually feel “off”. We realize that school and work provide a setting and structure that encourages regular meals and snacks. Sometimes, time off negatively affects our food choices and eating patterns. To make sure that this doesn’t happen to you, there are a few things that you should remember and look out for in both your eating patterns and in the diets of your children.
To begin, monitor your eating cues. Are you bored or really hungry? Do you find yourself munching on foods all day long? A true hunger cue can be felt in your stomach as a signal you that you really need to eat. An incorrect hunger cue comes from your head and often comes on fast and for a specific food or flavor. This type of hunger cue is more emotionally based and less due to physical or “true” hunger.
The second thing you can do is keep a detailed and accurate food record while you eat- not after. Writing while you eat reminds you not to overeat and keeps you more aware of your choices (do I really need another handful of pretzels?). Keeping a food journal encourages conscious eating, which is key to staying on track with healthful eating.
Lastly, during this holiday break consider doing a few things that you may not have time do to during your regular busy schedule. Possibly you can try a new recipe or create a schedule for your family that helps you all eat more balanced meals. Or maybe you have wanted to check out new foods at the grocery store but haven’t had the time. Now may be a great opportunity for you to explore these things.
As you look toward 2010 and think about how to make it a healthier year for you and your family, please consider the role that I can play for you. In both my practice and at Hannaford (Route 6, Carmel) I am available to you. In my practice, I am available to assist you in a complete family dietary makeover, which may be just what your family needs for 2010.
On January 23rd 2010, I will kick off our 3rd annual 10% Weight Loss Challenge at Hannaford. This FREE 8-week long weight loss program includes a weekly weigh in and support from me. The timing is flexible and each week you can pick up essential information for moving forward on your path to weight loss and more healthful living.
As always, please contact me if you would like more information on anything included in this article and send along your nutrition questions. Together we can make 2010 your healthiest year yet!!
Question:
My 13 month old son is a GREAT eater! He’s been eating solid pieces of food for a while now and won’t even touch something mushed or pureed. I’ve been giving him diced boiled veggies like carrots, string beans, peas, broccoli, etc. He has no problem finishing his plate but doesn’t seem to digest the vegetables…they often come out whole in his diaper. I’m worried he’s not getting all the nutrients from these undigested veggies….Is this ok? Should I be doing something else to help his digestion?
Dawn, Brewster, NY
Answer:
And the award for asking the question that many moms may have wondered goes to Dawn! I have to admit that after reading your question I checked with my family’s pediatrician for a second opinion on this one!
Your son is absolutely benefitting from the vitamins in his vegetables. As they pass through his digestive system his gastric secretions and enzymes that enable his food to be broken down absorb these important nutrients and help him grow and develop. The insoluble fiber found in the vegetables then allows them to pass (virtually appearing to be untouched). In the end your son is benefitting from a host of vitamins, antioxidants and fiber too. The peas are actually providing soluble fiber, which does break down (turns to gel) during digestion. Soluble fiber, which also includes beans, seeds and oat bran, has been clinically shown to reduce risk of heart disease by lowering cholesterol. Fiber from fruit, vegetables and whole grain foods are a very important part of a balanced diet.
I am so thrilled to hear that your son loves his vegetables! Please continue to offer these as he moves further into toddlerhood…even if at times he seems to refuse them.
Question: My 11 Year old son was just diagnosed with high cholesterol. We are trying to avoid medication. What changes should we make to his diet?
Answer: Let’s begin with a little nutrition 101. Dietary cholesterol is found in animal based foods including dairy foods (including creaming dressings, sour cream, etc), egg yolks, seafood, meats and poultry. To limit the amount of cholesterol in foods that fall into these groups select the leaner versions of meats and skim or non fat dairy choices.
There are two types of cholesterol found in our blood, which are described as HDL (“healthy”) and LDL (“bad”) cholesterol. Our levels of each of these cholesterols as well as the ratio between them matters greatly- often times more than our total cholesterol value on its own. Here are the recommended values for children ages 2-18 years (according to Kidshealth.org).
Category Total cholesterol (mg/dL) LDL cholesterol, (mg/dL)
Acceptable Less than 170 Less than 110
Borderline 170-199 110-129
High 200 or greater 130 or greater
(The American Heart Association recommends a ratio below 5:1)
The goal is to lower the bad cholesterol while leaving the good cholesterol alone or even raising if it is low. Monounsaturated fats, such as olive oil, nuts and seeds can actually help lower bad cholesterol and reduce your future risk. Polyunsaturated fats such as those found in fish are also highly beneficial and believed to be an important part of reducing future heart disease risk. High fiber foods can also lower your total cholesterol. Lastly, I can’t over emphasize the importance of exercise for maintaining an ideal weight and even for helping to raise the good cholesterol….both are very important for reducing future risk.
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A school lunch our kids will eat…
I am sure that I am not the only one who struggles with what to pack for my child’s lunch. Each school night I consider what I have available and then begin the delicate balance of packing what I wish my daughter would eat with what she wishes to eat! Seeing as my daughter is only four I know that I have many more years of this.
Yes, even though I am a dietitian I too struggle with what to pack and how to get her to eat (ironically, this is not a problem that I have with my fifteen month old son…). In defense of me and all of the other caregivers out there, the issue of what to pack is a valid one. The pressure is on for school lunch to be healthful, energy packed and of course kid-friendly. An ideal school lunch provides enough protein and carbohydrate to help our children get through the final hours of their long school day and possibly even sustain them for afterschool activities. Lastly, it needs to be portable, easy and simple to eat.
A few things to consider…
• Ideally, aim for whole grain (complex) carbohydrates as these will sustain your children longer. If you need to “disguise” them, try using a granola bar that includes them such as Kashi granola bars.
• Adequate protein is essential…even if you don’t pack lunch meats or cheese. Consider using a bean dip (with baked chips or carrots), humus or roasted soy nuts (or a soy nut butter) if you are struggling to come up with protein-rich (“nut free”) protein sources.
• Include your children…let them be the chef as much as possible. Maybe they can make a trail mix (with ingredients pre-screened by you!) to accompany a yogurt or create their own interesting sandwich or wrap.
If you are frustrated with how your kids are eating while at school then take a moment to talk with them about it. Sometimes, our children refuse to eat foods they love at home when they are at school for reasons that you wouldn’t have considered. Possibly, they don’t like the temperature of the lunch or maybe it is soggy by the time they get to eat. Or maybe, they are affected by something in the cafeteria (the noise, smells or other distractions). Figuring out exactly what is preventing them from eating may save you from future frustration.
If you are looking for more ideas or support with other aspects of your child’s diet then please get in touch! Email me at Allison@beyond-health.com.
If your kids like to cook, then maybe they can help you make these healthful cookies! Each cookie provides 4 grams of healthful fat, 3 grams of fiber, 7 grams of sugar and 2 grams of protein (all at 110 calories!)…and is perfect to round out their school lunch!
Kashi Rasin n’ Spice Cookies
Ingredients:
2 cups Kashi® Good Friends® Original cereal
1¾ cups whole-wheat flour
1 tsp baking soda
½ tsp salt
1 tsp cinnamon
½ tsp nutmeg
½ cup canola margarine, softened
½ cup evaporated cane juice crystals
2 eggs
½ cup raisins
1 tsp pure vanilla extract
Non-stick cooking spray
Directions:
Preheat oven to 375°F.
Put Kashi® Good Friends® Original cereal in plastic bag and lightly crumble with hands into smaller pieces.
In a small mixing bowl, combine flour, baking soda, salt and spices. Set aside.
In a large mixing bowl, beat together spread and cane juice crystals until light and fluffy. Add eggs and vanilla; beat well. Add crushed Kashi® Good Friends® Original cereal and flour mixture; mix until well combined. Stir in raisins.
Spray cookie sheet with non-stick cooking spray and drop batter by heaping tablespoon onto cookie sheet.
Bake at 375°F about 10 minutes or until golden brown. Let cool on wire rack.
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Question: My family eats out often. How do we do it and still eat well?
Answer: Many families eat out or order take out at least once a week. Luckily, these days eating out doesn’t have to compromise your diet. Many restaurants offer modified foods and/or are happy to substitutions. One of the most important things to keep in mind if you eat out often is that it can become a problem if you treat it like a special event…all of the time. In other words, just because you find yourself at a restaurant on a Tuesday night doesn’t necessarily mean that you should start your meal with an appetizer and bread dipped in oil! Here are a few other suggestions….
• “Breaded”, “batter-dipped”, and “tempura”= FRIED! Instead, aim for “grilled”, “broiled”, “flame-cooked” or steamed, poached, roasted or baked.
• Other terms to watch out for- “flaky”, “puffed”, and “crispy”- these not only indicate the presence of fat but generally contain the unhealthy fats, saturated fat and trans fat.
• Avoid “hollandaise”, “béarnaise”, “béchamel”, or beurre blanc, and other creamy entrees. For sauces, stick to wine, or thin, stock based sauces. Also, skip the gravy.
• “Escalloped”, “au gratin” and “parmigiana” also mean added fat.
• With pasta, opt for red sauces like “marinara” rather than cream sauces like “alfredo”.
To make it a bit more nutritious:
• Choose salads made with dark greens like spinach and romaine.
• Order a side dish of steamed or marinated vegetables.
• Opt for a baked potato instead of French fries, or have side salad.
• When ordering a pizza, ask for extra veggies and possibly light on the cheese.
• Request whole grain bread, brown rice.
• Request lettuce, tomatoes, onions and mustard or catsup for sandwiches and skip the mayo and “special sauce”.
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Question: How can I get my kids to eat healthier foods after school? I try to buy healthy snack foods but they don’t always want them. Any suggestions for better after school snacks?
Answer: Great question! I am sure that there are many parents that struggle with the same problem. School age children have a very long day with eating that is restricted to certain times. They come home from school genuinely hungry so it is challenging to help them eat something balanced and satisfying without giving them a meal.
Actually, I often recommend to families that they do encourage their children to think of this “eating occasion” as their dinner. I find that when I suggest this to kids they tend to turn to the refrigerator for leftovers or the freezer to defrost/cook something rather than simply looking in the pantry for a snack. Of course, I still encourage kids to sit with their families at meal time but instruct them to have a smaller portion (thus the leftovers for the next day!). Activities, work schedules and other chaos have many of us eating later than we wish, for our kids this is very hard. Rearranging their meals this way helps with this.
If leftovers aren’t available I suggest the following…
• Keep salad prepared in your fridge…if it is made they will eat it. Have them add cheese, nuts, grilled chicken, lunch meats or another protein to it
• Keep frozen meals in the freezer. Consider the Amy’s Organics or Kashi meals, which are made with wholesome ingredients
• Low sodium soup, cheese and crackers and can be a small meal
• Keep veggies available such as baby carrots, sugar snap pea, grape tomatoes…easy to grab and great with hummus or other dips
• Spinach nuggets (in the produce section) are a quick alternative to the chicken variety and much better for you
If snack is really what they want then try to make it well rounded with something like a yogurt parfait with some fruit and nuts or fruit and peanut butter or ½ a sandwich.
Thanks for you question…keep them coming!
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Question: My children don’t really like to drink milk. I am worried that they aren’t getting enough calcium. How much do they really need?
Answer: This is a common concern for many parents. There are several reasons why some children aren’t drinking milk or eating other dairy-rich foods. In some cases children don’t prefer the taste while other children may have dairy or lactose intolerances that prevent them from being able to digest these foods. Either way, your children’s overall diet or their ability to get adequate calcium doesn’t have to be compromised.
Unless your pediatrician has given you specific instructions use the following as a guideline to meet your child’s daily needs*:
• 500 mg a day for kids who are 1 to 3 years old
• 800 mg a day for kids who are 4 to 8 years old
• 1,300 mg a day for kids who are 9 to 18 years old
(*According to the Food and Nutrition Board of the National Academy of Sciences)
Aside from milk and yogurt there are many calcium rich foods including fortified orange juice, cereals, certain energy or granola bars and certain breads. If your child is willing (and able) to eat yogurt then I suggest the Stoneyfield Farm 2X Calcium and the new Danonino yogurt from Dannon, as both are made with extra calcium. In addition, if cheese is an option then use it as a calcium source too (many cheeses, including Cabot Cheddar are lactose free if that is a concern). There are also many foods that naturally contain this essential mineral such as almonds, tofu, broccoli, spinach, salmon and white or baked beans.
One buyer beware….be cautious of claims that a food is high in calcium without checking the nutrition facts panel. Also, be mindful of foods that are “yogurt covered” as these are sometimes higher in sugar…not calcium!
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Question: Should I be giving my 4 year old a daily vitamin? Some days I worry that she isn’t getting enough nutrients in.
Answer: There are so many vitamin choices out there for kids that it would seem that we should be giving our children a daily multivitamin. After all, why would they offer so many (and encourage them with Dora, Cars and Disney Princesses!). So that being said, do our kids really need them?
According to the American Academy of Pediatrics most kids do not need a daily vitamin. However, experts recommend a daily vitamin D supplement in order for kids to get in 400IU per day. This very important vitamin is found in milk, eggs and fish but many kids don’t consume enough to meet their daily needs. Recent research has indicated that many children (and adults!) are deficient in Vitamin D.
It is interesting to note that the American Academy of Pediatrics has found that parents that are encouraging multivitamins are often the same parents that are providing their children with a balanced diet to begin with. Furthermore, it doesn’t take much from each food group to meet our children’s daily needs. So maybe those few bites from even the pickiest eater are adding up to something!
Please remember that there are unique circumstances that do call for vitamin supplementation in kids. Please consult your pediatrician if you are concerned about your child’s health status.
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Question: School lunch has become so boring! My kids complain that they are tired of eating the same thing all of the time. Help!
Answer: It sounds like your school lunches need a makeover. Below are several ideas. Choose something form column “A” and add one, two or three things from column “B”. You might want to pack some of the “insides” (column B) in separate containers. Hopefully these are ideas that you haven’t thought of before or are twists on what is working!
Mix ‘n’ Match
A) Select one of these….
• Whole wheat bread (100%)
• Whole-wheat pita bread (100%)
• Bran muffin
• Lavash (flat bread)
• Corn tortillas
• Whole-grain low-fat crackers
• Flour tortillas
• Rice cakes
• Pumpkin or banana bread
• Cornbread
• Oatmeal bread
• Steam white or brown rice
B) And add one or more of these…
• Nut butter or peanut butter
• Hummus or mashed bean spreads
• Sliced lettuce, tomato, cucumber, summer squash, radishes, peppers
• Shredded carrots, beets, cabbage
• Thinly sliced apples or bananas (Note: Chiquita pre-sliced apple slices make this very easy!)
• Sliced low-fat cheese or soy cheese and grapes or other fruit
• Tuna
• Skinless roasted chicken breast or turkey
• Homemade chicken tenders or nuggets
• Apple or pumpkin butter
• Mashed sweet potatoes
• Salsa
• Refried beans
• Leftovers from dinner
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Question: My doctor told me a lot of adults have a vitamin D deficiency. Is this a problem for kids too? What foods are high in Vitamin D? Thank you!
Answer: Over the past couple of years Vitamin D has been getting a lot of attention. Thought of as the “sunshine vitamin”, we didn’t worry about our intake of this important vitamin. However, as we seek to spend less time in the sun and with changing diets, it has become a concern for adults and for children too.
A report from the American Academy of Pediatrics recommends a daily intake of 400 IU of vitamin D for children from babies through teens. This is an increase of 200 IU over previous recommendations.
I mentioned that vitamin D is referred to as the “sunshine vitamin”. This is because we are able to synthesize it when we are exposed to the sun. With this in mind, encourage your kids to get outside. YES, you can benefit even if you are using sunscreen so PLEASE always product your children from sunburn and over exposure. It is also very important to incorporate vitamin D into your family’s regular diet through foods rich in the vitamin such as eggs, dairy, soy milk, rice milk, and fortified cereals and breads. Fish is also high in vitamin D but please be aware that children (and adults) need to be mindful of consuming too much mercury when choosing fish.
There are many reasons to maintain adequate intake of vitamin D but one of the most important that comes to mind when I think about children is for calcium absorption. Vitamin D is essential for the absorption of calcium. Without it the calcium that you encourage for strong bones and teeth will not be able to do its job. In many cases, your dairy choices will be fortified with vitamin D to encourage this healthful combination.
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Question: My son is often trying to steal sips of my coffee and diet soda. He is in pre-school. Is this safe for him? Is caffeine very dangerous for children?
Answer: This is an interesting question. I am not so concerned about the sips of your coffee but it does raise an important concern about caffeine and children. Caffeine can be found in many different foods that children love including iced tea, dark and milk chocolate, hot cocoa, chocolate milk and lastly soda. Of these examples, the most caffeine is found in soda (12 oz has 34mg) and iced tea (70 mg for 12 oz), so you can add that to the list of many reasons why you should avoid these drinks for your children. To give you a reference on the other examples, 1 oz of milk chocolate has 6mg and 8 oz of chocolate milk has 5 mg. The United States hasn’t put forth guidelines for caffeine intake and children. However, Canadian pediatric health experts have set this limit to no more than 45 mg per day for pre-schoolers.
There are many reasons to limit caffeine in children. To begin, it can increase heart rate and blood pressure, cause concentration and sleep problems and induce headaches and upset stomach. Studies have shown that kids who consume one or more 12-ounce sweetened soft drinks per day are 60% more likely to be obese (Kidshealth.org). It is also important to note that children who are consuming caffeinated beverages may not be getting the vitamins and minerals found in more healthful drinks. This includes calcium, which is so important for the development of strong teeth and bones in children. However, despite what you may believe, experts agree that caffeine intake does not stunt growth.
The minimal caffeine found in a piece of chocolate cake is not the concern as much as the potential caffeine that children may get through their beverage choices. Water, seltzer and other non-calorie drinks, as well as milk and limited 100% juice are what we want to stress for children.
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Do you have a question for Alli? Email her at AskAlli@whatandwhen4kids.com , or use the form below. All submissions are in the strictest confidence.
Allison J Stowell MS, RD, CDN
