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.
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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
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