Cleaning for the House Cleaner

As a Registered Dietitian, I see diet diaries (a list of foods and amounts consumed over the past 3 days) from clients, both children and adults.  They reason they are referred to me or decide to see me is usually because they believe that their diet is not supporting proper health, or they are facing some medical issues that are diet related.  So when I receive a diet diary I expect to see some unhealthy foods and unhealthy quantities listed.  But this not usually what I receive.  I receive diets full of fruits, vegetables, salmon, whole wheat pasta, and non fat yogurt.

But these diet records don’t coincide with what I see in the grocery stores.  Stores would only sell what people are buying.  They will provide large quantities and choices of popular foods and smaller quantities and choices of less popular foods.  I live on an island in WA state.  The community here, about 20,000, is very educated and affluent.  Most people here have the ability to understand nutritional principals and the money to support optimal nutrition.  The parents here are all, at least on paper, supportive of proper nutrition for their children.  

No one that doesn’t live on this island comes here to grocery shop as the grocery stores are part of a national chain, so the same store is available everywhere.  Therefore I was really struck by what I see in the grocery store here.  As I walk in I see a bombardment of white flour/butter/sugar laden dessert foods, decorated in unnatural colors for Halloween.  Cakes, cookies and cupcakes, in non-recycleable plastic containers, and many with “decorative”  plastic Halloween doodahs (probably made in China) on these items. Adjacent, and similarly packaged are the “every day” selection of cookies, cakes, cinnamon rolls, brownies, and cupcakes. In addition to this there is the permanent bakery counter, and the inter-store rows of breakfast cereals, cakes, cookies, energy bars, snack or breakfast bars, crackers, chips, breads, and cake mixes, plus the frozen and refrigerator sections of more cakes, cookies, brownies, ice cream, ice cream novelties, and other frozen foods based on white flour.   The fresh fruit and vegetable section of the store takes up about one fifth of the total space.  So someone must be buying unhealthy foods, but WHO???

Is it possible that when I receive a diet diary the recorder has “cleaned up their act” for me, or perhaps given me what they know they should eat, not what they eat?  If so, perhaps they should just follow this diet diary.  Why see a dietitian when you know what to eat?  How can I help when you have, on paper, made the changes you know you should make?  It would be far better to be upfront so that I can help you to make changes that you know you can sustain over the long term, not for a three day diet diary.

Preschool Lunches- No Big Deal

Many parents tell me that their child doesn’t eat their packed lunch.  This doesn’t surprise me when I see the portions that are typically packed. When parents see what comes home from a packed lunch where the portions were too large, it looks as if the child ate very little, which is exactly how much they should be eating. 

Do you know what a serving of vegetables or pasta looks like for a toddler or preschooler?  You might be surprised.  I have been observing the lunches sent in by parents at a local preschool.  This preschool does a beautiful job at lunch, putting each child’s packed lunch on a plate and giving them a cup of water and utensils to eat with.  All of the children eat together at a table, assisted by the staff. 

However, the serving sizes of foods are usually way too big.  As just one part of a lunch consisting of 4 or more different foods, I have observed a 1 cup portion of fried rice, a 1 cup container of yogurt, a whole sandwich, ½ cup of crackers, a large apple (sliced) and ¾ cups of pasta salad.  Children ages 2-5 don’t eat or need that much at one meal and these serving sizes are sending the wrong message.  When adults constantly see over sized portions at restaurants, they start to believe that this serving is the appropriate amount that they should eat, but it’s not.   So sending a child too much food, even if it is nutritious food, sends the message “this is how much you should eat.”  No wonder so many of our children are overweight or obese.   

Young children have small stomachs so they need smaller meals and a few snacks throughout the day.  Lunch can consist of 4 choices, at the very most.  Children can become overwhelmed with too many choices.  Examples of serving sizes for preschoolers are:

1/2 -3/4 cups milk or 1 ounce of cheese (one slice) or 4 ounces of yogurt

½ -1 slice of bread or ¼ cup crackers

1 tablespoon of fruit or vegetable per year of age.  (A three year old would receive 3 tablespoons berries)

1 tablespoon of meat, or beans per year of age

1 egg

An exmple of an appropriate lunch for a 4 year old is:

½- 1/3 cup fried rice

4 tablespoons diced chicken

4 slices of apple

4 small carrot sticks

Milk can be served with lunch, but keep in mind that preschoolers only need 2 cups of milk a day, so serving water is fine.  Keep lunch child sized for your child.   You will be surprised how much they eat.

Preschool Lunches- No Big Deal

Many parents tell me that their child doesn’t eat their packed lunch.  This doesn’t surprise me when I see the portions that are typically packed. When parents see what comes home from a packed lunch where the portions were too large, it looks as if the child ate very little, which is exactly how much they should be eating. 

Do you know what a serving of vegetables or pasta looks like for a toddler or preschooler?  You might be surprised.  I have been observing the lunches sent in by parents at a local preschool.  This preschool does a beautiful job at lunch, putting each child’s packed lunch on a plate and giving them a cup of water and utensils to eat with.  All of the children eat together at a table, assisted by the staff. 

However, the serving sizes of foods are usually way too big.  As just one part of a lunch consisting of 4 or more different foods, I have observed a 1 cup portion of fried rice, a 1 cup container of yogurt, a whole sandwich, ½ cup of crackers, a large apple (sliced) and ¾ cups of pasta salad.  Children ages 2-5 don’t eat or need that much at one meal and these serving sizes are sending the wrong message.  When adults constantly see over sized portions at restaurants, they start to believe that this serving is the appropriate amount that they should eat, but it’s not.   So sending a child too much food, even if it is nutritious food, sends the message “this is how much you should eat.”  No wonder so many of our children are overweight or obese.   

Young children have small stomachs so they need smaller meals and a few snacks throughout the day.  Lunch can consist of 4 choices, at the very most.  Children can become overwhelmed with too many choices.  Examples of serving sizes for preschoolers are:

1/2 -3/4 cups milk or 1 ounce of cheese (one slice) or 4 ounces of yogurt

½ -1 slice of bread or ¼ cup crackers

1 tablespoon of fruit or vegetable per year of age.  (A three year old would receive 3 tablespoons berries)

1 tablespoon of meat, or beans per year of age

1 egg

An exmple of an appropriate lunch for a 4 year old is:

½- 1/3 cup fried rice

4 tablespoons diced chicken

4 slices of apple

4 small carrot sticks

Milk can be served with lunch, but keep in mind that preschoolers only need 2 cups of milk a day, so serving water is fine.  Keep lunch child sized for your child.   You will be surprised how much they eat.

Berry Season

Yes, it is finally spring.  Even if your weather is not as spring-like as you may like, there are other signs.  Spring foods are showing up in the markets.  Asparagus is one indicator.  But think strawberries if you are feeding children.  Even some of our youngest eaters, perhaps at age 9-10 months, can eat bits of fresh strawberries.  After strawberry season look for raspberries in June, blueberries in July, and blackberries in August.

Serve the berries as soon as possible after purchasing, fresh is best.  Even better, pick your own berries.  Look for “U-Pick” farms in your area.  The native wild strawberries (small and irregular in shape) are the sweetest.  You can easily find blueberries and blackberries growing wild.  Blueberries are easy for young children to pick as many are low to the ground.  Blackberries may be difficult as the plants are covered with prickers.  One way to allow small children to pick these with more ease is to take a shears and cut off a large branch from the blackberry bush.  Lay the branch on the ground and let the kids pick, or eat, blackberries from this branch.  Let your child really taste the natural sweetness of the fruit.  Why alter a berry by covering it in sauce, cream, or baking with loads of sugar?  If you find you have picked too many berries to eat within the next several days, they freeze well.  Lay the berries in a single layer on a cookie sheet.  When they are frozen solid, transfer them to a freezer bag. 

There are also some great children’s books about berries.  My two favorite are “Jam Berry” and “The Little Mouse, The Red Ripe Strawberry, and the Big Hungry Bear”.   Both books have beautiful pictures of ripe berries.  “Jam Berry” will be enjoyed by even the youngest baby as it has a wonderfully entrancing rhythm and rhyme. “ The Big Hungry Bear” has a delightful, yet suspenseful story that can be enjoyed by the reader as well as young children.

Food Choices Are Not Erratic

Today in class I noticed that a child whose mother thought no longer ate cheese was eating cheese.  I asked mom about this and she responded that since the child was offered cheese in class several weeks ago she is eating it again at home, but not orange cheese.  I explained that although this seemed erratic, it is typical and normal.  Our children eat not just what they know they enjoy due to taste, smell, appearance or texture, but what they are nutritionally drawn toward.

 So how do we, as mindful a parents, know what our children need nutritionally each meal or day?  We don’t, so our job is to offer a variety of healthy food over the course of the day.   Don’t fall into the trap of offering what you think your child will eat or not offering foods that they have previously refused.  This back fires in two ways.  One, even though a child ate a food once, or even if that food has been the favorite food for a few days, that doesn’t necessarily indicate the child will eat it at this time.  Two, if you only offer foods you believe your child will accept, you will slowly narrow food choices and eventually decide that you have a picky eater.

 When it is time for a snack or meal, think: what would I like my child to eat, what do I have, what is manageable at this time (do you want to cook or not, do you have a short or long time for eating, etc?).  Once you have made this choice put the food in front of your child.  They can eat or not.  Of course you can always choose to offer the current favorite food once or twice a day, as part of any meal or snack. But keep rotating in a variety of fruits, vegetables, grains, meats, dairy products, beans, nuts, seeds, oils, and fish as every food has it’s own unique nutritional profile.  You have done your job.

An Unscientific Study

As mindful as we try to be, there are times when our child’s behavior seems to make no sense to us.  This is no rational pattern or reason nor is there any developmental theory to support what we observe.  However you are looking at only one child.  I have had the pleasure of observing children eat and talking to parents for the past 20 years, in a child care settings and in classes with parents present.  I have made a few unscientific, non-research based observations.

Some babies will prefer to drink their meals.  No matter how mindfully you set the stage for a meal your baby or child drinks but not eats or very little.  I have heard this more often from parents of boys than of girls.  Babies between the ages of 6 months and 12 months should be fed on demand.  If your baby is able to take solids, offer solid food before the breast, bottle or cup.  If you have a drinker over 12 months of age and able to take solids, you can and should limit milk to 16 ounces (2 cups) a day.  Your child will probably not like this and may put up quite a fuss.  But as a mindful parent you will tell your child that to be healthy he needs to try more than milk.  You don’t need to force solids, but by limiting milk your child will soon increase their desire for solids.

The other common observation reported to me by parents is that a baby who once took semi soft solids is now refusing them.  When I suggest that the parent try crunchy and more textured foods the baby usually responds by eating once again.  It seems that for some babies, once they have experienced soft solids they are ready to move on.  This sometimes happens at the same time the baby is determined to feed themselves.  So go with it.  Your baby will come back to semi-solids eventually, but now they want to explore what is new.  Embrace this and let them try some Cheerios or especially made infant puffs.  Put a few in front of your baby and see what happens.

Saving Time, Money and your Sanity

 

How long does it take you to get yourself and your children ready for leaving the house, in the car, drive to the grocery store, get the kids out of the car and into the store, back to the car, strap everyone in, and drive home? Half an hour, maybe forty-five minutes?  If you are as busy as most parents, why would you do this more often than necessary.  Yet many of us go to the grocery store several times a week.

 

Most of us with toddlers need more time.  A simple way to create more time is to grocery shop one time per week. Impossible?  Not with a little planning.   Before going to the store decide what you are going to eat for dinner for the next 6 days.  Make a list of the items you need; then add staples plus breakfast, lunch and snack foods. Go to the store and shop from your list.  If you need milk more often, have it delivered or ask your partner to pick some up once a week.  If you buy fresh fish or meat, eat that earlier in the week.  Eat more delicate fruits and vegetables earlier in the week.

 

Weekly shopping saves time

• Gives you more free time during the week to do fun things besides shopping
• You will not be in a long check out line at 5:00 with everyone else who shops everyday

Weekly shopping saves money

• Less opportunity to buy impulse items
• Less opportunity for children to beg for items
• Less gas and car usage

Weekly shopping is healthy for you

• Less need to buy restaurant or fast foods

The more meals eaten at home or brought from home, the healthier the meal

Weekly shopping reduces stress

• You know you have the food for each day in the house
• You don’t have to decide each day what to make for dinner

 

To make this work—

• Pick one day a week to shop, usually the same day each week.  Make it a priority.
• Shop from a list derived from actual meal planning.

Sugar, Salt and Fat, Oh My

Is it bad for my child to have chocolate chip waffles? What about salt in their vegetables?  I get questions similar to these all the time and my answer is always the same no matter what high fat, high salt or high sugar food I am asked about.  Allowing your baby or child an occasional food with a high amount of fat, sugar or salt will not harm them today.  Just be careful that these foods are used mindfully; that you are fully aware that you are serving a fun food, not a nutritious one.

We don’t want to feed high (saturated) fat, sugar and salt foods to our babies on a regular basis of several reasons, all health related.  We know that too much fat and sugar lead to a number of chronic diseases including heart disease, diabetes, and obesity.  Obesity can lead to the previous diseases and can also cause back pain, sleep apnea, and some cancers.  Too much salt can cause high blood pressure which can lead to vascular and kidney disease.  All of these medical conditions occur after a life-long pattern of too much salt, sugar and/or fat. 

The best defense is to not allow our babies and children to become accustomed to these tastes, flavors, and textures.  We don’t want them to have an excess of salt, fat and sugar in their diet because then they will expect it, it becomes normal.  Most processed foods and restaurant foods are too salty, sugary or fatty.  Beware of canned goods, frozen foods, boxed meals, even breakfast cereals.  A child fed mostly processed and restaurant foods will develop an expectation for too much salt, sugar and fat.  So a whole wheat waffle without chocolate chips butter and syrup, a baked potato without butter and salt, or strawberries not dipped in sugar become unacceptable.  To avoid taste dependence on salt, fat and sugar, serve mostly whole foods: grains, beans, seeds, nuts, fruits, vegetables, lean meats, eggs, fish, and some dairy such as unflavored yogurt or milk.  Babies enjoy the tastes, textures and smells of real, fresh, unprocessed and wholesome foods.  Don’t take that gift away.

Kids Are On Automatic

My son has never been an adventurous eater.  In the past I have referred to him as the camel, waiting for fun food and loading up and by-passing most of the healthy stuff.  But an amazing transition has occurred.  My son was recently diagnosed with Crohn’s, an autoimmune disease that affects the digestive tract.  Many children with Crohn’s are small in height for their age, as is my son.  Before his treatment for Crohn’s he had not grown at all in 3 years, he is currently 9 years old and wears size 6 pants. 

Now that he is being treated for this condition an amazing transformation has taken place.  He is eating, a lot.  And he is chosing healthy nutritious foods.  He is also asking to taste foods that I have been serving for years but he has previously rejected.  A typical day for my son is:  2 multigrain waffles with syrup, a few nuts and raisins, pretzels, yogurt, an apple or pear, 1/2 cup to 1 cup refried beans with melted cheese, enriched chocolate soy milk, another apple or pear, 2 large pieces of vegetarian lasagna, carrot and cucumber sticks, 1 cup of low-fat ice cream, maybe another waffle or pretzel.  I offered to buy my son a snack at an asian grocery store, anything he wanted including cookies or snack foods.  He chose crab sushi, gobbling down 5 of the 6 rolls as I wandered the aisles. 

But what is so gratifying to me is that  his body is forcing him to eat both more quantity and greater quality as it is now ready to grow.  Since October when he started treatment he has grown 1/2 inch and gain 1 pound, not bad for a kid that hasn’t grown in three years.  This validates what I have been teaching parents for year: offer healthy foods to your child and they will be drawn to what they need.

No Dessert Unless You Eat Your Dinner

“No dessert unless you eat your dinner.”  Does that remind you of yourself when you come home from work?  Is that how you want your kids to remember you? As the parent that is gone all day, comes home, yells at the kids and denies them dessert?  Probably not.  You are likely a very loving, concerned, hard working parent.  So don’t let meal time make you in to the bad guy or girl.

 When the family sits down to eat, don’t comment on what your kids are eating or not.  Whoever provided the meal has already done the adult job, offering appropriate food at appropriate intervals.  At this point you have three jobs.  First is to model table manners, and correct inappropriate table manners.  Second is to model food acceptance by eating and enjoying the food.  Third is to have conversation with your children.  Don’t talk about anything that would make your child uncomfortable at the table, find other times to discuss problems.  Family meals are not the time to reprimand for past poor judgment, errors, or moments of downright meanness, or to warn against similar errors in the future.  Think of the dinner table as a place where everyone comes with a clean slate.

 If your child refuses to eat a certain food, or eat nothing at all, be nonjudgmental.  Feel free to remind them that if they are hungry now is the time to eat and that there will be no food offered after dinner.  Don’t let them have anything that is not on the table.  Don’t let them make a snack after dinner.  You don’t have to punish them for not eating; hunger will be a natural consequence if they choose not to eat. 

 Some children have eaten enough calories (energy) and met their nutritional needs in the 4-5 eating opportunities they had previous to dinner time.  Therefore by dinner time they can afford to be picky.  If a child hasn’t fulfilled their energy and nutritional needs and chooses not to eat, their body will provide appropriate feedback.  You don’t have to.  You can continue to enjoy your meal and your family.

What about dessert?  Let your child eat it whether they have eaten or not.  Don’t get into a power struggle.  An appropriate portion of dessert is not a big deal.  Arguing, bribing, or negotiating with your child every night is the problem, not the dessert  If your child has already consumed the necessary nutrients and calories they need for the day, they are eating the dessert solely because it taste good, which is why everyone eats dessert.  If your child did not get enough calories and nutrients during the day, eating the dessert will not satisfy their body.  They will be hungry in short order; their body is providing the feedback, not you.  If they ask for snack, remind them that they chose not to eat dinner and that now they need to wait for snack.  Some children do very well when the dessert is offered during the dinner.  The child will eat their portion of dessert first so the tension is gone.  Now they can enjoy the meal. They will eat if they are still hungry.  You are smiling, relaxed, calm, and happy to be home with your family.