How to Make Fast Food Healthier for Kids

Research shows that kids consume an average of 55 percent more calories when they eat out than when they eat at home. While you should limit fast food to an occasional treat, it’s not a nutritional disaster if you make healthy choices:

Child-size it.

Keep your kids’ portions under control by ordering the child-sized meals that were meant for them — and try one yourself. Just this one move will cut half the calories and fat from your meal. Or share one order of fries with two or three people. This way, you still get to enjoy a little fast food without a lot of calories. Still hungry? Order a side salad with low-cal dressing.

Balance it out.

Cut calories and increase nutrition by making some smart substitutions. Chowing down on a cheeseburger? Forget the fries and order a baked potato or salad instead. Can’t give up the fries? Order a grilled chicken salad instead of a burger.

Skip the extras.

Save major calories by saying no to toppings like cheese, bacon, mayo and special sauces on burgers; pepperoni, sausage and extra cheese on pizza; and bacon bits, tortilla chips, Chinese noodles and regular dressings on salads.

Water it down.

A large cola weighs in at 310 calories, all of which come from sugar. Regular and diet sodas also contain phosphorus, which can prevent kids’ bones from absorbing calcium. The best bet for the whole family: water.

Do You Know What Vitamins & Supplements Your Little One Needs?

The average healthy American child probably does not need much of anything to supplement their diet and the emphasis should be placed on offering a healthy diet in moderation of all portions of that diet to include fats and carbohydrates (sugar). Most regular vitamins we all hear about are needed in very small doses that are easily supplied by a varied North American diet. Having said that, there are certain groups of children who definitely need supplementation; to mention just a few, certain chronically ill children, certain children from third world countries suffering from starvation or emotional deprivation, or severely abused children in this country who have been subjected to the worst possible environmental deprivations.

The Academy of Pediatrics recommends the following for other special groups:

1. Since another recommendation is to limit sun exposure in children in order to prevent later skin cancers, and this restriction can lower amount of vitamin D normally produced in sunlight, and therefore, a supplement of 400 IU of vitamin D is recommended based on sun exposure (or lack thereof). For exclusively breast fed babies, 400 IU of vitamin D daily is recommended early after delivery. For those babies drinking 32 ounces of formula a day no vitamin D supplement is recommended since all American formulas have the correct supplement of this vitamin. Whole milk also has correct vitamin D supplement but whole milk not recommended for children over 12 months of age. Check with your baby’s Doctor about the need for this vitamin. Similar recommendations are made for calcium and phosphorus intake.
2. Babies who are full term and have no problems have probably received enough iron from their mothers during the last month of pregnancy to last the first 3- 4 months so an exclusively breastfed baby should begin Iron supplementation beginning at age four. Iron in breast milk is only partially absorbed. Preterm and developmentally disabled children are also at higher risk for Iron deficiency while formula fed infants will receive the proper amount of iron as long as they continue formula. Fortunately, it is common place for Pediatricians to check a blood count as an indication of iron status at age 9- 10 months and again at around 15 months and if anemia is found iron can be added to the diet. The bottom line again is to check with your Doctor for the need and amount of iron needed for your infant and child.
3. Large amounts of certain vitamins such as A, C, D and K has never been shown to provide any beneficial effects in normal healthy North American children and can be toxic– this is not a case of “if a little is good a lot is better”- often times this is not the best policy for anything.
4. As far as other vitamins (such as A & B) are concerned, I stick with my original paragraph that most healthy children eating a fairly well rounded diet over all, (not day to day) does not need any extra vitamin supplement at.

Homeopathic supplements for children are very popular now but there are no adequate recommendations for amount used and frequency for children and therefore should be used with caution; further knowledge and research is needed.

Other complementary medical treatments have no definite guidelines for use in children, but certain children may benefit from their use.

Always involve your child’s Doctor when considering going beyond the established guidelines in your children.

Overweight & Obese Kids: What’s Going On & What Can We Do?

The problem:

About one out of three American children can be considered overweight and that rate is growing very rapidly. Additionally, according to the CDC, in the years 2015-16, approximately 14-20% of our kids were considered obese. The causes are multiple and are most likely societal in nature and not caused by a health condition. Most parents who realize that their child is overweight come to the Doctor to have “their glands checked”. It seems just about everyone knows someone who has a thyroid or other glandular condition that has been blamed for that person being overweight. In fact, a medical problem in kids is one of the least likely causes for obesity.

If one takes time to carefully dissect our current society one would easily be able to notice the low rates of exercise in children and the high rates of sedentary activities. The television and the computer now rank among the chief contributors to the increase in overweight children. In addition, local budget cuts have resulted in elimination of some physical education and intramural sports. And yet another reason for obesity in our kids may be the result of the busy lifestyle of some dual working parents who have very little time to prepare healthy foods- so it‘s fast foods for the night, and it is easy to find the root causes for obesity in this country. As easy as it is to pinpoint some of the reasons for obesity, it is extremely difficult to do something positive about it.

Not only is it time consuming to prepare healthy meals but it is more expensive to buy than a typical American diet and in this economic slump it might not be the first place people wish to spend their money.

On top of these reasons there are certain environmental and familial factors that will contribute to overweight children. If the familial body type is not thin and wiry, this trend will tend to continue through generations and it becomes easy to “blame” the overweight problem on “genetics”. In fact most overweight kids have overweight parents who just do not recognize the “problem” in their children.

What to do

Again, the first thing to do if you think your child is overweight is to take him or her to the primary care provider for an evaluation, looking for the rare and very unlikely medical cause. The diplomatic nature of the approach your Doctor may take to this problem might belie the serious nature of the issue. Beware, it is very serious! The use, by your health care provider, of graphs and charts in the office at the time of the discussion can be very helpful to you, pay attention.

Your Doctor may discuss in front of your child and in a very frank manner, all the medical repercussions of becoming an overweight adult: high blood pressure, increased rates of diabetes, heart disease and strokes just to mention a few. Your child will probably be asked to help resolve this problem. That is very important because without his/her help any attempts will probably fail. After all, you can only control what your child eats when he/she is in the house: once out of the house for the day, it’s all on him or her- that’s tough!

The following are some ideas I believe can help when approaching your overweight child.

Diet related issues

Before you begin to count calories there are some simple mechanisms to put into place.

• Feed your child on a smaller plate than usual but fill the plate- the visuals help to keep the total intake down.
• Do not allow “seconds” and desserts should consist of such dishes as fruits and low fat products.
• Watch out for the “innocence of toppings”. These may carry the majority of calories in the dish you are preparing: low fat or no fat substitutes can now be found in your supermarket for salad dressings etc. You can probably eat a pound of potatoes and gain somewhere near a pound, but if you add the butter, cream and bacon that usually accompany those dishes all bets are off as to the accumulated weight gain.
• Begin to become aware of the information on the labels of just about all foods.
• This is not a bad time to institute low fat and low cholesterol “diets” in hopes of altering adult behavior in the future as this is a major contributor to poor cardiac health in this country. In particular, stay away from foods containing, transfats, unsaturated and polyunsaturated fats as these can contribute to plaque buildup in arteries beginning at a young age; concentrate instead on fruits, vegetables and fiber.
• Rid your house of all snack foods, whole milk and carbonated drinks as this must become an entire family affair.
• While I approve of skim milk after the age of 2 years old I do not approve of artificial sweeteners for children, as many of the past artificial sweeteners have fallen into disrepute at one time or another, and carbonated drinks and juices are generally “empty calories” devoid of anything nutritionally useful except for sugar which he/she does not need.
• Remember, the object of a “diet” is not necessarily to lose weight initially but to begin to alter life styles as your child grows into adult hood. Weight loss is a bi product or “collateral damage”, if you wish, of the particular “diet” you chose.
• When you begin to concentrate on weight loss you should aim for no more than 1 – 2 pounds per week as anything faster has a high likelihood of failing.
• Let your child enjoy an occasional birthday party filled with cake, ice cream, candy etc. Total abstinence will breed discontent.

Don’t forget exercise

The flip side of the coin is, of course, exercise: a reasonable diet without exercise or, vice versa, is like one hand clapping. Family endeavors will be most likely to generate the best results. Encourage sports of all kinds as this not only yields some of the exercise component but builds a sense of belonging and responsibility.

Build in “rewards” to recognize your child’s effort in trying to adhere to this new life style. You might very well encounter resistance at your initial efforts to begin this program but stick with it as it will greatly improve the quality of life for the entire family.

Are Your Children At Risk for Dehydration This Summer?

Welcome to summer, the kids are out of school, summer camps are in full swing, family trips all over the country have begun and just in case you haven’t noticed, it’s hot outside. It is turning out to be one of the hottest summers on record with temperatures reaching triple digits in many parts of the country. As it heats up, summer safety becomes a serious issue. With all this fun and traveling going on please don’t forget to ask yourself one very important question, “are my children hydrated well enough to handle this heat?” the answer is most likely no.

Thousands of children each year are admitted to hospitals with heat-related illnesses and most go home, but there are the cases every year where children end up overheating and dying because they were not hydrated properly. As I write this, it’s a beautiful 94 degree Saturday here in Miami with all the humidity you can handle and that means one thing for us here at the fire department. A huge increase in the amount of heat illness related calls we are going to run and most of them will be on children.

As parents when we think of dehydration, we think of our children being sick and having a bout of diarrhea and or vomiting, and the doctor tells us to keep them hydrated with plenty of fluids. That is all well and good and as good parents we make sure our little campers get plenty of fluids and are back healthy A.S.A.P., But the kind of dehydration I am talking about is the kind we as parents tend to overlook in the rush of our day to day lives and that is the everyday dehydration of our very active children. By the time a child says he is thirsty, he is already dehydrated, and with studies finding that 50% of children participating in sports activities were already dehydrated we need to be hydrating our children before, during, and after physical activity as well as keeping an eye out for the signs of heat-related illnesses.

Recommendations for hydrating children ages 6 to 12 include:

• 4-8 ounces 1 to 2 hours before activity
• 5-9 ounces every 20 minutes of activity
• After activity, replace lost fluids within 2 hours

Recommendations for hydrating young athletes ages 13 to 18 include:

• 8-16 ounces 1 to 2 hours before activity
• 8-12 ounces 10-15 minutes before activity
• 5-10 ounces every 20 minutes of activity

Being able to recognize the signs of heat-related illnesses is critical and should be done by us the parents as well as the coaches. A basic awareness of the signs of heat-related illnesses could make all the difference, so here are some key points to be on the lookout for as recommended by Susan Yeargin, PhD, ATC.

Types of heat illnesses

Athletes who exercise in hot or humid weather are particularly at risk of heat illnesses:

• Heat cramps
• Heat exhaustion
• Heatstroke

Symptoms of impending heat illness

In addition to educating young athletes about both the importance of hydration and the dangers of heat-related illness, ensuring that they are drinking enough fluids, and taking precautions to reduce the risk of heat injury in children in hot and humid weather, you need to watch your child for symptoms of impending heat illness:

• Weakness
• Chills
• Goose pimples on the chest and upper arms
• Nausea
• Headache
• Faintness
• Disorientation
• Muscle cramping
• Reduced or cessation of sweating

A child continuing to exercise when experiencing any of these symptoms could suffer a heat illness.

Heat cramps

Symptoms:

• Thirst
• Chills
• Clammy skin
• Throbbing heart
• Muscle pain
• Spasms
• Nausea

Treatment:

• Move child to shade
• Remove excess clothing
• Have child drink 4 to 8 ounces of fluid with electrolytes (sports drinks) every 10 to 15 minutes

Heat Exhaustion

Symptoms:

• Nausea
• Extreme fatigue
• Reduced sweating
• Headache
• Shortness of breath
• Weak, rapid pulse
• Dry mouth
• Rectal temperature less than 104?F.

Treatment:

• Move child to cool place
• Have child drink 16 ounces of fluid containing electrolytes for every pound of weight lost
• Remove sweaty clothes
• Place ice behind child’s head
• Seek medical attention, if no improvement

Heat Stroke

Symptoms:

• No sweating
• Dry, hot skin
• Swollen tongue
• Visual disturbances
• Rapid pulse
• Unsteady gait
• Fainting
• Low blood pressure
• Vomiting
• Headache
• Loss of consciousness
• Shock
• Excessively high rectal temperature (over 105.8F.)

Treatment:

• Call 911
• Remove sweaty clothes
• Immediate and continual dousing with water (either from a hose or multiple water containers) combined with fanning and continually rotating cold, wet towels on head and neck until immersive cooling can occur.

As parents we tell our kids to study and do their homework so they will be prepared, well we as parents need to do our homework as well when it comes to recognizing the signs of heat-related illnesses and staying on top of hydration. Luckily for those parents who live and breathe on their iPhone there is help. iHydrate is an app that reminds you to hydrate yourself and your children before, during and after activities. App or no app, stay alert, keep those children hydrated and please remember, when in doubt call 911.

Are You or a Family Member Ditching Dairy? CAUTION!

I once attended a Dairy Forum in Alexandria, Virginia that was all about lactose intolerance. It amazed me to learn how many people avoid dairy products because they think they are lactose intolerant! Before ditching the dairy, consider my caution for you and/or your family, as it can have major nutritional consequences.

When people think of milk and other dairy foods, they think of calcium. But the truth is that milk contains 9 essential nutrients that our bodies need in order to function normally. Of those nine essential nutrients, milk meets at least 20% of your daily value for not only calcium, but vitamin D, riboflavin and phosphorus. That is why the 2015-2020 USDA Dietary Guidelines for Americans strongly recommends including servings of fat free or low-fat dairy each day in order to meet your minimum nutrition needs*. Did you know that dairy foods are most Americans primary food source of vitamin D? Much in thanks to the great work by Dr. Michael Holick, we have been learning more and more about the epidemic of vitamin D insufficiency and deficiency that is having serious health consequences.

The lack of nutrient information regarding dairy really hit home with me the other day. An amazing, well-respected doctor I work closely with in my practice shared with me that when a patient comes to him with lactose intolerance, he simply tells them to avoid milk and start a calcium supplement. I had to remind him that dairy not only provides so many more nutrients than just calcium, as mentioned above, it also contains naturally occurring ACE inhibitors similar to the same components given in prescriptive form that help regulate blood pressure. That is why the government-backed blood pressure diet, called the DASH diet (Dietary Approaches to Stop Hypertension), has encouraged 3 servings of dairy, because it has all 3 of the nutrients of the DASH diet that help regulate blood pressure – calcium, potassium and magnesium. Milk also contains melatonin that helps decrease stress and promotes sleep. (Ever drink a warm glass of milk before bedtime? There’s a reason behind that!) And as if that was not enough, over the last several years there has been a slew of research coming out on the impact of dairy foods in weight management. Hmm…a link between a decrease in dairy foods and obesity? Many say, yes.

Growing up, our favorite mealtime beverage was milk. I grew up in a combined family of 6 children (think Brady Bunch, and I was “Cindy” — the youngest) and my mother reports that we went through 5-7 gallons of milk every week! I drank milk with every meal and so did all my siblings. But I remember very well that when I was around 17 or 18 years of age, milk and I started having problems. Within 2-3 hours of drinking milk, I would have bad stomach pain, bloating and eventually gas that was very characteristic of lactose intolerance. Oh, the shame as a teenage female! The very easy thing to do was just eliminate dairy to avoid the very embarrassing consequences. But as I fell in love with nutrition in the 90’s, I learned that this move was costing me dearly and as a result, negatively impacted my nutrition status. Now, I am enjoying dairy again and that has helped me be a positive role model for my young children.

So, the question for you is – have you or a loved one ditched dairy for the same reason I did as a teenager? If so:

1. Get Diagnosed. Don’t self-diagnose like I did because it could be something other than lactose intolerance. All that rumbles is not lactose intolerance! A proper diagnosis is done via a hydrogen breath test and it is covered under most insurance plans. Keep in mind that lactose intolerance is very different than a milk allergy. Lactose intolerance involves the lack of an enzyme that helps digest the milk carbohydrate, lactose. Milk allergy, or milk-protein intolerance, is mostly found in young children, and involves an immune reaction to the milk protein. If you or your child has a milk allergy, it is highly recommended that you see a Registered Dietitian for nutrition guidance. In this case, complete elimination of dairy components is necessary due to possible dangerous allergic reactions. The good news is that most children outgrow milk allergy by the time they are 3 years of age. It is rare that a person continues the allergy into adulthood. If they do, there are actually immunologists that can do milk challenges that will decrease or even eliminate the milk allergy altogether.

2. Work it in. Most people with lactose intolerance can tolerate small amounts of milk at a time and most can eat yogurt and cheese without the negative side effects. At your local grocery store, there are lactose-free milk products of varying brands – Lactaid®, Dairy Ease® and even store brands now. Lactaid® even has an organic version of lactose-free milk for those that prefer organic varieties. There are even over the counter oral lactase enzyme pills that a person can take prior to the ingestion of dairy. The National Dairy Council has great educational resources to help you find ways to get dairy in even when you have lactose intolerance.

3. Seek a Registered Dietitian (RD). Anytime you are thinking of eliminating an entire food group, it is highly recommended that you meet with a Registered Dietitian Nutritionist (RDN) in your area to develop a plan for you. You may not realize what key nutrients you are eliminating from your diet that may be compromising your health. As an RD myself, I am very sensitive to the food desires of my patients. If eliminating dairy or other foods are simply a personal preference, we will honor that and can ultimately work within your desires to put together an alternate nutrition plan that will meet all your needs.

Get the facts when it comes to nutrition. Even if it’s written, it doesn’t always make it factual. And we all come with our own nutrition biases, so ask questions about those biases that may have been handed down from generation to generation. Are they really true? As in lactose intolerance for instance, many African American families avoid milk altogether because they already assume it will be a problem. Lactose intolerance in African Americans is grossly overstated, and teaching your children to avoid dairy can have lasting consequences for for them and you. Proper diagnosis and learning ways to get dairy foods in can be the best move for your family. What is your nutrition bias? Dairy or otherwise, ask the questions and get accurate answers. You owe it to yourself and you also owe it to your family.

Editor’s Note: all links have been updated to reflect the most current information available.

• According to the 2015-2020 USDA Dietary Guidelines for Americans, the recommended amounts of dairy in the Healthy U.S.-Style Pattern are based on age rather than calorie level and are:
  • 2 cup-equivalents per day for children ages 2 to 3 years,
  • 2½ cup-equivalents per day for children ages 4 to 8 years, and
  • 3 cup-equivalents per day for adolescents ages 9 to 18 years and for adults.

Why You Need to Stop Giving Energy and Sports Drinks to Kids

First let’s differentiate between these two popular drinks. Sport drinks have water, sodium, potassium and sugar (among other things), while energy drinks include caffeine or other stimulants. For the most part, after moderate exercise, only water needs to be replaced and free access to water is key to training athletes. While large amounts of water can be lost in highly trained athletes, younger children will probably not lose an exceptional amount of anything, and water is the only thing necessary. Even in adult trained athletes, the amount of sodium and potassium lost through sweating is probably negligible; again water is the vital component needing replacement.

Also included in these drinks is a significant amount of calorie- containing sugars; highly trained athletes who have depleted their sugar resources might benefit from this addition as an immediate energy boost, but in younger children and non-training athletes, this only adds to the sugar intake and can contribute to childhood obesity and dental cavities. These same stimulants can be found in coffee and colas, also to be avoided in younger children.

The use of stimulants in children probably has more unwanted side effects than the possibility of any positive effects. Jitteriness, poor sleep, elevated blood pressure, and increased risk of dehydration through the diuretic effects of caffeine and other stimulants, can be just a few of these negative effects. Depending on the quantities consumed, it can even lead to cardiac irregularities with other potentially serious consequences resulting from that

Unfortunately, these products are promoted in every form of advertising by highly popular athletes in high profile positions and many parents have gotten the idea to have these drinks readily available for their children. Children may actually prefer this substitute fluid in place of other drinks during meals and other snack times. Milk and some juices are still important to the growing, developing child and should not be forgotten. By far the most important ingredient remains water and parents should promote it as the primary source of fluid intake.

Energy or health bars create the same dilemmas for parents and children and may also contain sugar, stimulants, fats, and vitamins and minerals that may not be appropriate for children or may be over the daily recommended intake for children since most are developed for adults.

Always read the labels carefully

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