Juice: A four letter word?

Mention the word juice around some parents, caregivers, dietitians, doctors, and other professionals (health or otherwise), and you'd think you said a four letter word! So, what's this food cop's take? (I hope you know I'm kidding about the whole food cop thing!)

I do not believe that 100% fruit juice is as evil for kids as it can be made out to be. If you know anything about my philosophy by reading previous blogs, you know that I definitely do not believe in categorizing foods as "good" vs "bad". A parent who provides a child with juice is not "bad" and a parent who does not is not "good". I believe that 100% fruit juice (I'm not talking about the stuff that's 5% juice and the rest water and sugar, i.e., "fruit drink", "cocktail" or "juice beverage") can be a nutritious part of a child's diet. In fact, 100% fruit juice does offer valuable nutrients, such as potassium, vitamin A, C and B6, magnesium, iron, and folate, in addition to flavonoids.

Some people fear fruit juice because of the....aaaak...sugar! Oh no! Guess what? While 100% fruit juice does contain naturally occurring fruit sugar (fructose) along with some other types of naturally occurring sugar, it does not contain added sugar, and again, it's got some important nutrients in it. What it does not contain is a lot of fiber, so that is one knock against it. Interestingly, kiddos who consume 100% fruit juice also take in less total fat, saturated fat, added fat and added sugar than non-juice consumers.

Another big concern over fruit juice is that will make a child overweight. It is true that our hunger is not as satisfied with foods/beverages in liquid vs solid or even semi-solid form, so we can more easily overdo it on calories when consuming liquid sources, such as fruit juice, fruit drinks, sports drinks, and sodas. While there have been a few studies detecting some relationship between fruit juice consumption and childhood overweight, most studies (14 in the last 10 years), found no relationship between fruit juice consumption and overweight in children. There's likely a combination of factors affecting rising rates of obesity in children and fruit juice alone is not the single culprit.

The other beef some people have with fruit juice is that it serves as a substitute for milk. However, recent research shows no significant difference in cow juice consumption between juice consumers and non-juice consumers.

So, what do I suggest? Moderation. What is moderation? I tend to follow the American Academy of Pediatrics guidelines for fruit juice consumption.

• Fruit juice should not be introduced to infants <6 months of age. (Human milk is the the best source of nutrition for children of this age.)
• For children 1-6 years old, fruit juice intake should be limited to 4-6 oz/d.
  
• For children 7-18 years old, fruit juice intake should be limited to 8-12 oz/d.
• Children should be encouraged to consume whole fruits to meet their daily fruit intake.

Here are a few things I do to moderate juice consumption:

• Offer water or milk (non-fat or 1% for kids ages 2+) first.
• Dilute the juice with water.
  
• Offer "icy juice". Fill a cup full of ice, then pour 100% fruit juice over it.
  

Get your drink on...

...and off the course that is! I recently answered a question regarding fluid intake during exercise. This is a question that I'm often asked, so I thought I would address it here. As an athlete, I know that there are a few typical things that many athletes (beginner or experienced) tend to forgo during workout or competition, and one of those is FLUID. People do without hydration during activity for many reasons. Here are some that I've heard: "It's too annoying to stop for a drink or carry a water bottle around with you." "I'll have to go to the bathroom if I drink anything during my workout." "I don't get thirsty." "I'm not working out long enough to need anything." "I can't tolerate fluids during my workout." I hate to break the news, but fluid intake during exercise is advised for optimal training and competition whether you're a casual exerciser or a pro.

Water is an essential and often overlooked nutrient, especially during activity. About 60-70% of the body is composed of water and it serves many important functions. During exercise water is necessary for transporting nutrients and oxygen to the muscles, removing waste products, and eliminating heat from the body. Even a water loss of 1-2% of body weight can hinder exercise performance. Just think about it...without adequate fluid in the blood, the heart has to beat faster to pump all the oxygen and nutrients to those hard-working muscles. With the heart working harder and the body temp rising, a person can become more easily fatigued, and endurance and power can suffer in a very short time. In addition, with the intensity of the exercise seeming more difficult, imagine what that does for one's mental stamina?

Some people say, "Simple. I'll just drink when I'm thirsty." While that is one of the first signs of dehydration and typically a good indicator of the need for fluid intake, it's not so reliable during exercise. Why? Fluid needs during exercise can be greater than what our thirst can gauge. So, while one might take a sip or two of water and no longer feel thirsty, his/her body actually has the need for more fluid.

I'm no perfect angel here. I've tried this both ways...without consuming any or adequate fluid during workouts/competition and with. Believe me, it makes a huge difference for me personally when I make sure I'm adequately hydrated before, during, and after a workout/competition.

So, how much does one need? Drink about 5-10 oz every 15-20 minutes during exercise. One gulp is about 1 oz. Water is a perfect choice for light to moderate activity in moderate conditions lasting <90 activities="" high="" intensity="" minutes.="" moderate="" nbsp="" or="" to="">90 minutes or in hot/humid conditions, a sports drink is appropriate to replenish fluid, electrolytes, and carbohydrate stores in the body. These are general guidelines, so there may be some individual differences. A Registered Dietitian may be able to help develop a fluid plan for training and competition that meets your individual needs. If you are training for an event, make sure that you train with whatever you plan to use during the event. You really don't want any surprises come race day. And no, pouring the fluid over the head does not help meet your fluid needs during activity.

Drink up!

The C word....

Cravings? Ever have 'em? Nah, never, right? If you have, you're not alone as over 50 to almost 100% of people studied have experienced food cravings or an intense desire to eat a specific food. Did you know that the top 3 most craved foods are: carrots, celery, and broccoli? I'm kidding here. What do you think they are? Based on recent research findings, craved foods tend to be rich in calories, fat, and carbohydrate. So, chocolate, ice cream, cookies, potato chips all fit into this category. People also tend to crave salty foods, too! The underlying cause of cravings is still not well understood though recent research points at different factors such as learned behaviors (i.e., habits) given certain situations or stimuli, short-term calorie restriction, and the release of feel-good chemicals in the brain in response to eating certain foods among other things. Regardless of the reason they exist, the fact of the matter is that many of us have cravings, and cravings can wreak havoc on one's mind and efforts at weight management.

Did you know that the average craving can last anywhere between 5 seconds to 15 minutes? Seriously. I know. It doesn't seem likely because when we're in that craving moment, it can feel like an ETERNITY, and that's why many of us typically raise the white flag to them swiftly. The good news is that these things can actually pass pretty quickly. If we actually take the time to allow ourselves to make an informed decision, we will better manage our cravings. Get rid of them? Not necessarily, but managing them, now that's realistic! So, what do you do?

1) STOP! - The first step in managing cravings is to take notice! Put yourself on guard. Realize that you are experiencing a craving. Imagine a huge STOP sign or a red light or a whistle going off giving you the warning signal.

2) relax... Now's the time to take a deep breath or two.

3) Ask - In order to make an informed decision, you need information. So begin to ask yourself a few questions. What is it that I'm craving? Am I hungry? What happened when I consumed this food before? What will happen if I do it now? What do I really want?

4) Decide - Your decision can go either way. After pausing long enough to consider the options, you allow yourself to make a more informed decision. You can choose to go ahead and fulfill that urge and eat the food. Or you can choose not to. You are not {good} if you don't eat it or {bad} if you do. It's not a moral issue! It's a decision, and it can be a simple one. It just takes time to develop the habit of becoming more aware of the cravings and making more informed choices about whether or not to satisfy them.

Based on my experience with many clients, I've found that following these steps has helped many better manage their cravings. It doesn't make them go away. No, I'm not sure there's a cure for them...yet! But it can make the situation much less stressful and allow enough time for the person to reflect on the decision while the craving actually either subsides or a final informed decision is made not to consume the food. All I can say is practice, practice, practice!

Now about that chocolate...

The au natural sweetener?

There's a lot of buzz in the food and nutrition world about a couple of new natural zero-calorie sweeteners, Truvia (from Coca-Cola) and PureVia (from PepsiCo). These two sweeteners contain stevia, an extract from a plant native to South America, and the FDA recently approved the use of these sweeteners as food additives that have been declared GRAS (generally recognized as safe). Some controversy swirls around stevia and stevia-containing sweeteners for several reasons. First, previous studies in animals suggested that high doses could result in male infertility and fewer and smaller offspring for females while other studies suggested potential cancer-causing activity. Critics of this approval also point out the loopholes in the GRAS identification since the testing on safety can be carried out by manufacturers themselves, which creates an obvious potential bias, and the companies can actually self-declare the safety of the additive without actually notifying the FDA or consumers. Therefore, the FDA does not need to review or approve this GRAS declaration of the scientists conducting the studies, and the only way for the FDA to reverse the GRAS classification is through litigation where it would have to prove that the additive is actually unsafe for human consumption. While stevia has been used in foods in countries such as Japan for decades, it has been banned in the European Union, Singapore, and Hong Kong.

What about the other side of the story? Well, the fact remains that stevia-extracts have been used in Japan and Brazil for many years with no reported harm to humans. Other studies have refuted previous trials regarding the physiological effects of stevia. Recent safety studies evaluated the effect of the equivalent of a 150 lb. person consuming 1,000-2,000 daily servings of stevia-sweetened beverages and findings indicated no harmful effects on general health, male or female fertility, and growth or development of adults or their young. Results are mixed on whether or not stevia-containing products may actually have positive effects on health, including blood pressure and blood sugar control in people with type 2 diabetes. In 2006, the World Health Organization (WHO) reported that stevia-extracts were not genotoxic (damaging to cell's genetic material) or cancer-causing based on their own research findings.

Many people are eager to taste the new naturally-sweetened beverages from Coca Cola and Pepsi as these products will likely be rolled out very soon in the U.S. What about you? I must admit that as a foodie, I'm very curious! I've actually tried stevia as a sweetener a long while back although I wasn't a big fan back then. Maybe these new formulations will provide a better taste? After doing my own investigation, I say that moderation is key here as I would with any alternative sweeteners. A possible guide on consumption could come from Australia and New Zealand's acceptable daily intake recommendations of about 4 mg/kg of body weight. For a 150 lb person, this could be the equivalent of about 1.5 cans of a stevia-sweetened beverage daily (and this includes a 100-fold safety cushion). To be honest though, you're probably better off consuming water, low-fat milk, 100% fruit juice or green tea for fluids or other nutrients, antioxidants, or phytochemicals rather than relying on these stevia-sweetened beverages from a nutrition perspective.

SMART resolutions

It's that time of year again. I'm seeing those commercials revolving around weight loss, exercise, and fitness. I see those reporters interviewing people about their New Year's resolutions. It's always interesting to listen to these. Here are a few examples of resolutions I heard: "I want to be healthier." "I want to exercise more." "I want to eat better." I think the intentions are great, but the execution is going to be a challenge with such resolutions. This is why I'm going to blog about how to set yourself up for success with SMART resolutions!

S - Specific - Make your goal specific. Instead of simply stating "I want to eat better." Be as specific as possible. What is better? Does that mean eating more fruit? More vegetables? Both? Will you incorporate more fish? Less red meat? What does 'eat better' mean for you? Consider the 6 W's - who, what, where, when, which, why? The more specific you are with the goal, the more likely you will be to accomplish it.

M- Measurable - Make your resolution measurable. What does that mean? Involve numbers here. So you decide that you'd like to "Eat more vegetables." Okay, great. What is more? Is that 2 cups/day? 3 cups/day? When you incorporate numbers, you give yourself a specific goal to shoot for and a way to measure your progress in accomplishing that goal.

A - Attainable - Make your resolution attainable or within reach. At the same time, a powerful goal will also stretch you. This will help enhance your attitude, skills, and abilities around achieving your goal. By setting a goal that is both within reach yet challenging, you will build your confidence in accomplishing the goal and create a cycle of success for yourself.

R - Realistic - Make sure your resolution involves something that you are both willing and able to work toward right now. Maybe you'd like to exercise more, so you decide to run a marathon in 6 weeks. Maybe it's something you'd like to do, but do you really have the time to train for it and train well?

T - Time-sensitive - Put a time frame on when you'd like to achieve that goal. Will it be by the end of next week? Next month? The next 3 months? This will provide a sense of urgency around the goal so that you continue to take the necessary steps toward achieving it.

Finally...write down your goals. I heard somewhere that some of THE most successful people in the world often write down their goals. This truly works. Put your goals in writing, make them SMART, and see what you accomplish!

Happy and Healthy New Year to you!

Need a perc up?

My caffeine habit started several years ago. I never liked coffee, but suddenly I found myself in the midst of a very busy and tiring time in life (aka, dietetic internship), and those around me swore by their brain-boosting juice, coffee. I didn't like it at first, but it grew on me. Here I am today, still sipping on my morning cup of Joe. Many people turn to caffeinated beverages or food (or even candies and lipsticks now!) for that extra jolt of 'energy'. So, if someone needs that energetic boost, do I tell them to reach for a cup of Joe? Not necessarily. Believe it or not, caffeine is not actually a source of energy. The major sources of energy in the diet are carbohydrate, fat, and protein. These nutrients provide fuel for the body to function each day. Caffeine does not provide energy.

So, when someone feels the need to reboot the brain, why does s/he take a quick stroll through the nearest Starbucks? Well, caffeine is a stimulant. Even in small doses, it stimulates the central nervous system causing an increase in heart rate and mental alertness among other things. In fact, studies show that caffeine does improve mental performance by enhancing alertness and reaction time, and this happens whether someone is a caffeine addict or a newbie. Caffeine consumption in moderate doses may also temporarily enhance mood, especially for those who are sensitive or don't consume much.

One thing to note is that caffeine does disrupt normal sleep patterns for most people if consumed too close to bedtime. First, it makes it harder for one to fall asleep, and once one is asleep, it can result in temporary awakenings throughout the night. So, if you have problems with sleep, I suggest limiting caffeine consumption within 3-5 hours of bedtime. Otherwise, you may find yourself in a cycle of: caffeine consumption close to bedtime, limited/interrupted sleep, and the need for more caffeine the next day to offset the effects of disrupted sleep.

You may have heard that caffeine is a diuretic, right? Well, it does have a mild diuretic effect; however, given that coffee accounts for about 75% of the caffeine that most people consume, there's no need to worry about dehydration anytime soon. The amount of caffeine contained in most caffeinated-beverages is not enough to have a major diuretic effect. In addition, the fluid from the beverage contributes to a person's fluid needs.

So, what is my advice? Moderate consumption, which is up to about 300 mg/day (or ~2-3 cups of coffee), is okay for most people. I say most because there are some exceptions. While some recommendations suggest that moderate caffeine consumption during pregnancy is okay, I err on the side of caution here, especially in the first trimester. A recent study indicated that pregnant women who consumed at least 200 mg/day experienced more miscarriages than those who consumed less than 200 mg/day during the first trimester. If possible, I suggest avoiding caffeine or limiting intake to <200 mg/day during the first trimester especially. Moms who breastfeed may also want to avoid/limit consumption to no more than 300 mg/day because higher intakes have been associated with increased wakefulness, irritability, and poor feeding for the baby. None of which any new parent really wants, right? Caffeine may also perpetuate problems for people with migraines, so it's best for those with a genetic predisposition for migraines to limit their intake. There are also certain medications, such as Ritalin, or nutrients, such as iron, that can be affected by caffeine, so always speak with a doctor, pharmacist, or RD regarding potential drug-nutrient interactions. Lastly, I advise parents/caregivers to moderate their child's caffeine consumption. It has the same effect in children and it tends to occur more quickly and last for longer than for adults. Plus, some of the major sources of caffeine in the child's diet aren't necessarily the most nutritious either (i.e., sodas, energy drinks, candy).

Cheers!

The WHAT and WHEN of feeding a toddler

I've entered an interesting phase in the feeding of my little 1 1/2 year old (though if you've seen her, you'd realize she's not really so 'little'). My once enthusiastic eater who tried anything and everything now shows a little more skepticism about food. Oh yes, and sometimes instead of eating it she likes to wear it! Hence the photo above (a la PB in hair). Ah toddlerhood! Her suspicions about unfamiliar foods can sometimes create a little anxiety for me. However, I find comfort in knowing that as long as I fall back on the division of responsibility in feeding developed by Ellyn Satter, my daughter and I will be fine! So, here's my reminder about that division of responsibility:
1) Parents/caregivers are responsible for what, when, and where a child eats.
2) The child is responsible for how much and whether to eat.

Upon the request of a blog-reader and friend, I decided to address the what and when aspect of feeding a toddler this week.

Some find it amazing that children actually need more calories and protein per pound of body weight than adults! The average 1-3 year old needs roughly 990-1050 calories per day; however, don't start tallying up those calories yet! Starting around the age of one a child's growth begins to slow in comparison to that first year of life, and if you have a toddler or have ever been around one during meal times, you will know that their food intake can seem quite sporadic. That's because they go through periods of rapid growth and slower growth. You've also probably noticed that those little ones can be quite active at times! The great thing about children is that they are very intuitive eaters. That is, they can feed themselves very well depending on their hunger and satiety cues. So being overly concerned about the how much part of a toddler's eating can actually do more harm than good, and counting calories is not necessary.

With that said, let's dig into this what part. You may or may not be surprised to know that what a child needs to eat is really not that different from what an adult needs. Although the portion sizes are scaled down quite a bit. We can take some cues from the Food Guide Pyramid for Young Children. This suggests: 6 servings of grains, 3 servings of vegetables, 2 servings of fruit, 2 servings of milk, and 2 servings of meat each day. So, how do I know what a serving is, you ask? Well, a good rule of thumb is to offer about 1-2 T of food per year of life. That would be appropriate for foods like meat, fish, poultry, pasta, rice, vegetables, and fruit. As for milk, about 1/4-1/3 cup is appropriate. (1/4-1/3 of an adult portion is a good start on other food items, such as bread or eggs). Keep in mind that these are amounts that you can start with; however, depending upon your child's appetite, s/he may eat more or less.

I haven't mentioned the dread F word...FAT! For children, fat should not be a bad word or nutrient. Children actually need a greater proportion of their calories from fat than adults. One benefit of fat in the child's diet is that it provides a concentrated source of energy. Consider those tiny little tummies. They can only hold so much food, and as long as children have some fat in their diets, they can more readily meet their energy needs. There are also some special types of fats, essential fatty acids, that our bodies must obtain from the diet. These essential fatty acids are important for the proper development of the nerve, eye and other tissues. In fact, the American Academy of Pediatrics advises against fat restriction in children ages 2 and under. After the age of 2, high fat intakes may increase the risk for childhood obesity and cardiovascular disease. At this point, it's okay for children to gradually consume fewer high-fat foods (i.e., whole milk) and consume more grain products, fruits, vegetables, low-fat dairy products, lean meats, and other protein-rich foods.

Now let's get to the when of feeding those tiny tots. If I've learned anything important about children, it is that they thrive on structure and routine. Throw that off, and you could have one rattled child on your hands! The same goes for feeding times. Children do well with about three meals and planned snacks in between (mid-morning and mid-afternoon are appropriate). Somewhere between 2-4 hours between meals/snacks works fine, and it's okay to schedule it at a time that works for your family. Let's revisit the whole tiny tummy thing again. Our little munchkins can't usually eat a large quantity of food at one time, so they often feel hungry before the next main meal. This helps the little ones maintain adequate energy sources throughout the day. It can also help mom, dad, or caregiver not feel so bad or worried if a child declines to eat what's offered at a previous meal because s/he knows that another meal/snack is coming down the pipeline soon enough and the child might be more willing to eat what is offered later, too.

So that's it in a nutshell...at least for now. This is another topic that I could expand upon, but I'll save that for another blog post.

Here's to a happy and healthy little one!