Some new tricks for your treats

Several years ago when I started my career as a dietitian, I decided to take a nutritional stand on Halloween by giving out non-traditional goodies.  Yes, you may officially slap me with a "Nutrition Geek" label.  As a newbie in the field, I possessed a great fervor for exposing my trick-or-treaters to nutritious alternatives in their goodie bag, and I figured they'd get their sugar fix from many other households. I started my Halloween goodie journey with boxed raisins. Don't ask me how they went over as I wasn't there when the kids sifted through their loot, but I wasn't too worried as my goal was to at least expose them to something they might not otherwise be exposed to.  (I will add that my child and many others I know DO like raisins for the record!)  Over the years, I've still maintained an enthusiasm about celebrating Halloween with the kiddos in different ways, so I thought I'd share some of my alternative treat options here in case you might want to experiment with this, too, if you haven't already.

• Non-food treats, like pencils, Play-doh, stickers, temporary tattoos, balls, spider rings, bubbles, crayons, etc.
  
• One study found that when given the choice between non-food treats, like Halloween-themed pencils, stickers, and toys and candy treats that children chose the non-food treats as often as they selected the candy treats.
• More nutritious goodies
• Small packages of dried fruit, fruit leathers, trail mix, whole grain pretzels or graham crackers, 100 calorie mini-bag popcorn, individual boxes of ready-to-eat whole grain cereal, whole grain granola or cereal bars
• Treats you (or your family) don't like
• This may help save you from temptation in the time leading up to Halloween and from the leftovers aftewards.  If you don't like it, there's less temptation to eat it.  For me, that includes anything with coconut in it -- Mounds, Almond Joy -- bleck!

Here's to a Happy and Healthful Halloween!

Dealing with the treat in the trick-or-treat

We're about to embark on one of the most beloved holidays for children -- Halloween.  I remember being excited about Halloween as a child. Maybe some of that had to do with the fact that it was also one of my dad's favorite holidays, too. As you reflect on your memories of this particular holiday, does any specific aspect of it come to mind?  Could you be thinking of the overflowing river of candy that is collected on this spooky night?  Many parents wonder how to handle all of that Halloween loot because it's full of sugar, sugar, and more sugar. Well, we can stir in the anxiety over the candy battle that could ensue or we can focus on the wonderful learning opportunity for our children.  So, how do we deal with the treats?

Relax!  When we consistently rely on the Division of Responsibility for feeding children, there's no need to worry that a little indulgence in the Halloween booty will cause a nutritional disaster.  If I've learned anything about feeding children, it's that extremes really wreak the most long-term havoc on a child's health and eating abilities. On one extreme, some parents establish total restriction of certain foods, nutrients, and amounts, and on the other, parents embrace a laissez faire attitude of "Oh eat what you want, when you want, and where you want."  Neither extreme will nurture a competent, well-nourished eater. Balance and moderation are two of the keys to a nutritious diet and to helping children foster a positive, enjoyable relationship with food.  While I genuinely admit that these dietary characteristics can be challenging to adopt at times, Halloween presents a perfect learning opportunity for your child.  It's okay to have some candy sometimes.

Decide on a few simple guidelines up front:  how much candy can your child have and when can he have it?  When your little one arrives home to admire the Halloween treats, help him divvy up the loot into stockpiles of "faves" and "not-so-faves".  You may just let him eat to his heart's content right away.  While that may sound startling, be reassured of this...children are very intuitive eaters.  They still get great pleasure out of eating certain foods and they know when they've had enough because they're very in tune with their natural hunger and satiety signals.  The Division of Responsibility gives us permission to let our children listen to their own internal cues to eating rather than relying on external cues (us).

Of the remaining treasures, one or two pieces can be eaten with meals and snacks. Allowing your child to satisfy his natural sweet tooth in this way provides an opportunity for your child to learn about balance and moderation -- two keys to his long-term nutritional health and well-being.  Your child will discover that he can delight in his candy and eat a well-balanced, nutritious meal.  Practicing these principles can be helpful in relieving some of the anxiety about those Halloween treats and will hopefully make the experience a happy and healthful one for everyone.

Is variety the spice of your diet?

It is said that "Variety is the spice of life!", but is variety the spice of your diet?   Did you know that when we're exposed to a greater variety of food, we tend to eat more?  Think about it.  Have you ever been to a buffet? A party where people brought special dishes from home?  A Thanksgiving dinner? Raise your hand if you've ever been in one of these situations and overate.  If you did not raise your hand, you are either a liar or have some superhuman ability to not get so tantalized by the numerous tasty-looking offerings.

Brian Wansink, author of Mindless Eating: Why We Eat More Than We Think, has conducted some interesting research regarding perceived variety and how it affects food consumption.  In one study, participants were given a bowl containing 300 M & M's.  However, one group received seven different colors of M & M's while the other received ten different colors.  You've had M & M's, right?  Even though some may disagree, they ALL taste the same regardless of their color. However, the people in the group given the bowl with ten different colors consumed 43% more M & M's than the other group (91 vs 64 M & M's). At 3.44 kcals per M & M, we're talking a 93 kcal difference here.  So, when it comes to some of the more energy dense foods, this whole variety thing could be a challenge.  Walk down any chip aisle or cookie aisle, and you might get an idea of where some of our problem with poor nutrition comes from in our country.  Geez, we have whole aisles in stores dedicated to chips, cookies, sodas, ice cream?!

Nonetheless, I tell my clients and students that variety can work against us but that it can also work for us.  Let's talk about how it can work for us!  I'm going to go out on a limb and conduct my own very informal mini-experiment here with you.  Look at the two following pictures of fruit bowls.

Option A

Option B

So, if given a choice, would you eat more often from Option A or Option B? I'm hoping you say B.  But if you selected A, might I suggest that you're a monkey or you have a banana fetish?  So, what's the point of having more variety in your diet? Well according to recent reports, only 33% of Americans consume 2+ servings of fruit per day and a mere 27% consume 3+ servings of vegetables a day, so we need as many strategies as possible to improve our intake of these two vital food groups.  Variety is one key to a more nutritious diet!  When we expose ourselves to more options -- colors, shapes, sizes, textures, aromas, tastes -- we might just eat more.  Eating a variety of foods adds a dimension of pleasure and interest in our eating, and I truly believe that we should enjoy eating...really!  Variety also helps increase the chance that we will consume adequate nutrients as well as non-nutrients, such as flavonoids.

So, here's the run down of  a few ways you might incorporate a greater variety of vegetables and fruits into your diet.

• Let your senses be your guide.  Look for new shapes (star fruit? lychee?), sizes (pommelo?), textures (cactus pads? kiwi?), aromas (durian?), and colors (tomatillos?). Note the photo heading this post...my inspiration.  This beautiful, succulent-looking, jewel-toned red pear caught my eye in the grocery store recently with its incessant calling, "Pick me! Pick me!".  I'm truly a sucker for something new, especially when it comes to my veggies and fruits. So, even if it's a different 'variety' within the same family of foods -- apples, pears, oranges, etc. --give something new-to-you a try.
• Savor your old favorites in a new way.  You already love 'em, but maybe you need to spice things up.  Vegetables in a smoothie?  Try Green Smoothies.  Like apples and pears? Bake them with spices  -- cinnamon and nutmeg work well.  Ever had a fruit soup?  Melons and berries and pears oh my!  Combine fruit with spice for some kick -- spicy melon salads add interest to the palate. Change the serving temp -- go for gazpacho.
  
• Enjoy seasonal eating.  When you eat seasonally, you get to appreciate fresh, ripe, and tasty food that has been harvested at its most natural time. Eating seasonally allows you to try out foods that you might not otherwise try.
  
• Visit your local farmer's market.  I absolutely love visiting the farmer's market as you can be introduced to a lot of great new-to-you produce, and you will often get to try before you buy.  Plus, it's also fun meeting the growers of my food:)  In California, you can search for certified farmer's markets here.
• Visit local ethnic markets in your area.  You will surprised at all of the new vegetables and fruits you'd never even heard of, seen, or imagined when you take an adventure into an ethnic market. 
• Join a CSA (Community Supported Agriculture).  Once you're a member, you receive a box of locally grown, seasonal produce every week.  While you typically know a little ahead of time what you can expect, it's often a wonderful surprise to see what arrives. It can definitely keep you on your toes in finding new ways to prepare the produce, especially if it's something you haven't really tried before.

Have a happy taste adventure!

Question: How do you incorporate variety into your vegetable and fruit options?

The 4-1-1 on Vitamin C and the Common Cold

It's definitely that time of year again...cold and flu season. It seems like people are succumbing to the seasonal plague left and right lately.  And maybe you, like many others, are ready to down some vitamin C to ward off that cold. Don't worry, I just went to Target the other day and their shelves are fully stocked with products, like Emergen-C, just for you.  But before you head on over to build up your own stash, let's take a look at the 4-1-1 on whether or not such products really work.

When researchers set out to see if our "cure" for the common cold really was a cure, their analysis of over 30 clinical trials conducted over a stretch of about 40 years uncovered some interesting results.  Overall, investigators found no significant effect of supplemental vitamin C on preventing the common cold for most healthy people.  I say most because the combined results of six studies detected a 50% reduction in risk of catching a cold for certain groups taking routine doses of 250-1000 mg/day of vitamin C  -- marathon runners, young skiers, and soldiers working in freezing temperatures to be exact. So, for the general population, loading up on vitamin C throughout the year or when cold season hits apparently doesn't really fend off those colds, but if you're exposed to extreme physical stress or cold temperatures, it might actually be helpful.

As far as vitamin C's use as a cold remedy goes, the evidence is mixed.  Thirty studies exhibited a slight reduction in the duration of colds for adults and children taking daily megadoses of vitamin C compared to those on placebo. What does this amount to?  If the average cold lasts about 7 days, this means that a routine vitamin C supplement may lessen the duration of a cold by 1/2 a day for adults and 1 day for children.  However, seven studies showed no difference between vitamin C megadoses and placebo for lessening the duration of a cold when supplementation started at the onset of symptoms.  In an analysis of 15 studies, regular megadoses or those taken after the onset of symptoms did not significantly affect the severity of cold symptoms.

One important note to make is that vitamin C is a water-soluble vitamin, which means that little of it is stored in the body.  A few studies suggest that the body's cells become saturated with daily doses of 200-400 mg and that digestive absorption decreases at doses >200 mg/day.  Given some of the hefty doses in available supplements, often around 1000-2000 mg, do you wonder what happens to the excess if our body cannot store it?  We eliminate it via the urine. And at intakes >2000 mg/d, one can potentially experience adverse effects, such as kidney stone formation, nausea, abdominal cramps, excessive gas, and diarrhea.

I know...you swear that you take (or have taken) vitamin C and it's truly helped prevent a cold, right?  Well, there may be good reason -- placebo effect.  In a surprising twist, investigators in one study found that individuals who took placebo but thought they were taking vitamin C recounted fewer colds than those who actually consumed vitamin C but believed they were receiving a placebo. 

So, where does this leave us -- the real, live persons surrounded by this onslaught of sneezes and sniffles?  If you don't mind sparing the expense and feel that saving yourself from 1/2 a day's worth of a cold (when you catch one) is worth it, then daily supplementation with up to 200 mg of vitamin C may be worthwhile to you. (The recommended intake is 75 mg/d for women, 90 mg/d for men, and an additional 35 mg/d for smokers.)  Will you be harmed by taking doses of up to 2000 mg/d? It's unlikely as the risk of potential adverse effects at that level is low.  However, one can easily obtain the recommended intake (and more) through food alone by aiming for at least 5 cups of vegetables and fruits daily.  Let's see how this is done.

• Breakfast: 1 large orange = 91 mg
• Snack:  2 kiwis = 128 mg
  
• Lunch:  1/2 c cherry tomatoes = 9.5 mg, 1 c romaine lettuce = 11 mg
  
• Snack:   1/2 c red bell pepper = 95 mg
• Dinner:  1 large baked sweet potato = 35 mg, 1/2 c broccoli = 40 mg
• Total =  409.5 mg of Vitamin C from the equivalent of 5 c of vegetables and fruits!

Stay tuned for future posts related to this timely topic.

Is gluten-free the new low-carb?

I've been seeing inklings of one of the latest diet crazes...gluten-free. Just a few months ago, Elizabeth Hasselbeck of The View published The G-Free Diet which is being presented as the next big thing in achieving optimal health and in treating conditions such as high cholesterol and ADD/ADHD. I'm sure the diet is catching on as I recently perused an online nutrition and health message board where I came across a poster who suggested gluten-free waffles as a "healthier" breakfast option. I cringed!  I really take issue with this new trend on several fronts.

First of all, it's a cRaZe -- aka, a fad, phase -- otherwise something that is going to come and go because it's really not what some people are making it out to be -- the panacea solution for achieving health. Ever hear the phrase, "If it sounds too good to be true..."? Yeah, that. There really are people who need to follow a gluten-free diet -- those with celiac disease or a sensitivity or allergy to gluten. However, going gluten-free before getting the proper diagnosis is ill-advised for a few reasons. In order to provide an accurate diagnosis for celiac disease, gluten actually needs to be present in the diet. If a person removes gluten from the diet, then the signs, symptoms and biological markers for the disease subside making confirmation difficult. To affirm a diagnosis of a gluten allergy or sensitivity, certain tests and special elimination diets or food challenges are recommended, and these tests can help determine the real culprit of someone's problems or rule certain things out with the guidance of a health professional.  And a formal diagnosis is important in order to ensure the appropriate steps are taken to manage the condition and prevent potential complications.  For celiac disease, the consequences are potentially serious including malnutrition, iron deficiency anemia and a slightly increased risk for intestinal and lymphatic cancer and osteoporosis. Also, an individual may run the risk of developing malnutrition by not incorporating appropriate gluten-free alternatives to ensure nutritional adequacy and from inadequate avoidance of gluten-containing foods and other products, such as medications, that contain hidden gluten.

Next, gluten-free does not equal healthy. Gluten-free products do not necessarily provide more vitamins, minerals, phytochemicals, fiber, healthful fats, etc. than their gluten-containing counterparts. Plus, gluten-free products can still incorporate plenty of added sugars, less healthful fats, sodium, and calories.  And don't even get me started on how I believe that one of the reasons the diet craze is taking off has something to do with the growth of this niche in the market and clever manufacturers/marketers adding fuel to the fire with more and more gluten-free offerings. Do we recall the low-carb thing?  It was EVERYWHERE, and what did it do for us? Hmmmm.... 

I've heard from some people who've gone gluten-free to manage autism, ADD/ADHD, and irritable bowel syndrome and others who are trying it out because they think it's more healthful. I've talked to people who claim that it's helped them feel better, and that may be true. At this point, there's not enough strong research-based evidence that suggests that a gluten-free diet does or does not help manage conditions such as these.  In some cases, the improvements may have a lot more to do with the shift in food intake from more processed foods to more minimally processed foods that happen to be naturally gluten-free (i.e., vegetables, fruits, nuts, beans, and lean proteins) than from the absence of gluten. I still believe it is important to receive a thorough medical assessment in order to assure that a proper diagnosis and treatment is obtained.  And I also think that professional guidance on meal planning is beneficial in order to ensure nutritional adequacy when eliminating gluten-containing foods from the diet. 

So, what's the bottom line? I'll go back to the beginning..."If it sounds too good to be true...".  While some individuals definitely benefit from following a gluten-free diet for medical reasons, most of us generally have no problem digesting, absorbing, and metabolizing gluten, and a gluten-free diet is not necessary nor is it more healthful. If someone hasn't been diagnosed with celiac disease or a gluten sensitivity or allergy and believes s/he may have a problem with gluten, then consultation with a physician(s) for the appropriate diagnostic tests is advised. When following a gluten-free diet, it's best to seek the help of a health professional, such as a registered dietitian, with experience in providing the appropriate nutrition education and developing individualized meal plans and strategies to ensure nutritional balance, adequacy, and safety when going gluten-free. For sound nutrition information on a gluten-free diet, you may want to check out Gluten-Free Diet: A Comprehensive Resource Guide by Shelly Case, a Registered Dietitian and expert in this area.  For recipes and cooking/baking tips, you may want to check out this blog at glutenfreegoddess.blogspot.com by Karina Allrich.


In good health...

My bytes: Energy bars

Ask someone what his or her major roadblock to eating more healthfully is, and I would have to guess that you'll often hear the word TIME. Many of my clients identify this as a major barrier, especially when I'm encouraging them to consume smaller, more frequent meals and snacks throughout the day. Who isn't busy in today's fast-paced world? Many of us, including myself, are pressed for time to make or even eat certain meals and snacks during the daily grind. What to do, what to do? Well, I'll tell you one of the things that I do. I go on the offensive when it comes to eating. You'll almost never catch me without some sort of snack on hand, usually a portable piece of fresh fruit in mother nature's own packaging (i.e., bananas) or an energy, granola, or protein bar. Seriously, I keep at least one bar in my purse, car, diaper bag, and desk at all times, and believe me, it's been a lifesaver on many occasions.

Going for long periods of time (typically >4 hours) without eating essentially begins to exhaust our body's energy stores, and then our hunger really kicks into high gear. When our hunger spikes, we are quickly driven to eat to alleviate some of the symptoms of hunger (i.e., headache, fatigue, stomach pangs). And if we're that hungry, anything looks good. Have you taken a look around yourself lately to see what that anything can be? Well, I'm not taking my chances on that anything.

So, how do energy bars fit into all of this? They let us rather than our environment take control of our food-related decisions during a nutrition "emergency". Remember, when we're extremely hungry, anything....no...everything looks good, and I'm sorry to say but our environment doesn't generally support the most healthful eating. Energy bars are also very convenient to carry and consume no matter where you are. Also, the individualized packaging provides automatic portion control, so no worries about going overboard on the calories. A bar newbie are you? Or someone who's just overwhelmed with the options? Well, I've listed a few bars that I currently like and recommend to clients OR if you're adventurous, try making your own. A couple of websites I like are www.eatingwell.com or www.foodnetwork.com.

• Larabars are a newfound favorite of mine as they are made with very simple whole foods, which makes them very flavorful.
  
• Pure Bars are another great option because they also keep it pretty simple on the ingredients and they're quite tasty, too.
  
• Zing Nutrition Bars were actually created by dietitians, believe it or not. One thing I like about these is that they contain more satiating protein in each bar at 10-13 g of protein each.
• Gnu Bars are great because they're chock full of filling fiber providing about 50% of what we need in a day!
• Raw Revolution Live Food Bars also have very few but easy to pronounce ingredients.
• Clif Nectar Bars are made with 5 or less 100% organic ingredients and are also a good source of fiber. They also offer bars that are on the lower calorie side.

Question: What energy bars do you enjoy?

Sugar by any other name...

I've noticed an interesting trend on food labels lately. More and more companies are moving away from using "sugar" in their products' ingredient lists. I think that there are a couple of driving forces behind the trend: 1) Health conscious consumers are trying to steer clear of "sugar" based on some of the latest recommendations. 2) People are interested in consuming more natural foods and ingredients, and "sugar", that white table kind that usually comes to mind when we hear the word, is not necessarily considered natural by many.

We can't simply take an ingredient, such as sugar, out of a food without some consequence...a sacrifice in flavor, texture, volume, and/or color. These are all characteristics that sugar contributes to food. So, if manufacturers aren't using "sugar" in their products, then what are they doing to maintain the quality? You may have to be a detective to figure it out, but if you browse through various food labels, you may be seeing ingredients such as "evaporated cane juice", "brown rice syrup", "grape juice concentrate", and "crystalline fructose". Technically, these are all sources of sugar (aka, simple carbohydrates). They are just different forms or are from different sources.

In terms of health, are these ingredients superior to the more refined table sugar? Not really. They are similar in calories at 4 kcals/gram. So, whether a product contains 20 g of "evaporated cane juice" or 20 g of "sugar", each contributes about 80 calories to the final product. Some will say, "But evaporated cane juice is less refined, so it's healthier." The additional nutrients contained in some of these alternative sources of sugar is minimal at best. Seriously, there are more significant and nutritious sources of these nutrients than evaporated cane juice, brown rice syrup, or fruit juice concentrate. Next, someone might ask, "Isn't "refined sugar" absorbed and metabolized more quickly by the body? Doesn't it turn into fat more easily?" It is true that some types of sugar are absorbed more quickly depending on their chemical make-up, but this feature isn't limited to the so-called refined sugars. Plus, once absorbed into the body, all sugars travel to the liver and are converted to other compounds, mostly glucose. Regardless of the source of sugar, if the body does not immediately use or store that glucose (in the form of glycogen) for energy, the excess is primarily converted to and stored as fat. Finally, I totally believe that if someone is going to consume something that contains sugar anyway but wants a product with less refined sugars for environmental, ethical, culinary, or other reasons (i.e., allergies), then go right ahead. However, I will state for the record that natural still does not equal healthful.

We have to ask ourselves what foods typically contain these alternative sources of sugar. Hmmmm...could they be...processed? Yes, and processed foods (i.e., comes in a box, bag, can, or package of some sort) are major sources of added sugar in the diet. So, what does this dietitian suggest?

To best achieve optimal nutrition, I propose the consumption of more fresh, minimally processed foods, such as vegetables, fruits, whole grains, nuts, and seeds. These foods naturally contain fewer added sugars and will also be more nutrient dense containing more vitamins, minerals, fiber, and phytochemicals than more processed or refined foods. Nutrient dense foods, especially fresh vegetables and fruits, will also naturally offer greater volume for fewer calories. So, they will be more satisfying without contributing an abundance of calories, especially from added sugars. When we focus on increasing our intake of more nutrient dense foods, we will naturally consume fewer foods that contain added sugars as there's just less room for them in our diet...and our stomachs:) Just try it. I dare you!

Am I suggesting that we cut out processed food altogether? No, but I do emphasize the importance of meeting nutrient needs through less processed, nutrient dense foods first. However, in the {real world}, I understand that we are exposed to a wide variety of foods, including processed foods, that we enjoy. Can you say CHOCOLATE? We may have a lifestyle for which processed foods provide a satisfying and convenient option, like energy bars. Or we may actually have a need for processed products, such as sport beverages for endurance athletes. So my second piece of advice is to read food labels to identify sources of added sugar. I know a lot of people who look for the Total Sugar content on the food label, and while this does tell you how much sugar there is per serving, what it will not tell you is whether or not that sugar is naturally occurring or added. So, a good rule of thumb is to read the ingredient list and most often select foods and beverages that do not list sources of sugar as one of the first three ingredients. And don't be fooled into thinking it's healthier just because it's listed as "organic". Organic does not equal healthy either. Here are examples of added sugar that you might see in an ingredient list:

• Agave nectar or agave syrup
  
• Barley malt
  
• Brown rice syrup
  
• Brown sugar
• Cane crystals or cane juice crystals
  
• Cane sugar
• Corn sweetener
• Corn syrup
• Crystallized cane juice
  
• Crystalline fructose
• Date sugar
• Demerara
  
• Dextrose
• Evaporated or dehydrated cane juice
• Fructose
• Fruit juice concentrates (grape, peach, pear, and pineapple are common)
• Glucose
• High fructose corn syrup
• High maltose syrup
  
• Honey
• Invert sugar
• Lactose
• Maltose
• Malt syrup
• Maple powder, maple sugar or maple syrup
  
• Molasses
• Muscovado
• Oat syrup
• Rapadura
  
• Raw sugar
• Rice syrup
  
• Sucanat
  
• Sucrose
• Sugar
• Syrup
• Tapioca syrup
  
• Turbinado

So put on your investigator's hat and start scanning those food labels. If it seems too overwhelming to look at every food item you buy, you may want to start with the top 5-10 foods that you consume most frequently. Once you get the hang of it, you'll become a pro. Happy hunting!