Picky, picky

Last week my husband, my daughter and I had lunch with some friends. I forget why now, but my husband mentioned how we do not force our daughter to eat anything. We simply present food to her and allow her to choose whether and how much to eat. Our friends asked us how we get her to eat things like vegetables, if she doesn't eat them. Well, we've made a commitment to live by the division of responsibility in child feeding (developed by child feeding specialist and RD, Ellyn Satter). These are: 1) Parents are responsible for what, when, and where children eat and 2) Children are responsible for whether and how much. Therefore, it is up to us to purchase, prepare, and serve a variety of healthful foods to our daughter and to trust HER to eat the right amount that she needs.

There are certain food items that our daughter doesn't eat (i.e., broccoli as of late); however, we do not force, push, or coax her to eat them. We offer a food to her, and she makes the decision as to whether or not she'll eat it and how much of it she'll eat. Even though she has turned down broccoli on several occasions, she's also eaten it on others. Sometimes it takes a child (or really anyone) up to 15-20 exposures before he/she will even try a food or try it AND like it. Heck, I used to HATE cottage cheese, but somehow one day I tried it as an adult and actually now like it. Go figure! It's our job to continue giving her the opportunity to try the broccoli. If after the first time she turned down broccoli we did not offer it to her ever again, she'd never really have the opportunity to try it and/or like it. There may be some foods that a child never eats/likes, and that's fine. There are some meals in which our daughter doesn't eat much at all, and that's okay. The beauty of the division of responsibility in feeding is that we do not worry that she's not getting enough nutrients since we know that we offer her a variety of healthful foods and she does eat many of them (just not always broccoli). This allows her to rely on HER internal cues (rather than external cues from us) to determine exactly how much she needs to eat while also being exposed to a variety of healthful foods.

These are difficult concepts for some parents and caregivers to grasp. I think it can be especially difficult depending on how their parents nurtured their feeding relationships or because as parents we often worry about the health and well-being of our children. Personally, practicing these principles has been helpful in relieving some of the pressure during feeding time for us and actually makes our meals much more relaxing and enjoyable, and that's really what I want to encourage in our daughter...a healthful AND enjoyable relationship with food and eating.

Happy Feeding!

Nutrition for the run of it

Some of you may know that I recently completed my second marathon two weekends ago. As I trained for the last six months, I was constantly reminded of the importance of sound nutrition to my physical performance. When I nourished my body well, I noticed a major difference not only in my physical state but mental as well. Throughout my training and up to my competition, it was interesting to hear the different thoughts and advice on nutrition that people would give me along the way. While the support and good intentions were always appreciated, it was often interesting to note the great amount of misinformation there must be about nutrition for sports out there. So, I thought I'd address a few of the sports nutrition in my blog.

1) "You can eat whatever you want since you just burned all of those calories!"

While it does seem tempting, it's not as easy as it sounds on several levels. Adequate nutrition is still important, especially for an athlete, so consuming nutritious foods, including vegetables, fruits, whole grains, and lean proteins, is essential even for an athlete. In fact, the need for certain nutrients are much greater for athletes than for non-athletes. Secondly, in order to ensure peak performance, having the right combination of nutrients is vital. Because carbohydrates provide a primary fuel source during physical activity, especially endurance activity, it's important to include foods rich in carbohydrates, like whole grains. Plus, with the need for more carbohydrates (at least for an endurance athlete) being so much greater, it can leave little room for foods high in fat and calories. Finally, I've found that in order to maintain a healthful diet, it's best to be consistent with the food intake, especially when coming off the training/competitive season.

2) "Be sure to load up on those carbs the night before!" or "Are you having a big pasta dinner the night before?"

Obviously, people are aware of the importance of carbohydrate for optimal performance. However, it's not just about loading up on carbohydrates the evening before a race. For optimal training and competition performance, it's best to consume an adequate amount of carbohydrates daily. In addition, true glycogen or carb loading involves increasing carbohydrate consumption ~6 days before the event to max out glycogen stores rather than simply doing so the night before. It's also important not to try out something new just before or during an event. So if one truly wants to load up on carbohydrates, it's best to practice during training along the way in case adjustments are needed.

3) "Don't you need some Gatorade?" (after a standard training run of 40-60 minutes)

Fluid replacement sport drinks have their place in training and competition, particularly for high intensity stop-and-go and endurance sports. However, they're most beneficial for activity lasting >90 minutes. So, for a short 40-60 minute run, water will do just fine.

4) "Make sure you drink enough water during the run!"

Not only is it important to be well-hydrated during the event, but it is also important to maintain proper hydration on a daily basis. Staying adequately hydrated even during training is important as even a loss of 2% of body weight can result in impaired performance, and I speak from experience when I say that even mild dehydration can reduce mental stamina during any run. And it's important not to forget to replenish fluid losses after the training or event. (See #3 re: the need for sport beverages during activity lasting >90 minutes.)

5) "You don't really need that stuff do you?" (regarding carbohydrate gels)

Consuming carbohydrate during high-intensity events like basketball or endurance events like marathons helps replenish muscle glycogen (stored energy) and improve performance. It is important to try out these gels or other supplements during training as adjustments may be needed depending on individual tolerance and preference. It's best not to try something new on event day!

That's about all for now. Keep moving and happy training!

The truth about trans fat

This topic may seem a bit un-hip at the moment as various items in nutrition news become hot and then not in no time. However, trans fat still interests me. I teach my students about it, and I still get asked about it a lot in practice. I thought I'd write about it this week because it still seems to be an area of interest for many. In fact, in July 2008 California lawmakers approved legislation for a ban on trans fat in foods from restaurants and bakeries, and the law will take effect in 2010. This follows the somewhat controversial ban on trans fat in restaurants in New York City and others.

First of all, what is trans fat? Well, it's a type of fatty acid in which the chemical structure has been changed. This can be done industrially in order to enhance the shelf life and texture of foods. There are two types of trans fats: industrially produced (usually found in margarines, shortening, baked and fried foods) and naturally occurring (found in beef fat and milk). It appears that it's the industrially-produced type that poses the most health risk.

Why all the hype? Well, let me count the ways.

First and foremost, intake of trans fat is linked with increased risk of coronary artery disease, risk of fatal and nonfatal heart attacks, and sudden cardiac death. It is associated with increasing total and LDL (bad) cholesterol, lowering HDL (good) cholesterol, and increasing total to HDL and LDL to HDL cholesterol ratios. Plus, the effect on LDL cholesterol appears to be dose-dependent meaning that trans fat has an affect at varying doses rather than starting at say an intake of X grams/day.

It doesn't stop there. There are several other avenues through which it possibly contributes to heart disease including causing the arterial walls to be less flexible and activating inflammatory responses, which is increasingly associated with heart disease.

The shocker for me was the effect on the unborn fetus and breastfed infant. Of course, this is a potential risk, but it may adversely affect growth and development by interfering with the metabolism of essential fatty acids needed for growth and brain development (DHA and ARA). However, it may also just be that women who consume a diet high in trans fat may also not eat sources of healthy fat (omega-3 fatty acids like fish, fish oil). In one study, newborns with high levels of trans fat in their blood system tended to have smaller head circumferences, which can be an indicator of brain growth/development. This was a small study with several limitations, but the data are intriguing. What I don't believe a lot of pregnant and/or breastfeeding women realize is that what they eat really can affect their babies negatively. The ONLY way a fetus or solely breastfed infant can have trans fat in their bodies is through the mother's dietary consumption.

Other studies show either no or some positive association between trans fat and cancer and diabetes. There are also studies linking trans fat with impaired insulin sensitivity or insulin resistance. This appears to be mostly in obese subjects and/or those who already have diabetes and/or insulin resistance.

The good news is that the FDA started requiring placement of trans fat content in foods on the Nutrition Facts Panel as of Jan. '06. So even before then, companies were scurrying to remove or reduce trans fat from their foods. This was done in other countries well before us, and the average trans fat intake in those countries declined with this change. That's good news for us! At the same time, in order to make up for this reduction in trans fat, many food manufacturers utilized fat sources that are high in almost equally unhealthy -- saturated fat. Be careful! Read the label. In addition, something can say it has 0 grams trans fat or 'trans fat free' and still contain trans fat. In order to state these things, it has to contain <0.5g trans fat per serving. Check the ingredients list, and if you see the words "partially hydrogenated" and whatever type of vegetable oil listed, it contains some trans fat. Be aware that the trans fat content includes both industrially produced ("partially hydrogenated") and naturally-occurring. Also, supplements may contain trans fat as well. They are also required to list this info on their Supplement Facts Panel. In fact, one woman I know saw that her child's Flintstone gummy vitamins contained "partially hydrogenated vegetable oil".

As for the ban on trans fats, I have no problem seeing industrially-produced trans fat disappear from the food supply. There is no real human need for it other than to offer a dense source of energy (calories), and there are other nutrients and types of fat that can serve that purpose. It is simply not an essential nutrient meaning our body does not need trans fat for survival or to function properly AND it is actually potentially harmful. Yet another reason to get a little closer to mother nature when it comes to the food we eat:)

Here's to a healthy week!

Pick me up

Let's face it, we are all busy! Whether you're working 40+ hours a week, taking care of the kids, or going to school/studying like crazy, this busyness causes many of us to put some vital health habits to the wayside. In the end, someone's keeping score and it's our body, taking another hit. I'm writing on this particular topic because someone recently asked me for some suggestions on how to get a quick energy pick-me up during the day. So, I thought I'd write my blog providing some reminders and quick tips on how to maximize energy levels.

The first bit of advice that I think is one cornerstone to optimal energy levels is SLEEP! Sleep is a vital component to optimal health. When we get enough sleep, we are able to feel more rested and energized the following day. Sleep also allows our brains to process the thoughts for the day helping us learn and form memories. Just how much depends on who you are. According to the National Heart, Lung, and Blood Institute (NHLBI) most adults need between 7-8 hours of sleep a night. As for the kiddos, newborns need a whopping 16-18 hours/day, preschoolers between 10-12 hours/day, and school-aged kids at least 9 hours/day.

Consuming a nutritious and well-rounded breakfast can also be a proactive step toward more daily energy. Breakfast does just what it says, it 'breaks the fast' that we've experienced over night. When we wake up in the morning after not having eaten for several hours, our body's energy reserves are lower. Therefore, breakfast can set the tone for your energy levels throughout the day. Be sure to incorporate a good source of carbohydrate (i.e., whole grains or fruits are excellent), protein (i.e., low-fat yogurt, milk, natural peanut butter or nuts), and fat (i.e., avocado or nuts). By consuming a balanced breakfast that incorporates all three major nutrients, energy will be released to the body more steadily, therefore, maintaining more stable throughout the morning and keeping hunger at bay for longer.

Eating several small, frequent meals and snacks throughout the day also helps people stay on top of their energy needs. I usually recommend eating a small meal or snack every 3-4 hours upon waking. Including a good source of carbohydrate, such as whole grains, vegetables, fruits, or dry beans, provides an important fuel source for the body; however, it's also important to include a good source of protein and/or fat at each meal and snack for the same reasons as mentioned earlier.

Keep portion sizes in check. Sometimes when we're tired, we have the tendency to overeat and this can actually be an energy drain.

Drink up...water, that is! Even mild dehydration (losing 1-2% of body weight from dehydration) can result in weakness and fatigue. When we are dehydrated, even mildly, our bodies have to work a little harder as a result. The recommendation is to drink ~8-12 cups/day.

MOVE! Even short bouts of physical activity in 10-minute increments throughout the day can provide a quick energy boost. So, if you're feeling lethargic, take a break and get moving. You will feel more refreshed and energized!

Well, I hope I've helped you make it a healthier day!

With this economic turmoil...

I thought it seemed timely to post some tips on eating healthfully on a budget.

1. Plan, plan, plan ahead!
Planning meals in advance can save tons of time and money. When we know what we're going to eat and we've already purchased those foods, we can avoid the eating out trap. Personally, I like to plan my meals one week at a time. After planning the meals for the week, make a grocery list and stick to it. Much of our impulse spending occurs in a grocery store, believe it or not.

2. Search for savings
Look through grocery store ads, circulars, or the Sunday paper for specials and coupons. You can also rack up savings through websites such as The Grocery Game (though there's a regular fee) or The Coupon Mom. The key with coupons, however, is to only use them for foods on your grocery list.

3. Avoid shopping when hungry. Enough said!

4. Stock up on sale items or purchase in bulk.
For instance, if whole wheat pasta is on sale this week and it's a staple in your diet, stock up, if you have space.

5. Scan the unit price.
Many stores now place the price/unit (i.e., $/ounce) on the tag beneath the item. This allows you to comparison shop for the best buy.

6. Consider generic or store brands.

7. Purchase produce in season.
Not only will it be cheaper, but it will also be even tastier!

8. Purchase locally grown.
The closer to home an item is grown, the less distance it has to travel, therefore cutting down on shipping costs. This also supports the local farmers and economy. I love visiting the local farmer's market for great deals (they're often willing to bargain) and excellent food! It's also awesome to be able to meet the people who actually produce the food you're about to eat!

9. Consider more meatless meals.
While meat offers a great source of protein, iron, and other important nutrients, it actually costs more per serving since it's a step or two further on the food chain than grains, vegetables, or beans.

10. Cook in bulk and freeze leftovers for another meal.

11. Purchase items in their truest form.
When we purchase items such as pre-cut/washed bagged salads or pre-peeled/cut carrots, we end up paying more because we're paying for the convenience of these items. However, if we purchase these whole, fresh items and prep them ourselves, we can save oodles!

12. Purchase frozen vegetables, fruits, or 100% juices.
These items can be just as healthful but can cost less than their fresh counterparts, especially when not in season.

13. Look above and below eye level on store shelves.
Generally, higher priced items are placed at eye level while lower priced bargains can be found above or below that.

14. Make a budget and stick to it. In fact, only shop with CASH!
I've personally learned that this is truly an excellent way to save money. We are much more emotional with cash than we are with a debit/credit card or even a check. So those impulse buys look much less enticing when you only have $X in hand.

15. Prepare your own meals at home.
The average person spends about $8 on a fast food meal. However, a meal prepared at home will not only cost much less, but you will know exactly what went into it!

I know that I have family and friends who are super savers when it comes to shopping, so I wonder if I will get any additions to this list?

Happy Shopping and SAVING!

What we want most

If you didn't already know, I currently teach college-level nutrition courses. One is an introductory nutrition course, which I love to teach. Last week, I asked my students to respond to a discussion board question I had posted. I asked them what their major barriers to healthful eating were. The most common answers were: time, money, taste, availability. This is not really a surprise to me. These are very common barriers for college students and really for many Americans in general. During class, I had asked my students what the pros of consuming a more nutritious diet were. Most seemed to agree that better health, performance, and quality of life were important. Many of them raised their hands when I posed questions about what they would like out of life...to stay healthy, feel better, look better, perform better, etc. I guarantee that if I posed these same questions to almost any other audience the answers would be the same. However, saying is one thing, doing is another. The culture we live in presents many challenges to living healthfully. At the same time, many people want the best out of life...to live long and prosper as a Spock might say;)

What's the problem? One quote comes to mind...we often give up what we want MOST for what we want in the MOMENT (source unknown). In fact, there is actual research showing that people do just this. I've read of research studies in which people are offered a sum of money, usually a smaller amount immediately (let's say $5) and a larger sum later on down the road (let's say $25). It appears that people have the tendency to choose the smaller amount that they can get NOW vs the larger amount that they can get LATER. What I spend a lot of time encouraging people to do is one of two things. One is to realize that every action we take is based on a choice. For instance, we can make the choice to go overboard at the smorgasboard on Thanksgiving or we can choose to enjoy a few of our Thanksgiving favorites in moderation. Once we realize that the actions we take are based on choices, we then realize that we actually do have some control over our health. We are able to take responsibility for our health. Secondly, I encourage people to focus on what they really want. What is it that they hope to accomplish or achieve by making choices to eat more nutritious foods and move more? Is it that s/he wishes to improve cholesterol, blood pressure, blood sugars? Would s/he like to perform better in sports? Would s/he like to live longer in order to see his/her children/grandchildren grow up, get married, have their own children? In order to keep what we want most at the forefront, I often encourage people to physically make a list of what they want most. I even encourage people to take it a step further...put each reason on a post-it note and post it in different spots (i.e., bathroom mirror, car dash, computer screen, checkbook, blackberry, etc.) as gentle reminders. This can be especially helpful when someone is making new changes with his/her food intake or physical activity since getting started and staying focused is sometimes the most challenging part. As I always say, go after a life of health, you deserve it!

The sweetest of sweets?

A friend recently brought the following ad from the Corn Refiners Association (CFA) : http://www. sweetsurprise. com/tvads. php?vid=TwoBites. flv and wanted to know my opinion about the ad. I've decided to take my first stab at offering an RD's point of view about the currently vilified sweetener high fructose corn syrup (HFCS).

So, let me just hit the main points that the Corn Refiners Association make in this ad. First of all, it's stated that HFCS is made from corn. This is true to a point; however, it's not as if the makers of HFCS take corn and squeeze it to produce HFCS. The process of producing HFCS from corn is a bit lengthier and more complicated than that. It essentially starts out as cornstarch and is processed with enzymes to produce the HFCS. The second major point is that HFCS contains the same calories as sugar or honey. This is actually true. Both sugar, honey, as well as other caloric sweeteners and HFCS yield approximately 4 calories per gram. Lastly, the ad states that HFCS is fine in moderation. I would agree. Consumption of this ingredient is not going to cause the demise of someone's health when done so in moderation. Although I'd be curious as to what the CFA's definition of "moderation" is when it comes to HFCS.

Something that the ad didn't address is some of the information or rumors that have been floating around about HFCS.

• First of all, the name high fructose corn syrup has been misleading for people. HFCS is actually only high in fructose in relation to regular corn syrup. In reality, HFCS contains approximately the same amount (55% fructose and 45% glucose) of fructose as table sugar (50% fructose and 50% glucose). One piece of information swirling around out there is that HFCS increases triglyceride levels in the blood. Consumption of this caloric sweetener may very well contribute to elevated triglycerides (and therefore heart disease) in people prone to having higher levels of this fat in their blood, but the so-called risk of this is the same as that for regular sugar, too. Also, some people maintain that consumption of HFCS (particularly the fructose) causes disruption in the regulation of appetite via the hormone, leptin, causing someone to eat more than s/he normally would. While it is true that research has exhibited that fructose may not stimulate the production of leptin, which regulates appetite and fat storage, given the proportion of fructose in HFCS, the effect is not any greater for HFCS than for regular sugar. In fact, some forms of HFCS contain less fructose than regular sugar!
• Secondly, it's been associated with being one of the primary causes for obesity. This primarily stems from a commentary article authored by George Bray, Samara Joy Nielsen, and Barry Popkin in the American Journal of Clinical Nutrition in 2004, which posed some possible relationships between trends in consumption of HFCS and obesity rates over several decades. However, since the publishing of this article, more research has been conducted on HFCS and has found that HFCS alone does not necessarily cause a person to gain weight. However, the calories from this caloric sweetener consumed in excess of what a person needs may promote weight gain. Therefore, it's a calorie issue rather than an ingredient issue. In fact, the authors of this article have since clarified that while HFCS is not necessarily the most healthful ingredient, it is not necessarily the Evil One that it's made out to be either.
  

So, am I giving HFCS a huge thumbs up here? Not necessarily. I think the point I'd like to make here is that we need to look at the bigger picture. What is HFCS? It is a form of sugar. What foods contain HFCS? Processed foods. HFCS does not occur naturally in these foods as does the sugar in fruit or milk; therefore, HFCS is considered an {added sugar}. What are the latest guidelines regarding consumption of added sugars? Well, the Dietary Guidelines for Americans 2005 recommend that we choose and prepare foods and beverages with little added sugars or caloric sweeteners. So, while the recommendations do not suggest that we need to completely eliminate added sugars from the diet, they still suggest limiting consumption of added sugars.

What does this all mean to me? We can best achieve optimal nutrition by consuming more fresh, whole, minimally processed foods, such as vegetables, fruits, whole grains, nuts, and seeds. These foods will naturally contain fewer added sugars and will also be more nutrient dense containing more fiber, vitamins, minerals, and phytochemicals than processed or refined foods that contain HFCS. These foods, especially whole, fresh vegetables and fruits, will also naturally offer greater volume for fewer calories. So, they'll be more satisfying without contributing an abundance of calories, especially from added sugars.

Maybe HFCS gets a bad rap because it gives people something to blame for some of the current health concerns in our country today. It gives us an enemy to watch out for. In reality, the effects of this particular caloric sweetener are not that different from other forms of added sugar, such as table sugar, honey, or molasses, and I believe that's really what we should look at. While I personally believe that there is possibly an overuse of this sugar in foods for reasons that I won't get into here, if it weren't HFCS, it would be some other form of sugar, and it would still be in foods that are mostly processed rather than in their most natural form. That's what we really need to consider. Remember: balance, moderation, and variety are three keys to a more nutritious food intake. Salud!