Tag Archives: diet

Good eating habits as a way of preventing obesity and eating disorders

Back-to-school time involves changes in just about everything: schedules, homework, sports, family time—even eating. Being rushed in the mornings makes having a decent, healthy breakfast a challenge. Families have to decide if kids will take lunch or buy the school lunch. Then comes the evening meal with people going in different directions, and often little time to prepare or eat a meal together. It’s no wonder that healthy eating and family time often take a back seat to homework, sports, and other activities.

As we all know by now, obesity among children and teens in our country is a widespread problem, and eating disorders (EDs) are also more common than before.

An article published last week on the website of the American Academy of Pediatrics (AAP) discusses how the same attitudes and habits can lead to both obesity and EDs. According to one study, dieting can actually be a precursor to obesity and EDs. Dieting “was associated with a twofold increased risk of becoming overweight and a 1.5-fold increased risk of binge eating… Another study found that normal weight girls who dieted in ninth grade were three times more likely to be overweight in 12th grade compared with non-dieters.”

In addition to dieting as a cause, “weight talk”—no matter how well-intentioned—and “weight teasing” can lead to EDs and obesity. “Weight talk, or comments made by family members about their own weight or to the child to encourage weight loss, has been linked to both overweight and EDs. Teasing children about their weight also has been associated with the development of overweight, binge eating and extreme weight-control behaviors in girls and overweight status in boys. Body dissatisfaction is a known risk factor for both obesity and EDs.”

So, how does a parent help a child be satisfied with her or his body? How do you encourage your teen toward a healthy relationship with food? “Adolescents who are more satisfied with their bodies report parental and peer attitudes that encourage healthful eating and exercise to be fit, rather than dieting.”

The article contains recommendations for pediatricians, and that guidance also applies to parents:

“Discourage dieting, skipping of meals or use of diet pills to lose weight. The focus should be on a healthy lifestyle rather than on weight.
Encourage more frequent family meals, which provide an opportunity to model healthy food choices and provide time for teenagers and parents to interact.
Promote a positive body image among adolescents. Body dissatisfaction should not be used as a reason to lose weight.
Encourage families not to talk about weight but rather to talk about healthy eating and being active to stay healthy.
Carefully monitor weight loss in an adolescent who is obese or overweight to ensure the teen does not develop the medical complications of semi-starvation.”

Don’t forget family meals. Though your children and teens may roll their eyes, the time spent together around the table is a time to connect over healthy food and discussions about topics great and small. Turn off the television and cell phones (including yours!) and enjoy each other’s company. It will make all of you healthier.

Diabetes testing and prediabetes

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Our last two blogs have been about diabetes, types 1 and 2. Now, let’s look at risk factors, testing, and what is called prediabetes.

Risk factors are slightly different for the two types of diabetes (see our previous two blogs to learn more about those types). We’ve gleaned these sets of factors from an article by the Mayo Clinic. Check out that article for more detailed explanation.

Type 1 risk factors

Family history
Environmental factors (such as exposure to certain illnesses)
The presence of damaging immune system cells (autoantibodies)
Dietary factors—though studies don’t show a direct cause and effect, there seems to be some relation to things like early consumption of cow’s milk and cereals, for example
Geography—people who live in some northern European countries have greater risks

Type 2 and prediabetes risk factors

Being overweight or obese
Inactivity
Family history
Race—it’s unclear why certain races (including blacks, Hispanics, American Indians and Asian-Americans) are at higher risk
Age—although type 2 diabetes is increasing at alarming rates among children and youth, risk increases with age
High blood pressure
Abnormal cholesterol and triglyceride levels

Other risk factors in the article pertain to adults.

Prediabetes is a condition that means your blood sugar levels are higher than normal but not yet in the “diabetic” range. It also means that you are at an increased risk of developing type 2 diabetes.

The American Diabetes Association has an online test you can take to determine possible risk. If you believe your child is at risk, talk to your pediatrician.

Please note that the top two risk factors for type 2 diabetes are things over which you likely have a great deal of control. A healthy diet and age-appropriate activity are your best tools for prevention, for your child and for you.

E. coli and other nasty things: how to have good food safety for your cookout or picnic

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The holiday weekend approaches, with plans for picnics, cookouts, reunions, and fun! At the same time we’re hearing about a recall of nearly 2 million pounds of ground beef that is possibly contaminated with E. coli bacteria. How can you be sure about the safety of the food you’re serving your family?

You are right to be cautious. Foodborne illnesses can be very serious, even deadly. E. coli, in particular, can cause organ failure, and children may be especially vulnerable.

Here are some basic rules to keep in mind.

Cook ground meats ALL the way through. Pink interiors mean raw meat, and when that meat is ground, microbes that used to be on the surface of the meat can now be deep inside it. If the meat is fully cooked, any E. coli should be taken care of.
Cook poultry completely through. Chicken, in particular, can be contaminated with Salmonella.
Don’t reuse the plate that held raw meat or poultry. It must be washed before being used to hold cooked meat or other foods. The same goes with knives and other utensils.
Keep food separate. Fruits and vegetables shouldn’t be stored in the same container with uncooked meat and poultry, for example.
Chill leftovers soon. This is important when you’re at a picnic and far from your refrigerator. Take a cooler and ice packs.
Keep your hands clean. Wash them often. Take hand sanitizer on your picnic. Don’t change a baby’s diaper while preparing food.
Wash your fruits and vegetables. When you clean poultry in the sink, be sure to sanitize the sink afterwards so that you don’t contaminate food, dishes and utensils.

More information is available here from the Centers for Disease Control and Prevention.

A fun holiday is a safe holiday. Enjoy the time together and have a great weekend!

Stomach virus recovery

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“Stomach bugs” are making their rounds right now. Rotavirus, in particular, is quite contagious and may have even made the rounds through every member of your household. It causes diarrhea, vomiting, stomach pain, etc. Sound a little too familiar?

What to do?

According to the American Academy of Pediatrics, usually, the virus goes away on its own. Watch, though, for dehydration and high fever. Dehydration can be serious in a small number of cases. Give small amounts of fluids until the vomiting ceases. Water is fine, but fluids like Gatorade can add electrolytes. Stay clear of acidy drinks (like orange juice) and milk.

Be watchful regarding dehydration. Pay attention to the frequency of urination. The urine will become more concentrated and less frequent, but child should still be urinating.

While your child is sick, give a very bland diet: avoid dairy, fried foods, fast foods, hot dogs, etc. Some good foods are bananas, rice, applesauce and toast (BRAT).

However, it’s recommended that as soon as the stomach is settled, you should return to a balanced diet of fruits, vegetables and protein (meat, yogurt).

Call the pediatrician if diarrhea and vomiting don’t subside within three days, if there’s been no urine output for 10 hours, or if the fever is high or doesn’t subside. See our blog about when to be concerned about a fever.

As always, stay healthy!

Should we go gluten-free?

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“Gluten-Free” is the new catchword for “healthy diet,” or so it would seem if you read grocery store labels. Do gluten-free foods really make your family healthier? It’s not always a simple answer.

Just what is gluten? It’s a protein found in wheat and some other grains. Why do some people avoid gluten? There are several reasons.

Less than 1% of the population cannot eat gluten because they have celiac disease. According to the National Institutes of Health page on the subject, “celiac disease is an immune reaction to gluten, a protein found in wheat, rye, and barley.” It can be diagnosed as early as infancy or at any later time, and you can find a list of symptoms here from the American Academy of Pediatrics. The only way to get relief from those symptoms is to completely eliminate gluten from the diet, a task that isn’t easy because so many products contain wheat flour.

Others think that a gluten-free diet makes them feel better, though that could simply be because they are eating fewer carbohydrates and calorie-laden fast foods.

Still others believe that gluten contributes to behavioral problems or may even have a link to autism. Those ideas remain unproven, but there is a great article here.

Gluten-free advocates often tout a huge list of health benefits that are completely without scientific basis.

Celiac disease cannot be diagnosed without specific tests. If it’s something you suspect your child may have, talk to your pediatrician. And if you have to put your child on a gluten-free diet, you need to speak to a dietician about what nutrients you may be missing in the process. Don’t forget that our office has a dietician on staff for just this type of consultation.

Bottom line: there’s nothing wrong with eating gluten-free foods, but don’t go totally gluten-free without consulting your pediatrician.

Our own dietician on staff!

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Did you know that Georgetown Pediatrics has our very own dietician? Amy Crist has been with us for about 9 months and is available by appointment through our office.

Working part-time for us, Amy is a registered dietician (RD) with a master’s degree, has also worked at Georgetown Community hospital, and makes her home right here in Georgetown.

Amy loves working with infants, children, adolescents and their parents in developing healthy eating habits, including those who have dietary restrictions. She is a frequent speaker at local elementary schools to teach children about healthy eating and nutrition. She’s even led a support group on breast feeding. She is happy to have an appointment with you and your child or teen to discuss:

breast feeding,
dietary restrictions and planning as a result of disease or condition (diabetes, drug therapies, etc.),
concerns about weight or eating disorders,
helping the whole family develop healthy eating habits,
diet and sports,
picky eaters,
and anything else you want to talk over with a dietician.

Call our office and set up an appointment soon!

Amy Crist, our dietician

Calcium for teens

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You might think that once your son or daughter hits older childhood and puberty, the need for calcium drops.

Actually, the opposite is true. The recommended daily allowance (RDA) increases to 1300 mg of calcium for children and teens aged 9-18. Essential bone growth and development are continuing in these years, and it’s important to lay a strong foundation with calcium. Calcium in the teen years can help stave off osteoporosis in later life. Unfortunately, many adolescents, especially girls, don’t receive enough calcium to meet the RDA.

Another important note: our bones stop absorbing calcium in our early 20s, so you are “banking” the calcium you take as a teen for later years. That doesn’t mean you no longer need calcium after your teenage years, but it does highlight the importance of getting the right amount of calcium while the bones are still absorbing it.

What are good sources of calcium? There are two: food and supplements.

Milk and milk products are the best food source, with skim milk providing all 1300 mg in 4 ½ eight ounce glasses per day. Not everyone likes milk, and some can’t drink it because of lactose intolerance.

The American Academy of Pediatrics lists these other food sources for calcium:

“Most foods in the milk group: milk and dishes made with milk, such as puddings and soups.
Cheeses: mozzarella, cheddar, Swiss, Parmesan, cottage cheese.
Yogurt.
Canned fish with soft bones, including sardines, anchovies, salmon.
Dark-green leafy vegetables, such as kale, mustard greens, turnip greens, bok-choy.
Tofu, if processed with calcium sulfate.
Tortillas made from lime-processed corn.
Calcium-fortified juice, bread, cereal.”

Supplements are a good option, but be sure that any calcium supplement also contains vitamin D which aids in calcium absorption. A daily multivitamin does NOT provide enough calcium to meet the RDA. Don’t take all the supplements at once. It’s best to take part of the supplement in the morning and part later in the day. Check with your pediatrician for additional recommendations.

As you teach your teens to build strong life skills, don’t forget to help them build strong bones as well.

artwork by Audrey