‘nutrition’

All Articles tagged ‘nutrition’

You Mamas Taking Iodine?

A new policy statement from The American Academy of Pediatrics finds that many women, including up to 1/3 of pregnant women, may have low levels of iodine putting them at risk for iodine deficiency. The reason for the deficiency is the changing food source. Over the last 20-30 years our major source of salt has shifted away from table salt (supplemented with iodine) to salt from processed foods, sea salt or gourmet salts that have no supplemental iodine. This is especially important for breastfeeding and pregnant women as iodine is essential for thyroid function that supports fetal and newborn brain development.

This policy statement was news to me. I had no idea that the salt used to make most processed foods lacked iodine, that the majority of prenatal vitamins didn’t provide iodine, and the number of women who may have a deficiency. I’m not alone; when I polled my Mama Doc Facebook community most moms & many doctors also commented this was a newsflash. Here’s more:

Iodine Deficiencies– Shifting Sources Salt

  • WHY ARE WE DEFICIENT? Most processed foods made are with salt that is not iodized.  Since we get most of our salt from those foods we’re taking in less iodine than we used to.
  • TABLE SALT INTAKE: Table salt is iodized, many gourmet salts are not. Consider ensuring that when cooking in your home (ie putting salt in the pasta water or salting the veggies) you use iodized table salt so your intake of iodine goes back up. REMEMBER: this doesn’t mean you should eat MORE salt, just swap in the table salt for the fancy salts when you can.
  • WHY DO WE NEED IODINE? We need iodine for thyroid hormone synthesis as thyroid is essential in brain development and metabolism. The policy reminds us that even mild iodine deficincy can affect fetal and early childhood neurocognitive development stating, “adequate thyroid hormone production is critical in pregnant women and neonates because thyroid hormone is required for brain development in children.” The recommendations from AAP spelled out:

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The Power Of A Sugar Cube


There’s no question the challenge of unhealthy weight and rising obesity rates in America present a complex problem for children, their parents, and their doctors. No wonder I cycled through so many emotions while watching the new movie Fed Up. As Fed Up premiers all over the United States today it’s provoking a fiery, national conversation about the threats of obesity on our nation’s children. I loved the power behind the film.

Instead of pointing the finger at children for poor choices or limited activity, filmmakers Katie Couric and Laurie David take a deep dive into the mechanics of how food is being made in America, how food companies have contaminated our culture, and how with a changing food source we’re obligated to return to a menu of primarily fresh foods to heal our children.

This movie is guaranteed to cause you to re-evaluate the number of processed foods you bring into your home.

Fed Up is constructed out of powerful interviews and activist-like thinking as national experts illuminate the fallacy that eating less and exercising more will singularly improve the health of our nation and curb the obesity epidemic. It feels a little like a get-out-the-vote campaign blended with a whole new kind of math. In fact there’s lots of new thinking challenging the simplicity of previously held beliefs about energy gap. With overweight and obesity threatening our longevity and our national bank account, Fed Up assures us that we’ll have to take on one big sugar cube, the food industry, to lean-up our nation. Read full post »

A Detour From The Kid’s Menu

Wikimedia Creative Commons

Last weekend while heading home from a weekend medical conference in Canada we exited off the interstate to drive through the Skagit Valley on the country roads. The skies were clear and the valley stunning. The land is so spacious in the valley, stuck between the mountains and the sea, it inspires a feeling of brimmed, fertile opportunity. The moment we exited the highway the drive home immediately felt more of an adventure.

Unsurprising to any parent who drives with children in the car, as I ate up the scenery the boys got hungry. We pulled off the road to grab a late, impromptu lunch. For once we weren’t in a hurry so spontaneity governed as we honed in on a spot where we could sit down and eat while looking over the Puget Sound. The plan was nearly thwarted–as we opened the door to the tiny restaurant just off Chuckanut Drive I immediately saw a sign declaring they didn’t serve children under age 9. Instead of being outraged by the ageism, I asked if we could have lunch. The boys were tucked under my arm. They’re 5 and 7 and clearly look nothing like a near 10 year-old. The restaurant was nearly empty as it was close to 2pm. The waitress smiled.

Turns out we looked like better business than no business and we were seated in the back corner. Read full post »

When Should I Start Baby Food?

first foodsWhen to start baby food? The timing on starting baby food may seem confusing. If you survey your neighbors, your own moms, the doctors you see, and the child care or daycare providers who help you, I bet you’d get about 4 different answers backed with 4 different theories and rationales. The reason is, the pendulum on when and how to start baby food has changed. Bits and pieces of old data mixed with contrasting new research findings are getting tossed around. Most new parents I talk with are a bit puzzled on what is truly best.

It’s okay to start your baby on baby foods or “complementary foods” when they show signs of readiness if they are at least 4 months of age. Signs of readiness include watching you eat (following your spoon’s every movement at a meal), lip smacking and licking when they smell food, and opening their mouths when you present them with a spoonful of food. Most babies ready to eat have also doubled their birth weight and started cooing and laughing, sitting up with assistance, and rolling over.

I used to advise families to wait until 6 months to start baby foods but new research over the last couple of years has caused me to change my tune. Read full post »

What You Should Know About Energy Drinks

I think of energy drinks as the new liquid accessory for many teens. Something to hold onto with nervous hands and something to spend money on when they’re really tired or need a “boost.” Teens report drinking them because of inadequate sleep, a need for energy, and wanting to mix them with alcohol. It’s big business to market energy drinks to those in high school or college and that big business is remarkably successful. More than a 1/3 of teens (39%) say they’ve had an energy drink in the last month and “jock identity” is associated positively with a frequency of energy drink consumption.

These drinks may really make you look cool…

College students may be even more compelled to drink them; one study found 50% of students had consumed at least one to four drinks in the last month. It’s hard to remember from our vantage point, adults aren’t really the target of energy drink advertising and sponsorships. Because of that paucity of advertising, only 15% of adults say they drink them.

Trouble is, there’s nothing really good for us in these energy drinks. We don’t ever need the caffeine, guaranine, ginseng, and sugar from these concoctions. Energy drinks can have 3-4 times the amount of caffeine in a regular cup of coffee but you may never know it. The labels can be opaque and misleading. The labels aren’t regulated and the content of caffeine isn’t mandated. A can of soda can have no more than 65mg of caffeine while one energy drink (Wired X505) has 505mg. I think this should make you mad.

A recent summary came out in Pediatrics in Review to help guide teens (and their doctors) on what they need to know. But many of us are still catching up. These are not “health” drinks although some of the claims on the bottle and advertising may suggest so. Most parents would prefer their athlete drink water over energy drinks. Thing is, their athlete would do far better. Caffeine can make you anxious, have palpitations, elevate your blood pressure, cause digestive problems, and increase insomnia. The sugar in these drinks will likely just add weight, not great energy, to your athlete.

Things To Know About Energy Drinks

  • Energy drinks are not regulated by the FDA like soda is. The FDA is investigating health effects but there are no current mandates in place for manufacturers. A can of soda is limited to 65 mg of caffeine. Energy drinks don’t have those limits and often the bottles and cans don’t even list all ingredients that have stimulant-like effects. Popular energy drinks have anywhere from 150mg of caffeine per bottle to up to 505mg. For reference, a typical 6 oz cup of coffee has about 100mg caffeine. Read full post »

Can Soda Companies Help Fight Obesity?

Screen Shot 2013-01-28 at 10.38.06 AMI’m curious what you think. Do you think companies that make, sell, and market soda can improve the challenges we face with obesity? I’m asking sincerely. I was struck by the Coca-Cola ad (below) recently released. I’m a pediatrician and I’ve never worked for a beverage company or any company that sells products to children. I don’t like that these companies market salty, fatty, sugary products to children. As a pediatrician, I would suggest I’m very biased. The food industry spends $15 BILLION marketing and advertising to children every year. Food advertising, directly to children, is known to increase rates of obesity. Even familiarity with fast-food ads has been found to be problematic. As parents, this isn’t hard to believe; I’ve seen my boys introduced to a product on TV and then ask for it at the grocery store. Because of my bias, I’m asking you—do you think companies like Coca-Cola and Pepsi can help?

As the obesity problem persists, strategies have turned to protocols and regulation. Today, the American Academy of Pediatrics (AAP) released it’s first policy on managing weight-related diabetes. And in the past few years, the American Heart Association released a statement asking for increased regulation on advertising high-calorie, low nutrient-dense (“junk”) foods to children. In 2006, The Institutes of Medicine (IOM) said, “Food marketing intentionally targets children who are too young to distinguish advertising from truth and induces them to eat high-calorie, low-nutrient (but highly profitable) “junk” foods; companies succeed so well in this effort that business-as-usual cannot be allowed to continue.”  Similar sentiments are shared by the American Psychological Association, the Center for Science in the Public Interest (CSPI), Children Now, the American Medical Association, and the American Academy of Pediatrics. The public, too. Last fall, the majority (67%) of international readers polled in The New England Journal of Medicine believed we should regulate sugary-beverage consumption. This on the heels of New York’s regulation banning sale of large sugary drinks. This isn’t just about a tax. Can these companies help? Read full post »

Mix And Match: Goldilocks Formula

Often new parents are nervous about mixing and matching infant formula they offer their babies. They worry if they switch from one formula brand to another, they may cause their baby fussiness, stool changes, upset or worse–that they could put their baby at risk.

It’s safe to mix and match infant formulas if you are following standard mixing instructions. Really.

Although spitting up or gassiness is usually not due to the protein in formula (cow’s milk versus soy versus hypoallergenic), sometimes changing formula helps new babies and their parents who worry. Switching them up can even help clarify worries in some scenarios when a parent worries about excessive gassiness, intolerance, or significant urping or spitting up.

Experimentation with formula brands in an otherwise healthy newborn is okay. But it’s not necessary at all, either.

It’s fine to make a bottle that is ½ formula from the blue can and ½ formula from the yellow one. Fine to serve Simulac one week, Enfamil the next, Earth’s Best or Goodstart followed by Soy formula the following day. Fine to buy one brand that’s on sale only to buy the other brand next week. Read full post »

Buy Organic Food Or Not?

I was surprised by a recent clinical report on organic foods. I summarized the findings in the video. Sure, I thought organic foods didn’t offer any more nutrition (vitamins, minerals, fatty acids) than foods grown conventionally. I’d seen a large study published in the Annals of Internal Medicine evaluating research spanning 1966 to 2011 that didn’t cite evidence that foods were more nutritious or better for us, per se. But I did recognize that data was on the side of organics when it came to keeping our children healthy and safe–because of pesticides.

I wasn’t entirely correct.

The American Academy of Pediatrics’ clinical report found that although levels of pesticides differ on fruits and produce, the effects on the health of our children remain inconclusive for recommending organics. Read full post »

Should I Feed My Children Rice? Arsenic & Rice

Recent reports have heightened concerns about arsenic levels in rice products here in the US. This has left many parents wondering if we should be serving rice to babies and children. The video summarizes my current recommendations.

Read the report from the Pediatric Health Environmental Specialty Unit mentioned in the video. References on authors and sources are at the end of the report. This report is calm, informative, and backed by experts—there appear to be no false claims.

Remember, arsenic is a naturally occurring element on earth. However, natural doesn’t necessarily mean “good for you.” There are two types of arsenic–organic and inorganic. In general, it’s the inorganic arsenic that we worry about. The big picture goal for all of us is to eat a diverse diet full of a variety of foods thus protecting us by decreasing exposures to any one thing.

Arsenic is large quantities has been found to pose health risks. So taking steps to minimize consumption of foods high in arsenic may be beneficial. Before you bail on rice althogether, know that not every group is ready to tell you to rid your pantry of rice. Here’s what the American Academy of Pediatrics says currently (fall 2012).

5 Tips To Reduce Arsenic Consumption For Your Family:

  1. Have your water checked for arsenic if you have well water or a private water supply. The Environmental Protection Agency (EPA) mandates arsenic levels in public water. But if you have any questions or concerns about public water, call your water company and ask about report data. Read full post »

Too Much Salt? More Bad News

Salt is back in the news. Not surprisingly, salt continues to get a bad name because eating too much salt can put us at risk. This is a bummer for those of us who prefer a salt lick to a popsicle. And it’s especially bad if we developed a salt-eating habit in childhood. An article published today found that increases in salt intake are correlated with the finding of high blood pressure. Not news, exactly. But the article asserted that for each increase in 1000mg of sodium intake each day, the risk of elevated BP increased significantly. Every little grain of salt seems to count. This was especially true among children who were of unhealthy weight (over 1/3 of the children studied). Thing is, the longer we have high blood pressure, the more damage our bodies sustain. So if high pressures start in childhood, risks increase throughout our lifetime.

Blood Pressure In Children:

  • Normal blood pressure for children shifts and changes as they grow. Normal BP varies based on age, gender, and height. Your child should have their blood pressure routinely checked starting at 3 years of age. Ask the nurse, medical assistant, or doctor to report  your child’s blood pressure and confirm the numbers are normal for their age and height.
  • Salt may increase blood pressure by causing the body to retain more water, giving our blood more volume. When blood volume and pressure increases, the changes can load stress on our heart and our blood vessels. Over time, those longstanding increases can cause damage to our organs putting us at higher risk for heart problems and/or stroke. You should know however, there are many people who develop high blood pressure as they get older who don’t eat excess salt, for unknown reasons. Medically significant high blood pressure requiring treatment is rare in childhood but can start at any age. Even so, anyone who eats excess salt is at risk for elevating their pressures at any age.
  • Many children with high blood pressure don’t know it. The article reported that 15% of the 6000 children evaluated had high blood pressure. Boys were more likely to have high pressures.

Below is a video I published previously on where salt comes from in our diet, how much salt children can consume by age, and ways to help reduce our cravings for salt as a family. Number one thing to do in any household to reduce salt intake is to reduce processed food sources–canned and processed foods account for the majority of salt in our diets. Read full post »