Powdered Infant Formula--Not for Premature or Sick Babies!

A few days ago, a baby in New Mexico died--and the culprit was most likely a rare bacteria found in his formula. This is very sad and prompts me to write on the topic of Enterobacter sakazakii, the bacteria thought to be responsible.

What is Enterobacter sakazakii and where is it found? 

Enterobacter sakazakii, also called E. sakazakii, is a type of bacteria most recently associated with the use of powdered infant formula in hospital neonatal units and the subsequent death of some premature infants. The bacteria is also found in the gut of humans and animals and the environment.

Who is at risk for the infection?

 According to the US FDA, "premature infants and those with underlying medical conditions are at highest risk for developing E. sakazakii infection."(1) Several outbreaks of the infection have occurred in neonatal intensive care units worldwide. There is compelling evidence that the use of powdered infant formula had served as the source of the infection.

How could powdered infant formula contain bacteria?

According to the World Health Association, "Powdered infant formula is not a sterile product--even when manufactured to meet current hygiene standards. This means that it may occasionally contain pathogens that can cause serious illness."(2) 

Bacteria can enter a food during processing in 2 ways--through the raw material the food is made from and through contamination through other means. A food can also be contaminated with bacteria when the food is prepared for eating--in this case, when the powdered formula is reconstituted with water. Bacteria can enter the formula through dirty water, a dirty bottle or nipple or dirty hands. Small amounts of bacteria can grow to larger amounts that can cause illness when held at room temperature too long.

What can be done to prevent an infection from E. sakazakii?

• Breastfeeding is the best way to feed babies--especially those that are premature or have medical problems. (No cases of E. sakzakii have ever been associated with breastfeeding!) Even if breastfeeding needs to be done by a tube or eye dropper at first with milk that is pumped, the baby still gets all the hundreds of nutrients and immune building components of the breast milk. Also, ANY amount of breast milk is helpful in building the immune systems of infants--even if it is just for a few weeks or months.
• If breastfeeding is not possible, premature infants, low birth weight infants and those with medical issues should not be given powdered infant formula. Instead they should be given formula that is available in liquid form. 
• If circumstances don't allow the use of liquid formula, certain preparation practices can help reduce the risk of illness from E. sakazakii and other food borne illnesss. Keep in mind that the following preparation method should be used for infants that are at higher risk of infection--premature, low birth weight, immunocompromised infants--especially those under 2 months of age. Ask your doctor about formula preparation steps that are right for your baby.
• These safe food handling practices, summarized from the World Health Organization can also help decrease the risk of any type of food borne illness: They can be found at: www.who.int/foodsafety/publications/micro/pif2007/en/ 

1. Wash hands with soap and water and dry.
2. Wash bottles, nipples and bottle rings with hot soapy water and use a brush to remove dried milk from bottle and nipple.
3. Sterilize bottle by covering with water and bringing to a rolling boil. Turn off heat and leave pan covered until equipment is needed.
4. Clean and disinfect surface to prepare formula. Wash hand with soap and water and dry with clean or disposable cloth.
5. Boil some safe water. Add hot water (no cooler than 158 degrees F or 70 degrees C) to bottle and add correct amount of powdered formula.
6. Immediately cool bottle to feeding temperature by running cool water over it or by putting in a container of ice water. To avoid contaminating the bottle, make sure the cooling water is below the lid of the bottle.
7. Dry the outside of the bottle with a clean or disposable cloth.
8. Check the temperature of the formula by dripping a little on the inside of your wrist. It should feel lukewarm, not hot.
9. Feed the baby.
10. Discard any formula that the baby did not drink within two hours.

FOR MORE INFORMATION ABOUT BREASTFEEDING, SEE:

www.womenshealth.gov/breastfeeding/inc

(1) Health Professionals Letter on Enterobacter sakazakii Infections Associated with Use of Powdered (Dry) Infant Formulas in Neonatal Intensive Care Units. Food and Drug Administration. Center for Food Safety and Applied Nutrition. October 2002. www. cfsan.fda.gov/~dms/inf-ltr3.html

(2) Safe preparation, storage and handling of powdered infant formula-Guidelines. World Health Organization 2007. www.who.int/foodsafety/publications/micro/pif2007/en/

Healthy Breakfast at Starbucks!

What could be a better way to start your day than with a cup of vanilla latte or flavored steamed milk from Starbucks? A breakfast treat to go along with it that won't undermine your goals of healthy eating.

On a recent trip to Starbucks, when I inquired about the oatmeal, the guy in line in front of me offered up his opinion: "I eat the oatmeal every day--it's great! But today I'm having a chocolate donut!." And that's a healthy eating attitude, my friends--eat healthy most of the time with that occasional splurge...He was not the only guy to order oatmeal during my visit either--a few suits, joggers and students also ordered it. Maybe we should say "Real Men eat Oatmeal!" 

OK, so back to those new items for those watching their waist, cholesterol or general health--in other words, all of us! Here are my two cents on the items I've tried:

Vivanno: Here's the scenario--you're on the road to a meeting and you need something to tide you over until your early dinner. You don't want to spill ketchup on your suit from a burger--or smell like a fast food eatery either. Best choice for a tasty, meal to sip: Vivanno, which is a healthy smoothie containing real banana, whey protein and fiber. I've had the Orange Mango Banana Blend as a lunch replacement and it's filling as well as tasty, which I can tell you from personal experience, is sometimes difficult to achieve when concocting with whey powder!! I've heard from other dietitians that moms with morning sickness have found the Vivanno to go down really well, too. It's also a perfect mid-morning or afternoon snack for Moms-to-be, people trying to gain weight, or as an after workout replacement.

Vivanno Nutrient Breakdown: 270 calories, 5 grams fat, 16 grams protein, 5 grams fiber

Chewy Fruit and Nut Bar: Imagine one of those little fruit and nut granola bar that comes in a little package and leaves you wanting just a little more. Now imagine it baked fresh with the dried fruit still moist and tangy. That's the Chewy Fruit & Nut Bar-great to go with your morning java.

Chewy Fruit and Nut Bar Nutrient Breakdown:  250 calories, 4 grams fiber, 5 grams protein

Perfect Oatmeal: I'm an oatmeal kind of gal, while my husband is not--he says it's because I always put cinnamon and spice in it. Well, what he liked about this oatmeal was it's purity--no extra spices, unless you put your own! I liked the fact that the brown sugar was pre-measured in a little packet, which ended up being the perfect amount of added sweetness. The dried fruit, also in a little pouch, was nice and moist and contained raisins, currants and cranberries-which again added the perfect touch of sweet and sour.  A nut medley pouch also came with--giving the customer the option of putting it or not. This is great for those allergic to nuts, because there is no chance of cross contamination.

Perfect Oatmeal Nutrient Breakdown: up to 390 calories, depending on the toppings, and 1.5 servings of whole grains.

Apple Bran Muffin: OK, so if you have ever tried to bake with whole grains, you know that it's an art. Consider this a masterpiece! It's made with whole wheat flour, oats and wheat bran and has apples, tart cherries and honey. I like the nutrient balance--being high in fiber and protein for a muffin--which means it's probably going to carry you until lunch! Bran muffins tend to be either very dry, or greasy--this was neither, telling me that while not fat-free, it probably has a moderate but not excessive fat content.

Apple Bran Muffin Nutrient Breakdown: 330 calories, 7 grams fiber, 7 grams protein.

The Bottom Line: Do your diet a favor this holiday season--eat regular meals and snacks starting with breakfast to keep your energy up and your stress level down. Starbucks makes it easy with their healthy new breakfast options.

New MyPyramid for Preschoolers!

There's good news for parents--it's a new interactive tool to help parents feed their little ones. It's the MyPyramid for Preschoolers. Developed by the USDA Center for Nutrition Policy and Promotion (CNNP), it was developed in record time under the direction of the new director Brian Wansink, PhD, with guidance from Madeleine Sigman-Grant from the University of Nevada Coopeand Trish Britten from the USDA CNNP.

Here's what you can find on the site:

Customized Eating Plan: Simply plug in your child's height, weight, age and sex and you get a customized eating plan specifically for your child. Pretty cool!

Growth during the Preschool Years: You can find information about typical growth patterns as well as create a custom growth chart for your child.

Developing Healthy Eating Habits: A Wealth of Advice about Common Questions

Physical Activity: Lists ideas for family activities, age-appropriate activities and more

Food Safety: All you need to know about food safety as well as choking hazards.

Sample Snack Patterns: Gives 2 examples of meal and snack patterns

Check out the new MyPyramid for Preschoolers at: www.mypyramid.gov/preschoolers/index.html

Exploding Eggplant!

I'm sure if you spend any time in the kitchen, you've had at least one major mess up or accident that made you laugh--if not at the moment, then later!

Well, recently I had such an event happen to me as I was grilling some eggplant. (It's been a common pastime for me lately as we've got a bumper crop of it in our garden and I grill it to make Baba Ganoush for my husband.) Anyway, I was grilling whole eggplants on one side of the grill and steak on the other. After using the fork to turn the steak, I nudged the eggplant over to it's other side.

And powey--it exploded on me! I am not making this up! It would have been worse had I been closer to the grill, but I did have pieces of cooked eggplant on my shirt, on my arm (ouch!) and in my hair! I screamed but only my dog Ginger appeared to notice, as she looked out the sliding glass door at me. So let this be a lesson to all you who grill eggplant (which by the way is a really tasty way to eat it!) Please use tongs and not a fork to move it around on the grill!

AAP says More Vitamin D for Babies and Children: YES!!

The American Academy of Pediatrics issued a new recommendation for vitamin D for children; increasing it to 400 IU per day, from the previous 200 IU. The details are in "Prevention of Rickets and Vitamin D Deficiency in Infants, Children, and Adolescents," at http://www.aap.org/pressroom/nce/nce08vitamind.htm which recommends all children receive 400 IU a day of vitamin D, beginning in the first few days of life.

The recommendations include breastfed and non breastfed infants, older children and even some guidance for pregnant women:

• Breastfed and partially breastfed infants should be supplemented with 400 IU a day of vitamin D beginning in the first few days of life.


• All non-breastfed infants, as well as older children, who are consuming less than one quart per day of vitamin D-fortified formula or milk, should receive a vitamin D supplement of 400 IU a day.


• Adolescents who do not obtain 400 IU of vitamin D per day through foods should receive a supplement containing that amount.


• Children with increased risk of vitamin D deficiency, such as those taking certain medications, may need higher doses of vitamin D.

"We are doubling the recommended amount of vitamin D children need each day because evidence has shown this could have life-long health benefits," said Frank Greer, MD, FAAP, chair of the AAP Committee on Nutrition and co-author of the report. “Supplementation is important because most children will not get enough vitamin D through diet alone.”

My Take on Vitamin D:

There has been a buzz about Vitamin D among health professionals in the last few years. Research implies there is a serious epidemic of vitamin D deficiency--and according to http://www.vitamindcouncil.org/, (a nonprofit dedicated to the mission of ending worldwide vitamin D deficiency) is implicated as a major factor in the pathology of at least 17 varieties of cancer as well as heart disease, stroke, hypertension, autoimmune diseases, diabetes, depression, chronic pain, osteoarthritis, osteoporosis, muscle weakness, muscle wasting, birth defects, periodontal disease, and more.

The best source of vitamin D is sunshine--for adults and older children, that is. To give you an idea, 20-30 minutes of summer sun exposure causes your skin to produce 20,000 IU of vitamin D--comparatively, the most reliable food source--milk, contains 100 IU per cup. In our busy lives, many people hardly see the sun--and when they do, they are slathered with sunscreen, hats and shirts. Don't get my wrong--I've been just as afraid of skin cancer as the rest of us. But there's a big difference in spending hours in the sun unprotected and spending a few minutes.

In the past year, I've been foregoing sunscreen on my arms during my walks, 2-3 times per week. I live in a very sunny place--over 300 sun-filled days a year--and when I had my Vitamin D tested earlier this year, it was normal--but not in the super high range. People who live in higher latitudes, those who are overweight and those with dark skin need much more amount of time without sunscreen to yield the same amount of vitamin D. Those north of Atlanta, don't see much UV light in the winter, so even if they were to brave the elements bare-armed, their vitamin D production is basically zip.

The current RDI of 400 IU is seriously low, according to researchers, who recommend up to 5,000 IU for those who never see the sun. Those who are clinically deficient, as shown by blood testing, might be given a prescription for even more.

The AAP recommendation is a strong step in the right direction, but now we need new recommendations on the needs of adults. Until then, take your work break outside if it's sunny--especially if you are pregnant or trying to get pregnant! And if you have any health problems and don't see much sun, are dark skinned or overweight, ask your Dr. to test your Vitamin D3 levels.

Fall in the Air? Try this Creamy Healthy Soup

Fall is in the air, at least here in Texas! Fall brings out the "cooking" side of me--I especially want to put on a pot of chili or soup, or make a batch of cookies. (Yes, dietitians really do eat cookies!)

My husband taught me a great and healthy way to make a creamy vegetable soup--it's a French blended soup. They tend to eat a lot more pureed soups and veggies in Europe than we do here.

Below you'll find a recipe for Basic Creamy Veggie soup from my book Baby Bites. The beauty of it is that you can use virtually any veggie or combo of veggies you feel like--including the bits of leftover veggies in your fridge that you're wondering what to do with!! The colors of the soup vary--from orange to bright green to brown, depending on what you put in them. (I love spinach-carrot or butternut squash-apple) For a nice presentation, swirl a little plain yogurt or sour cream on the top, and float a few croutons.

Basic Creamy Veggie Soup

Yield: about 8 cups (2 liters)

2 pounds (0.9 kilograms) any raw vegetable,
chopped into 1-inch pieces
(smaller for faster cooking) Some vegetables
that work well are asparagus,
broccoli and carrots, spinach and
carrots, and spinach, broccoli, and
carrots

1 pound (500 grams) new potatoes,
peeled and cut into 1-inch pieces

2 to 3 cups (500 to 750 milliliters) liquid
such as cooking liquid, soymilk, rice
milk, breast milk, or formula (If your
baby is one year or older, you can use
whole milk.)

1 to 2 ounces soft pasteurized cheese,
such as cream cheese or Laughing
Cow (optional)

1. Time the cooking of the vegetables
and potatoes according to the vegetables
you use. (For example,
spinach cooks quicker than the
potatoes, so you’d need to start
cooking the potatoes first, then add
the spinach.) Cook in a minimal
amount of liquid until vegetables
and potatoes are tender.

2. Purée in batches in a blender,
adding liquid as needed. If you like,
add cheese while puréeing.

3. Pour soup back in pan and stir to
mix all batches. Reheat if needed.

Excerpted from Baby Bites: Everything You Need to Know About Feeding Babies and Toddlers in One Handy Book

Enjoy!

Toddler Teeth: Keeping Those Pearly Whites Cavity Free!

Tooth decay has been increasing in toddler teeth--a trend that has dentists worry that they may also have a likelihood of more lifelong tooth decay.

Until 2004, the prevalence of tooth decay in toddlers aged 2-5 had dropped, but a study released in 2007 showed that it's now increasing. Experts suspect the increase in tooth decay is from too much sugar in the diet. Some toddlers have a steady stream of juice, juice drinks and milk flowing over the teeth during the day--in essence creating a "sugar bath" that is prime plaque making material. Below are some tips to keep toddler teeth healthy and cavity free:

• Brush after every meal and snack. Getting kids into this healthy habit can lead to a lifetime of healthy teeth.
• Limit sweet drinks--like juice as well as juice drinks, etc. The American Academy of Pediatrics suggests toddlers limit their juice drinking to 4-6 ounces per day.
• Don't put baby into bed with a bottle of milk, formula, breast milk or juice.
• Especially watch out for drinks that have a combination of added sugar and citric acid--like sports drinks, enhanced waters and lemonade, for example.
• Toddlers should visit their dentist regularly--starting at one year.
• When teeth start touching, start flossing!

Give Your Child These Tooth Friendly Snacks:

• Crunchy raw fruit and vegetables, like carrots and celery (if they are too hard to chew, steam slightly to avoid a choking hazard.)
• Cheese
• Nuts and nut butters (again a choking hazard for kids under 5)
• Make water the drink of choice at snack time-or make a juice spritzer by adding plain club soda to juice.
• Always brush teeth after eating and drinking caloric drinks.

Fish for Babies? Yes!

Should you give your baby fish to eat? New research implies the answer is yes! In a recent study published in the British Medical Journal, it was found that feeding as little as one portion of fish to babies less than 9 months may cut the risk of eczema by almost 25%. Eczema is a chronic skin condition affecting 10-15% of children and is related to other allergic (atopic) conditions like asthma, hay fever and food allergies. The study was done at the University of Sweden and involved about 5,000 infants.

For more information about the study:

http://www.gu.se/english/about_the_university/newsandevents/international_+press/

What type of fish? It didn't matter--however --fatty fish like salmon, add brain building fat (DHA) that babies may not be getting enough of.

What About Allergies?

In the past, the standard recommendation was to delay introducing potentially allergenic foods like dairy, nuts, and fish way past 1 year. However, that advice recently changed. From the summary portion of the latest American Academy of article about this topic:

Effects of Early Nutritional Interventions on the Development of Atopic Disease
in Infants and Children: The Role of Maternal Dietary Restriction,
Breastfeeding, Timing of Introduction of Complementary Foods, and Hydrolyzed
Formulas by Frank R. Greer, MD, Scott H. Sicherer, MD, A. Wesley Burks, MD, and the Committee on Nutrition and Section on Allergy and Immunology.

PEDIATRICS Volume 121, Number 1, January 2008

"Although solid foods should not be introduced before
4 to 6 months of age,there is no current convincing
evidence that delaying their introduction beyond this
period has a significant protective effect on the development
of atopic disease regardless of whether infants
are fed cow milk protein formula or human
milk. This includes delaying the introduction of foods
that are considered to be highly allergic, such as fish,
eggs, and foods containing peanut protein."

In a nutshell, the article summarizes that EXCLUSIVE BREASTFEEDING for at least 3-4 months does reduce the incidence of some atopic diseases. Research proves once again that breast milk is the ultimate Super Food!

Are You Bashing Your Diet with a Bad Breakfast?

The Good News:


After years of hearing that breakfast is sooooo good for you, you've decided it add it to your schedule!

The Bad News:
You may be doing your body more harm than good if you are eating a typical fast food breakfast!
Dave Zinczenko and Matt Goulding, the authors of Eat This, Not That, have revealed the 8 worst breakfast foods--their results may surprise you!!

Worst Side Dish:
Large Hash Browns from Burger King:

620 calories: (which would cover an average breakfast for most people)
40 grams of fat, (11 g saturated, 13 g trans) More trans fat than you should have in a day!
1200 mg of sodium: half the recommended sodium for a day


Worst Sandwich:
Hardee's Monster Biscuit

710 calories
51 g fat (WOW!)
2250 mg sodium (about a person's limit for the day)

Worst Pastry:
Cinnabon Classic Cinnamon Roll
813 calories
32 g fat (5 g trans fat)
117 g carbs

Worst Smoothie:
Smoothie King Grape Expectations II (40 oz.)
1,102 calories
256 g sugars
740 mg sodium

Talk about surprising! Ya think you've finally got it together by drinking a fruit packed smoothie--but the calories in this thing will bust any diet! And with the amount of sugar in this thing...well...just watch out! And please don't drink this if you have diabetes!

What to Eat Instead: Bridget's Favorites

My favorite fast food breakfast:
McDonald's Egg McMuffin:
310 calories
12 g fat (5 g saturated)
820 mg sodium
30 g carbs

Even if you really went for it and ate 2, the diet damage would be less than other fast food breakfasts.


Smoothies:

Unless it's for a meal replacement, order the small size and make it sugar free, because smoothies can be a good way to a get a fruit or two (or in many cases, a fruit juice or two)

I recently went to Smoothie King for the first time. Besides being a pricey after-school snack (about $11 for myself, my son and his friend--and we ordered smalls) I also suspected that there was mucho sugar syrup added to the smoothies. I ordered mine sans sucre--a Splendafied version of the Mangosteen smoothie, which was absolutely delish!)

Cinnamon Rolls

I have to admit, that as a cinnamon lover, it's really hard to resist the tempting smells of the spice when I'm at the mall or airport. And for the first time in years, I did indulge while at the San Jose Airport--opting for the cinnabites--and sharing it with my sister. But just looking at the nutrient info on the classic roll is kind of disgusting!! Only eat this if you can share it with your 4 best friends!!


Hash Browns and Other Breakfast Potatoes

A potato is a really healthy food! But as a breakfast food, it takes on a cloak of "Super-Bad". Be it fried potatoes or hash browns, it's got it in for you in the fat and sodium department. If you really want a potato, wait until lunch, and have it baked! (Use more sour cream than butter to cut the fat and go easy on the cheese and bacon.! You can also mix in some low-fat Italian dressing to moisten it) If the skin is well scrubbed, I like to cut it into pieces and dip it in light Ranch. The skin has lots of fiber and nutrients.

You can find the complete article (and the rest of the Worst Breakfast foods) at http://health.msn.com/nutrition/articlepage.aspx?cp-documentid=100216490&page=1

BOTTOM LINE: breakfast really is a good thing for your diet, health and waistline, depending on what you eat.

The MSN article mentioned a study showing that high quality protein breakfast helped with weight loss. That study was done with EGGS, yes, eggs!! Just watch what company your eggs keep on your plate (skip the bacon and sausage; add ham if you're not watching your sodium. Even better, make a veggie omelette or frittata. Some other breakfast favorites of mine:

• Nutrigrain Whole Grain Blueberry Waffles with peanut butter and honey or blueberries
• Kashi Go Lean Crunch Cereal spriinkled with Salba and fruit and topped with Horizon Organic Skim Milk
• Eggs scrambled with onion, tomato and garlic served with fat-free refried beans and avocado slices and a tortilla or toast

Ok...and sometimes I eat some hot French Bread with Kerrygold Irish butter. Yum!

BPA Concerns Revisted

Last week, an article in the Journal of the American Medical Association about BPA and the risk of heart disease gives more power to the argument that BPA may indeed be hazardous to our health. BPA or biphenol-A, is a chemical used to make plastic hard, is widespread in the environment--from CD cases to water bottles and baby bottles. It is also used in the plastic liners of cans.

The problem, researchers have been saying for years, is that some of the BPA in plastic can leach out of the plastic and into our food or water--especially if the plastic is exposed to chemicals or high temperatures. Animal studies have linked BPA, which in the body can act like estrogen, to breast, prostate and reproductive system problems as well as a few types of cancer. A recent report also stated "some concern" as to the effects of BPA on the brains of fetuses. infants and children.

This study looked at more than 1400 adults and measured the level of BPA in their blood as well as chronic disease diagnosis, blood markers of liver function, glucose and a few other blood tests. The results showed that the higher amounts of BPA in the urine was associated with diagnosis of heart disease and diabetes. You can see the study at http://jama.ama-assn.org/cgi/content/full/300.11.1303

WHAT'S THE BOTTOM LINE HERE?

This study did not determine that high levels of BPA causes heart disease or diabetes--it only showed that there is an association. What it does do is point to BPA as a chemical we might want to have less of in our food supply until more research is done. Until then, choose food storage containers that don't have BPA:

Plastics with the recyclying code of 1,2 or 5.
Glass or ceramic
Plastics labeled "No BPA"

Forward thinking companies are rushing to the market with BPA free products, so it shouldn't be hard to find them!

Back to School--What's For Dinner??!!

Yesterday I was trading stories with my friend Millie about the craziness of the Back to School Schedule. We agreed, between School Open Houses, College Night, Sports Practice and Girl Scouts, it's hard to all sit down together at once, much less have the time between driving to put together a meal! Be both use non-traditional menus to keep our sanity during this busy time. Millie said sometimes it was fruit, yogurt and nuts at her house, or some scrambled eggs.
Ditto I agreed--eggs and bean burritos were the fave in this part of Texas.

Was this a guilty admission among friends? No! Because these foods make for healthy dinners that kids eat!

Sometimes we think that "dinner" has to mean meat, veggies and potatoes or the like. In my book, good dinner can be just about whatever you can throw together that has protein, fruit or vegetables and a source of complex carb.

Whether you're the mom of 3 like Millie, with kids from elementary to high school-- or an empty nester staring at the fridge and not liking the idea of cooking, these 12 days of dinner ideas are for you!

• Whole grain waffle with peanut butter & honey with a fruit yogurt smoothie


• Scrambled eggs on a whole grain engish muffin topped with salsa and avocado


• Grilled ham and cheese sandwich with fresh fruit on the side


• Rotisserie chicken sliced over a green salad with cherry tomatoes and julienne carrots


• Bean burrito using canned beans


• Microwaved vegetarian lasagna with a side caesar salad


• Crock pot beef stew


• Tuna fish salad served in a scooped out tomato


• Pasta salad made with leftover pasta, with added thawed frozen veggies (one with black bean and corns is good), cherry tomatoes, grated low fat cheese, and leftover chicken


• Deviled eggs served whole grain crackers and a yogurt fruit parfait for dessert


• French bread pizza using jarred pasta sauce, grated mozarella, and thinly sliced mushrooms and black olives

Calcium Crisis--Continued

Milk is generally the number one calcium source for kids--and teens. But what if your kid is vegetarian; two of every 100 older kids in the US is. Not to worry--there are plenty of vegetarian sources of calcium that are absorbed as well or better than milk.

Greens that are low in oxalate (bok choy, broccoli, Chinese/Napa cabbage, collards, kale, okra, turnip greens) provide calcium that is highly bioavailable to the body for absorption (49% to 61%), in comparison with calcium-set tofu, fortified fruit juices, and cow’s milk (bioavailability in the range of 31% to 32%) and with fortified soymilk, sesame seeds, almonds, and red and white beans (bioavailability of 21% to 24%)

On the other hand, oxalates present in some foods can greatly reduce calcium absorption, so vegetables that are very high in these compounds, such as spinach, beet greens, and Swiss
chard, are not good sources of usable calcium despite their high calcium content.

The following list shows vegetarian as well as dairy sources of calcium, for comparison.

The Dietary Reference Intake for Calcium (the amount of daily calcium that should be consumed) for kids is:

Children 1-3 years: 500 mg

Children 4-8 years: 800 mg

Children 9-18: 1300 mg

Soyfoods
Cultured soy yogurt, fortified, 1/2 c (125 mL) 367 mg
Soybeans, cooked, 1/2 c (125 mL) 88 mg
Soybeans, dry roasted, (soy nuts), 1/4 c (60 mL) 60 mg
Soybeans, green, 1/2 c (125 mL) 130 mg
Soymilk, fortified, 1/2 c (125 mL) 100-159 mg
Tofu, firm, calcium-set, 1/2 c (126 g) 120-430 mg
Tempeh, 1/2 c (83 g) 92 mg

Legumes (cooked, 1/2 c/125 mL)
Black beans 46 mg
Chickpeas, garbanzo beans 40 mg
Great northern or navy beans 60-64 mg
Pinto beans 41 mg
Vegetarian baked beans 64 mg
Nuts, seeds and their butters mg
Almonds, 1/4 c (60 mL) 88 mg
Almond butter, 2 tbsp (30 mL) 86 mg
Sesame tahini, 2 tbsp (30 mL) 128 mg

Breads, cereals, and grains
Cereal, ready-to-eat, fortified, 1 oz (28 g) 55-315 mg

Fruits
Figs, dried, 5 -137 mg
Orange, 1 large 74
Orange juice, fortified, 1/2 c (125 mL) 150 mg

Vegetables (cooked, 1 c/250 mL)
Bok choy (Chinese cabbage, pak choi) 167-188 mg
Broccoli 79 mg
Collard greens 239 mg
Kale 99 mg
Kale, Scotch 181 mg
Mustard greens 109 mg
Okra 107 mg
Turnip greens 206 mg

Other foods
Blackstrap molasses, 1 tbsp (15 mL) 172 mg

Dairy products
Cow’s milk, 1/2 c (125 mL) 137-158
Cheddar cheese, 3/4 oz (21 g) 153
Yogurt, plain, 1/2 c (125 mL) 137-230
Dairy products
Cow’s milk, 1/2 c (125 mL) 137-158
Cheddar cheese, 3/4 oz (21 g) 153
Yogurt, plain, 1/2 c (125 mL) 137-230

Source: Position Paper of the American Dietetic Association and Dietitians of Canada: Vegetarian Diets, Journal of the American Dietetic Association. 2003 Volume 103, No 6

Is Your Teen in a Calcium Crisis?

There is no time in life when a person needs more calcium than during the tween and teen years. Why? During those few years, teens accumulate more than 25% of their TOTAL bone mass. By the time a teen finishes his growth spurts at around age 17, they've accumulated about 90% of their adult bone mass.

The Bad News: Teens Don't Get Enough Calcium!

Past age 11, the majority of us don't get the calcium we need. 75% of teen boys and 90% of teen girls don't get enough calcium. National health experts call this a "calcium crisis"--if the bones aren't built to their optimum strength during the growing years, they are more prone to fractures and osteoporosis later in life.

If you've got a teen at home, you can probably relate. Our house has milk drinkers on both ends of the spectrum. One stopped drinking milk years ago when he started having problems with lactose intolerance, the other probably has the strongest bones in the neighborhood because he drinks a quart of milk a day!

So how does my non-milk drinking son get his calcium? Here's his typical calcium intake and sources:

At Breakfast: 10 oz of skim milk mixed with 1 packet of Carnation Instant Breakfast (with a Lactaid chaser): 575 mg calcium

Snack: Sandwich with 2 oz of Brie on French bread: 110 mg calcium

Snack: 1-4 oz Danon Activia yogurt: 150 mg calcium

Snack/Dinner 16 oz Tropicana Calcium fortified orange juice: 600 mg calcium

Total Calcium for the Day: 1435 mg: 110% of the DRI for calcium for teenagers

Activity also Important!

Weight bearing physical activity causes new bone tissue to form-- which makes bones stronger.

What's Considered Weight Bearing?

Walking
Running
Dancing
Climbing stairs
Jumping rope
Playing team sports, such as basketball, soccer, and volleyball
Older teenagers can build even more bone strength through weight training, but they should check with a health care provider before starting any type of training.

Ten Ways to Get Your Kid off the Couch

1. Walk the dog


2. Shoot some hoops


3. Use a punching bag


4. Ride his bike to a friend's instead of getting a ride


5. Play active video games: Dance Dance Revolution, Wii Tennis, Baseball or Golf, Wii Fit


6. Do household chores: vacuuming, sweeping, mowing the lawn


7. Join a team--the YMCA has teams that stress having fun more than winning.


8. Jump on the trampoline


9. Take a hike


10. Give the whole family a pedometer and challenge each other to increase their steps.

Stay Tuned for Tomorrow's Post, when I'll talk about vegetarian sources of calcium, too.

Healthy Gums...Healthy Pregnancy

Thinking about getting pregnant? See your dentist. Not the advice you were expecting to get? Of course, it's also recommended that you receive preconception counseling from your doctor about health issues you need to get under control before you get pregnant. But seeing your dentist is just important. Why?



Research is showing time and again that gum health is the window to the body's inflammation level. If you have gum disease (a step beyond gingivitis where the bacteria actually slips below the gum line) the bacteria apparently sets off an inflammatory response in the body, which can set off a cascade of events which can lead to preeclampsia. Preeclampsia, characterized by extreme water retension, especially in the face and hands, and high blood pressure, can escalate into eclampsia, which can be fatal.



Gum disease in pregnancy can increase the risk of premature delivery up to seven times!
According to Dr. Don Callan DDS, a periodontist who researches dental bacteria in Arkansas, "There is definitely a relationship between preterm birth and bacterial toxins that migrate into the rest of the body, which can activate premature labor. Most dentists are also now aware of research that suggests that harmful bacteria under the gum line can actually damage the heart, increase symptoms of rheumatoid arthritis and damage artificial joints."

These factors increase risk of gum disease:


Hormonal changes: pregnancy, puberty, menopause
Smoking
Diabetes (there is some evidence that uncontrolled gum disease can actually lead to diabetes.)
Stress
Genetics
Clenching or grinding of teeth
Obesity

So before you get pregnant, take care of your gums and teeth. Get your teeth cleaned and brush and floss regularly. If you're already pregnant, see your dental hygienist once or twice during the pregnancy. Floss at least once a day and brush after every meal.



For more information:

http://www.nlm.nih.gov/medlineplus/news/fullstory_64317.html

Quick Family Meals on a Budget

Cutting the Food Budget

On the economic front, the news is dire. Gas prices are soaring and food prices are increasing almost as fast. After you've trimmed down the clothes and entertainment budget, the food budget is the next to get cut. Is it possible to have tasty, nutritious meals on a budget? Yes, but you probably need to make some changes in the way you buy, cook and eat:

Getting Ready:

• Shop the sales, make a list.


• Plan to use leftovers--creatively.


• Never go to the store hungry.


• If you need to shop with kids in tow, make sure they are well rested and not hungry.

At the Store:

• Buy chicken, fish, and shrimp in bulk at club stores. If you want to buy natural beef on a budget, go directly to the farmer, such as Alder Springs Ranch http://www.alderspring.com/ or US Wellness Meats http://www.uswellnessmeats.com/, which also carries lamb, bison, pork and chicken.


• Before buying fruit in 5 pound economy bags, confirm that they're cheaper--sometimes they're not.


• Think outside the bun for convenience. No time to cook? Scramble a few eggs. Make a veggie fritatta with last night's stir fried veggies. Eggs are still the cheapest, contain nature's perfect protein and 13 essential nutrients including choline. (Choline is essential for normal brain development for infants and the unborn. Most women don't get enough!) For health and nutrition facts and great egg recipes see: http://incredibleegg.org/


• Weigh your time against the cost of convenience. If buying washed lettuce drastically increases the chance that your family will eat salad, go for it! Salad dressing? With a recipe you can make it yourself, better for less.


• Stock up on products that can be used in many ways--such as pasta sauce. Besides pouring it over pasta, it can be used as a dip for string cheese or grilled zuchinni, or a topping for fish, chicken, pork or even eggs! For more tips and recipes, see http://www.feedourkidswell.com/


• Keep a few true convenience meals on hand that keeps you from eating out. Frozen veggie lasagna is a favorite of mine. But I like it with a little extra Ragu...

At Home:

Make double portions of protein and of casseroles, soups and stews. Freeze the soups and stews and use the protein for creative leftovers. Here are a few to get you started:

• Grilled chicken breast: chicken burritos, pasta with chicken and artichoke hearts, chicken and brown rice casserole, chicken caesar salad.


• Beef Roast: roast beef sandwiches, shredded beef tacos, eggs with shredded beef and green chile, sloppy joes, beef stuffed baked potatoes.


• Roasted or grilled salmon: salmon salad, salmon with pasta and Ragu mixed with fat free sour cream, salmon chowder


• Make a menu and try to stick with it. This will make life less stressful for the whole family and help you cut food costs. With a plan in hand, you're less likely to eat out.

When Eating Out:

• Eat an apple on the way--you'll be less tempted by expensive (and high fat) appetizers.


• Take advantage of early bird and small portion specials.


• Rethink take out. It doesn't have to be high fat or fried. A grilled chicken dinner at Taco Cabana is $12.99--and it includes rice, beans, tortillas and fresh salsa. Add your own salad and some strawberries for a balanced, tasty meal. How do I know? We had that for dinner on Thursday nite! Another take out idea is Chinese--a few entrees and a few side dishes, with brown rice can feed a whole family.


• Start with a brothy soup or salad.


• Drink water. Sodas and alcohol can add significantly to your bill (and your waistline.)


• Share an entree with your spouse or friend and order extra side dishes.


• Order one dessert and 4 spoons; your wallet and your weight will thank you!

Pregnancy Weight Gain--Gaining Just the Right Amount

"Eating for Two" goes the old saying. And that's a dream come true for women--eat what tickles your fancy, and all for a good cause!!

But too much emphasis on weight gain during pregnancy may be leading to more weight gain, delivery complications and gestational diabetes for the mom, and a larger weight gain and future health problems like metabolic syndrome and overweight for the baby.

The majority of women in the US are overweight--so to begin with, they don't need to gain as much weight since part of the weight for pregnancy is fat--stored for future breastfeeding. That means a weight gain of only 15-25 pounds, according to the Institute of Medicine--and up to 15 pounds for a BMI in the obese range. The Institute of Medicine is now discussing updating the weight gain guidelines that have been used since 1990. (for more info, see http://www.newswise.com/articles/view/540511/)

Nutrients for Two--Making Every Bite Count!

The truth is, calorie needs don't increase that much--but the need for more nutrients does. The requirement for most vitamins and minerals increase 10-20%--but some increase by almost 50%. And when you consider that many women start their pregnancy with nutrient deficts, it's important to make every bite count during pregnancy.

Ten Tips for "Eating Expectantly"

1. Start every day with a good breakfast. Eggs are a super food for pregnancy because they are one of the richest sources of choline, a vitamin necessary for normal brain development. Scramble them with some bell peppers or salsa to boost iron absorption. A high fiber cereal with low fat milk or soy milk, a sprinkle of flax seed and a fresh fruit is another good choice.


2. Focus on Fiber--try to have at least 5 grams of fiber with each meal. This helps with constipation and fills you up faster. Whole grains have a treasure trove of nutrients that refined grains are missing. Half of your grains should be whole grains.


3. Make Produce a Priority: Most pregnant women need to eat 2 cups of fruit and 3 cups of vegetables a day. Start at breakfast and have a fruit or veggie at each meal and snack.


4. Get Your Vitamin D. Researchers now believe that there is a vitamin D epidemic in the US. Vitamn D deficiency is correlated with seventeen cancers--even a possible link to autism. Current recommended intakes of vitamin D are thought to be too low and don't correlate with natural Vitamin D from sun exposure. Twenty minutes of full body unprotected sun exposure in a fair skinned person produces about 20,000 IU of vitamin D. The current DRI for vitamin D is 200 IU You'd have to drink 200 glass of vitamin D milk to get the same amount from food! Sunscreen, pollution, higher latitude and cloud cover all decrease the amount of UV rays that gets to the skin, affecting Vitamin D production. (see http://www.vitamindcouncil.org/ for more info)


5. Vary your Protein. Lean beef and pork, cold water fish, chicken (even the dark meat), eggs, tofu, beans, and nuts--they're all good and they should all be part of your diet!

Buying Organic--Is it Worth It?

Spring has sprung, at least here in West Texas! It's a perfect time to think about growing your own pesticide-free veggies. It's also a great time to plant a fruit tree for pesticide-free fruit year after year! If you don't have the space or inclination for a garden, you may think about buying organic produce.

But--buying all organic can definitely bust the food budget. How can you know when it's worth it to buy organic? Here is where to start:

1. Keep a food diary for what you and your children eat for a week. (Pregnancy and early childhood are sensitive times for pesticide exposure.)
2. At the end of the week, tally up what you eat the most of.
3. Look at where your top foods land on the Environmental Group's "Shopper's Guide to Pesticides in Produce" http://www.foodnews.org/
4. If any of your top foods land in the top 12 worst for pesticides, consider buying organic.

For an excellent article on the topic-see "Buying Organic--Is it Worth It?" by Stephanie Wood, published in March 08, Baby Talk magazine and also found online. I'm quoted in the article: http://www.parenting.com/article/Mom/Health/Eating-Green-1201726268247

Happy Spring!

Bridget

A Pinch of Plastic in Your Food?

Worried about the University of Missouri Study about BpA in baby bottles? Read on for more information. This article was originally published in the Winter 2007 Feeding Kids Newsletter (http://www.nutritionforkids.com/) and should give you more insight on Bisphenol A.

A Pinch of Plastic in Your Food?

When you stop to think about it, plastic plays a big role in our lives--particularly in food storage and preparation. The question is--is it safe to have so much of our food in contact with plastic? The short answer is yes--but it depends-- on what type of plastic, what type of food and what conditions the plastic is exposed to.


What's In Plastic?
Specific chemicals are added to plastic to give them the properties that make them so useful--hard, soft, flexible, or stretchable. Over the last 10 years, the safety of some of these chemicals has been called into question, especially since under some conditions, the plastic can leach into food.

Phthalates and adipates belong to a group of chemicals called "plasticizers" --they help soften plastics into flexible forms and are found in polyvinyl chloride plastic (PVC) and some cling wraps. So common are phthalates in the environment, it's difficult not to come into contact with them at home; they're found in nail polish, 5 gallon water bottles, cosmetics, fragrance in detergents and cleansers, adhesives, inks and vinyl shower curtains. Bisphenol A (BPA) is an industrial chemical used in plastic to make it clear and shatter resistant. It is also used in the epoxy linings of food cans, dental sealants, CD's and DVD's. Its use is widespread-- in 2003 close to 2 billion pounds were used for plastic and resins that come in contact with food.

What's the Problem?
Phthalates and BPA are considered "hormone" or endocrine disruptors" because when present in large enough amounts, they mimic hormones in the body, which can affect many organs and systems including the reproductive system. Steven G. Hentges, Ph.D., Executive Director, Polycarbonate/BPA Global Group at the American Chemistry Council says, "As a general rule, the amount of any substance leaching from a plastic can increase with longer time and higher temperatures."

The Government Says:
• The Center for the Evaluation of Risks to Human Reproduction, a division of the National Toxicology Program of the US Department of Health and Human Services says in a draft report there is "some concern that exposure to BPA causes neural and behavioral effects to fetuses, infants and children."
• Current levels of seven phthalates studied by the National Institute of Environmental Health Sciences posed "minimal" concern for causing reproductive effects. However, the National Toxicology Program concluded that high levels of one phthalate, Di-n-butyl phthalate, may adversely affect human reproduction or development.

American Chemistry Council spokesperson Steven Hentges Says :
Bisphenol A has been comprehensively evaluated by government bodies around the world. All support the conclusion that bisphenol A is not a risk to human health, in particular at the very low levels to which people could be exposed from use of consumer products.

The Inter-Industry Group for Light Metal Packaging Says :
Human exposures to BPA from use of protective liners for food cans is exceedingly low, hundreds or more times lower than safe exposure levels set by U.S. and international regulatory agencies.

The safety of BPA-derived protective coatings in food and beverage containers have undergone independent reviews of the science by multiple regulatory agencies, including the US Food and Drug Administration, The United Kingdom Food Standards Agency, the Research Center for Chemical Risk Management of the National Institute for Advanced Industrial Science and Technology of Japan and most recently the European Food Safety Authority. Every regulatory review conducted to date has affirmed that BPA based can liners are approved for use in food contact applications and safe for use.

The Bottom Line:
Animal studies and some human studies have shown possible harmful effects of some plastic-bound chemicals that can migrate into food. Experts on both side of the issue agree that most of us ingest microscopic amounts of chemicals from plastic in food and the environment. The difference of opinion is in what "reference dose" is actually safe. While industry officials stand by current regulatory standards, the Environmental Working Group and other consumer interest groups advocate for lowering the level of what is allowed in contact with food.

Until there is enough evidence for a conclusion, you can use common sense and a bit of caution especially for the pregnant women, infants and young children. That's because tiny amounts of any chemical during critical development of organ systems could have long ranging effects, especially on reproductive systems.

Practical Info:

Regarding use of plastics with food, these are things you can do to keep that pinch of plastic out of your food:

Because plastics can leach small amount of chemicals into food when heated, watch what plastics you use in the microwave:
*Don't let plastic wrap touch food during microwave cooking, or use a hard plastic cover, wax paper or white, microwave safe paper towels.
*Don't cook with any plastic that is not meant to be heated. This symbol is often imprinted on containers that are safe for the high temperatures of the microwave: However, The National Geographic Green Guide notes that this is only a guarantee that the plastic won't melt, not that chemicals won't leach into your food.

If you're not sure, use glass or lead-free ceramics, especially for foods you are actually cooking, not just reheating.
*Never use plastic grocery bags or other materials not for food use.
*Don't heat food in plastic that is meant for one-time use (frozen dinner containers) or that is not labeled as safe for the microwave. (Margarine tubs, yogurt containers, Styrofoam to-go boxes.)
*When plastic shows signs of age--turning cloudy, cracked or otherwise well used, many experts recommend discarding it. However, the American Chemistry Council notes that it's somewhat of a myth that cloudiness indicates plastic is degrading. (Another urban legend regarding freezing plastic bottles is also untrue--you can freeze plastic water bottles!)

Because chemicals are more likely to leach out when in contact with high fat foods, follow these tips:
*Remove deli foods from plastic wrapping from the grocery store.
*If possible, buy oil in glass or metal bottles. Or make sure the plastic bottle is one recommended below.
*For the processed foods you do buy, get them in a variety of packaging--canned, paper, boxed and plastic. Keep in mind that canning as a food preservation method has a 200 year long history in regard to safe food preservation.
*Eat whole foods! As is consistent with every piece of current dietary advice --eat as many whole foods as possible--this will automatically reduce your exposure to any chemicals found in packaging.

Plastic by the Numbers:
When choosing containers you'll use over and over again, look for recycling codes, as well as abbreviation of plastic type on the bottom of the container. If there is no number, or abbreviation, call the manufacturer to find out.
According to the National Geographic Green Guide, safer plastics to use for food and water are :

#1 Polyethylene Terephthalate (PETE or PET also widely recyclable) Common products: individual water bottles, soft drink bottles and medicine containers.

#2 High Density Polyethylene-(HDPE--also widely recyclable) Common products: Toys, milk bottles, shampoo

#4 Low Density Polyethylene (LDPE) Common products: Ziploc and Glad bags, wrapping films, grocery bags, some squeezable food bottles

#5 Polypropylene (PP). Common products: Syrup bottles, yogurt tubs, diapers, some baby bottles

*Polyactide or PLA On the cutting edge of "green", this plastic is corn based, which is safe to use with food, compostable and biodegradable but does not withstand heat.

Plastics to Use More Caution With:
#3 Polyvinyl chloride (PVC) is considered one of the most toxic plastics, often a likely candidate for phthalates and adipates. Common products: meat wraps, cooking oil bottles.

#6 Polystyrene (PS) Common products: foam containers and clear disposable take out containers, plastic cups and cutlery. It may leach styrene, a possible carcinogen.

#7 Other Usually indicates Polycarbonate, which could contain BPA as well as phthalates. Polycarbonate is not used for food packaging, only for home food storage, according to Hentges.


What about Baby Bottles?

As of 2006, 95% of plastic baby bottles were made of polycarbonate. Here are alternatives and safer ways to use Polycarbonate plastic.
*In general, opaque or colored bottles are BPA free. Here are some BPA free models made out of #5 polypropylene: Medela Baby Bottles, Gerber Fashion Tint bottles, Gerber Lil' Sport Bottles and Evenflo opaque and pastel bottles are reported to be #5 plastics, which are BPA free. Born Free bottles are made of Polyamide (PA), another BPA free plastic.
*Use disposable bottle liners, made by Gerber and Playtex, which don't contain BPA.
*Don't heat formula or breast milk in Polycarbonate plastic bottles since chemicals are more likely to leach out when heated
*Use glass instead--however this option has different safety risks

Food for Thought:
We live in a world polluted with many environmental chemicals. While BPA and phthalates may be transferred in tiny amounts in food, they are also common pollutants in air, water, and can be found in everyday products like cleaning supplies, adhesives and even cosmetics.

Do what you can at home to reduce your exposure to environmental chemicals--but stronger regulations at the federal level are critical for all chemicals that could affect vulnerable populations like children and pregnant women. The reference dose for BPA was developed by the EPA in 1987, 10 years before research showing possible adverse affects of very low doses was done.

Clearly it's time for an update and it may be coming. Congressman Albert Wynn, Chairman of the Senate Subcommittee on Environment and Hazardous Materials
said in a November 9th 2007 press release: "…broadly, our chemical policies are not working. …we now know that children are especially vulnerable to toxic chemicals, even at extremely low doses. Further, these effects in children can be cumulative as they grow up. However, these sorts of relatively recent observations are not reflected in the federal laws, supporting the need to make serious revisions to our chemical policies."

Let's all advocate for stronger environmental policies for the health of our children...and theirs.

Bridget Swinney is a registered dietitian and author of Baby Bites, Eating Expectantly and Healthy Food for Healthy Kids.

THIS ARTICLE MAY BE REPRINTED WITH PERMISSION FROM THE AUTHOR; CONTACT BRIDGET: babybitesbook@gmail.com. MEDIA: For a copy of a Good Morning Texas interview where Bridget discusses the impact of environmental chemicals in a child's diet, also contact Bridget.