health, wellness and nutrition

Jan 5, 2010

Healthy School Lunches By Anne Kolker MS Registered Dietitian

School Lunch

By Anne Kolker MS Registered Dietitian

Photo by Pavel Danilyuk

Every parent wants to know what to make for school lunch. It is frustrating to find out your child didn’t eat a thing you made, even after they suggested what to put in it. It is also frustrating because it is just another thing to remember in a busy day of parenting. Of course many schools provide lunch either from vendors (Roundtable Pizza, etc) or from the USDA’s National School Lunch program (NSLP). At the end of this article I will recommend some good lunch ideas.

In the meantime, now that I have your attention, I wanted to inform you about school policies that are supposed to improve school lunches among other things related to wellness.

Did you know that Congress passed a law requiring public schools participating in the NSLP or even just in the Special Milk Program to adopt a school wellness policy (WP) by 2006? Congress recognizes that schools play a critical role in promoting student health, preventing childhood obesity, and combating problems associated with poor nutrition and physical inactivity [1]. The objective of a WP is to set goals for nutrition education, physical activity, campus food provision, and other school-based activities designed to promote student wellness.

Physical activity and nutrition education are two areas in school that can get pushed aside with more and more emphasis on academics (i.e. standardized testing) and only so much time in a school day. Furthermore, the NSLP traditionally has not offered healthy lunch options (relying on commodities such as cheese [high in saturated fat]). Similarly, schools that do not participate in the NSLP may rely on vendors to provide lunch (e.g. McDonalds, Burger King, Togo’s, etc).

Your district’s WP should have language specifically addressing the nutrition content of school lunch and items sold a la carte. Even if your kids attend a private school, it is a good idea if they adopt some type of wellness guideline. Most WPs follow the suggested government recommendation such as the following:

Each food item will have no more than 35% of its calories from fat (excluding nuts, seeds, cheeses, peanut butter, avocado, and other nut butters) and no more than 10% of its calories from saturated and trans fat combined with a goal of total elimination of trans fat.

School fundraisers, such as bake sales, may be addressed to match similar nutrition guidelines. Do you think this goes too far touching upon the sacred bake sale? Perhaps, but when you think about all the added sugar kids are eating in a week. (1-2 lbs per week) from birthday parties, soccer practice, and even from candies handed out by teachers, it is a good starting point. We expect our school to offer the best curriculum and set high standards, so it is essential that schools set standards in other areas as well. Rather than think of it as limiting, think of it as being creative. Instead of selling brownies, try a walk-a-thon, a car washing event, or selling holiday cards and gift wrap. Instead of just relying on fast food companies to deliver lunch, talk to local foodservice caterers. Or work with your vendor to replace cookies with fresh fruit.

Check with your school district and find out what is in your school’s WP. Also, find out if you are under the school requirements for minutes of physical activity. Ask if kids are being withheld from recess (this is not an acceptable practice and takes away important time for a child to be active). A WP should address all of these areas and should have been created with input from teachers, parents, students, and other stakeholders in the community (generally by a wellness committee). Unfortunately, there is no penalty at this time if your school does not have a WP nor are there any penalties for not following the guidelines. Hopefully, parents and teachers will want to ensure that a guideline is created and is being utilized. It takes commitment from at least one person to ensure these policies are created and followed.

Ahhh, but back to school lunch. What should a parent do when a child only wants to buy school lunch and it isn’t healthy, or a child is bored with the lunches you pack from home? And really, does one meal a day make a difference? Yes. When kids get used to eating high fat food, this can form a long-term habit (fat does taste good). The time to set permanent healthy behavior is early and reinforcing during school is no exception.

Depending on the age of your child, have her help plan lunch or even prepare part of it. This can be done just once or twice a week to get your child involved.

Remember that children love to get out and play and sometimes will eat very little so they can have more time on the school playground. Packing a snack for early or late recess may be a good idea (peanuts and cashews are full of fiber and protein). Don’t be upset with them if their lunch is only half consumed. She is just a social butterfly. Offer sliced peaches and plain yogurt when she gets home. Make a fruit smoothie with your son using frozen fruit, vanilla yogurt, and milk.

Talk to your child about the lunch program and help him choose a healthy option. Although it is quite convenient not to pack a lunch, try a bag lunch at least two times a week. For older kids this can help your budget as kids who can go off campus can spend a lot on lunch (of questionable nutritional value).

Healthy things to pack:

Edamame (soybean) or sugar snap peas (good source of protein)
Cube cheese and offer it on a toothpick
Trail mix (nuts, dried cranberries stick pretzels)
Sliced mango, kiwi, or apples (use orange juice to help prevent browning)
Vanilla yogurt with raspberries and granola or nuts on top (place it in a small plastic container (use an ice pack to keep it cold)
Use leftover chicken from dinner last night and make a sandwich vs. processed sandwich meat which is high in sodium (salt)
Use a cookie cutter to shape sandwiches into hearts, flowers, etc (young kids love to eat fun-shaped sandwiches)
Open faced bagel with cream cheese and a face (use raisin for the eyes, a cashew for the nose etc.)
Peanut butter and banana sandwich – apples will work too.
Fresh mozzarella cheese in a tortilla
Use a thermos in the cold months and fill it up with soup or pasta with a little bit of chicken broth for added taste
Cereal. Just make sure it is high in fiber (5 grams) and low in sugar (under 10 grams). Provide a container with a top and a spoon; your child can add the milk provided at school.

For more information on Federal Wellness Policies check out these websites:

http://www.fns.usda.gov/tn/Healthy/wellnesspolicy.html

http://actionforhealthykids.org/wellnesstool/index.php

http://www.opi.state.mt.us/schoolfood/wellness.html

[1]. http://www.fns.usda.gov/tn/Healthy/wellnesspolicy.html

This family wellness article is provided by Nourish Interactive, visitwww.nourishinteractive.com for nutrition articles, family wellness tips, free children's healthy games, and tools. Available in English and Spanish.

Healthy Breakfast Foods for Kids By Michelle Mirizzi MS Registered Dietitian

Rise and Shine: It’s Breakfast Time!

By Michelle Mirizzi MS Registered Dietitian

Most of us already know that breakfast is the most important meal of the day. Beginning your day without breakfast is like trying to fly a kite without any wind. It’s hard to get started and even harder to keep going. Breakfast is the first chance your child’s developing body and brain has to refuel its glucose levels, (that’s the brains basic fuel), after several hours of sleep.

Photo by Julian Jagtenberg

Why is breakfast the most important meal of the day? Here are just a few reasons why your child should eat breakfast:

Studies show that eating breakfast everyday is important in maintaining a healthy body weight. Starting your child’s day with a healthy breakfast will also make them less likely to eat high-calorie snacks during the morning.
Eating a well balanced breakfast improves their intake of fiber, vitamins and minerals, especially iron and vitamin C; these nutrients are essential in a balanced diet. In fact, a good breakfast provides one-fourth to one-third of the day’s energy and nutrient needs.
Children who eat a healthy breakfast tend to show improved academic performance, longer attention span, better attendance and decreased hyperactivity in school.
Skipping breakfast will often make your child feel tired, restless or irritable by mid-morning. By eating breakfast, your child will have energy throughout the morning and help him/her concentrate better in class. This also means fewer trips to the school nurse’s office.

Breakfast can be served hot or cold, sitting down or eaten on-the-run. Breakfast can be a typical breakfast food, or left-overs from dinner the night before. The main point to remember is to include it in your morning routine for both you and your child. A good breakfast is easier than you think. By choosing the right foods, you can feed your child quickly at home or create a brown bag to go.

A nutritious breakfast includes foods from at least three of the five food groups:

Fruit group; fresh whole fruit such as bananas, apples, oranges. Sliced fruit which can be added to cereal, yogurt or oatmeal.
Vegetables group; 100% vegetable juice, or mushrooms, asparagus, or green peppers in an omelet.
Grains group; whole-grain breads, dry cereal, bagels, english muffins, flour tortillas, rice.
Milk group; low fat or fat free milk, yogurt or cheese. If your child is lactose intolerant, choose lactose-free products that still have the calcium and other nutrients needed.
Meat and beans group; eggs, lean meat, peanut butter, beans.

Traditional and non-traditional breakfast ideas:

Whole grain cereal with fruit and low fat milk
Oatmeal with raisins and low fat milk
Waffles, turkey bacon and fruit juice
Bagel with cheese or peanut butter
Breakfast burrito: scrambled eggs, cheese and veggies wrapped in a flour tortilla
Grilled cheese sandwich and juice
Turkey sandwich and a cup of low fat milk
Rice bowl with chicken and vegetables on top

Follow these easy tips to make time for breakfast in the morning:

Do some of your morning chores the night before, such as selecting clothes to wear and getting backpacks ready for school.
Set the alarm for 15 minutes earlier to allow more time to prepare and eat breakfast as a family.
Skip the audio-video temptation: make breakfast time about eating rather than watching TV, playing a video game or using the computer. You may find it easier to get out of the house on time as well.
Offer something non-traditional like leftovers from the night before. Eating nutritious food for breakfast is better than eating no breakfast at all.
Have items available in your kitchen that can be quickly and easily assembled in the morning such as whole grain cereals with milk, fresh fruit, yogurt or bagels.
Pick one morning a week where you make a special breakfast such as pancakes and eggs. You can set up the mix the night before or even make the pancakes and freeze them to reheat when needed.

Creating healthy habits

Children are “copycats”; They like to do what someone else is doing. Parents and older siblings can act as role models by setting a good example and taking the time to eat breakfast every morning. Rise and shine with breakfast and help your child develop a healthy habit that will benefit them throughout their life.

Easy Healthy Eating and Fitness Tips By Michelle Mirizzi MS Registered Dietitian

Easy Healthy Eating and Fitness Tips

By Michelle Mirizzi MS Registered Dietitian

March has been declared National Nutrition Month® by the American Dietetic Association, so I can’t think of a better time to talk about ways to improve your child’s lifestyle and eating habits. We all know that a banana is a healthier snack than a bag of potato chips and that playing outside is better than sitting on the couch watching television. But, sometimes making those choices is not so easy. Forming new healthy habits takes time and practice, but it can be done! The key to keeping children involved is by making eating and exercising a family activity.

Eat Together As a Family:

Make mealtimes a family event by sitting down at the table together for at least one meal a day. If dinner time is too busy with activities, try starting the day by eating breakfast together. Ideally, mealtimes should be a pleasurable experience that allows your child to try new foods and to learn good eating habits from their parents. Siblings can also be a great role model during mealtime. Most children have definite food likes and dislikes. However, parents should still encourage trying new foods during mealtime. Provide a small quantity of the new food so that your child does not feel pressured and begins to accept the new food.

Do you remember the clean plate club? Try not to expect your child to eat everything on his or her plate. Instead let your child choose their own portion size, provided that the food is nutritious. Children need to learn to pace themselves and become aware that they are full. Don’t take it personally, leaving food on the plate does not mean your child is not thankful for a good meal. Remember that they will have another meal again and it is better to save the leftovers for another meal than overeat and risk becoming overweight.

Make Mealtimes a Routine:

Get your child involved in cooking and planning family meals. Take your child with you to the grocery store and spend some time reading nutrition labels and comparing products.
Eat around a table. It’s easier to talk to each other when you are face to face.
Set a time for family meals. That way your child knows that, for example, dinner is at 6:00pm or breakfast is at 7:30am each day.
During mealtime, focus on each other by turning off the TV and letting the answering machine pick up the phone.
Talk to your child about their day or something enjoyable. Mealtime is not the time for complaining or lecturing about lost homework.
While children need to mind their manners at the table, try not to pester them.
Keep meals from lasting too long. If your child gets fussy, let them be excused and take their plate to the sink.
Offer fresh fruit for dessert – not as a reward, rather as a great way to finish the meal.

How Much Should My Child Eat?

The exact amount of calories and servings your child needs will depend on his or her gender, age and how active they are each day. Children who are more active burn more calories, so they can eat more without gaining weight.

The USDA’s food guide pyramid, also known as “mypyramid” is a simple outline showing how much food to eat from each of the food groups. A rainbow of colored, vertical stripes represents the five food groups plus fats and oils.

MyPryamid has food organized into five main groups:

Grains, Breads and Cereals group; provides fiber and B vitamins which help digestion and carbohydrates which provide energy
Meat, Beans and Nuts group; provides protein to help build muscles and a strong immune system
Vegetables group; provides Vitamin A which helps maintain healthy skin and good eyesight
Fruits group; provides vitamin C, vitamin A and fiber which helps to heal wounds as well as aid in digestion
Milk and Milk Products group; provides the majority of calcium for the development of strong bones and teeth

Make Healthy Snacks An Easy Choice:

Keep healthy snacks on hand for your child to eat between meals. A growing child can not get all the nutrients and calories from just three meals a day. Healthy snacks will also help your child eat the recommended minimum amount of at least 5 servings of fruits and vegetables each day. However, don’t expect children to cut up their own fruits and vegetables! When children are hungry they don’t want to wait. Prepare snacks in advance and have them easy to reach. Good snack choices are planned, small and well-balanced. They should contain small amounts of carbohydrates, protein and fat.

Some ideas include:

Fruits and nuts
Low-fat yogurt and fresh fruit
Peanut butter and celery
Whole grain crackers and cheese
Cheese quesadilla
Bowl of whole grain cereal and low fat milk
String cheese and crackers
Turkey sandwich on a piece of whole wheat bread
Cottage cheese and fruit

Keeping Your Child Active:

Children need to be active for 60 minutes on most days of the week to maintain good health and fitness. This doesn’t mean that children need to be in an organized sport to be active. Simply spend less time in front of the television or computer and more time doing daily activities like walking, using stairs or playing outside. Recent studies show that participation in team sports declines as children get older. The effects of long term inactivity can put children at risk for obesity, high blood pressure and type 2 diabetes. Once again, children mimic what their parents and older siblings do, so make a conscious choice to be active yourself!

Finally, have a heart-to-heart talk with your child this month about the importance of eating well and being active. Always try to be supportive and celebrate successes that your child achieves. Most importantly, let your child know that you love them and that you want to help them have a happy and healthy life!

More Fruits and Veggies, Please! By Anne Kolker MS Registered Dietitian

More Fruits and Veggies, Please!

By Anne Kolker MS Registered Dietitian

As a dietitian and a mom of three young children, I naturally have a bowl of fruit on the kitchen table. You may think that this has always been the case. The truth is that it wasn’t. The practice of having fresh fruit sitting out didn’t occur to me until I had a friend from out of town visit me. This was during the time when I only had one young child and was studying nutrition. The light bulb went off. I realized fruit wasn’t a big part of our diet. I concentrated on vegetables and whole grains because ironically, I am allergic to many fruits.

Of course placing a bowl of apples, pears, and bananas in a colorful bowl from Crate and Barrel isn’t enough. True to what I have learned about children’s eating habits, slicing fruit and placing it at an easy-to-reach location right after school does the trick. Serving dips like ranch dressing or peanut butter with carrots for dinner also works. This holds true for adults too. Imagine being served fresh slices of peaches and plums right before the end of dinner. Sounds yummy doesn’t it? That’s right, you’ll actually eat it vs. just staring at a lonely whole peach sitting in front of you. Please, try this experiment at home!

Lonely fruit and vegetables seems to be a national phenomenon. According to the USDA, fewer than 15 percent of elementary students eat the recommended 5 or more servings of fruits and vegetables every day. Furthermore, average fruit and vegetable intake among 6-11 year olds is only 3.5 servings a day 1.

Does low fruit and vegetable intake really matter when children are young? Chronic illness such as heart disease, stroke, and cancer are usually concerns for adults. However, life-long positive eating habits (such as eating low fat foods, consuming foods with high fiber, eating less processed foods) are habit-forming when started young. Furthermore, certain diseases such as diabetes and high cholesterol are starting to appear in children who are overweight. Finally, fruits and vegetables have so many naturally occurring vitamins, minerals, phytochemicals, and fiber that are good for your health.

Are our busy lifestyles to blame? Certainly, if you have kids you are getting in the car to go somewhere (to a restaurant, to soccer practice, etc.). Packaged food such as chips or power bars are very convenient and there is something about opening up a package that seems so easy compared to slicing up that lonely piece of fruit. It really is just a mindset though. Once you start packing up the fruits and veggies in Tupperware containers you will get in the habit. Plus, fruits and veggies are low in calories and fill you up.

We are constantly bombarded with food advertisements and not necessarily for healthy food such as fruits and vegetables. In fact, children 2 to 11 years old are exposed to an average of 150 to 200 hours of commercial messages, or 20,000 commercials a year and the majority of these advertisement are for cereals, candies, or other sweets.

So, what is a parent to do? Role modeling is my motto. If you are eating your fruits and vegetables, your children will too. In 2002, researchers at Pennsylvania State University examined parental pressure (“finish your vegetables” or “do as I say”) vs. role modeling (“do as I do”) among 191 five year old girls. The results showed that a daughter’s fruit and vegetable intake was positively related to their parent’s reported fruit and vegetable intake.

So what can you do this week?

Get your kids involved:

Have them choose the veggies and fruit they want when you are at the store.
Let the kids create a fruit kebob for a snack. Lay out the different fruit in an assembly line. Try pineapple, grapes, sliced strawberries, and more.
Create a rainbow chart with different colors representing the different fruit. When you eat blueberries, mark this down in the blue section.
Plan to go to the farmers market this weekend.
Have your kids create a fruit salad; this is great for building motor skills in young children (remember to slice grapes in half as they can be a choking hazard for young kids).
Keep a chart and see how easy it is to get fruit and veggies into your diet. Here are examples of one serving of fruit or veggie: a small banana, 6 strawberries, ¼ cup of raisins, ½ cup of mini carrots or broccoli.
Grow your own fruit and veggies. Go to your local nursery and purchase seeds. If you have a small back yard, just use pots. Home grown veggies really taste great.
Buy one less packaged item (crackers) and replace it with kiwis or some sugar snap peas.
Add sliced bananas on top of pancakes.
Try making fresh applesauce (link to recipe?)
Limit packaged fruit (Jell-O and fruit) or canned fruit with syrup.
Plan the night before. If you are off to the zoo tomorrow, get the lunch boxes out, wash the grapes and mini carrots.
When your kids get home from school, have the sliced fruit on the table and eat this snack together.
Limit fruit juice as many brands have added sugar. Although 100% with added vitamin C seems like a good choice, real fruit is still a better choice (real fruit contains fiber, vitamins and minerals).
Try something new: grilled asparagus with prosciutto.
Try taste testing events with different veggies and dips and different varieties of fruit.

Fiber and Your Child: How Much Fiber is Enough? By Michelle Mirizzi MS Registered Dietitian

Fiber and Your Child: How Much Fiber is Enough?

By Michelle Mirizzi MS Registered Dietitian

Fiber is an important nutrient that keeps your child’s intestines working comfortably. Foods that are good sources of fiber are beneficial because they are filling and therefore discourage overeating. High fiber foods stay in the stomach longer and require more chewing; prolonged chewing will help satisfy your child’s appetite.

Research has shown that there is a positive relationship between fiber in our diet and reduced risk of many diseases including diabetes and certain cancers. Fiber can also reduce the risk of heart disease by lowering LDL cholesterol (bad cholesterol). When combined with drinking adequate fluids, fiber also helps move food through the digestive system and protect against constipation.

Photo by Syed Muhammad Afifi

Where is the fiber? Dietary fiber is found in plant foods like fresh fruits, vegetables, beans, lentils and whole wheat grains. There are two types of fiber – soluble and insoluble. Soluble fiber acts like a sponge. It absorbs water in the intestines and forms a gluey gel which picks up cholesterol and carries it out of the body. Insoluble fiber acts like a broom because it doesn’t dissolve in water. It adds bulk and softness to the stools and keeps them moving along comfortably preventing constipation.

Fiber Content of Selected Foods (in grams)

Fiber Content of Selected Foods	grams
Apples (with skin)	3.5
Peas (1/2 cup)	3.6
Kidney beans (1/2 cup	7.3
All Bran cereal (1/2 cup)	10-13
Oatmeal, cooked (2/3 cup)	3.0
Whole wheat bread (1 slice)	1.5

So, how much fiber is enough? Here are the most recent recommendations from the Dietary Reference Intake (DRI’s):

Fiber recommendations per day:	grams
Children 4 to 6 years old	25
Boys 9 to 13 years old	31
Girls 9 to 13 years old	26
Adults	25-35

When increasing fiber in your child’s diet, it is best to do so slowly, because large, sudden increases can cause discomfort, gas and bloating. Make sure your child drinks plenty of water throughout the day. For fiber to do a good sweeping and sponging job there has to be enough water for it to absorb.

Help your child meet their daily fiber needs, by gradually increasing fiber in their diet by following these tips:

Choose whole grain cereals for breakfast such as Raisin Bran or Wheat Bran. Select cereals with at least 3 grams of fiber or more per serving.
Eat whole fruits instead of drinking fruit juices. Whole fruit has more fiber, vitamins, minerals and phytochemicals. Plus an apple or a handful of berries will keep your child feeling full longer than a glass of fruit juice.
Use whole grain bread, rolls, pita or bagels for sandwiches.
Replace white rice, bread and pastas with brown rice and whole grain products. If your kids resist at first, try mixing in half brown rice or whole wheat pasta and gradually add more.
Cut back on refined foods. In many refined foods, the fiber containing parts have been removed.
Snack on dried fruits such as apricots, figs or raisins. Have your child make their own trail mix using raisins, peanuts, and oat bran cereal.
Encourage your child to use the Nutrition Facts label to find out how much fiber is in each serving of food. A good rule of thumb to remember is if the food has 5 grams or more per serving it is considered high in fiber.
Be a positive role model; children learn many of their behaviors by watching what older siblings and grown-ups do. The next time the fresh vegetables are passed to you, take a serving and say, “I love fresh vegetables!” Soon your child will be eating it and saying they love it too.

All You Need to Know About Uterine Fibroid Embolisation – A Non-Surgical Treatment for Fibroids by Gopakumar Rajan

Tiny plastic beads shrunk my agonising fibroids and saved me from a hysterectomy

Until recently, many women with fibroids - non-cancerous growths in the womb - were advised to have a hysterectomy. Sue Hutton, from Southampton, opted for an incision-free procedure called uterine fibroid embolisation.

Uterine fibroids are a common medical condition affecting women of all ages. These benign growths are formed within the uterus and can cause a range of symptoms such as heavy bleeding during periods, pelvic pain, frequent urination, and infertility. Traditional treatment options for fibroids include hysterectomy or myomectomy, which are invasive surgeries that can lead to significant pain and downtime.

However, there is another treatment option available for women with fibroids – Uterine Fibroid Embolisation (UFE). This non-surgical procedure involves the injection of small particles into the blood vessels that supply the fibroids, causing them to shrink and die over time.

The Procedure

UFE is a minimally invasive procedure that is typically performed in an outpatient setting under conscious sedation. The procedure begins with the insertion of a thin, flexible catheter into the femoral artery in the groin. The catheter is then guided through the artery and into the blood vessels that supply the fibroids. Small particles are then injected through the catheter, blocking off the blood supply to the fibroids and causing them to shrink and die over time.

The recovery time for UFE is typically shorter than that of traditional surgical options. Most patients are able to return to normal activities within 1-2 weeks after the procedure.

Benefits of UFE

UFE offers several benefits over traditional surgical options for fibroids, including:

1. Non-Surgical Treatment: UFE is a non-surgical procedure, which means that it does not involve any incisions or cutting into the body. This reduces the risk of complications and significantly shortens the recovery time.

2. Preservation of the Uterus: Unlike hysterectomy or myomectomy, UFE does not involve the removal of the entire uterus. This means that the patient can maintain their reproductive capabilities and will not experience the hormonal changes that can occur with a hysterectomy.

3. Improved Fibroid Symptoms: Studies have shown that UFE can significantly improve fibroid-related symptoms such as heavy bleeding, pelvic pain, and frequent urination.

4. Improved Quality of Life: UFE can lead to a significant improvement in the overall quality of life for women with fibroids. Patients can resume normal activities and regain control of their daily lives without the fear of fibroid-related symptoms.

Potential Risks

As with any medical procedure, there are some potential risks associated with UFE. These include:

1. Infection

2. Pain or discomfort

3. Allergic reaction to the particles used

4. Damage to the blood vessels or other organs

However, these risks are relatively rare, and the benefits of UFE generally outweigh the potential risks.

Conclusion

Uterine fibroid embolisation is a safe, effective, and non-surgical treatment option for women with fibroids. This minimally invasive procedure offers several benefits over traditional surgical options, including a shorter recovery time, preservation of the uterus, and improved fibroid-related symptoms. If you are suffering from fibroids, talk to your doctor today to see if UFE is the right choice for you.

#UterineFibroidEmbolisation #NonSurgicalTreatment #Fibroids #WomenHealth #Gynecology