Archive for the ‘weight loss’ Category
Monday, August 16th, 2010
A new study from the journal Pediatrics finds that girls are beginning to develop breasts at the early age of 7 or 8. These results support the findings of a 1997 study that noted puberty beginning in girls at the age of 7 or 8. But why are our children starting puberty so much earlier? Evidence indicates that the increasing rates of obesity play a major role.
According to current medical understanding, puberty normally begins in girls between ages 8 and 12 and in boys between ages 9 and 14. Historically, “precocious puberty” (early-onset puberty) has been defined as before the age of 8 for a girl and before the age of 9 for a boy. The beginning of puberty is marked by penile enlargement or pubic hair growth for boys and breast bud formation and pubic hair growth for girls. If a child shows such signs of puberty before this age, she is sent to a pediatric endocrinologist for a full workup.
Why does obesity lead to early-onset puberty? Adipose (fat) tissue is metabolically active; fat tissue produces estrogen. The more fat tissue a child has, the more estrogen she is exposed to. It is generally accepted that overweight kids begin puberty earlier for this reason.
The presence of increased amounts of environment chemicals that mimic the effects of the sex hormones may also speed up the onset of puberty. To date, there is no evidence to prove that assumption. Dr. Frank M. Biro, the author of this new study, believes environmental chemicals are playing a role and will begin studying girls’ hormone levels and lab tests measuring their exposures to various chemicals. More research needs to be done before we can conclusively state that these chemicals are affecting our children.
Early-onset puberty can lead to medical problems. Girls who begin menstruating early have a slightly increased risk of breast cancer than other girls; such girls have a longer lifetime exposure to estrogen and progesterone, which can increase the growth of certain tumors. While this study looked at breast growth and not menstruation, breast growth is also a sign of hormone exposure and likely also indicates an increased risk of cancer.
Kids with early-onset puberty also suffer from short stature. While they initially appear taller than their peers, their growth plates close early, preventing the attainment of normal height. The child who was the tallest in her class soon becomes shorter than her friends.
Girls with early puberty are also more likely to have polycystic ovarian syndrome (PCOS). PCOS is a hormone disorder that begins in puberty and causes infertility, acne, and other endocrine abnormalities.
The onset of puberty differs among races. African American and Hispanic children often begin puberty earlier than kids of other races, even when weight is taken into account. This differential was confirmed in the current study. While all kids seemed to enter puberty earlier, African American and Hispanic children began the earliest.
Not all doctors agree with the results of this study. Dr. Catherine Gordon, a pediatric endocrinologist and specialist in adolescent medicine at Children’s Hospital Boston, said that so far, most evidence showed that neither breast development nor menstrual age had changed for white girls of normal weight. Yet according to Dr. Biro, “our analysis shows clearly that the white participants entered puberty earlier than we anticipated.”
The new study included 1,239 girls ages 6 to 8 who were recruited from schools and examined at one of three sites: the Mount Sinai School of Medicine in Manhattan, Cincinnati Children’s Hospital or Kaiser Permanente Northern California/University of California, San Francisco. The group was roughly 30 percent each white, black and Hispanic, and about 5 percent Asian.
At 7 years, 10.4 percent of white, 23.4 percent of black and 14.9 percent of Hispanic girls had enough breast development to be considered at the onset of puberty.
At age 8, the figures were 18.3 percent in whites, 42.9 percent in blacks and 30.9 percent in Hispanics. The percentages for blacks and whites were even higher than those found by the 1997 study that was one of the first to suggest that puberty was occurring earlier in girls.
The question remains, when should doctors refer a child for a precocious puberty workup? Some endocrinologists worry that if we accept puberty beginning at age 7 or 8 we would overlook serious medical problems, like endocrine diseases and tumors. On the other hand, if this earlier puberty is the new norm, why should we frighten families and waste valuable time and money on unnecessary tests? At this time, current practice does warrant a workup for any girl who shows signs of puberty before age 8.
It is clear that early-onset puberty is just one more effect of the child obesity epidemic. It is imperative that we help our overweight children attain a healthy weight as soon as possible. Parents are urged to get help for their overweight kids as soon as they begin to show signs of abnormal weight gain.
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Tuesday, July 27th, 2010
Beans contain a wider variety of nutrients than most foods, including calcium, potassium, vitamin B6, magnesium, folate, and alpha-linolenic acid. Beans are also a great source of complete proteins which are necessary for the normal functioning of the body.
Beans are a fabulous source of fiber! In fact, a cup of beans has twice as much fiber as a cup of most vegetables. Beans provide a major source of soluble fiber, which, when passing through the digestive tract grabs and traps bile that contains cholesterol, removing it from the body before it’s absorbed. Eating a cup of beans a day will lower cholesterol and decrease risk for heart disease by as much as 22%. The high fiber also makes you feel full so you eat less throughout the day, helping with weight maintenance. The soluble fiber in beans also helps to decrease insulin resistance, the starting point for Type 2 Diabetes. Beans are also a great source of insoluble fiber which increases stool bulk and decreases the risk of constipation and hemorrhoids.
Beans also contain compounds called isoflavins which help prevent normal cells from turning cancerous. Soybeans contain phytoestrogens which are thought to decrease the risk of breast and prostate cancer.
Beans fill many dietary requirements, including 32%DV of folate, 9%DV of potassium, and are very high in protein and fiber but and low in fat. Dried or canned beans will give you the same benefit, but canned beans are high in sodium so be sure to drain and rinse well.
Parents are sometimes wary of giving their kids beans due to the “gas factor”. Beans cause gas because they contain large amounts of a particular carbohydrate called raffinose. Our GI tract can’t digest raffinose so it travels to the large intestine where it is rapidly fermented by the bacteria that naturally live in our intestines. The end products of this fermentation are gasses, such as carbon dioxide and hydrogen. The gases accumulate and eventually leave the body as flatulence. Both the absorbance of gas and the composition of intestinal bacteria vary widely among people so some people experience more gas after ingesting beans than others.
Most kids love to eat hot dogs with baked beans. My mom used to chop the hotdogs up and mix them right in with the baked beans. Beans can also be easily served in Mexican dishes, such as tacos or fajitas. Nobody can resist a hot bowl of chili topped with melted low-fat cheese! My kids love to eat hummus. In fact, that is how I first got my kids to eat raw vegetables! Hummus is also delicious with pita bread. There are lots of ways to get kids to eat beans without a fight!
A younger toddler (age 1 – 2) requires 2 oz of meat/beans each day. An older toddler (age 3-4) requires 3 – 4 oz of meat/beans each day. ¼ cup of dried beans is equivalent to 1 ounce.
| FOOD ITEM |
GRAMS OF PROTEIN |
| 1 cup of most beans |
14 – 15 |
| 4 oz ground beef |
28 |
| 4 oz chicken breast |
30 |
| 1 egg |
6 |
| 1 Tbsp peanut butter |
4 |
| 1 oz cheese |
6 – 10 |
| 1 cup milk |
8 |
| ¼ cup almonds or peanuts |
8 – 9 |
| FOOD ITEM |
GRAMS OF FIBER |
| 1 cup beans |
13 – 15 |
| 1 medium apple |
5 |
| 1 cup broccoli |
4.5 |
| 1 cup sweet potato |
6 |
| 1 cup bran cereal |
20 |
| 1 cup whole wheat pasta |
6 |
| 1 slice whole wheat bread |
2 |
| 1 oz almonds |
4 |
| FOOD ITEM |
MILLIGRAMS OF CALCIUM |
| 1 cup soybeans |
261 |
| 1 cup white beans |
160 |
| 1 cup navy beans |
125 |
| 1 cup milk |
300 |
| 1 cup spinach |
272 |
| 1 oz most cheeses |
220 |
| 8 oz low-fat yogurt |
345 |
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Friday, July 16th, 2010
The body can do amazing things and we often underestimate its capabilities, especially when it comes to detoxifying itself. Years of evolution have enabled our bodies to “detox” naturally; those who could not self-detox died out through Natural Selection and “Survival of the Fittest”.
Toxins enter the body through food or water, chemicals used to grow or prepare food, and even the air that we breathe. Luckily, our bodies have the ability to process those toxins through organs like the liver and kidneys and eliminate them in the form of sweat, urine, and feces.
The American diet is low in water and whole grains and too high in refined sugar, caffeine, unhealthy fats and protein. Over consumption of the aforementioned nutrients can create food sensitivities, nutritional deficiencies, bacterial overgrowth, yeast infections, weak hair, skin, and nails, and a host of other conditions.
But does that mean we should all “detox” our bodies from harmful toxins? From my perspective, the whole “detox” craze is just another money-making industry preying on the insecure and teaching faulty eating principles. “Detox” diets aim to eliminate harmful processed foods and refined sugar a few times a year by limiting us to just a certain few foods for a period of time. But our bodies are designed to function best with a healthy, well-balanced diet. I do encourage a diet with minimal processed foods and refined sugar. But we don’t need to fast to accomplish this goal. And further, shouldn’t we aim to eat well all the time? How effective can a few days of restriction really be when we are eating garbage the rest of the time?
Detox diets are designed for short-term use and require fasting. If used for longer periods of time, they may cause health problems. Further, significantly lowering one’s calorie intake during a fast will result in a slowing of the dieter’s metabolism, thus making long term weight loss more difficult.
The Master Cleanse (aka lemonade diet) requires limiting our food intake to water with lemons, laxative tea and salt water in order to “cleanse” the body. Weight loss may occur from this diet but it is mainly from loss of water, not from fat loss. If used over a long period of time, the body will begin to break down muscle mass for energy. So while you may see a drop on the scale, it is from metabolically active (and much-needed) muscle rather than from fat. This diet is nutritionally void and lacking nutrients. Many dieters quickly regain the lost weight upon completion of the Master Cleanse. It is clear that we were not meant to live on lemons and laxatives!
Many detox supplements contain herbs and laxatives designed to make the dieter “eliminate” often. Over-elimination can cause dehydration and mineral imbalances and may permanently affect the digestive system if used for too long. Make sure you read the ingredient list before beginning any cleansing regimen and research each ingredient so you know what you are ingesting. These programs often utilize senna, a known laxative. The other ingredients listed in many cleanse systems are herbs that are not FDA approved and have not been scientifically proven to do anything, let alone “cleanse” the body. Everyone is different and we don’t know how our bodies will react to these untested/unresearched herbs so be very cautious when starting a detox diet. If you want to try one of these cleanses, be sure to get your doctor’s approval!
Detox diets are NOT designed for those who have health conditions. People who have diabetes, heart disease, eating disorders, other chronic medical conditions or are pregnant should avoid these regiments.
Detox diets are also NOT recommended for children or teens. Kids and teens require nutrients, calories and protein to support their development. Eliminating macro and micronutrients, even for a short period of time, may disrupt energy levels cause emotional imbalances.
Instead of following the newest trend or looking for a quick fix, try eating a wholesome diet all year round! Make sure you eat lots of fruits, vegetables, and whole grains. Stick to lean sources of protein. Drink lots of water. And try to avoid processed foods as much as possible. If you are feeling run-down or tired, speak to your doctor. Unfortunately, there is no magic formula for good health or weight loss!
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Tuesday, June 29th, 2010
Summer is finally here and it’s time to hit the beach. But summer doesn’t give us the right to eat poorly. It’s important to stay healthy all year round. Relaxing at the beach is a great way to spend the day, but make sure you bring some healthy treats to share.
Before you set out for a day at the beach, it’s always smart to plan ahead and pack some yummy food to bring along. Instead of bringing junk food, this year try something new and healthy. I love to freeze different foods the night before my beach escape. Frozen fruits, like grapes and blueberries, are especially refreshing in the heat, taste great, and provide you with healthy nutrients. Freezing yogurt the night before can also make for a great beach snack. By the time you’re ready to eat, the yogurt won’t be frozen but will be nice and cold. You can also bring along some granola or make your own trail mix. These snacks provide energy and can be added to the yogurt and fruit to make your own parfait. Try to avoid salty foods though, like salted pretzels or salted nuts. It’s important to stay hydrated and keep your energy level up when spending the day in the sun. Salty foods will do just the opposite by dehydrating you. Foods like fruit and veggies are high in water content which will provide you with a little extra hydration. Making sure you have lots of water is extremely important as well. For those who don’t love to drink plain water, bring along some flavor packets to keep everyone happy. Drinking is the key to making it through a day at the beach and in the sun.
Plan on eating a meal at the beach? Don’t spend all your money on greasy cheeseburgers and pizza; instead, bring a healthy lunch that everyone will enjoy. Reduced fat peanut butter and cut up apple pieces on a whole-wheat sandwich will be popular, especially with the kids. Besides being easy to prepare, the peanut butter will provide some protein and the apples will add some extra water content. To make the sandwich even more enticing for the kids, try putting the peanut butter and apples in small whole-wheat tortillas to make eating more fun. It tastes extra-yummy when the peanut butter melts in the sun and gets all gooey. Don’t forget extra napkins! Feel free to add some of that granola or some banana. Making a normal sandwich into a wrap not only makes eating more exciting but also makes them cleaner; wraps are easier to hold so you don’t have to worry about your sandwich contents falling into the sand.
If your kids insist on eating at the snack bar, let them choose between a grilled chicken sandwich and grilled chicken fingers. Most snack bars will be happy to substitute grilled chicken for the fried chicken on the kids’ menu. Forego the fries and get baked potato chips instead. If your kids are clamoring for the ice cream truck, have them choose ices over ice cream for a lot less fat.
With all these healthy choices, everyone will be satisfied and you are guaranteed to enjoy a great day at the beach. Your friends and family with thank you, as will your body. And don’t forget the sunscreen.
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Tuesday, June 15th, 2010
Quench your Thirsty Thoughts!
It seems like every time you turn around there is a new drink in town. Whether it’s a new sports drink or fruit juice, top companies are concocting some of the worlds’ top diet busters. Unfortunately consumers are unaware of how quickly drinks can pack on the pounds. Drinking calories is not nearly as satisfying as eating calories so you take in more calories without becoming full!
Most drinks contain “empty calories.” In other words, they are void of minerals and/or nutrients. Sugary sodas and frappuccino drinks definitely subtract years from your life and add pounds to your waistline: not a healthy combination. Sports drinks and fruit juices are not any better and should be limited to athletes or an 8 oz glass a day, respectively.
Many parents of wary of giving kids drinks with artificial sweeteners. Studies show, however, that they are completely safe for kids. I give them to my own children with no hesitation.
Below are a list of drinks to try and drinks to avoid. Feel free to use the list to help you navigate the beverage world!
Try These Drinks
1. Smart Water or other bottled water
2. Vitamin Water Zero
3. Crystal Light
4. Unsweetened Iced Tea
5. Fuze Slenderize
6. G2
7. Seltzer, Flavored or Original
8. Flavored Water
9. Sparkling Water
Avoid These Drinks
1. Iced Tea, Any Type with Sugar
2. Energy Drinks (Red Bull, Rockstar, etc)
3. Coffee Drinks made with Whole Milk
4. Frappucino
5. Any type of regular soda
6. Fruit Punch
7. Lemonade
8. Gatorade, Powerade, Fuze, or any Sports Drink
9. Hot Chocolate
10. Vitamin Water
One important tip: Don’t forget to look at the serving size!
When looking for the perfect drink to quench your thirst, you must first look at the nutrition label and serving size. If there is a load of sugar per 8 oz glass (most bottles are 16 oz) than steer clear of that drink! Also, the frozen coffee drinks are loaded with whole milk, cream, and sugar; for a healthier alternative try making your own with skim milk, coffee, sugar substitute and low fat yogurt. Just remember that we don’t recommend coffee drinks (even decaf!) for kids.
When all else fails drink good old H2O! If it’s too plain for you, add fruit or lemon slices for extra healthy flavor and antioxidants!
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Friday, May 21st, 2010
Camps are generally nurturing environments designed to help your child succeed and grow. Whether playing sports all day or learning about science experiments, all children need healthy foods to help their endurance and brain activity. Healthy lifestyles begin with healthy food choices and healthy food choices should be encouraged every day, no matter where you are; school or camp! Because you are a concerned parent, there are a few questions you must ask the camp administration upon admitting your child into summer camp.
Here are a few suggestions to help make the most out of your child’s camp experience:
- Make sure the camp is accredited by the ACA (American Camp Association). It is the best evidence parents have of a camp’s commitment to a safe and nurturing environment for their children. This voluntary accreditation guarantees parents that camp practices have been measured against national standards and go a step beyond basic licensing requirements.
- Speak to the camp administration regarding their food resources and snack-time availability. Ensure their food suppliers have a high-quality reputation and encourage a break be made for a snack time if there is not any.
- Talk to the camp nutrition staff (if there is one) and ask them what types of meals are served. Remember, you want fresh fruits and vegetables, whole grains and lean meats being served to your child on a daily basis.
- Does the camp have any nutrition guidelines? If so, what are they? Ask to speak with the camp official who is in charge of the menu.
- If your child is attending a day camp, you may want to ask if children can bring their own lunches and snacks; by doing this you can control the nutritional value of the meal.
Focus on a healthy lifestyle all year round! Months and months of health food choices during school cannot afford to be offset by unhealthy food choices made in the summer. It is important that children are served well-balanced and healthful meals at summer camps not only to maintain their weight loss but to remain fit and active. Become an advocate for your child and demand that healthy meals are served at camp. Do not be afraid to ask questions concerning the nutritional value of meals being served to your child; summer camps want to provide special experiences for your children so they should be happy to help you in any way possible.
Top 10 Snacks for Camp-Go-ers!
- Hummus with fresh carrots, celery and peppers for dipping.
- Peanut butter spread on rice cakes.
- 2 cups of air-popped popcorn.
- Trail mix made of low fat and low sugar granola, assorted nuts, seeds, raisins and craisins.
- Non-fat plain yogurt topped with fresh berries.
- 1 cup of edamame.
- Apple slices and low fat string cheese.
- 1 small whole wheat pita stuffed with 2 turkey slices, spinach leaves and fat-free cheese.
- Baked sweet potato chips.
- Your favorite flavor Fiber One bar.
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Friday, April 16th, 2010
We all know smoking is a bad habit that not only affects the smoker, but also impacts innocent bystanders. But new studies are showing just how much the most innocent of all, our children, are impacted by smoking.
New research from the American Heart Association shows that secondhand smoke is particularly harmful to toddlers and obese children. And its negative effects are broader than previously believed.
There are certain markers of vascular injury (possibly a precursor to heart disease) that indicate an increased risk of heart attack. Obese children with exposure to secondhand smoke have significantly increased levels of these markers, indicating a likely increased risk for cardiovascular disease. This new study also showed that obese children had twice the levels of these markers than normal-weight children.
This increased risk is particularly disturbing because overweight and obese children are already at increased risk of heart disease. Exposure to secondhand smoke is just making a bad situation worse. And with one out of every three children in our country overweight and obese, exposure to secondhand smoke could lead to a significant number of heart attacks.
As a pediatrician, I have heard every excuse from smoking parents. “I never smoke around the kids.” “I wash my hands before touching my children after smoking.” “I go outside to smoke.”
But the unfortunate truth is that children are exposed to secondhand smoke in every one of the above situations. Smoke remnants remain on clothes and in hair and continue to be harmful. There is no way to fully eliminate all the toxins from smoking. Besides not smoking, of course.
I know that giving up smoking is not easy to do. Nicotine is addictive and smokers go into withdrawal when they quit. But there are so many options out there to help smokers. If you want to quit smoking, you can consider nicotine gum or a nicotine patch. You can also speak to your physician about certain medications that can help.
The bottom line is that your children’s health is at risk, particularly if they are overweight or obese. Don’t continue to make excuses or downplay the effect your smoking has on your kids. Exposure to secondhand smoke is more dangerous than we previously thought. The best way to ensure your child has a healthy future is to stop smoking today!
American Heart Association (2009, November 18). Secondhand smoke exposure worse for toddlers, obese children. ScienceDaily.
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Monday, March 22nd, 2010
A South Carolina woman was charged with criminal neglect when her 14 year old son reached a shocking 555 pounds. I am sure that many of you can understand the charge because the example is so egregious. But how do we know this is really the mother’s fault? And if we do decide to charge parents of obese kids with child abuse, where do we draw the line?
As a Pediatrician and Child Obesity Expert, I see a wide range of overweight children. Some patients are simply ten pounds overweight while others are more than one hundred pounds overweight. How do you decide who to charge with criminal neglect?
Many of the parents of my morbidly obese patients have been struggling (unsuccessfully) to keep their kids’ weights down. They beg. They plead. They keep junk food out of the house. They lock their refrigerators. Yet these kids still manage to gain access to food.
It is somewhat easier to protect a younger child. But even at school, a kid can overeat. All a child has to do is cry that he is hungry and the lunch aides will serve him a second (or even a third) helping. And many a heavy child has begged their thinner classmates for some of their lunch. At the many parties thrown in class (for birthdays, holidays, and “special” days), these kids try to eat as many servings as possible. Even worse, a Mom may give her daughter some money to buy a turkey sandwich and never know that she used it to buy French fries and cookies instead. Parents have very little control over what their kids are eating out of the house.
Socioeconomic factors also play a role in the development of child obesity. I will admit, my family and I ate at McDonald’s last month during a long car trip and I was shocked at how little it cost. My family of four ate for less than $15. It’s no wonder that families with little money often opt for this cheap, but unhealthy, option.
Obesity rates are also affected by environmental factors, like access to playgrounds and parks. Many families live in unsafe areas where kids can’t simply go outside to play. These children are often kept indoors for their own safety. And what do these kids do while cooped up in the house? Eat and watch television, more risk factors for weight gain. How can we blame parents for these inequities?
Some kids are genetically predisposed for obesity. While less than 10% of all cases of child obesity are due to known genetic defects, it does happen. Some individuals are deficient (or resistant to) the effects of a protein called leptin. Leptin is what tells our brain that we are full and no longer need to eat. Mice studies prove that mice with leptin defects become obese, sometimes to the point of eating themselves to death! These mice will eat until they become sick… and then they eat some more.
Some obese individuals have been found to have these same leptin defects. Clearly, obesity in these kids cannot be their parents’ fault. It is possible that genetic defects are responsible for more cases of child obesity than we realize because we haven’t yet discovered the responsible genes. I would hate to put a mother in jail or separate a family only to find out a few years later that the child suffers from a previously unheard of genetic defect. There is simply no way to know for sure whether a child is obese because of a parent’s neglect or some genetic predisposition.
This is not simply conjecture. A family in Britain was on a Social Service’s watch list, at risk for losing their children, due to their kids’ weights. Luckily, Dr. Sadaf Forooqi discovered a gene deletion that left these kids unresponsive to leptin, causing them to live in constant hunger. Dr. Forooqi spoke to authorities and Social Services dropped the investigation. Had Dr. Forooqi not made that discovery in time, this family would have been devastated for no reason!
So let’s go back to our initial example of the 555 pound South Carolina teen, Alexander Draper. His mother, Jerri Gray lost custody of her son and is being charged with criminal neglect. Gray is facing 15 years on two felony counts, the first U.S. felony case involving childhood obesity, said her lawyer, Grant Varner. Could Alexander suffer from an unknown genetic abnormality? Are we sure that he can control his hunger in a normal way? Alexander Draper hasn’t even been tested for genetic causes of obesity, according to Varner. How can we justify putting this woman in jail for something that may not be her fault? We don’t know what goes on in that house. It is possible that the problem lies within Alexander’s DNA. And how can we punish his mother for that?
Now I am not saying that all parents are blameless. It is horrifying to see parents feeding obese children unhealthy foods and parents must be responsibility for keeping their kids as healthy as possible. I am just not sure that jail is the answer.
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Friday, March 12th, 2010
We were starting to think that Vitamin D deficiency was a thing of the past. I mean, when was the last time you met someone with rickets? But a recent study in Pediatrics showed that over six million children in the United States do not get enough Vitamin D. That is one out of every five kids! It seems that Vitamin D deficiency is more common than we thought.
Vitamin D is an important vitamin! New studies are proving that vitamin D can help prevent many diseases such as cancer, depression, diabetes, hypertension, osteoporosis, chronic fatigue, autoimmune diseases and cardiovascular disease. Other research has linked low Vitamin D levels to obesity; studies show that overweight individuals are much more likely to be Vitamin D deficient. It is not clear, however, whether increased body fat leads to Vitamin D deficiency or if low Vitamin D levels cause a person to gain weight. Is one responsible for the other? More research is needed in this area.
There are a few different ways to get vitamin D. Vitamin D may come from foods or vitamin supplements; vitamin D can also be made by the skin when it is exposed to ultraviolet rays (UV light). Fortified foods are the main dietary sources of Vitamin D as few foods naturally contain it. Although milk is fortified with vitamin D, dairy products made from milk, such as cheese and ice creams, are generally not fortified with vitamin D. Fatty fish and fish oils are natural sources of Vitamin D.
Vitamin D deficiency is often missed because there are no real symptoms associated with it. Rickets and osteomalacia (softening of the bones) are the most common signs of vitamin D deficiency but there is no way for parents to tell if their child is suffering from these illnesses. The only way to prove that your child is vitamin D deficient is by completing a blood test which screens for a particular form of vitamin D, called 25-hydroxyvitamin D (25(OH)D).
Think that name sounds complicated? Unfortunately, many doctors do too. In fact, doctors often order the wrong blood test when assessing vitamin D levels. Be sure to ask for 25(OH) D blood test not 1, 25-dihydroxy-vitamin D (aka calcitriol). With such complicated names, it is no wonder that such mistakes are made!
Vitamin D deficiency exists when 25(OH) D levels fall below 25 ng/mL. Levels may vary depending on time of year, direct sunlight exposure, skin color and vitamin D consumption. Levels should be between 50 – 80 ng/mL year-round for both children and adults.
As a doctor, I am finding more and more children with low levels of vitamin D, mainly because kids are spending less time in the sun. These days, toddlers are more often inside watching TV than playing outside. And if they are in the sun, they are lathered with sun block, which reflects the sun’s rays and decreases vitamin D formation. Obviously, sunscreen is important and should not be avoided! But it does lead to lower levels of vitamin D. Also, many toddlers do not get enough vitamin D to meet their needs since there are limited food sources of high vitamin D content.
The current recommendation is 400 IU per day in the form on of vitamin D3 (cholecalciferol). New studies are showing that higher levels may be needed to prevent the diseases discussed above. Many are now recommending 1,000 IU per day in the form of vitamin D3 (cholecalciferol). If your child doesn’t get this amount of vitamin D in his diet, you may want to consider a multivitamin that contains vitamin D.
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Friday, March 5th, 2010
Recently, America’s school lunch menus have been under fire and parents are becoming increasingly concerned about the state of their children’s health and well-being. Federal law, under the School Lunch Act, provides nutritional guidelines and criteria to which schools must adhere. These guidelines include the amount and type of foods the cafeteria must offer, in addition to placing limits on nutrients like saturated fat, cholesterol and sodium. Specifically, school lunches must provide 1/3 of the Recommended Daily Allowance (RDA) for protein, calcium, iron, vitamin A, vitamin C, and 1/3 of the Recommended Energy Intake (REI) for calories. In addition, the cafeteria must offer 5 components as part of a school lunch, of which three of the five must make their way onto the child’s lunch tray. These include a starch, meat (or meat substitute), fruit, vegetable and milk. There are similar guidelines for schools that serve breakfast as well. These guidelines are especially important because many children eat the majority of their meals at school.
Milk contributes a good portion of nutrients to school lunches. It is a valuable, nutrient-dense source of protein, calcium and vitamin D, all of which are important for achieving adequate nutrition and optimal growth in school-age children. However, whole milk can significantly contribute to the saturated fat and cholesterol content of a meal.
According to the American Academy of Pediatrics (AAP) whole milk and other full-fat dairy products are only appropriate for children under the age of 1-2 years old. Children under two, who are in a stage of rapid growth and brain development, have high energy and dietary fat requirements. They need the extra fat that whole milk contains.
Everybody else, however, should choosing low fat dairy products, including skim milk. In fact, the AAP states that no child over the age of two should be drinking whole milk. Skim milk is identical to whole milk in terms of nutritional value, but is markedly lower in saturated fat, cholesterol and calories. Diets high in saturated fat are associated with increased risk for obesity, heart disease and certain cancers. Saturated fat intake causes harmful buildup in the arteries and blood vessels of healthy individuals, starting in young children. It is important to begin healthy eating habits as a child and to continue making healthy choices throughout life.
A good portion of a child’s learning happens through modeling. That is, by watching their parents or other caregivers’ actions, they learn how to be an adult. This is especially important when it comes to eating: your food preferences as an adult are closely related to the foods you saw your parents eating. But what happens when your child is eating 2 out of 3 meals a day at school, plus a snack? Because they are eating so many meals outside the home or the care of their parents, kids are increasingly reliant on teachers, caregivers and cafeteria staff to guide them to make healthy choices and model healthy eating behaviors.
The fact is, the people who are responsible for serving food to or eating with your children usually receive no formal nutrition education. In most cases, a position as a preschool classroom aide or a kitchen worker requires a high school level education. Regardless, whatever their educational background, it is a common misconception for people to think that whole milk has a nutritional advantage over skim milk. It is also very common that parents encounter teachers or caregivers who have different beliefs than their own when it comes to feeding their child. Especially when you’re talking about the welfare of a child’s health, when a parent feels one way but their caregiver feels another way, this can create some tension. A well-meaning day care worker just may not be aware of or understand the reasons why full-fat milk can be dangerous, even for young children. Parents often have a difficult time getting this message across but should continue to be an advocate for their child’s health.
In situations like this, as a parent you have the right to decide what your child does and does not eat. You can stress this issue to the teacher in a polite way while still standing firm. If needed, refer them to an appropriate resource, such as www.MyPyramid.gov, the American Academy of Pediatrics, your pediatrician, or even a local dietitian for further advice on this matter. Your child’s health comes first!
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Tags: child diets, child nutrition, Child Obesity, diets for kids, milk, milk in schools, nutrition for kids, school lunch, whole milk
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