how-to-help-your-child-to-gain-weight-photo

How to Help Your Child to Gain Weight

by with No Comment Child & Family NutritionInfant NutritionToddler NutritionWeight Management

So often in the media we hear about the obesity epidemic and how too many children are overweight or obese. But what about those on the flip side of the coin? Some children may have difficulty eating due to selective food choices, aversions, or underlying medical concerns, making it challenging for them to consume enough calories to support their growth and development.

Being underweight is not the same as simply being thin or slender. Some children have a naturally slight build and maintain it with a well-balanced diet and physical activity.

TheĀ child’s weight can cause great worry to the parents.

IS YOUR CHILD REALLY UNDERWEIGHT?

Assessing whether your child is truly underweight is the first step in addressing any concerns you may have. It’s important not to let comments from others or comparisons with other children cause unnecessary worry.

If you’re concerned about your child’s weight, it’s best to seek professional advice from your health care professionals. Weight loss or inadequate weight gain can sometimes be a sign of an underlying medical condition, so it’s important to have your child evaluated if you’re worried.

By consulting with health care professionals, you can get a better understanding of your child’s weight status and any potential issues that may need to be addressed. This will help ensure that your child receives the appropriate support and guidance to promote their overall health and well-being.

THIN OR UNDERWEIGHT? CHECK THE GROWTH CHARTĀ 

Children demonstrate their thriving and well-being through normal growth and development, which is typically assessed and monitored using growth charts. Public health nurses or pediatricians routinely plot a child’s weight, length, or height on these charts during well-visits and check-ups.

By tracking a child’s growth over time and comparing it to standardized growth curves, health care professionals can assess whether the child is growing at an appropriate rate for their age and identify any potential concerns. This allows for early intervention if there are any signs of growth faltering or deviation from the expected growth trajectory.

There are 4 nutrition indices to define nutritional status of children as measure through anthropometric measurements – body weight and height.

  1. weight-for-age (risk for underweight)
  2. height-for-age (risk for stunting)
  3. body mass index (BMI)-for-age (risk for overweight)
  4. weight-for-height (risk for wasting)

Percentiles (from 3 to 97) represent the normal window of growth we can expect for children.

The 50th percentile shows the AVERAGE – This is where most children are.

It means that below 50th percentile is lower than the average, but still normal. Above 50th percentile is above the average, but still normal too!

Here’s what the percentile values on a growth chart do mean:ā €

A 2 year old boy who places on the 48th percentile on the weight-for-age growth chart means that 52% of all the boys (same age) out there weigh more than him and 48% weigh less than him.ā €

OR

Even if your child is at the 8th percentile for his weight, meaning that 92% of kids his age weigh more than he does, if he has always been at the 8th percentile, then he is likely growing normally. It would be concerning and it might mean there was a problem with his growth if he had previously been at the 50th or 75th percentile and had now fallen down to the 8th percentile

What you should actually look at is how they progress over time on the growth chart and whether or not they’re staying on THEIR particular curve.Ā Children who are growing normally will track their growth predictably on their own personal growth curve. Whether 48th percentile or 8th percentile, it doesn’t mean that his particular weight is good, bad, right or wrong. There is no ā€œgoalā€ to reach here. It just shows that body come in all shapes and forms. Some children are meant to be more petite or smaller, some are meant to be more largely built or much taller. Just look at their parents and family history as a good indicator!Ā Genetics will win!

If time passes and you notice they’ve dropped from the 48th to the 15th percentile, that’s more of a concern! Same thing goes when it’s a big jump from the 60th percentile to the 85th percentile. That’s more of what we would call “falling off the growth curve”. It could be, of course, due to over/under-eating, malabsorption issues or some other underlying medical issue or it could be something as simple as a growth spurt.ā €

The key message here is that there’s no right or wrong percentile for your toddler! Every child has their own established growth curve. Where another child has nothing to do with where your child should be. Having a chubby or a skinny toddler does not mean they are healthy or not healthy. And trying to actively change their natural curve does a lot more harm than good.ā €

Last, the growth chart is a good indicator of your child’s overall nutritional status.Ā  If your child appears to be maintaining a usual and predictable pattern on the curve, you can rest assured that your child is getting adequate calories for normal growth.

It is not just about extra calories.

 

WHAT HAPPENS IF FALTERING GROWTH OR UNDERWEIGHT IS DIAGNOSED?Ā 

If faltering growth or underweight is diagnosed in a child, it can be an indicator of underlying health conditions or developmental concerns. In such cases, the doctor will typically refer the child to a pediatrician, a specialist child doctor, for further investigations.

Additionally, the pediatrician should refer the child to see a Pediatric Dietitian to assess their diet and eating routine. If this referral does not occur, it’s important for parents to advocate for their child and request a referral. They can also choose to seek assistance from a private dietitian specializing in pediatrics.

 

GETTING STARTEDĀ 

Sometimes, parents use ineffective strategies to get their child to gain weight and grow, including negative feeding practices, in an attempt to feed them high calorie foods to boost their weight.

First, building a healthy food relationship (not just calories) is more important.

Understand the FeedingĀ RelationshipĀ 

A parent’s role is to choose what foods to offer, when, and where. Parents should provide healthy foods and offer regular meals and snacks.

A child’s role is to decide how much to eat and whether or not to eat at each meal.

Zero Pressure

Sometimes your child may refuse meals or snacks. Don’t beg, bribe or threaten your child to eat certain kinds or amounts of food.

Pressuring a child to eat can make them eat less.Ā 

Away from DistractionĀ 

Families should enjoy healthy eating together. Your child shouldn’t be singled out from the rest of the family. Everybody eats at the table together. Your child will focus on eating with fewer distractions. Turn off the TV, computer, IPad, and put toys aside around feeding time.

Stick to Mealtime Schedule

Regular meals and snacks will help your child eat enough food to grow well and be healthy. Offer food every 2-3 hours at planned times.

Offer 3 meals and 2-3 snacks each day.Ā 

Watch Empty Calories

Limit foods like sugary drinks, candies, potato chips and donuts. These foods don’t help children grow well.

Set Mealtime Boundaries

Set some table rules at meal times such as “everyone stays at the table until dad/mumā€™s finished”, even if your child doesnā€™t want to eat what youā€™ve served. Because they are sitting with food in front of them, they may end up picking at it! This is useful if your child wants to rush off and play rather than eat. But donā€™t force or nag them to eat. Youā€™re just asking them to stay at the table. You donā€™t want to turn mealtimes into a battle.

Avoid Filling Up on FluidsĀ 

Drinking too many fluids like milk and juice may make a child less hungry for meals and snacks.

Serve no more than 2-3 cups of milk each day. Limit fruit juice to 0-1/2 cup each day. Ā 

Read Label

Limit foods and drinks labelled “light”, “low fat”, “fat-free”, “low calorie” or “sugar-free”.

Watch Your LanguagesĀ 

Watch your language and conversation around body size and shapes. If you talk about people being fat, on a diet, over-eating, or you are watching your own weight by counting calories or you obsess over food labels and your own body shape, then a child picks up on this quickly. Children mirror a parentā€™s pattern and chatter. Catch yourself out and avoid this kind of chatter, especially if your child has suddenly started eating less and is starting to lose weight, they may have started dieting because of this unhealthy conversation.

 

CAN FOOD INTOLERANCE AFFECT MY CHILD’S WEIGHT?

Yes, food intolerance can potentially contribute to a child’s low weight if it leads to inadequate food intake or nutrient absorption. For example, lactose intolerance may necessitate restricting certain dairy products, which could impact a child’s overall nutrient intake if suitable alternatives are not provided.

It’s crucial to ensure that any foods omitted from a child’s diet due to intolerance are replaced with suitable alternatives to prevent nutritional deficiencies. Unfortunately, many children may not receive proper guidance on how to replace missing nutrients when certain foods are eliminated from their diets.

Consulting with a Pediatric Dietitian can provide tailored dietary advice to ensure that your child receives all the necessary nutrients for growth and development, even in the presence of food intolerances. A dietitian can help identify suitable alternatives and ensure that the child’s diet remains balanced and nutritious.

 

CAN CONSTIPATION CONTRIBUTE TO POOR APPETITE?

Yes, constipation can contribute to poor appetite in children because they may feel full or uncomfortable, leading to a decreased desire to eat.

To help alleviate constipation and improve appetite, you can incorporate the following strategies:

  1. Offer fruits and vegetables at least five times a day. These foods are rich in fiber, which can aid digestion and alleviate constipation.
  2. Ensure your child drinks at least eight glasses of water each day, and even more in warmer weather. Staying hydrated can help soften stool and promote regular bowel movements.
  3. Replace white versions of breakfast cereals, pasta, rice, and bread with wholemeal or wholegrain versions. Whole grains are higher in fiber, which can help regulate bowel movements and prevent constipation.

Implementing these dietary changes can help manage constipation and promote a healthy appetite in children. Additionally, I have another blog on managing constipation, you can read here.

 

FOODS TO GAIN WEIGHTĀ 

Parents and caregivers often ask: “How can I help my underweight child gain weight with calorie-dense foods?” orā€œHow many calories should my children be eating?ā€.

They are usually struggling with knowing which foods to feed their child to help them gain weight.

Every Bite CountĀ 

Every bite of food and every gulp of liquid can make a contribution to your childā€™s ability to gain weight and grow.Ā Offer foods high in calories and rich in nutrients at every meal and snack.

Make some simple switches to double up their energy intake without making them eat more.Ā 

THE RIGHT WAY TO INCREASE CALORIESĀ 

In Malaysia, it’s easy to find highly processed sugary snacks, many are packed with empty calories lacking in essential nutrients like protein, fiber, vitamins, and minerals.

When aiming to increase your child’s calorie intake, it’s crucial to prioritize nutrient-rich foods. Here’s what to look for:

1. High Protein

Protein plays a crucial role in supporting growth hormone levels and may aid in increasing height and weight, especially in children who are extremely picky eaters or experiencing stunted growth. Complete protein sources contain all the essential amino acids necessary for child growth. These include:

  1. Lean meats
  2. Poultry
  3. Fish
  4. Eggs
  5. Milk
  6. Cheese
  7. Yogurt
  8. Soybeans
  9. Quinoa

However, even if a protein source is incomplete, you can still combine different sources strategically throughout the day to ensure your child receives all the necessary amino acids.

Here are some examples of high-calorie protein sources:

  1. Eggs
  2. Greek yogurt
  3. Cottage cheese
  4. Meat, poultry, and fish
  5. Tofu
  6. Beans and other legumes
  7. Hemp seeds
  8. Nutritional yeast
  9. Protein powders (which may be beneficial in some cases, but it’s important to choose high-quality brands)

 

2. Healthy Fats

Healthy fats are essential for providing concentrated calories, supporting brain function, and aiding in the absorption of fat-soluble vitamins like A, D, E, and K. Including a good source of healthy fats in each meal is ideal for overall health. Here are some examples of healthy fats:

  1. Avocado
  2. Coconut, coconut oil, and coconut milk
  3. Olive oil
  4. Full-fat dairy products such as cheese, milk, yogurt, and kefir
  5. Fatty fish like salmon, tuna, sardines, and mackerel
  6. Nut and seed butters (great for adding to smoothies)
  7. Chia seeds and flaxseeds
  8. Tahini and sesame seeds
  9. Butter and ghee
  10. Good quality mayonnaise

 

3. Iron

Itā€™s well known that iron deficiency leads to a failure to grow at normal rates, and with the high rates of iron deficiency even in Malaysia, focusing on iron (and vitamin C for absorption) is critical for underweight/short stature children.

Examples of high calorie iron rich foods include:

  • Beef
  • Chicken
  • Fortified Oats
  • Beans and lentils
  • Tofu
  • Dried apricots

 

4. Calcium and Vitamin D

Calcium and Vitamin D are vital for bone growth, especially in growing children. Ensuring an adequate intake of calcium is particularly important for vegan children to support their overall health and growth. Here are some high-calorie sources of calcium and Vitamin D:

  1. Full-fat yogurt
  2. Full-fat cheese
  3. Salmon, rainbow trout, sardines (also rich in Vitamin D)
  4. White beans
  5. Soybeans (edamame)
  6. Egg yolks

 

5. High Fibre

In addition to these sources, quick forms of calories from high fibre starchy fruits and vegetables are essential for providing energy from unprocessed foods in your child’s diet. Some examples include:

  1. Sweet potato
  2. Potato
  3. Winter squash
  4. Banana
  5. Grapes
  6. Pineapple
  7. Goji berries
  8. Raisins, prunes, dates

SOMETHING TO KEEP IN MINDĀ 

Here are some tips to effectively increase your child’s calorie intake:

1. Customize Meals

Prepare meals with added calories specifically for your child without altering the entire family’s diet. For instance, add extra oil or butter to one serving of pasta, spread more nut butter on your childā€™s bread, serve whole milk with meals, or mix in additional cream and maple syrup to oatmeal.

2. Opt for Individual Servings

Purchase smaller packages and individual servings of foods to minimize waste while experimenting with different options.

3. Consider Portion Size

Recognize that young children have smaller stomachs and may not be able to consume large volumes of food. Choose foods from above that offer higher calorie in smaller portions.

For example, while hummus provides 25 calories per tablespoon, cream cheese offers 50 calories per tablespoon, and peanut butter provides 100 calories per tablespoon. If your child consumes small amounts, opt for calorie-dense options like cream cheese or peanut butter when serving with toast.

4. Maintain Balance

Ensure a balanced diet by incorporating high-calorie foods (that your child actually enjoy) alongside nutritious options. For example, if your family is having grilled chicken for dinner, pair it with high-calorie side dishes like sweet potato fries and steamed broccoli. Then, add extra butter to the portions for the child who requires additional calories.

 

ACTIVE LIFEĀ 

Give your child more time to be active. Being active can make children hungrier for meals and snacks. Limit screen time, like watching TV and using other electronics. Read this post to learn how to increase physical activity level of your child.

 

BLUR PIC

I’ve also got another free FOODS TO GAIN WEIGHT guide you can use for your children to get you started so you can start feeling better about every bite your child takes.

BOTTOM LINEĀ 

If you’re concerned about your child’s weight but they haven’t been diagnosed as underweight, it is important to discuss your concerns with their pediatrician. The pediatrician can review their growth history and determine if further evaluation or dietary adjustments are necessary.

Remember, the need for high calorie nutritious foods may be short term, and it’s essential to prioritise your child’s overall health and well-being. While it’s important for your child to eat, at the same time not to turn mealtime into a battle or power struggle. Creating a positive eating environment can help promote healthy eating habits in the long run.

If youā€™re struggling to put weight on your child or worried about their nutrition, consider seeking guidance from a pediatric dietitian. A dietitian can work with you to develop a tailored plain to meet your child’s nutritional needs and ensure they are receiving the necessary nutrients for growth and development. Ultimately, the goal is to have a healthy, happy, and confident child.

Are you worried about your thin child? Are you thinking that you might want some one-on-one nutrition counselling, either for you, or your baby or child? Check out my one-on-one nutrition counselling services here.Ā 

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Special Diets for Children with Autism Spectrum Disorders – Part 2

by with One Comment Child & Family NutritionPicky Eating

There is no cure for Autism Spectrum Disorder (ASD); the ideal treatment includes educational and behavioral interventionsĀ that meet the specific needs of the child. Because autism is incurable, many parents seek alternative therapies, including specialized diets. Although research is limited and results vary, several diet strategies have been suggested as possible treatments for ASD.

One of the most popular diets eliminates gluten (a protein found in most grains, including wheat) as well as casein (a milk protein). Other dietary interventions include restricting food additives; including probiotics in the diet; following a yeast-free diet; and supplementing the diet with vitamins and minerals.

The amount of information available via internet, books, parent network and other organizations to parents of children with ASD, can be overwhelming and often contradictory.

SPECIAL DIETS

There are many diets parents say work for their children to improve health, behaviour, attention, sleep and reduce ASD symptoms. Although some of these diets are a popular treatment for ASD but there is a lack of consistent and good quality scientific evidence to support their recommendation as a treatment for ASD symptoms.

All diets have something in common – unprocessed foods. Feeding your special needs child a healthy and balanced diet help with therapy results and behaviour. Let’s take a look at these diets.

GLUTEN FREE CASEIN FREE (GFCF) DIET

The most commonly tried and the most studied diet is the Gluten Free Casein Free (GFCF) Diet.Ā Gluten is a type of protein found in wheat, rye and barley. Casein is a protein found in milk.

Picture source: Examine.com

It has been suggested that people with ASD have a “leaky gut”. The poorly digested casein and gluten leak into the bloodstream where these “opoid-like” proteins interfere with the normal functioning of the nervous system, affecting mental function and behaviour. Therefore, it is proposed that by eliminating foods containing gluten and casein from the diet, autistic behaviours may be reduced.

How To

Prior to starting a gluten free diet, it is important to test for Celiac Disease especially if the child exhibits any potential signs or has first degree relatives with Celiac or other auto-immune disorders. The reason this is suggested is that gluten needs to be consumed for the test for Celiac to be accurate and in case the family chooses to stay on the diet, it is important to test first.

Also, prior to starting the diet, the family requires education regarding foods to avoid, foods to eat and hidden sources of gluten and casein.

It is really important to not just focus on what not to eat, but to explore what the child can eat.Ā 

There are many expensive gluten free products available but there are also many foods that are NATURALLY gluten free and less costly then the specialty products.

It is helpful to eliminate gluten or casein one at a time so that you can assess the effects of each protein. Normally, casein is easier to remove from the diet first.Ā 

Evidence

GFCF diets can increase the challenge of ensuring adequate nutrition. Some studies indicate that these diets may be effective for certain children, controlled scientific studies have not proven this to be true so more research is needed.

FEINGOLD DIET (PROGRAM)Ā 

This dietĀ is food elimination program developed by Ben F. Feingold M.D. This diet is created for individual who has behaviour disorders, such as hyperactivity, learning problems, and attention deficit disorder (ADD). It removes all synthetic colourings and flavourings, certain preservatives (BHT, BHA and TBHQ) and salicylates from the diet (Check out the list).

SYNTHETIC (ARTIFICIAL) COLORS & FOOD DYES

Nearly all food dyes (Blue 1 and 2, Green 3, Red 3, Red 40, and Yellow 5 and 6, Citrus Red 2) found in modern food, medicine, toothpaste, beverages, vitamins, cosmetics are synthetic. They are made from petroleum.

A dye which is listed as “FD&C” is permitted by the Food & Drug Administration (FDA) to be added to foods, drugs, and cosmetics.Ā 

A randomized, double-blinded, placebo-controlled trial was conducted at Southampton University in England. They found a link to food dyes and hyperactive behavior in children. The research does not prove that food colorings actually cause ADHD behaviors but there does seem to be a link.

SYNTHETIC (ARTIFICIAL) FLAVOURING

Used as low-cost substitutes for natural flavourings.Ā An artificial flavoring may be composed of hundreds of separate chemicals whichĀ are not usually listed individually, there is no restriction on what a company can use to flavor food. You may see them listed as “flavouring”, “artificial flavouring”, “butter favouring” .

Artificial flavorings are combinations of many chemicals, both natural and synthetic. Ā 

ā€œVanillinā€ (sometimes listed as ā€œvanilla flavoringā€) is very common artificial flavoring that causes problems for many people. ā€œNatural flavoringā€ does not always mean ā€œall-natural flavoringā€ – it depends on the brand.

The only vanilla accepted for the Feingold Programā€™sĀ FoodlistĀ  is vanilla that actually came from a vanilla bean.

Most flavorings have simply never been studied forĀ ā€œside effectsā€ relating to human health, and none hasĀ ever been studied for neurotoxicity.

Of course, out of the thousands of artificial flavoringsĀ commonly used, some are surely perfectly safe;Ā however, nobody knows which ones they are ā€“ andĀ even if we knew, we still would not know which onesĀ were in what food products. Therefore, the FeingoldĀ Program must simply eliminate all of them.

ARTIFICIAL PRESERVATIVES

Preservatives are used primarily to prevent fats and shortening from becoming rancid.Ā  They allow foods to have a longer shelf-life.Ā  Most preservatives are not believed to be a health hazard, but the three petroleum-based preservatives that are eliminated by the Feingold Diet have been found to trigger behavior and health problems:

  • BHA (Butylated Hydroxyanisole, E320)
  • BHT (Butylated Hydroxytoluene, E131)
  • TBHQ (Tertiary Butylhydroquinone, E319).Ā 

While the avoidance of particular additives is very common, there has been little good quality research on the affect of food additives on people with ASD.

ARTIFICIAL SWEETENERS

Aspartame, acesulfame-K, neotame, and saccharin have been known to cause headaches, mood changes, nausea, vomiting, and diarrhea in the general population (here).

SALICYLATESĀ 

Salicylates are a family of plant substances found naturally in a variety of fruits, vegetables, nuts, herbs, jams and juices. Also, these chemical compounds are similar to aspirin.Ā Salicylates may be elevated in produce that is picked early and shipped long distances and in concentrated foods such as tomato sauce, ketchup or fruit juices.

Foods high in salicylates include almonds, apples, apricots, avocados, berries, broccoli, cherries, citrus fruits, cloves, coffee, cucumbers, dried fruits, grapes, kiwis, nectarines, olive oil, peaches, peppers, pickles, pineapple, plums, prunes, raisins, rose hips, strawberries, tea and tomatoes.

How To

Current recommendations of the Feingold diet would recommend a two-stage plan. Stage One lasts 4 weeks, and eliminates the above-listed ingredients, plus natural salicylates (including aspirin products). After a person has been successfully on this Stage One diet for 4-6 weeks, the food containing natural salicylates are added back in carefully to to test for tolerance. The effects of natural salicylates are dose-dependent. Some people find they need to remind on Stage One, while others are able to tolerate some salicylate-containing items occasionally, and still others can eat them freely. The artificial colors, flavours, preservatives, and sweeteners listed above are not re-introduced.

Evidence

The Feingold diet can involve significant inconvenience and cost, as well as significant limitations on what child can eat.Ā At this time no rigorous randomized trials have been conducted to evaluate the efficacy of the Feingold diet for easing the symptoms of ASD.

YEAST FREE DIETĀ 

It is believed that a “leaky gut” in people with ASD, may be caused by an overgrowth of yeasts (Candida) in the gut, resulting in symptoms such as fatigue, headache, mood swings, sinus, congestion, depression, poor memory and concentration and cravings for sweets. Excess yeast in the gut is thought to penetrate the intestine wall, causing yeast and other unwanted particles to be absorbed into the body. The absorbed yeast particles are thought to active the immune system, resulting in an allergic hypersensitivity to Candida.

How To

Yeast live and feed on sugar. Therefore, the diet requires to avoid all foods that contain any type of yeast, and foods that break down into simple sugars.

Evidence

Yeast overgrowth in the gut is usually treated by prescribed medications and there is no evidence that eating less dietary sources of yeasts helps.

SPECIFIC CARBOHYDRATES DIET (SCD)Ā 

The Specific Carbohydrate Diet (SCD) helps children with autism who may be experiencing difficulty with digestion or malabsorption in the intestine resulting in GI issues. SCD starts to help and restore balance in the intestines by eliminating complex carbohydrates the the body has difficulty breaking down, which causes an overgrowth bacteria. The bacteria in the intestines feed off the complex carbohydrates creating more bacteria, which SCG refers to as the vicious cycle.

How To

This is not a “low carb diet” or “Paleo Diet”. The diet eliminates foods that contain complex carbohydrates (rice and potatoes), and replaces with simple carbohydrates (banana, and squashes). The diet will continue to keep the body well feed but starve the microbial flora. The SCD also encourages the use of fermented foods, especially homemade yogurt, and probiotics. The consumption of fermented foods and probiotics replaces the starving microflora with beneficial bacteria. Given enough time, the diet changes the nature of the microbial flora and gives the body the nutrients and environment needed to heal.

Evidence

The SCD is a very strict, complex and restrictive diet which requires an individual to prepare foods on his own. More scientific studies are needed for people with ASD.

ResourcesĀ 

SUPPLEMENTATIONĀ 

People with autism may have abnormal or impaired metabolic or biochemical processes and high doses of vitamins or minerals may be needed to correct for this (here) . Also, children with autism are selective eaters and supplement use may just by improving overall nutrient intake.

The treatment may provide “benefit” but may not be “treating” the autism.

There are numerous dietary supplements which have been suggested as possible treatments for people with ASD including Vitamin B6, Folic Acid, Vitamin B12, Vitamin C, Vitamin D, Magnesium, Omega-3 fatty acids,Ā Probiotics andĀ Digestive Enzyme.Ā 

BOTTOM LINEĀ 

More research is needed to support a link between autism symptoms and nutrition.Ā If you are considering a supplement or a special diet, speak with your childā€™s doctor or a Registered Dietitian first. They can help you make the right choice and lower the risk of possible side effects or nutrient deficiencies.

Keep in mind that restrictive diets require careful planning to make sure your child’s nutrition needs are being met.

If you enjoyed this post,Ā you may alsoĀ also be interested in learning about Nutrition Concerns for ASD, check out myĀ last blog post. Ā 

Disclaimer:

The above information is not meant to diagnose or treat and should not take the place of personal consultation, as appropriate, with a qualified healthcare professional.Ā 

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Nutrition Concerns for Children with Autism Spectrum Disorders – Part 1

by with 2 Comments Child & Family NutritionPicky Eating

Autism Spectrum Disorder (ASD) is a complex developmental and neurological condition that typically appears during the first three years of life. ASD includes:

  • AutismĀ č‡Ŗ闭ē—‡
  • Asperger SyndromeĀ é˜æę–Æä¼Æę ¼ē»¼åˆē—‡
  • Pervasive Developmental Disorders (PDD) å¹æę³›ę€§å‘č‚²éšœē¢
  • Rettā€™s disorderĀ é›·ē‰¹ę°ē—‡
  • Childhood Disintegrative Disorder (CDD)Ā å„æē«„ęœŸå“©č§£ē—‡ orĀ Heller syndromeĀ ęµ·å‹’ē—‡å€™ē¾¤

People with ASD have trouble with social interaction and communication. They may also have unusual interests, activities, and behaviours. (CDC).

It is about four times more common in boys than in girls.

PREVALENCE

According to the Centres for Disease Control Prevention, one in every 59 children in United States is diagnosed with autism.Ā In Malaysia, there is no official registry for the number of individuals diagnosed with autism. The only statistics which shed some light into the occurrence of autism in Malaysia is a local survey conducted in 2008 which revealed that autism affects one in 625 children.

SIGNS & SYMPTOMS

  • Trouble communicating with people include delayed talking
  • Trouble interacting with people including not wanting to be held or cuddled and poor eye contact
  • Behaviour that is different than other people
  • Lack of interest in playing with other children
  • Lack of interest in food or uncommon food preferences
  • Trouble with motor skills including picking up small objects, catching a ball and riding a bike

Autism affects each person differently and can range from mild to severe.

DIAGNOSIS

There is no medical test, like a blood test, to diagnose the disorders.Ā A medical diagnosis of ASD is most frequently made by a Family Physician, Developmental Pediatricians,Ā Child Neurologists,Ā Child Psychologists or Psychiatrists. (CDC).

ASD can sometimes be detected at 18 months or younger. By age 2, a diagnosis by an experienced professional can be considered very reliable (here).Ā Ā However, many children do not receive a final diagnosis until much older. This delay means that children with ASD might not get the early help they need.

CAUSES & RISK FACTORS

There is no known cause for ASD, but both genetics (here) and environment are believed to play a role, such as advanced parental age (here), medications during pregnancy (here, here), parental obesity (here) and environmental pollutants (here).

TREATMENT

There is no known cure for autism. Treatment is based on individual, such asĀ early intervention, physiotherapy, speech therapy, occupational therpy, behavioural therapy, toĀ help individuals cope with their symptoms.

Behaviour modification needs to be tailored to each individual child and family situation.

NUTRITION CONCERNS

Child with ASD often repeat behaviors and have narrow, obsessive interests. These types of behavior can affect eating habits and food choices, which can lead to the following health concerns.

  • Social impairment. It may limit a child’s ability to learn eat through modeling. The child may not be motivated by eating with peers or family members.
  • Restrictive, repetitive andĀ rigid behaviours. TheĀ child may have difficulty accepting new foods due toĀ sensitive to the taste, smell, color, texture, temperature and packaging of foods. They may limit or totally avoid some foods and even whole food groups. Rigidity may also lead to an insistence on sameness in food, including the presentation of food, utensil use, brand and location where to eat.Ā Common dislikes include fruits, vegetables and slippery, soft foods; prefer crispy and crunchy foods (potato chips, French fries, crackers).
  • Not eating enough food. The child may have difficulty focusing on one task for an extended period of time. It may be hard for a child to sit down and eat a meal from start to finish. Allergies or intolerances appear to be more common in children with autism and can decrease overall food intake.
  • Constipation.Ā This problem usually is caused by a child’s diet low in fibre and high in processed foods, abnormal function of GI tract and sensory response (withholding due to discomfort with the sensation of defecation).
  • Medication interactions. Some stimulant medications used with autism, such as Ritalin, lower appetite. This can reduce the amount of food a child eats, which can affect growth. Other medications may increase appetite or affect the absorption of certain vitamins and minerals. If your child takes medication, ask your healthcare provider about possible side effects.

STRATEGIES FOR DEALING WITH SELECTIVE EATING

Because children with ASD often have restricted diets as well as difficulty sitting through meal times, they may not be getting all the nutrients they need, particularly iron, calcium and protein. Here are some nutrition strategies that you can use to help make feeding a little easier. These strategies may help in the slow and steady process of improving feeding issues.

1. Be Prepared for Pickiness

Many parents find their child’s sensitivity to tastes, colors, smells and textures the biggest barriers to a balanced diet. Getting your child to try new foods ā€” especially those that are soft and slippery ā€” may seem nearly impossible. You may find that your child avoids certain foods or even entire food groups.

  • Get your child involved. Have your child visit the supermarket with you to choose a new food. When you get home, research it together on the internet to learn about where it grows. Then, decide together how to prepare it. When you are done, don’t worry if your child doesn’t want to eat it. Simply becoming familiar with new foods in a low-pressure, positive way eventually can help your child become a more flexible eater.
  • Avoid snaking all day. This decreases appetite, willingness to try new foods, and the number of total calories taken for the day.
  • Limit mealtime. Limit mealtimes and snacks to 15-30 minutes.
  • Use the rule of 3.Ā Work to broaden the variety of a child’s diet expanding on already accepted food groups. A good rule of thumb is to only offer three foods at a time. Include one to two foods your child already likes and one food your child does not yet like. If your child will not tolerate the new food on his or her plate, place the new food near him or her on a separate plate to help get your child used to the new food.
  • Food presentation. Present new foods in small bites and in fun, creative or familiar ways to make it more likely that your child will eat it.Ā 
  • Reward positive behaviours. Offer praise when your child approaches or tries new foods. Immediate rewards, such as a sticker, can be helpful to encourage new feeding behaviors. Remember that rewarding good mealtime behaviors will increase the likelihood that they will happen again.
  • Ignore Negative Behaviors. When possible, ignore your child when he or she is doing things such as spitting, throwing or refusing food. Remember, you donā€™t want to encourage these behaviors by paying attention to them.Ā 

2. Make Mealtimes Routine

A child with ASD will have to work harder at mealtimes because a busy kitchen, bright lights and even the way the furniture/utensil is arranged all are potential stressors.

  • Set a feeding schedule and routine.Ā Serving meals at the same time and same place every day is one of the simplest ways to reduce stress. You can use visual timetables and visual schedules. Written timetables or picture symbol schedules detailing when and where they will eat, what will be eaten and the type of behaviour expected at meal times makes mealtimes more predictable and a less anxious occasion for the child.
  • Provide comfortable and supportive seating. Place your child in a high chair or booster seat that he or she is ale to sit upright without leaning or dangling his or her feet. This physical stability promotes good feeding behaviours and reduces distracting behaviours by allowing them to feel “grounded” and safe.
  • Remove all distractions.Ā Distractions such as the TV or iPad which can take the focus off the food and the task at hand. Feed your child only when he or she is alert and attentive.Ā If your child is sensitive to lights, try dining by candlelight.

3. Regular Bowel Movement

Traditionally, a high-fiber and fluid diet, as well as regular physical activity are recommended to treat constipation but this is not always an effective recommendations. Making a dietary change is a long process but is necessary. First is to make it safe and comfortable for the child to have bowel movement.

  • Stool softeners or lubricants may be used to reduce the potential of pain with defecation.
  • Regular bathroom routine are needed to reduce anxiety and facilitate normal bowel movement.

BOTTOM LINE

Caring for a child with ASD can be challenging on many levels, and healthy eating is no exception. For children with ASD, a nutritious, balanced diet can make a world of difference in their ability to learn, how they manage their emotions and how they process information.

Changes in dietary intake will be a slow process and not all strategies will work for each child.Ā 

A Dietitian can identify any nutritional risks based on how your child eats, answer your questions about diet therapies andĀ help guide your child on how to eat well and live healthfully.

AUTISM RESOURCES IN MALAYSIAĀ 

The National Autism Society of Malaysia (Nasom).

Autism Behavioral Center

Early Autism Project MalaysiaĀ 

If you enjoyed this post, you may alsoĀ be interested in learning about Special Diet for Autism. Ā 

Disclaimer:

The above information is not meant to diagnose or treat and should not take the place of personal consultation, as appropriate, with a qualified healthcare professional.Ā 

understanding-lactose-intolerance-photo

Understanding Lactose Intolerance

by with No Comment Child & Family NutritionDigestive HealthInfant NutritionToddler Nutrition

WHAT IS LACTOSE?Ā 

Lactose is is a naturally occurring sugar found in milk and other dairy products (yogurt, cheese and ice cream). When you consume food or drinks containing lactose, an enzyme named lactaseĀ in the small bowel will break down lactose into two simple sugars: glucose and galactose. These nutrients are then absorbed in the small intestine.

Image source: http://www.evo-ed.org/Pages/Lactase/cellbio.html

WHAT IS LACTOSE INTOLERANCE?Ā 

However, some people might produce less lactase than the others. If the small bowel has insufficient lactase, the lactose consumed will not be digested properly and will continue through to the large bowel. Lactose in the large bowel will be fermented by the gut bacteria, which produces gases including hydrogen, carbon dioxide and methane. This gas production not only can lead to unpleasant gastro-intestinal symptoms such as distention, bloating, flatulence and constipation but can also draw water into the large bowel resulting in loose stools or diarrhea.

Some people may have a temporary lactose intolerance due to Ā viral infection like the stomach bug, while others can experience it when they have a digestive disorder like celiac disease. Still others may experience lactose intolerance their entire lives.

SYMPTOMS Ā 

  • bloating
  • abdominal pain due to gas
  • tummy cramps
  • nausea
  • loose stool orĀ diarrhea

If you are lactose intolerant, the symptoms may vary and are dose-dependent. That is, the more lactose you consume, the worse the symptoms become. Symptoms may occur immediately after drinking milk or eating dairy products, or they may be delayed for hours.

Lactose intolerance is NOT an allergy to milk.Ā 

DIAGNOSISĀ 

To diagnose lactose intolerance, the hydrogen breath test is a simple, non-invasive and reliable investigation test.Ā Lactose intolerance is indicated when hydrogen and methane levels of breath meet a certain criteria following the oral consumption of standard dose of lactose.

Another simple way to diagnose lactose intolerance is an elimination diet which involves removing lactose in the diet and assessing whether symptoms improve, followed by a re-introduction of lactose in the diet to assess whether symptoms return.

WHAT FOODS CONTAIN LACTOSE?Ā 

Read the ingredient list on product labels to find out if the product contains a lactose-cotaining food. Food items to look out for include: milk, milk solids, malted milk, buttermilk, curds, cheese flavours, non-fat milk powder, non-fat milk solids, sweet or sour cream, lactose, whey and yogurt.

Note: 1) the cultures in yogurt help to digest lactose 2)Products that contain lactic acid, lactalbumin, lactate and casein do not contain lactose.Ā 

IF YOU ARE LACTOSE INTOLERANT, SHOULD ALL DAIRY PRODUCTS BE AVOIDED?Ā 

Yes, you will need to modify the diet in order to alleviate the discomfort and symptoms at the beginning. The first step is to remove all sources of lactose in the diet that can cause problematic symptoms, including milk and dairy products.

The second step is to find nutritious substitutions for those items you’re removing:

Note: 1)”Lactose free” means that there is no detectable lactose in the food. 2)”Lactose-reduced” means that at least 25% of the lactose in the product has been removed.

Recent research has suggested that most people with lactose intolerance can consume up to 12 to 15g of lactose without any symptoms. You can still tolerate some foods that contain lactose like yogurt or cheese, even if you are lactose intolerant.

OTHER TIPS ABOUT INCLUDING LACTOSE IN YOU AND YOUR CHILD’S DIET:Ā 

  • Drink milk in smaller quantities. Most people with lactose intolerance can tolerate 1/2 cup milk at a time.
  • Eat small amounts of lactose-containing foods spaced throughout the day.
  • Eat with other solid foods may delay digestion, offering more time for the lactase enzyme to break down lactose.
  • Yogurt may also be tolerated (plain better than flavoured), because the live bacteria in the yogurt partially digests the lactose before consumption. Yogurt is also a semisolid, which moves slowly through the digestive tract.
  • Aged cheese tend to have lower lactose content.
  • Try lactase enzyme drops or tablets from the pharmacy.Ā Tablets are taken before eating foods that have lactose. Enzyme drops can be added to milk before drinking.
  • Soy products do not contain any lactose and can be a suitable substitute for dairy products, providing they have calcium added.

Do you have a child with lactose intolerance? How are you managing?Ā Did you know that I provide one-on-one nutrition counselling service for children and families? If you are diagnosed with lactose intolerance, I can help to ensure you are not missing out on important nutrients such as Calcium. This isĀ particularly important for children. If this is something youā€™d like to learn more about, check out here.Ā 

a-parents-guide-to-physical-activity-for-kids-photo

A Parent’s Guide to Physical Activity for Kids

by with No Comment Child & Family NutritionToddler Nutrition

Physical activity has many benefits for children. Being active is important to help kids grow and develop. Did you know? Physical activity can also help children:

  • Lower the risk of childhood overweight and obesity
  • Promote fitness and bone health
  • Increase self esteem and social skills
  • Increase concentration, help improve academic performance in school
  • Improve sleep
  • Promote heart health and lower the risk for heart disease and Type II diabetes

Even though increasing physical activity can seem like a challenge, the benefits are worth it! Read on to learn more about physical activity and get tips on how to encourage your children to get active.

Habits formed early can last a lifetime.Ā 

HOW MUCH PHYSICAL ACTIVITY DO CHILDREN NEED?Ā 

Children and youth need a total of at least 60 minutesĀ of moderate to vigorous physical activity per day. The 60 minutes doesnā€™t need to be done all at once to see health benefits. Any activity done for 10 minutes or more can count towards the total of 60 minutes per day.

  • Moderate aerobic activities make you sweat a little and breathe harder.
  • Vigorous aerobic activities make you sweat a lot and be out of breath.
  • Strengthening activities that build muscles and bones.

Three days a week should include activities that strengthen muscles and bones like sit ups, jumping and swinging on playground swings and bars. Vigorous activities such as running, swimming and biking should also be included at least 3 days per week.

HOW CAN I GET MY CHILDREN MORE ACTIVE?Ā 

Here are some budget-friendly ideas to get the kids up and moving:

  • Play outside!

Encourage your kids to play outside before homework time and dinner.

Any activity is better than no activity. But more is even better!

The longer the kids are active the better! Encourage them to play tag, hide and seek, jump in the leaves or build a castle in a sandbox.Ā Arrange an outdoor treasure hunt, search for bugs and rocks. My toddler love going for a family bike ride. Head to different areas to discover new neighbourhoods and trails.

Bike Riding
  • Walk, run or skip!

Go for a walk after dinner or head to the neighbourhood park before starting bedtime routines. This is also a good time for older children and teens to be active before working on homework. A little running around can help them think clearer and be more efficient when doing their homework.

Evening walk
  • Join a program that includes regular physical activity

Check your community or childā€™s school for programs near youĀ like dance, taekwondo, karate, basketball, volleyball, indoor soccer, swimming lessons, yoga, gymnastics, trampoline, orĀ figure skating.

Swimming
  • Let’s Dance!

Dancing is popular for both boys and girls. Turn on your favourite music and dance! There are many different kinds of dancing; find one that is right for you. A few examples are hip hop, belly dancing, tap, jazz and salsa. My favourite is Zumba. Many cultures are famous for their styles of dances. Experience a dance from across the globe!

BOTTOM LINE

Physical activity can be easy and fun. Be a role model and get active with your children so that the whole family will benefit.

If you would like to take advantages of more tips, resources and advice on nutrition for children, check out my service.Ā 

The Important of Family Meals

The Important of Family Meals

by with No Comment Child & Family NutritionPicky EatingToddler Nutrition

We are busy! Itā€™s challenging to find time to eat meals with friends and family. But, itā€™s important to share meals, becauseĀ it opens dialogue, connects people and helps us eat a more balanced diet. Itā€™s an enriching experience for people of all ages to share meals — from children to older adult.

WHY SHARE MEALS WITH OTHERS?

The biggest barriers to eating together are busy schedules like work and evening activities. It takes creativity to balance busy schedules, but itā€™s worth the effort because everyone benefits when you eat in the company of others!

  • Children who eat with their family have more nutritious diets, better academic performance, a lower risk for being overweight and less risk of eating disorders. Plus, children tend to have increased intake of vegetables and fruit, and a decreased intake of sugar-sweetened beverages.
  • Teens who share family meals get better grades, and are less likely to smoke, use drugs or alcohol, or to participate in serious fights.
  • Adults who eat with friends and family tend to eat more vegetables and fruits, drink less pop, eat fewer meals at fast food restaurants, and have lower body mass indexes.
  • Older adults who eat as part of a group have better diets, improved nutrient intake and lower rates of malnutrition.
  • People who come together in communities can eat together at community kitchens, where they learn to cook, share meals, try new foods, have fun and learn about nutrition.

START A CONVERSATION

For many people, sharing meals is a favourite time of day to interact with family and friends. It allows people to connect share traditions, learn, communicate and listen. If you are new to family meals, here are some Doā€™s and donā€™ts:

  1. DO give everyone at the table a chance to speak.
  2. DONā€™T use it as a time to scold or discipline picky eaters.
  3. DO ask questions that require more than a ā€œyesā€ or ā€œnoā€ answer. So, instead of ā€œdid you have a good day?ā€ try asking ā€œtell me something interesting that happened today.ā€

Grab your FREE Mealtimes Conversation Starters listĀ  HERE .

BOTTOM LINE

Sharing family meals doesnā€™t only mean dinner! If your evening schedule is hectic, share breakfast meals or have brunch together on the weekends. Most studies done on the benefits of family meals start with sharing at least four meals together per week. So, they all count!

Let’s enjoy the benefits of bringing families and friends together with food. How often do you have family dinner and how do you make it successful?

Adapted from the Dietitians of Canadaā€™s Nutrition Month campaign materials.Ā 

Teaching Children to Cook

Teaching Children to Cook

by with No Comment Child & Family NutritionPicky EatingToddler Nutrition

Starting from a young age, inspiring children to shop, cook and prepare foodĀ can set them up for a lifetime of healthy eating. A great way to teach children about food is to let them SHOP and COOK with you. Yet, a recent Ipsos survey found that 38 per cent of parents rarely or never let their child prepare a meal or snack ā€“ itā€™s a missed opportunity, but it can be easily fixed!

FIVE TIPS FOR COOKING WITH CHILDREN

Itā€™s fun and rewarding to involve children in meal preparation ā€“ whether itā€™s at breakfast, lunch or dinner. Here are five tips for getting your children involved:

  1. Pick a recipe together: Children need to be part of the plan from the beginning, and it helps if they prepare something that they love to eat. Shop for groceries together too!
  2. Incorporate learning: Build on lessons they learn in school, such as math, social studies, media literacy, spelling, science and reading. Younger children can practice fine motor skills.
  3. Keep it fun! Imaginative play helps children get deeply involved. Make a theme night or turn your kitchen into a restaurant or reality cooking show.
  4. Be a role model: If youā€™re excited, they will be too. Try a new food, describe the flavour and be adventurous to inspire your eaters to do the same. Get other members of the family involved.
  5. Be cool about the mess: Spills and accidental messes happen, and itā€™s important to remain calm about little mishaps. Keep kitchen towels handy for cleaning up spills.

Children are much more likely to eat what they make, so cooking at homeĀ is a great tip! If you have picky eaters. Itā€™s fun for them to eat their art creation!

Cooking with children helps reduce mealtime battles and boost their willingness to try new foods. Itā€™s great for their self-confidence too.

WHAT CAN MY CHILD DO?

Hereā€™s a guideline of kitchen skills based on age:

  • 2-3 year olds can wash vegetables and fruit or tear lettuce and salad greens
  • 3-4 year olds can mash potatoes and bananas or mix together batters
  • 4-6 year olds can measure dry and liquid ingredients or set the table
  • 6-8 year olds can toss salad ingredients together or make a simple breakfast
  • 8-12 year olds can make their own school lunch or help to plan meals
  • Teens can follow more complicated recipes or assemble and mix most ingredients. They can also be in charge ofĀ making one meal per week.

Did you teach your children how to shop and cook? Share your fun story.Ā 

Adapted from the Dietitians of Canadaā€™s Nutrition Month campaign materials.Ā 

Top 5 Tips For Staying Cool When Feeding Kids During CNY

Top 5 Tips For Staying Cool When Feeding Kids During Chinese New Year

by with No Comment Child & Family NutritionPicky EatingToddler Nutrition

When I think about Chinese New Year in the past, many of my memories involve food. Cooking with my Mom, buying homemade cookies, preparing deep-fried spring rolls and sipping sugary-sweetened beverages or fake alcoholic drinks.

No matter what your Chinese New Year traditions are, food is always a huge part of the celebration. Thatā€™s why I think itā€™s important to put all weight loss goals on hold, give yourself a break andĀ enjoy holiday foods without feeling guilty. I also think itā€™s important, as parents, to let our children enjoy holiday foods too ā€” without being a food police and monitored our children’s diet for Ā 24/7.

The Chinese New Year, in fact, present a great opportunity for our children to learn about moderation and mindfulness, if we give them the chance.

TOP FIVE TIPS FOR HOW TO MANAGE INDULGENT HOLIDAY FOODS WITH YOUR CHILDRENĀ 

1. Have a healthy breakfastĀ 

If there is one meal that should be non-negotiable, itā€™s breakfast. Children are hungry in the morning, so itā€™s a great opportunity to take advantage of their rumbly tummies and serve your children a balanced meal. We know thatĀ eating breakfastĀ offers a wide range of benefits, but when protein (such as yogurt, milk, nuts, meat, eggs etc.) is included, it can tame the cookie monster later onĀ by helping to control appetite and blood sugar levels. Breakfast is often the only meal that we can rely on timing-wise during the holidays (and even this can be random), so try to maximize nutrition here.

2. Throw your timetable out the windowĀ 

Without completely disregarding the time and allowing a food-free-for-all, try to be flexible when it comes to meal and snack timing during the holidays. Although you should ultimately maintain your role as the feederĀ (deciding what, when and where your child eats), itā€™s ok to relax a little during the holidays and go with the flow. Meals are often served earlier or later than usual, and snacking tends to beĀ moreĀ frequent. When you do have some control over what is served (I focus on breakfast), try to include a nutritious variety of food, with milk or water to drink, and let the rest unfold as it willĀ ā€” holiday eating is random and fun and everyone (including children) should enjoy it.

3. Let your children decideĀ 

At family gatherings, there will be platters of delicious foods that everyone is going to want to try (including your children). If there is a buffet, let your children explore different foods by guiding them through and allowing them to choose what they would like to try (not what you want them to eat). Try not to steer them towardsĀ healthy foods, but instead give them control over what goes on their plate. Allowing themĀ to explore different foods that arenā€™t offered at home on a regular basis will help to widen their palate and give them a sense of independence and confidence when it comes to food. Ā Children will often choose some nutritious foods and some dessert foodsā€“this is ok (and normal)! If you can, wait to visit the dessert table after your child has filled up on mealtime foods (or if you canā€™t avoid it the first round, visit it last). Sweet foods like chocolate, candy and cookies will almost always be gobbled up prior to nutritious mealtime foods, so children are more likely to fill up on them if given the chance.

Encourage balanced eatingĀ and mindfulnessĀ by modelling.Ā Try to include veggies and fruits, lean protein-rich foods and some indulgent delicious foods too. EatĀ slowly and enjoy every bite. Leave foods that you donā€™t love (or that youā€™re too full to eat), behind, and have seconds of foods that you love and are hungry for. Modelling mindful, normal eating (regardless of what time of year), will benefit your child greatly, because they view how you eat as ā€œnormalā€.

4. Don’t restrict treats and sweetsĀ 

The holidays present a great opportunity to teach your children about moderation and handling easy-to-love indulgent foods in a mindful way. After all, there will come a time when theyā€™re exposed to unlimited amounts of theseĀ foods, and you want to prepare them for that. The idea is to raise children who are relaxed around indulgentĀ foods; who make mindful, matter-of-fact decisions about when and how much they indulge (long term). Evidence showsĀ that children who are restricted in their indulgent food intake eat more of them when they get the chance and are more overweight than they might be otherwise!

But how do parentsĀ teach their children about moderation?

Ellyn Satter, who is a leader in the field of child nutrition and feeding (and the master-mind behind the ā€œDivision of Responsibility in Feedingā€œ), suggests includingĀ some savoury, high-fat foods like chips or fries at a meal sometimes (along with nutritious foods), and if dessert is offered, including a small servingĀ for everyone who wants it (allowing everyone to decide when toĀ eat itā€“before, during or after a meal). The reason she suggestsĀ limiting desserts to one serving at a meal is because children will take the easy way out and fill up on dessert otherwise. To counteract this scarcity created at mealtime however, Satter suggests periodicallyĀ letting kids have unlimited access toĀ sweetsĀ at aĀ sit-downĀ snack time, where theyĀ arenā€™t competing with other mealtime foods. For example, putting out a plate of cookies and a glass of milk, and letting your children eat as much as theyā€™d like. When children feel that treats are limited or forbidden, theyā€™re more likely to go crazy on them. And snack time presents a good opportunity to let them have unlimited access (periodically), and naturally learn about moderation.

Itā€™s true, children will often go crazy at first (which is normal),Ā but the novelty will wear off and they will tend to eat less and less. Try doing this not only during the holidays, but throughout the rest of the year too. Satter suggests offeringĀ nutritious sweets when you can, such as oatmeal cookies or banana bread, which will make it easier for you to trust the process!

5. Focus on family time, not food

Instead of fighting with your children to sit down to the table to eat dinner, let them know that they donā€™t have to eat if they donā€™t want to (after all, they have likely filled up on yummy snacks all afternoon with their siblings, friends or cousins) but that they do need to sit down at the table with everyone to visit, laugh and catch up. When you take the pressure off of children to eat, they are often more open to trying foods and being less ā€œpickyā€ with their choices. You may be surprised at how much your children end up eating, and even if they donā€™t, itā€™s OK. You will enjoy yourself so much more if you resist telling them to have ā€œthree more bitesā€ and focus instead on creating happy holiday memories.

Happy holidays from my family to yours!

If you enjoy this post,Ā you might also interested in reading aboutĀ how to get your kids back into routine after Chinese New Year.Ā 

how-to-deal-with-halloween-candies-photo

How to Deal with Halloween Candies

by with No Comment Child & Family NutritionPicky EatingToddler Nutrition

Halloween is here! As parents most of us will have to face that large pillow-sack full of treats or candies that makes its way onto our kitchen table or living room floor, whether it is this year or in years to come. The question is, how will you deal with it as a parent? Do you let your children have a candy free-for-all so that it disappears quicker, or do you allow only one or two treats per day so that it lasts until Christmas? Do you make it disappear in other ways like by getting your children to trade it in for non-candy alternatives or donating it?

Last year, my son was young enough that he didn’t really know what’s going on. He hadn’t quite reached the stage where candy was the main attraction for Halloween. He was excited to get into his “Superman” costume and head out trick-or-treating.

Halloween 2016

How you choose to deal with Halloween candies as a parent is a personal thing and there isn’t one right way to go about it. Why should we be worried about our children consuming a lot of candy? If sugar-rich foods like candy are consumed too often and in large amounts, it can contribute to poor dental health, displacement of other nutrient-dense foods, and unhealthy weight gain.

So, how do we teach our children about “treats” in general?

As a dietitian and mom, I take the approach that there are NO BAD FOODS, JUST BAD DIETS approach.Ā What you do between Halloween this year and next year is relevant, what happens on October 31 is irrelevant. Ā Fun-foods like candy and chocolate are delicious (come on, let’s be honest!) and shouldn’t be limited too much, or else you or your children will desire them even more.

This year, my son kind of knows what Halloween is. As much as I feel the need to put my “dietitian hat” and play “Treats Police”, I try not too. I don’t want to take the joy out of Halloween from my son. Instead, take this opportunity to teach my son how to manage his treat intake on his own (now and in the future), and not feel the need to sneak, hide or gorge on treats. I want to take the advantage of this fun holiday to build my son’s healthy relationship with foods.

Halloween 2017
Halloween 2017

Here’s what I’ve done when my son is at the stage where candy takes priority over cute costumes.

LAST MINUTE BUYERĀ 

Grocery stores are clever, they like to position those huge piles of Halloween candy conveniently when you first walk into the grocery store and your cart is empty AND where you canā€™t help but stare at them when youā€™re waiting at the check-out lane. Therefore, make sure to wait until the day before (or a week before) to buy Halloween candy, so that you and your kids don’t have to deal with the “SEE-FOOD SYNDROME“. Also, I always buy my least favourite treats to hand out – lollipop, gummy candies, smarties, etc. If I were to buy anything chocolate, that would be a different story.

If your favourite candies/treats are in the house, itā€™s more likely that you and your family will eat it ALL. Remember: Out of sight, out of mind; In your sight, in your mind.Ā 

FULE UP BEFORE TRICK-OR-TREATING

Start the day with a wholesome, filling breakfast; encourage a healthy lunch, and be sure to serve healthy and balanced dinner to fill their tummies before heading out trick-or-treating. This way, you can prevent your kids become “candy monster” by the time they come home.

POUR IT OUT AND SORT IT OUTĀ 

Using small bucket/bag and limiting number of houses your kids visit so that their candy-collection is smaller to begin with. When you arrive home with your childā€™s little sack full of goodies, before you do anything, pour it out and sort it out. Get them to separate “the favourites” and “the least favourite”, and ask if they will share with you. This is a good opportunity to teach them to be “picky”. Observe how much they consume without making any comments or rules since you might be surprised how many kids can self-regulate and eat only a few pieces.

SWITCH WITCHĀ 

Children can choose a few of their favourite candies and then leave the rest out for the “Switch Witch” who takes it away and replaces it with a desired toy or non-food gift ( movie tickets, books, crayons or cash for older kids). Also, some parents have their kids actually donate it to a local food bank or a dental office.

LET THEM ENJOY

On Halloween night, I let my son pick two to three candies to try out. For older children, you can also allow your child to eat as much as he/she wants.

Forbidding them from having any candy may just increase their desire for it.

Trust me, your child might surprise you by having a few and then deciding to save the rest or gorging on them and eating until they feel sick.Ā Enjoying fun-foods like candy and chocolate once in a while (even if that means a little everyday) is normal and itā€™s important that they don’t label these foods as “bad” foods.Ā It also decreases the chances of your children sneaking candy or over-indulging when youā€™re not there.

And I promise you, one night of gorging on treats will not effect he/her long-term nutritional status or weight.Ā Most of the time, the children seem to grow bored with their candy after a few days if itā€™s not restricted and rationed like crazy.

BOTTOM LINE

How do you make sure Halloween isn’t a nightmare for you or your children?Ā Think of it as a great opportunity to teach your children about moderation, balance, and healthful indulging.

Happy Halloween !!

Did you know that I offer personalized nutrition counselling for children and families? If this is something you’d like to learn more about, check out my service here.Ā 

foods-to-pack-on-family-road-trip-photo

Foods to Pack on Family Road Trip

by with No Comment Child & Family NutritionToddler Nutrition

School holiday is fast approaching, and family road trips/vacations are big part of the fun! It can be challenging enough to feed your family nutritious meals and snacks at home, let alone when you’re on the road, or in different countries. Here are my top tips and tricks to help you keep your family well-nourished while onĀ vacation.

PLAN AHEAD

Before going on a trip, write out a menu for every meal and snack. Pack all foods or ingredients that are included in the menu. Gather proper cooking equipment such as pots, plates, utensils, napkins, wipes, hand sanitizer gel etc. Make sure to bring containers or Ziplock bags to store leftover and use for portable meals and snacks for the next day.

PREPARE AHEAD

Obviously, you need an insulated cooler and some ice packs. Prepare whatever you can in advance such as homemade trail mix, homemade baking, no-bake energy balls, etc.Ā Keep meal planning simple, making sure to include these meals components:

  • Whole grain: oats, whole grain bread, whole grain wrap or pita, brown rice, quinoa, corn on the cob, yam/sweet potato, etc.
  • Protein rich foods: fresh or cooked meat, nitrate-free deli meat, eggs, peanut/nut butter, beans, lentils, hummus, greek yogurt, cottage cheese, milk, cheese, tofu/tempeh.
  • Veggie or fruit: Any fresh raw vegetables or fruit, unsweetened dried fruit, pre-made salad mixes, fresh pre-washed and chopped veggies (broccoli, cauliflowers, carrots, cherry tomatoes, cucumbers, snap peas, peppers). Apple, bananas, pears, oranges are great because they do not need to be refrigerated. You can also include unsweetened applesauce.
  • Water: Drinking enough water to keep your body hydrated is very important especially after a full day of outdoor activities. Be sure to bring along a reusable water bottle to refill throughout the day.
  • Enjoy small portion of not-so-healthy foods:Ā I follow 80/20 Ā rule while on a road trip or vacation, making sure to reserve one or two meals for my not-so-healthy foods likes pizzas, burgers, hotdogs, ice cream and then striking a balance by serving raw veggies with dip or fruits alongside it, and making more nutritious meal choices the rest of the time.

If you are at a resort or hotel where you are able to access to kitchen (stove or microwave). Here are some quick and easy family road trip/vacation meal ideas:

Breakfast

  • Overnight oats: rolled oats, greek yogurt, milk and fruit (use small mason jars for individual portion and it is portable)
  • Yogurt parfaits: yogurt and homemade granola (1 & 2) and fruits
  • Eggs: hard-boiled eggs, or mini egg muffins
  • High fibre breakfast cereal with milk
  • Pre-homemade whole grain pancakes, French toast or waffles: add your favourite fruit on top

Lunch/DinnerĀ 

You can make a picnic style lunch quickly. A picnic lunch is just a mix of different finger foods that together would make a balanced meal.

  • Whole wheat crackers or pitas with tuna salad or egg salad, fresh pre washed and chopped veggies with dips (hummus orĀ tzaziki)
  • Whole grain wrap with turkey, cheese and lettuce or spinach, with a piece of fruit on the side
  • Layer ingredients for a hardy salad in a container or mason jar. Put your dressing on the bottom by vegetables like slices cucumbers and carrots. Next add chickpeas, edamame or chopped hard-boiled eggs. Finish with salad greens and pumpkin seeds on top. Shake before serving and add pita wedge on the side.
  • Turkey tacos – pre-made ground turkey with taco seasoning, avocados, lettuces, tomatoes, peppers, salsa, cheese, and taco shells
  • Snack plate: hard-boiled eggs, cheese, almonds, crackers, fruits, fresh pre-washed and chopped veggies with hummus

My Favourite Road Trip SnacksĀ 

  • Fresh pre-washed and chopped veggies with dips (hummus or tzaziki)
  • Greek yogurt with homemade granola and fruits
  • Low-sugar granola bars
  • Homemade trail mix with unsweetened dried fruits
  • Apple with peanut butter
  • Whole grain crackers and cheese
  • No-bake energy balls

BOTTOM LINEĀ 

Try to limit the amount of less nutritious snacks such as potato chips, candy, chocolate, soda pop, etc. not only because they’re not very nutritious and high sugar/calories, but also because they don’t really fill you up, so you can eat a lot without really noticing. Instead eat these foods mindfully, choosing ones that you love and can’t live without and enjoy it. Most importantly, remember to enjoy the outdoors and all the great food while spending time with family and friends.

What’s in your packing list now?Ā