Tips for supporting your immune system through nutrition

By Rebecca Janda, registered dietitian at CHOC Children’s

While practicing good hand hygiene and following guidelines set out by the Centers for Disease Control and Prevention are the best ways to prevent the spread of infectious disease, nutrition plays an important role in optimizing immune health. Here are a few ways you can support your immune system through nutrition

Maintain sufficient protein and calorie intake

Proteins are made up of amino acids, which are the building blocks of immune cells and are essential to their function. Amino acids are also required for cellular repair and recovery, which makes them extra important during active infections. Try to include a source of protein in each meal. Choose whole food sources such as eggs, beans, lean meats, poultry, yogurt, nuts and seeds that provide added vitamins and minerals in addition to their protein content.

Immune cells require fuel, or calories, to function optimally. Maintaining adequate calorie intake is crucial to keeping cells functioning at their best. Large calorie deficits can weaken the immune system. Making healthy swaps that naturally reduce calories by a small amount, such as choosing a piece of fruit instead a bag of chips, can have added nutritional benefits, but large calorie reductions should be avoided.

Incorporate 1-2 servings per meal of fruits and vegetables, preferably in whole food form

  • Vitamin C — In just about every fruit and vegetable you can find at least a small amount of vitamin C. This nutrient acts as a very important antioxidant and stimulates the production of certain immune cells. While citrus fruits are known to be good sources, it may surprise you that strawberries, red bell peppers and kiwis contain more vitamin C per serving than citrus! The vitamin C content of food is reduced dramatically with time, processing and exposure to oxygen – meaning a fresh whole orange is a much better source of vitamin C than a glass of orange juice.
  • Vitamin A (Beta-Carotene) — Fruits and vegetables are also very good sources of vitamin A in the form of beta-carotene. Vitamin A plays a critical role in enhancing immune function by stimulating and regulating immune cells. Orange sweet potatoes contain the largest amount of beta-carotene per serving, but pumpkin, carrots, cantaloupe and many other orange and even green fruits and veggies are also great sources of this immune-boosting vitamin.
  • Other nutrients — Lycopene found in guavas and tomatoes help increase immune activities. Anthocyanins found in berries, red cabbage, and pomegranates have immune regulating properties.

Add more seafood to your menu

Zinc is a mineral that has anti-viral properties and is essential to wound healing. The best source of zinc is in seafood, especially oysters. Zinc is also found to a lesser extent in lean meats, poultry, beans, whole grains, dairy products and enriched cereals if seafood is not for you. Try to incorporate a serving of seafood several times per week, or daily if you are getting your zinc from non-seafood sources.

Always try to obtain nutrients from their food sources rather than supplements. Whole foods are safer and contain added benefits in addition to their nutritional properties.

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Recipes to make with kids during quarantine

By Kristin Cheng, registered dietitian at CHOC Children’s

Current shelter-in-place orders have changed so much about our day-to-day lives, including how we navigate cooking. Many families are eating at home more often, making shorter grocery trips, and finding more creative ways to utilize limited ingredients. This extra time with kids at home can serve as a great opportunity to involve your little ones with hands-on cooking and meal prep.

Get out your chef hats! Here are some of our favorite kid-friendly recipes to transform your quarantine days into a fun family activity —with a delicious treat as a bonus:

No-bake frozen yogurt berry granola treats

yogurtcups

Ingredients:

  • 4 tablespoons peanut butter
  • 4 tablespoons honey
  • 2 cups granola
  • 2 ½ cups Greek yogurt, any flavor
  • ½ cup berries or dark chocolate chunks for garnish
  • Mint for garnish, optional

Directions:

  1. Heat peanut butter and honey in the microwave for 30 seconds, or until melted.
  2. Pour into a medium sized bowl and stir to combine with granola.
  3. Divide mixture evenly into 12 lined muffin cups. Press firmly to the bottom.
  4. Top each cup with yogurt, divided evenly.
  5. Garnish with toppings of choice.
  6. Cover tightly with foil and freeze for at least two hours.
  7. Keep frozen and thaw for a few minutes before eating.

Recipe courtesy of Tasty.

Mini egg frittatas

minieggfrittatas

Ingredients:

  • 8 large eggs
  • ½ cup whole milk
  • ½ teaspoon black pepper
  • ¼ teaspoon salt
  • ⅓ cup grated Parmesan cheese
  • 1 cup fillings of choice: finely chopped or sliced ham, chicken, mushrooms, bell peppers, onions, spinach, olives, parsley, tomato

Directions:

  1. Preheat the oven to 375°F.
  2. Spray two muffin tins with nonstick spray.
  3. Whisk eggs, milk, black pepper, and salt in a large bowl.
  4. Stir in cheese and desired fillings.
  5. Pour mixture into each muffin tin to about ¾ full. This will allow some room for the egg to puff up.
  6. Bake for 8-10 minutes or until the egg puffs up.
  7. Use a rubber spatula to remove the muffin cups from the tin.

Recipe adapted from Food Network.

DIY pizza

homemadepizza

Ingredients:

Pizza dough:

  • 1 tablespoon active dry yeast
  • 1 cup warm water (120°-130°F)
  • 2 ½ cups all-purpose flour, plus some extra for rolling dough
  • 1 teaspoon salt
  • 1 teaspoon olive oil

You can also use any premade 12” pizza crust, pita bread or naan bread as a crust substitute.

Toppings:

  • ⅓ cup tomato sauce
  • 2 cups shredded mozzarella or Monterey Jack cheese
  • 2 cups toppings of choice: mushrooms, bell peppers, zucchini, onion, olives, tomatoes, jalapeno peppers, pineapple, pepperoni, chicken, ham, basil, garlic, artichokes, etc.

Directions:

  1. Add yeast and water to a large mixing bowl. Stir once to activate yeast and let it sit for five minutes.
  2. Add flour, salt and olive oil. Mix until a dough is formed and knead on a floured surface for two minutes.
  3. Place in a greased bowl and turn to fully coat in oil. Cover and let it rise for 20 minutes.
  4. Preheat the oven to 400°F as you wait for the dough to rise.
  5. After 20 minutes, place the dough on a flat surface and roll into a 12” circle. Place on a 12” greased pizza pan.
  6. Spread tomato sauce evenly on the crust.
  7. Sprinkle cheese evenly atop the tomato sauce.
  8. Add desired toppings.
  9. Bake for 20 minutes or until the cheese is bubbling or turning brown and the crust is starting to crisp.

Recipe adapted from Food.

Spring rolls

springrolls

Wrap:

  • 2 oz. rice vermicelli
  • 8 rice wrappers (8.5” diameter)
  • 8 large cooked shrimps – peeled, deveined and cut in half or 1 cup cooked chicken, shredded
  • ½ cup raw carrots, chopped
  • 1 ⅓ tablespoons fresh Thai basil, chopped
  • 3 tablespoons fresh mint leaves, chopped
  • 3 tablespoons fresh cilantro, chopped
  • 2 lettuce leaves, chopped

Fish sauce:

  • 4 teaspoons fish sauce
  • ¼ cup water
  • 2 tablespoons fresh lime juice
  • 1 clove garlic, minced
  • 2 tablespoons white sugar
  • ½ teaspoons garlic chili sauce, optional

Hoisin peanut sauce:

  • 3 tablespoons hoisin sauce
  • 1 teaspoon fine chopped peanuts

Directions:

  1. Boil water in a medium saucepan. Boil rice vermicelli for three to five minutes or until al dente and drain.
  2. Fill a large 10” plate with a thin layer of water. Dip both sides of the rice wrapper for one second on each side to soften. Lay wrapper flat on another clean plate.
  3. In a row across the center, place two shrimp halves (or shredded chicken), a handful of rice vermicelli, carrots, basil, mint, cilantro and lettuce. With the row laying horizontally, fold the bottom side inward, followed by the left and right sides. Slowly roll the wrap upward to seal completely.
  4. Mix sauce ingredients in two separate small bowls.
  5. Dip wraps into sauce and enjoy!

Recipe adapted from Allrecipes.

Zucchini fries

zucchinifries

Ingredients:

Fries:

  • 2 zucchinis, cut into 3-inch pieces
  • 1 cup panko breadcrumbs
  • ½ cup grated parmesan cheese
  • 1 tablespoon garlic powder
  • 1 tablespoon dried basil
  • 1 teaspoon salt
  • 1 teaspoon pepper
  • 2 eggs

Dip:

  • 1 cup plain Greek yogurt
  • 1 tablespoon lemon juice
  • 2 tablespoons fresh chives
  • ¼ teaspoon salt
  • ¼ teaspoon pepper

Directions:

  1. Preheat the oven to 425°F.
  2. Cut zucchini into 3-inch pieces.
  3. In a large bowl combine panko breadcrumbs, parmesan, garlic powder, basil, salt and pepper.
  4. Whisk eggs in a shallow bowl.
  5. Dip zucchini in eggs, coating evenly, and then toss in bread crumb mixture.
  6. Place on a baking sheet lined with parchment paper.
  7. Bake for 15-20 minutes, flipping halfway.
  8. While fries are baking, combine all dip ingredients in a small bowl and set aside in the refrigerator.
  9. Dip and enjoy!

Recipe courtesy of Taste.

Berry banana smoothie

berrybananasmoothie

Ingredients:

  • 1 cup frozen mixed berries
  • 1 frozen ripe banana
  • 1/2 cup low-fat vanilla yogurt
  • 1 cup milk, or dairy-free alternative
  • 1-2 tablespoons honey optional

Note: if using fresh fruit, add ice

Directions:

  1. Add all ingredients into the blender and puree until smooth. Serve immediately.

Recipe adapted from Food Network.

Rainbow fruit kabobs

rainbowfruitkabobs

  1. Cut an assortment of fruits. Some examples include pineapples, grapes, blueberries, raspberries, blackberries, strawberries, watermelon, apples, tangerines, honeydew, cantaloupe, kiwi and bananas.
  2. Arrange fruit on skewer sticks.

Bugs on a log

bugsonalog

Ingredients:

  • Celery stalks, cut into 3” pieces
  • Spread: peanut butter, Greek yogurt, or hummus
  • Toppings or “bugs” — raisins, cranberries, blueberries, peas, black beans or diced peppers

Directions:

  1. Place desired spread along the groove of celery stalk.
  2. Top it off with “bugs” of choice.
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Tips for minimizing trips to the grocery store during COVID-19

By Caitlyn Truty, registered dietitian at CHOC Children’s

Now more than ever, it is important to keep your family nourished and healthy. For your safety and the safety of those around you during the COVID-19 pandemic, it is also crucial to minimize your time spent grocery shopping and reduce the frequency of your grocery runs. Having a plan and making a strategic grocery list ahead of time will ensure your visits to the store are as quick and efficient as possible, and that you don’t have to make them as often. Use the following tips when planning your next venture to the store:

Take inventory

Before leaving home, take inventory of what you have on hand to know what you do and do not need. This will help prevent the need for multiple grocery trips for missed or forgotten items. Knowing what you already have will also help with meal planning and finalizing your grocery list.

Plan for two weeks

Plan out your family’s meals for about two weeks. Plan to make meals that will yield leftovers that are easy to freeze for later consumption. If you’re using up fresh produce during the first week after a grocery store trip, plan to get creative by using non-perishable foods during the second week to extend the time between your grocery store visits. Use canned or frozen meats, vegetables, and fruits in your home recipes and be sure to keep other nutrient-dense, non-perishables on hand to incorporate into your meals and snacks. Here are some ideas:

  • Add canned fruit to your yogurt or cottage cheese and top oatmeal or salads with dried fruit.
  • Incorporate canned vegetables into your favorite casserole dish or use as toppings for taco bowls.
  • Spread nut butters on toast or add to smoothies. Keep nuts or trail mix around for snacking.
  • Use canned meat such as chicken to fill enchiladas and add canned beans or lentils to soup or salad.
  • Add rice, quinoa, barley or other cooked grains to salads or simply use as a side dish for any meal.

Make a strategic grocery list

Create a complete grocery list before going to the store. Organize your list by matching similar foods and their location in the grocery store. This will prevent you from running back and forth between aisles. ChooseMyPlate.gov has an easy grocery list template to help you organize your list, and ensure you come home with a variety of foods from each food group to support balanced nutrition.

Avoid browsing

Once at the store, stick to your grocery list and avoid unnecessary browsing. Choose one store to shop at to avoid running around town. Also, if able, go grocery shopping by yourself. This will not only help with social distancing but will also eliminate distraction so you can get in and out as quickly as possible.

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A dietitian’s tips on flexible meal planning during COVID-19

By Alexia Hall, clinical dietitian at CHOC Children’s

Trips to the grocery store, while essential, are not the first thing anyone wants to do right now. Knowing in advance what is in the pantry and using some helpful meal planning tools will make good use of the food ingredients you have on hand, allow for less shopping overall and dramatically decrease food bills.

Stifling to a cook’s creativity is the sometimes-overwhelming amount of clutter in the back of the pantry. Multiples of similar items are often bought on sale to save for a future meal. Also, highly possible are the extra purchases made while caught up in the “fever” of the first few weeks of social distancing. Sometimes a disorganized pantry can be years in the making and may even result in a few science projects hiding in dark corners! In any event, a messy pantry makes it tough to figure out what to cook. The first order of business is to figure out what is there and establish some order. Once that is done, the internet abounds with ideas on what to do with the odd can of beans or the lonely mushrooms and wilting spinach hiding in the back of the fridge!

To help with taking an inventory, some find it easiest to just take everything out and spread it around the kitchen counters. Food with expired dates should be tossed. Products that have “sell by” or “best if used by” dates on them are different from expired dates. According to the USDA, sell by/best by dates are not an indicator of the product’s safety, while expired dates are a safety indicator. Manufacturers use “best if used by” dates to help consumers and retailers decide when the food is of the best quality and whether the taste or texture could be affected if dates are past due. These rules apply unless it is infant formula, which should always be tossed if any of the recommended dates have passed. When in doubt, or when it is unclear what type of date is on the package, err on the side of caution and throw out if past the date.

Here are some examples of commonly used phrases, according to the USDA:

  • A “Best if Used By/Before” date indicates when a product will be of best flavor or quality. It is not a purchase or safety date.
  • A “Sell-By” date tells the store how long to display the product for sale for inventory management. It is not a safety date.
  • A “Use-By” date is the last date recommended for the use of the product while at peak quality. It is not a safety date except for when used on infant formula.
  • A “Freeze-By” date indicates when a product should be frozen to maintain peak quality. It is not a purchase or safety date.

After tossing out the old and expired items, combining all like items in single packages will also help to control clutter. If there is large number of any one item, such as a case of beans, consider leaving just two cans with the oldest expiration dates in the pantry and storing the rest in a box in a closet or a garage. Clearing away these extras will help to easily see what is on hand and it will also allow for planning in a more focused way.

Tips for taking a pantry inventory:

There are a variety of free or paid smartphone apps, such as Pantry Check or Cooklist, that will keep track of pantry items, as well as organize grocery lists and favorite recipes in a highly functional way. Some of these apps have the ability to use the phone camera as a barcode scanner to drop items into the inventory. There are also a variety of free printable forms online to help you take a pantry inventory. Any method chosen should keep track of the following basics:

Pantry

  • Baking supplies such as flour or sugar
  • Broth
  • Beverages
  • Canned goods
  • Fresh items such as fruit, bread or tomatoes
  • Grains such as cereals, rice, pasta or quinoa
  • Herbs and spices
  • Oils and vinegars
  • Sauces and mixes

Refrigerator

  • Dairy
  • Alternative dairy
  • Cheese
  • Condiments
  • Eggs
  • Fruits
  • Lunch meats
  • Nuts and seeds
  • Vegetables

Freezer

  • Desserts
  • Fish
  • Frozen fruit
  • Frozen vegetables
  • Meats — beef or pork
  • Poultry — chicken or turkey
  • Pre-made meals (note the type and date)
  • Bread

Remember to spell out the quantity and type of each item to help give the inventory list the useful information needed. This new completed tool will help to use non-perishable items in an efficient way, limiting grocery store visits to just the produce aisle while efficiently using the items already in your pantry.

Finding recipes for what you have on hand:   

Once everything is out on the counters, it might be easy to look at the ingredients and plan meals around them, finding a use for each one. Alternatively, here are several other sites that allow for an online recipe search that filters for the ingredients on hand:

  • Allrecipes Dinner Spinner — a free mobile phone app for both Android and iPhone that allows filtering ability as well as the ability to create custom collections to organize, store or share recipes
  • Fridgetotable.com — a website that allows you to select a main ingredient and add other popular ingredients according to what you have on hand
  • MyRecipes.com — offers the ability to search through the recipes in the Cooking Light magazine
  • Supercook — a website and app that allows you to add the main ingredient in the search area and then sort the results listed by the highest-rated recipes or the percentage of users who would make it again
  • Tasty.co — set filters for ingredients, mealtimes and dietary restrictions
  • Yummly.com — recipe recommendations personalized to your tastes, a digital recipe box, a shopping list, and an option for grocery delivery

Making up a recipe on the spot with the ingredients on hand is also an option, depending on the family’s tolerance level of different flavors. Using a few specific tips to modify basic recipe templates can easily work out. Consider these three ideas:

 Soups:

Soups are great because they are an easy way to use up vegetables on hand while pairing them with animal or plant-based proteins for a complete and balanced meal. One of the most important tips to making a good soup is to “sweat” the aromatic vegetables first. Onions, garlic, ginger or celery should be sautéed in a little olive oil before adding the broth, tomatoes or water. This softens them and releases their aromatic flavors. Cooking the more fibrous vegetables in the broth first and then adding the more tender vegetables at the end (such as dark leafy greens that require less cooking times) will help to ensure that all vegetables are finished cooking at the same time. Raw meats and pastas can be added for a long simmer time to cook in the broth or can be added precooked at the end.

Slow cookers:

One beautiful thing about slow cooker dinners is the “fix it and forget it” idea. One tip is to brown the meat before adding it to the slow cooker, which can increase the overall flavor of the dish. Just like soups, you can add a variety of vegetables according to what you have. Place the longer cooking, more fibrous vegetables like potatoes, carrots and other roots at the bottom of the slow cooker where they will have the chance to cook faster. Add fresh herbs close to the end of cooking times to keep their flavor fresh. On the other hand, consider cooking large batches of chicken, beef or pork in a slow cooker with just mild flavors like broth, salt and pepper so that they can be easily divided into batches and modified later for more specific flavors.

Frittatas:

Why not have breakfasts for dinner? Frittatas are so easy to make and are a perfect use for any fresh or frozen vegetable. It’s a good idea to precook vegetables before adding the eggs, as the raw vegetables will release too much water and won’t cook fast enough before the eggs are done. A good ratio to use is about four eggs to each cup of raw vegetables. Consider sautéing the vegetables in an ovenproof pan and cooking off or draining any excess liquid. Once tender, add your spices and salt and pepper. Add the whisked eggs and then finish cooking in the oven watching closely for the frittata to puff up, being careful not to overcook. Do not add fresh herbs or tender tomatoes until the dish is out of the oven.

A note about making substitutions:

You may need to get a little creative if you are trying to use what you have instead of going to the store. Here are a few substitutions to remember:

  • Italian seasoning — substitute with pantry staples such as oregano, basil, parsley, salt and pepper.
  • Buttermilk — mix 1 cup of any regular milk, or nondairy milk, with 1 tablespoon of vinegar or 1 tablespoon lemon juice, and wait 10 minutes for the milk to curdle.
  • Eggs — ¼ cup of applesauce, ½ banana or other fruit puree will do as a substitute for each egg, and so will 1 tablespoon of chia seed soaked in 3 tablespoons of water for five minutes.
  • Olive oil can be substituted for butter in a 1:1 ratio, though flavor considerations are important depending on what you are making.
  • When it comes to spices, experimentation is fine, but you should start with small doses and increase to your taste slowly. You can always add more later, but it is impossible to take it out if you have added too much.

Using up the items in the pantry will help free up space, both physically and mentally. Going through this cleansing process will eventually allow for more creativity and efficiency, and maybe even a little more freedom in the kitchen. Creating a flexible pantry will make a healthy lifestyle just that much easier to maintain and restock once social distancing requirements are lifted.

And finally, consider donations with any extras to a food pantry in your neighborhood, as most are very impacted right now. Making extra food items into gifts for someone less fortunate is another thoughtful way to make good use of these items.

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Eat right, “bite by bite”

By Alexia Hall, clinical dietitian at CHOC Children’s

During March, we celebrate National Nutrition Month, an annual celebration promoted by the Academy of Nutrition and Dietetics. This health observance is a wonderful opportunity to encourage everyone to focus on making positive choices for healthy food and physical activity.

The Academy of Nutrition and Dietetics says it best, when conveying the importance of good nutrition:

Good nutrition doesn’t have to be restrictive or overwhelming. Small goals and changes can have a cumulative healthful effect, and every little bit (or bite!) of nutrition is a step in the right direction.”

This year’s theme “Bite by Bite” has several key weekly messages including; eating a variety of nutritious foods, the benefits of planning out meals each week, and identifying resources for learning culinary skills to create healthy food. Everyone can use these tips to become more mindful of what we put in our mouth — dietitians included!

Here are some specific suggestions to help us reach these goals:

Eat a variety of nutritious foods every day: 

  • Try to include healthful foods from all food groups. For example, try to choose dark green leafy vegetables as well as vibrantly colored fruits, especially berries. Strive for filling half your plate with vegetables and fruit at each meal.
  • Choose a variety of both animal and plant-based proteins and try to include heart-healthy fish, like salmon, twice per week.
  • Learn how to properly read the nutrition facts panel to understand the nutrition in your food. Here’s a guide to understanding how to read a food label.
  • Take time to practice mindfulness while enjoying your food each day. Chew your food slowly and focus on the meal, rather than the news on your smartphone. Studies show that when we are mindful, we may eat less and concentrate on more healthful foods.
  • Plan out meals each week:
    • Plan a week’s worth of menus by using inspiration from the web, such as recipes from healthy food magazine sites, or inspiration from your favorite healthy cookbooks. Check out CHOC’s healthy meal prep tips for busy parents.
    • Use a grocery list to shop for healthy foods and take inventory of what you have before leaving home. Here’s a list of tips for healthy grocery shopping.
    • Plan for what you will eat while traveling to school and work by either packing a healthy lunch or scoping out what healthy items you can buy at restaurants or markets near you.
    • Double up on recipes for healthy dinners so you can take leftovers for lunch.
  • Learn culinary skills:
    • YouTube videos abound with cooking techniques. My family learned out to make our favorite steak from watching a YouTube video of our favorite celebrity chef!
    • Most grocery stores or butchers offer tips and suggestions on how to cook specific proteins and other healthy items.
    • Many classes available at local community centers focus on culinary arts for both adults and children.

Consulting with a registered dietitian can help you achieve your nutrition goals. Both dietitians and dietetic technicians are trained in personalizing nutrition advice to meet your specific goals and unique needs.

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