Organic fruits and vegetables vs. conventionally grown

By Colleen Trupkin, registered dietitian at CHOC Children’s

Many of us start the new year with a goal of eating healthier, but sometimes it’s hard to know what that means. Eating more fruits and vegetables is often a good place to start, but a common question is whether organic fruits and vegetables are a better choice.

For starters, it helps to understand what the label “organic” means in the U.S. For fruits and vegetables to be labeled as organic by the U.S. Department of Agriculture (USDA), it means that items cannot be genetically-engineered and no man-made fertilizers or pesticides may be used in the growing process. While people often think of organic produce as having no pesticide residue, this may actually not be the case. Organic produce may still have pesticide residue from the environment or processing facilities, but there is no need to panic! The USDA Pesticide Data Program  has been monitoring our food supply since 1991 to ensure safety. While pesticide residue may be found in both traditionally and organically-grown produce, levels are very low — well below the already low threshold set by the Environmental Protection Agency (EPA) for pesticide residue.

It is important to remember that whether you choose to buy organic or conventional food items, it is the quality and variety of your diet that is most important. Eating fruits and vegetables is an important part of a healthy diet, but only one in 10 Americans consume the recommended amounts. Eat a rainbow of color and variety of produce to get the most health benefits and aim for at least five servings per day, regardless of whether that produce is organic or traditionally grown. Don’t forget to wash all fresh produce before cooking or eating; it is dirty until washed!

The Food and Drug Administration (FDA) also recommends several tips for reducing pesticide residues and preventing foodborne illness from any produce:

  • Always wash your hands for 15-20 seconds with soap and warm water before handling produce.
  • Wash all fruits and vegetables before eating.
    • It is important to wash items before you peel or cut them to ensure residue from the outside is not transferred to the portion you will be eating.
    • Use a brush for heartier vegetables such as potatoes or carrots, especially if you will be eating the skin.
  • Throw out the outer leaves of leafy vegetables, such as the outer leaves from a head of lettuce.

Whether you choose to buy organic foods is a personal decision. At this time, there is not conclusive scientific evidence that shows that organically grown produce is necessarily healthier. However, if you choose to go that route, consider organic options for items without a protective skin to scrub or peel. Most importantly, kick off the new year with a resolution to get “Five a day” of fruits and vegetables from all colors of the rainbow!

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Winter squash: Benefits, tips and recipes

By Kristen Miller, registered dietitian at CHOC Children’s

Winter squash appears in the supermarket during the fall and winter months. They come in many varieties and are often characterized by their thick, hefty rinds and bulky appearance. While the tough exterior may appear intimidating, it also gives the fruit a long shelf life. Winter squash can be stored in a cool, dry place for up to three months!

Various winter squash varieties share the health benefits of being  low in calories, fat and cholesterol and high in fiber, vitamins, minerals and antioxidants. Three common winter squash varieties found in most supermarkets include acorn squash, butternut squash and spaghetti squash. Here are some of my go-to tips for choosing the right squash and preparing it, as well as a favorite recipe.

Acorn squash

Acorn squash has a distinct acorn-like shape and has a mild, buttery-sweet flavor. Choose acorn squash with a dull dark green color, firm rind and smooth exterior. Avoid any that are yellow or orange. The fruit is packed with nutrients, and is specifically high in vitamin C, thiamine and magnesium.

If the rind is too tough to cut, try microwaving for a short time to soften the exterior. Acorn squash can be roasted, sautéed, made into soups or even baked into pies.

Butternut squash

Butternut squash can be spotted by its bell shape and has a sweet nutty flavor. Choose butternut squash that has a tan-yellow rind. If you want a slightly sweeter flavor, choose one that is darker orange. But be careful, darker means riper! Make sure to check for soft spots or bruising, as this would indicate rot. The fruit is high in vitamin A, vitamin C and magnesium.

To make butternut squash easier to maneuver, cut the neck and work with the two halves separately. If you want to avoid the knife and cutting board all-together, many popular winter squash varieties, including butternut squash, can be found pre-peeled and cubed. The versatile nature of butternut squash caters to both savory and sweet lovers.

Spaghetti squash

Spaghetti squash has an oblong shape and a very mild flavor. The common supermarket varieties have a yellow rind. Choose a firm spaghetti squash that does not have any bruising. Once cooked, the flesh of spaghetti squash can be fluffed with a fork to form noodle-like strands that resemble spaghetti. The fruit is a good source of vitamin C, manganese and vitamin B-6.

Use the “noodles” mixed with your favorite spaghetti sauce for a vitamin-packed pasta alternative, turn the squash into a burrito bowl, or use in casseroles. See the recipe below for a savory dish that requires minimal ingredients and very little prep work!

3-Ingredient Twice-Baked Spaghetti Squash Recipe


  • 1 spaghetti squash (medium size)
  • ½-1 cup pasta sauce (adjust according to preference)
  • ½- 1 cup shredded mozzarella cheese (adjust according to preference)
  • Salt and pepper (to taste)
  • Optional: fresh garlic (fresh chopped basil , dried oregano or Italian seasoning)


  1. Preheat oven to 375 degrees F. Line a baking sheet with parchment paper.
  2. Carefully cut spaghetti squash in half lengthwise (before cutting, consider softening in microwave for a few minutes). Remove and discard seeds. Place spaghetti squash cut side down on baking sheet. Bake for 45 minutes or until a fork can pierce the shell easily.
  3. Remove from oven. With a fork, loosen and separate spaghetti squash strands from shell. Reserve shells.
  4. Place strands in a bowl. Mix strands with pasta sauce (and additional spices, if you wish). Spoon mixture back into the empty shell(s). Sprinkle with mozzarella cheese.
  5. Bake for 7-9 minutes or until cheese is melted, bubbly, and slightly browned. Spoon and serve directly from shell.

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How to help your child develop a healthy relationship with food

By Amanda Regan, registered dietitian and certified lactation educator-counselor at CHOC Children’s

In a culture filled with fad diets and mixed food messages, it can feel confusing to try and be healthy. Today, we find so many labels on food telling us how we should already feel about what we’re eating —good, bad, clean, or guilt -free. These mixed messages about food can feel even more confusing for young children and teens.

Those at a vulnerable age can be more susceptible to triggers, such as product labeling, that could negatively affect their relationship with food or even contribute to the development of an eating disorder. Unfortunately, eating disorders have become increasingly more prevalent among all kids of different genders, race, shapes and sizes. Eating disorders also have the highest mortality rate out of any mental illness.

We as parents have an opportunity to help our children develop a positive relationship with food. A person’s relationship with food starts as young as infancy, so it’s important to make mealtimes as pleasant as possible from the very beginning. Here are some tips on how to help your child not only feel good about everything they eat, but also feel good about themselves.

Avoid putting your child on a diet

Research shows that dieting behaviors are most commonly linked to eating disorders in kids. Growing children should not be put on a diet unless it is deemed medically necessary. According to the American Academy of Pediatrics, if a child is overweight, the recommendation should be to encourage a healthy lifestyle, rather than focusing on weight. Although we don’t always realize it, our children are always listening to us. So, try not to talk about weight, calories, or dieting in front of your child. Even if you, yourself, are on a diet.

Avoid attaching labels to food

Try not to think of food as either bad or good, but instead focus on nourishment for you and your child. Labeling food is a way of telling your child how they should already feel about the food they are eating, instead of letting them decide for themselves. Let your child know that all food can fit in a healthy diet, as long as the majority of their diet is a balance of all the food groups. This means that yes, even treats can have a place in a healthy diet.

 Refrain from body talk

Avoid talking about appearance or body image in front of your child. Your child’s body is constantly changing and developing — especially during the adolescent years — and it can leave them feeling awkward and self-conscious. Children are sensitive to comments about body image.

 Have family meals

Frequently eating meals together has been shown to prevent disordered eating behaviors such as restricting, binging and purging. Family meals provide opportunities for you to model healthy behaviors in front of your child. They have also been associated with overall improvement in dietary quality. When having family meals, try to provide the same food for everyone and avoid making separate meals.

 Know your role in the feeding relationship

With food, your role job as a parent is to provide nutritious food for your child; their job is to decide how much they eat. Try not to pressure your child in any way when it comes to eating. Helping your child build a positive relationship with food involves trust. Trust in your child to finish their meal when they are full and eat more when they are hungry. Force feeding or restricting food intake can turn mealtimes into a battle ground.

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Healthy meals for your family: Tips from a registered dietitian

By Mary Sowa, registered dietitian at CHOC Children’s

Looking for help to plan healthy meals for your family? Choose My Plate, a program of the USDA, is a great place for recipe ideas and tips for meeting your nutritional goals.

Start Simple with MyPlate:

This page offers tips on how to incorporate each food group into your diet. You can also find information on the foods that should be limited in our diets, including salt, saturated fats and added sugars.

More tips include ideas for preparing meals ahead of time, snack ideas for kids, and how to incorporate different foods to help meet vegetable goals.

MyPlate Plan:

On this portion of the website, you can enter gender, weight, height and activity level, for a calculation on your specific energy needs. Once you have that information you can select the calorie level, along with the servings and suggestions for each food group to meet those calorie requirements. You can also enter information on behalf of your child, to see their specific calorie needs. See an example MyPlate Plan.

Action Guide:

Action guides are specific to adults, parents/caregivers, kids/teens, and teachers/health educators. These guides offer tips for enjoying local foods, growing your own food, tips for picky eaters, activity sheets for kids, recipe ideas and more.

Healthy eating on a budget

This section will help you create a grocery store game plan and stick to your budget and help you prepare healthy meals. The kitchen timesavers tip sheets offer advice for organizing your kitchen, clearing the clutter, chopping extra, doubling your recipe and more tips to help you maximize your time in the kitchen.

These are just four features of Choose MyPlate to explore. This resource offers endless tips, plans and recipes to help improve or maintain healthy eating habits.

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Do I need a lactation consultant?

By Cindy Baker-Fox, registered nurse and international board-certified lactation consultant at CHOC Children’s

In addition to the proven health benefits for mom and baby, breastfeeding can be a wonderful experience that fosters bonding. But in some cases, breastfeeding and breast milk production can be challenging for both mom and baby, and may require assistance from a lactation consultant. The most common concern among moms new to breastfeeding is, “Is my baby getting enough milk?” The process can be difficult or confusing for new moms who are looking for support and education. As a result, some moms may stop breastfeeding earlier than they had hoped. In these cases, it may not be necessary to stop breastfeeding, but rather work with a lactation consultant who can evaluate milk supply, a baby’s breastfeeding skills, and any other factors that may be resulting in breastfeeding issues. They can also provide interventions and follow-up care until the problem, or concern, is resolved.

The difference between lactation consultants and lactation educators

Lactation specialists with the title IBCLC (international board-certified lactation consultants) are clinicians who have received advanced education and training in the fields of lactation, breast anatomy and physiology, infant feeding development, infant oral anatomy, and complex lactation issues and challenges. They have hundreds of hours of experience working with breastfeeding moms and babies. Lactation consultants are usually registered nurses, registered dietitians, feeding therapists, or doctors. Others working in the field of lactation may be trained as lactation educators or lactation counselors. These individuals have more limited training in lactation and breastfeeding than lactation consultants, and they focus mostly on education and support, rather than diagnosis and treatment of complex breastfeeding and lactation issues. A lactation consultant can assess, diagnose and treat many breastfeeding issues. When medications or special therapies are required, the lactation consultant will refer the mom and baby to a specialist who can provide additional care.

Common breastfeeding problems

 The most common breastfeeding problems moms encounter that might require lactation services include:

  • Difficult or painful latching
  • Low milk supply or too much milk supply
  • Infant weight loss (more than 10% loss from birth weight) or inadequate weight gain after two weeks post-birth
  • Fussiness at the breast, breastfeeding refusal, and nursing strikes
  • Breast or nipple pain and/or infections
  • Babies with special feeding needs including premature infants; twins and multiples; infants with medical issues that make latching and sucking difficult; or newborns with hyperbilirubinemia, yellow skin from too much bilirubin in the blood
  • Preparing to go back to work or school
  • Weaning and formula use
  • General breastfeeding education, support and follow-ups

How to find lactation services

Insurance companies, including Medi-Cal and Cal-Optima, are required to provide lactation services and supplies for the mom and baby in the hospital as well as at home. Services may be free or fee-based depending on the lactation provider and the family’s insurance coverage. Many birth hospitals offer free or low-cost breastfeeding clinics and services specifically designed for new moms, newborns and growing infants. Support groups are also common resources provided by birth hospitals. The Special Supplemental Nutrition Program for Women, Infants and Children (WIC), a federal program of the USDA, is another critical resource for many moms, and they too provide in-depth breastfeeding services, including consultations, classes, support groups and nutritional services. La Leche League support groups are also a good resource for education and support. They are available in most communities and provide a vital connection to lactation specialists and other breastfeeding moms in the community.

What to do if you need help breastfeeding:

  • Talk with your baby’s pediatrician who can evaluate if your baby is gaining weight properly and assess his or her mouth to determine if there are any conditions that might be causing sucking or breastfeeding problems. Many pediatric offices have lactation educators in their practice, or they can refer you to a lactation consultant in the community.
  • Contact your insurance company to determine your benefits for lactation services. They may require a referral from your pediatrician.
  • Contact your birth hospital or local community hospital to determine if they offer a breastfeeding hotline, breastfeeding workshops, classes or private consultations.
  • Call the National Women’s Health and Breastfeeding Helpline: 1-800-994-9662. Offered through the U.S. Department of Health and Human Services, this hotline is designed to address breastfeeding women’s questions. The hotline is available Monday through Friday, 9 a.m. to 6 p.m. ET.
  • Call your local WIC office to obtain information about their services and to determine if you qualify for their breastfeeding and nutrition programs.
  • Check with your local public health department, county health office, or any special mother/baby program to which you belong to determine if they offer breastfeeding education and support.
  • Reach out to a family member, friend, neighbor or co-worker who has breastfed. They may be able to provide you with the help and encouragement you need. You might be surprised to hear that they too had breastfeeding issues, and they might be able to share their tips and wisdom with you.

Breastfeeding help is often just a phone call away. Never hesitate to reach out for help. Working with a lactation specialist may be just the thing you need to help achieve an enjoyable successful breastfeeding experience and reap the benefits associated with breastfeeding.

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