Melon Mania!

By Stephanie Prideaux, Dietetic Technician, Registered

Children are mostly back in school, the fair has packed up its things, and summer, I’m afraid, is coming to a close. Although we might not have all the free time or outdoor movies in the park, we can hold on to summer through many of our favorite foods that are still in season. Melons, the snack I brought to almost every single gathering this year, are in season through as late as November, depending on the variety. Seasonal fruit means budget-friendly prices. Use this opportunity to sample melons you may have never heard of, such as canary melon or Santa Claus melon (also known as piel de sapo).

Melons are one of the ultimate warm weather snacks for their juiciness and refreshing mildly sweet flavor. In fact, melons like watermelon and honeydew are made of about 90 percent water. Their natural sweetness is a great substitute for sugary desserts or sugary beverages. Melons can even be transformed into delicious drinks with little to no added sugar, such as in the style of aguas frescas. Healthy frozen desserts such as snow cones or popsicles can be made from melons, such as in the recipe below. When in a pinch for time, skewered melon chunks are an easy option that kids love—and it’s a great way to taste test new types of melon.

You don’t have to be a culinary artist to transform melons into amazing things. With a little experimentation, or a recipe like the one below, melons can be used in ways that may not commonly come to mind. Never underestimate the deliciousness of any fruit with some lemon juice and chili powder. Melons can even be made into salsas and soups, or grilled or pickled.. Their mild but distinct flavor allows them to be served with fish, chicken, in tacos, as a dip, or in countless other ways.

Adding melon to main dishes is a unique and colorful way to pack in extra nutritional value, too. Melons are notorious for being great sources of vitamin C, which is perfect for children. Vitamin C is an antioxidant that protects their growing bodies against damage from the sun, air pollution, cigarette smoke and more. . This vitamin is also used to make collagen, which can help heal wounds from playtime cuts and scrapes. Iron deficiency is a common condition affecting children, but vitamin C can combat this by increasing the amount of iron their bodies absorb when eaten at the same time as meat, fish, poultry, beans, lentils, spinach, peas, nuts or raisins.

Melons are also good sources of dietary fiber, which prevents constipation and promotes heart health. Cantaloupe and watermelon, with their bright red and orange colors, are also good sources of vitamin A. This vitamin plays key roles in normal vision, immunity, future reproduction, as well as normal organ function. Potassium, essential for brain and nerve function, muscle growth and function, in addition to water balance, can also be easily found in cantaloupes. The list goes on and on. All melons are well-rounded and scrumptious sources of nutrients essential for growth, energy, normal function.

MELONS & FOOD SAFETY

Melons are nutrition powerhouses, but improperly handled food can spoil the fun. Remember, melons grow in the ground sitting on dirt. This is why melons should always be washed and scrubbed prior to slicing into it. If not, we risk moving any illness-causing bacteria from the outside of the melon to the inside. Be sure to wash your hands and never use an unwashed knife or cutting board–especially if it was used for meat. Once cut, keep melon cold or else discard after two hours of being at room.

RECIPES

Honeydew Avocado Salsa

zest of one lime

2 tbsp lime juice

1 tbsp olive oil

2 ½ cups honeydew melon, diced

avocado, diced

salt and pepper, to taste

Simply toss ingredients together and enjoy!

Variations:  toss diced melon and/or any other fruit with lime juice, green onions, chiles and herbs for versatility.

Minted Watermelon Popsicles

4 cups seedless watermelon, diced

2 tbsp sugar

¼ cup mint leaves, minced

2 tsp    lemon zest, finely grated

pinch of salt

Puree watermelon with sugar in a blender or food processor until smooth. Stir in remaining ingredients and pour into ice cube trays or popsicle molds. Freeze until hard, about three hours, inserting popsicle sticks halfway through freezing.

Variations:  cantaloupe with lemon juice; honeydew with lemon juice and cinnamon; watermelon with lime juice and cayenne

Recipe Sources:  Food & Wine

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Healthy Eating Tips for the School Year

It’s time to head back to school, and with that comes a fresh opportunity to establish new habits with children and teens. As your family falls into a routine around the school day, be sure to incorporate healthy eating into the mix to ensure everyone has a strong year.

Tips for School-Age Children (Ages 6-12)

School-age children need healthy foods and nutritious snacks to fuel their busy bodies. They have a consistent but slow rate of growth, requiring them to eat four to five times a day (including snacks). Eating healthy after-school snacks is important, as these snacks may contribute up to one-third of the total calorie intake for the day. Remember that school-age children may also be eating more foods outside of the home.

Many food habits, likes and dislikes are established during this time. This makes it a perfect time to experiment with new foods, as school-age children are often willing to eat a wider variety of foods than their younger siblings.

Follow these seven tips to ensure good nutrition habits for school-age children:

  1. Always serve breakfast, even if it has to be “on the run.” Some ideas for a quick, healthy breakfast include fruit, milk, bagel, cheese toast, cereal, peanut butter sandwich and fruit smoothies.
  2. Take advantage of big appetites after school by serving healthy snacks, such as fruit, vegetables and dip, yogurt, turkey or chicken sandwich, cheese and crackers, or milk and cereal.
  3. Make healthy foods easily accessible.
  4. Allow children to help with meal planning and preparation.
  5. Serve meals at the table, instead of in front of the television, to avoid distractions.
  6. Fill half of the plate with colorful fruits and vegetables.
  7. Provide calorie-free beverages (water) throughout the day, to avoid filling up on non-nutritive calories.

healthy eating tips

 Tips for Adolescents and Teens (Age 13 and Up)

During adolescence, children become more independent and make many food decisions on their own. Many adolescents experience a growth spurt and an increase in appetite, and they need healthy foods to meet their growth needs. Adolescents tend to eat more meals away from home than younger children. They are also heavily influenced by their peers.

Discuss these nine healthy eating tips with your adolescent to ensure he or she is following a healthy eating plan:

  1. Have several nutritious snack foods readily available. Oftentimes, teenagers will eat whatever is convenient.
  2. If there are foods that you do not want your teens to eat, avoid bringing them into the home.
  3. Drink water. Try to avoid drinks that are high in sugar. Fruit juice can have a lot of calories, so limit your adolescent’s intake. Whole fruit is always a better choice.
  4. When cooking for your adolescent, try to bake or broil instead of fry.
  5. Make sure your adolescent watches (and decreases, if necessary) his or her sugar intake.
  6. Eat more chicken and fish. Limit red meat intake, and choose lean cuts when possible.
  7. Arrange for teens to find out about nutrition for themselves by providing teen-oriented magazines or books with food articles and by encouraging them and supporting their interest in health, cooking or nutrition.
  8. Take their suggestions, when possible, regarding foods to prepare at home.
  9. Experiment with foods outside your own culture.

Get more tips for establishing healthy eating habits with kids.

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Coming Soon: A New Food Label!

By Stephanie Prideaux, Dietetic Technician, Registered at CHOC Children’s

“Very soon you will no longer need a microscope, a calculator or a degree in nutrition to figure out whether the food you’re buying is actually good for our kids,” joked First Lady Michelle Obama on the night that the biggest changes to the food label in twenty years were publicly announced.

These updates are made to reflect new scientific knowledge and respond to America’s current state of health. The nutrition facts tell us what is in our food so that we can make healthy choices to fuel our busy lives and prevent disease.

What’s New?

The new rules affect the familiar black and white (and commonly overlooked) nutrition facts panel. Companies can start at any time, but you can be sure to see them by July 27, 2018. Familiarize yourself with the major changes so you can be sure you’re buying the best foods for you and your family.
new food label

Big and Bold Calories
Calories (the amount of energy food contains) per serving will now be bigger and bolder, making them easier to read.

Serving Sizes That We Actually Eat
Instead of the standard portion sizes used in the past, these new servings will be increased or decreased to match the amount that people in the U.S. normally eat. Odd-sized servings, like a 20-ounce bottle of coke, which would previously have read as one and a half servings, will be labeled as one whole serving. Packages with multiple servings that might also be eaten in one sitting, such as a bag of chips, will have two columns: one with nutrition information per serving and another with information per whole package.

Added Sugar
Packages will also start to list how much sugar was added to sweeten the product. Watch out, because every 4 grams added is like putting a whole teaspoon of sugar in your food or drink!

Percent Daily Values (%DVs) Updated and Better Explained
Percentages posted to the right of each nutrient are a simple guide that most people can use to make healthy food choices. Remember that we only need to eat 100 percent of these. So, if all of our foods for the day are adding up to be far above or under 100 percent, you may want to make different choices in your meal pattern. For example, many Americans are eating too much sodium and cholesterol, which can lead to heart disease.

Say Hello to Vitamin D and Potassium
Vitamin D and potassium play important roles in health and preventing chronic disease, but many people are not getting enough. These have been added to help people make healthy choices toward meeting their recommended daily intake.

Goodbye, Vitamins A and C!
These days, it is rare for someone not to get enough of these two vitamins. We still need them, but we can happily say goodbye to them from our nutrition facts panel.

The Bottom Line:

 While these changes are baby steps in the right direction, for many people the new label may not be as user-friendly as we originally hoped this version would be.

Many of the healthiest foods you can find will never even have a food label. Fruits, vegetables, nuts, seeds, whole grains, beans, meats, dairy, and water are whole unprocessed items that will help us reach 100 percent of the nutrients we need to help us feel great, look great and prevent chronic disease.

All foods can fit into a healthful lifestyle. When choosing packaged foods, remember to read the label and be a little like Goldilocks with your nutrients: not too much, not too little, but juuuuust right.

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5 Tips for Developing Healthy Eating Habits in Kids

By Shonda Brown, RD, CSP, CNSC, clinical dietitian at CHOC Children’s

Kids’ food preferences are influenced in large part by their caregiver’s own food preferences, as well as the behavior they model. Too often parents want their children to eat healthy, but they either don’t offer healthy options or don’t eat healthy foods themselves.

Helping children develop healthy eating habits early in life as well as assuring adequate nutritional intake during a time of rapid growth and development is paramount in reaching and maintaining health well into adulthood. In fact, research has shown that exposing toddlers to a variety of foods and flavors increases the number of foods accepted in later childhood.  Unfortunately, less than half of children 2-17 years old meet their recommended daily intakes of vegetables, seafood and beans, and less than 20 percent of their recommended intake of whole grains, according to a 2010 study by The Healthy Eating Index, a report of the United States Department of Agriculture.  A report from the Feeding Infants and Toddlers Study showed that approximately 25 percent of children failed to eat a single serving of fruit or vegetables on the survey day and up to 85 percent of children consumed some type of sweetened beverage, dessert or salty snack. Sadly, of the vegetables consumed, french fries were the most popular.

More than one quarter of total daily calories are consumed outside the home, highlighting the need to assure meals purchased at restaurants are providing children with balanced nutrition. The National Restaurant Association introduced the Kids LiveWell program in 2011 in an effort to improve the nutritional quality of food and beverages offered on kids’ menus. Improvements over the past few years include restaurants now providing fruit and vegetables as side options instead of fries or chips, and milk or water instead of soda. However, only 9 percent of meal combinations offered at the top 50 restaurant chains meet the Kids LiveWell nutritional guidelines.

Here is what you can do to turn the tables on “kids’ food”. Incorporate the following tips to help children choose healthy foods and develop healthy eating patterns that may last a lifetime.

  1. Prepare meals together

Have your child create a new meal or snack from a few healthy ingredients. Talk about how it smells, tastes, looks and feels. Children as young as two years old can help out in the kitchen. You can have your child wash fruits and vegetables, or stir ingredients. Children are more open to trying new foods if they have opportunities to explore and learn about the food before they eat it.

  1. Make healthy foods fun

Be creative when offering new foods. You can make bugs with fruit kabobs or faces with vegetables on homemade pizza. Giving foods fun names is always a hit – like “monster brains” for cauliflower or “silly billy green beans.”

  1. Help them learn to love a variety of healthy food

Start by setting an example – a child is more likely to accept a new food if they observe parents, siblings or friends taste and enjoy the food.  Food acceptance is also related to exposure. It often takes 10-15 times before a child may accept a new food so it is important to be patient as well as persistent. Some helpful tips are

  • Offer small portions at first
  • Offer a new food with familiar foods
  • Allow your child to decide if they are going to try the new food
  • Offer praise when a child tries a new food
  1. Make mealtimes family time

Children who eat meals with their families at home have better quality diets and higher intake of fruits and vegetables. Remove any distractions such as TV or iPads from the dinner table. Allow children to make choices and serve themselves – this empowers them and gives them confidence. Enjoy time together as a family and talk about fun things that happened during the day.

  1. Make healthy choices when dining out

There are no magical foods that only kids eat. Children can be served the same foods as the rest of the family. If you are out at a restaurant, you can skip ordering from the kids menu and order a healthy option from the regular menu. The portion size will likely be more than what your child needs, so you can share between siblings or bring home leftovers. If you order from the kids menu, chose the fruit, yogurt or veggie sides instead of high calorie, low nutrient sides such as chips and french fries. Skip the sugary beverages such as soda and chose low fat milk or water instead.

Keep healthy foods available whenever you can, and maintain a relaxing and encouraging environment around mealtimes. You never know, your child may just munch on Swiss chard picked fresh from the garden, beg that you prepare scallops for dinner or think raisins and nuts are dessert.

Learn more about nutrition services at CHOC Children’s.

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Get Up and Grill!

By Amanda Czerwin, RD, CLEC, clinical dietitian at CHOC Children’s

Summer is here! And you know what that means- it’s time to get outside and start firing up the grill. Barbequing is a great way to bring your family and friends together and cook up a nutritious meal at the same time. Here are a few tips for your next grilling adventure in order to make a safe and tasty meal.

Before throwing your foods over the fire, make sure your grill is clean and ready to go. Consider using alternative products that may be safer for your environment. Then light up your barbeque and allow it to thoroughly heat up before cooking to kill any lingering bacteria.

Now comes the difficult task of deciding what to cook up! There are plenty of ways to get creative and try something different besides the typical hot dogs and hamburgers. If you’re looking to cook meat, then try choosing some leaner options such as chicken, fish, ground turkey or lean pork chops. It’s important to also avoid charring your meat as much as possible to prevent any carcinogenic compounds from forming. According to the Academy of Nutrition and Dietetics, one of the best ways to prevent this is by trimming any extra fat and skin off your meats before cooking. When fat drippings fall off meats, it can cause flames to flare up, causing extra charring. It’s also recommended to cook your foods over a longer period of time, at lower temperatures to avoid charring. You can also turn your food over frequently while cooking and scrape off any charred areas.

Brighten up your grill with colorful vegetables to add more flavor and nutrition to your meals. Put together delicious vegetable kabobs with veggies like zucchini, onions, cherry tomatoes, mushrooms and bell peppers. And who said burger patties had to be made out of meat? Switch it up one night and try grilling a black bean burger or making your own veggie patties using your favorite finely chopped vegetables.

You can even grill fruits too! Grill fresh pineapples slices and add them to a turkey burger or grill a colorful fruit kabob and add it to a fresh salad. Fresh grilled peaches or bananas added to angel food cake, low-fat ice cream, or whipped cream can also make a tasty treat.

Try cooking up this recipe at your next barbeque!

Quinoa Black Bean Burgers:

Ingredients

  • 1 (15 ounce) can black beans, rinsed and drained
  • 1/4 cup quinoa
  • 1/2 cup water
  • 1/2 cup bread crumbs
  • 1/4 cup minced yellow bell pepper
  • 2 tablespoons minced onion
  • 1 large clove garlic, minced
  • 1 1/2 teaspoons ground cumin
  • 1/2 teaspoon salt
  • 1 teaspoon hot pepper sauce (such as Frank’s RedHot Sauce)
  • 1 egg
  • 3 tablespoons olive oil

Directions

  1. Bring the quinoa and water to a boil in a saucepan. Reduce heat to medium-low, cover, and simmer until the quinoa is tender and the water has been absorbed, about 15 to 20 minutes.
  2. Roughly mash the black beans with a fork leaving some whole black beans in a paste-like mixture.
  3. Mix the quinoa, bread crumbs, bell pepper, onion, garlic, cumin, salt, hot pepper sauce, and egg into the black beans using your hands.
  4. Form the black bean mixture into 5 patties.
  5. Heat the olive oil in a large skillet.
  6. Cook the patties in the hot oil until heated through, 2 to 3 minutes per side.

Recipe via www.allrecipes.com

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Boost Your Health with Spiralized Vegetables

By Jill Nowak, RD, CDE, CLEC, clinical dietitian at CHOC Children’s

There is a popular trend transpiring with preparing vegetables, known as “spiralized vegetables.” Spiralizing vegetables can be more appealing and accepting to those who struggle with eating vegetables, and it’s also a great way to sneak extra vegetables into your loved ones’ diets who are picky eaters.

Thanks to this new trend, eating your vegetables just got easier. Spiralizing vegetables can be achieved when using the latest new kitchen tool, the spiralizer, which turns vegetables into noodles.  Spiralizers can be found in a variety of kitchen home stores or purchased online for a variety of price points, depending on features, accessories, and blade options. Other alternatives to the spiralizer include a grater, mandolin, julienne peeler or conventional vegetable peeler, which can achieve similar spiralized effects. Firm vegetables work best and keeping the skin on when possible increases the fiber and nutrient content.

Some of the best vegetables to spiralize include:

  • Beets
  • Butternut
  • Broccoli Stalks
  • Carrots
  • Jicama
  • Potatoes (Russet, Yukon Gold, Sweet)
  • Squash (Butternut, Zucchini, Yellow)

Spiralized vegetables can be served raw or slightly cooked in salads, soups, side dishes, casseroles or main entrées. Preparation can include sautéing in a little olive or grapeseed oil, boiling, baking or simmering. Not only can spiralized vegetables help boost our vegetable intake, but they can provide more options to families with diverse nutrition profiles or goals. For example, spiralized vegetables can be another alternative to pasta for those living with food allergies or sensitivities to wheat or gluten, such as celiac disease. Also, vegetable noodles can be an option for individuals watching their calories or those living with diabetes who may be watching their carbohydrate intake. Here’s the breakdown- 1 cup of pasta is around 200 calories and45 grams of carbohydrates.  Swap it out with zucchini noodles, with a larger portion size of 2 cups, and it’s about 70 calories and14 grams of carbs. Clearly, spiralizing vegetables is a win-win, boosting our vegetable consumption, while satisfying and meeting our health goals. 

Here are two recipes to enjoy…have fun spiralizing!

Zucchini Noodles with Cilantro-Avocado Pesto
5 zucchini
2 cups cherry tomatoes (optional)
1 avocado
1/2 cup pecans
2 cloves garlic
1 handful cilantro
1 handful parsley
2 tablespoons lime juice
a dash of kosher salt
a dash of black pepper ground

Step 1: Make zucchini into noodles using a spiralizer, or alternative method using a julienne or vegetable peeler or mandolin set on the julienne setting.

Step 2: Make your sauce by combining the last 6 ingredients (pecans to lime juice) in a food processor or blender, then pulse on high until smooth.

Step 3: Each person will get a zucchini (turned into noodles) for themselves. Toss 1/5 of the dressing on the noodles, stir, and top with cherry tomatoes or other veggies of your choosing.

Nutrition Facts:  Serves 5 (serving size: 1 zucchini with 1/5 sauce) CALORIES 159; FAT 12.7g (sat 1.4g, mono 7.15g, poly 3g); PROTEIN 4.1g; CARB 11.14g; FIBER 4.8g; CHOL 0mg; IRON 1.5mg; SODIUM 44.5mg; CALC 51.3mg

For a tutorial on using a spiralizer, this recipe and more spiralized recipes visit: www.cookinglight.com

Zucchini Noodles with Turkey Meatballs

Meatballs

Cooking spray

1 ¼ pounds lean ground turkey

2 garlic cloves, minced

1 tablespoon dried oregano¼ cup fresh Italian parsley, finely chopped

1 teaspoon dried minced onion

2 tablespoons grated Parmesan cheese

1 egg, slightly beaten

½ cup oatmeal (use Gluten Free (GF) oats for those requiring a GF diet)

 Noodles and Sauce

1 (24-ounce) jar lower-sodium pasta sauce

4 medium zucchini

 Instructions

  1. Preheat the oven to 375 degrees F.
  2. Coat a baking sheet with cooking spray.
  3. Mix the turkey, garlic, oregano, parsley, dried onion, parmesan cheese, egg, and oatmeal in a bowl and mix well.
  4. Scoop the meat mixture into 12 meatballs and lay them on the baking sheet. Bake the meatballs for 25-30 minutes or until cooked through and they reach an internal temperature of 165 degrees F.
  5. While the meatballs are cooking, use a, a spiralizer, julienne peeler or mandolin set on the julienne setting and cut the zucchini into “noodles”.
  6. Place the noodles in a large microwave dish with a lid and microwave for 2 minutes. Heat the marinara sauce in a large sauce pan. Add the cooked meatballs to the hot sauce and pour over zucchini noodles.

 Nutrition Facts: (serving size: 1 zucchini + 3 meatballs) CALORIES 445; FAT 20 g (sat 4.8g); PROTEIN 37g; CARB 29g; FIBER 7g; CHOL 150mg; SODIUM 605mg  POTASSIUM 605 mg

See more at www.diabetes.org.

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Brighter Futures for Families with PKU

May is PKU Awareness Month

By Mary Sowa, MS, RD, CSP, CNSC, CLEC and Jan Skaar, RD, CSP, CNSC, CLE, clinical dietitians at CHOC Children’s

Did you know that one in 10 Americans is living with a rare disease? Phenylketonuria (PKU or PAH) is a rare genetically-inherited disorder that occurs in one in 10,000 to 15,000 newborns in the United States. PKU was the first disorder to be identified at birth by the California Newborn Screening (NBS) program, which now screens for over 70 rare disorders. The main focus for NBS is to detect conditions that can be treated with diet or medications to prevent intellectual and other disabilities.  NBS has been identifying babies born with this condition, allowing early treatment and improved outcomes, for five decades. In decades past, treatment options were limited, often resulting in severe intellectual disabilities.

Individuals with PKU are unable to process the amino acid phenylalanine (Phe), which is an essential amino acid found in foods with protein. Children with the “classic” form of PKU need to avoid meat, chicken, fish, eggs, nuts and other foods with high protein content. They may also need to avoid regular breads, pasta, cereals and grains. It is not just a vegetarian diet. Daily intake of a specialized formula, which provides a source of Phe-free protein, vitamins and minerals, is essential for regulating blood Phe levels. Compliance with the specialized formula and low protein food products is the cornerstone to help prevent complications associated with high Phe levels in the brain. Elevated Phe levels can affect school performance, sleep, disposition and executive functioning. Experts recommend that individuals with PKU follow a “Diet for Life.”

“A disorder that is treatable with a special diet?” That must be the end of the story, you might think. Far from it. Besides having more taste-friendly options on the market for specialized PKU formulas, there have been advances in treatment options that were not available to PKU families a couple of decades ago. These include a medication called sapropterin to lower Phe levels in the blood, therapy with large neutral amino acids, and enzyme substitution.

Sapropterin dihydrochloride is a FDA-approved medication that helps the phenylalanine hydroxylase (PAH) enzyme work more effectively to break down Phe in the body. A trial period of close patient monitoring with frequent blood tests is conducted while initiating the sapropterin. Those individuals that are responders to the medication are able to control their blood Phe levels and have a more liberalized protein intake.

For some patients, it may mean the difference between tasting a hamburger or just dreaming about it.

Large neutral amino acids (LNAA) are another treatment option. They are most often used with older teens or adults who have problems controlling their Phe levels with diet or do not respond to the sapropterin. The individual with PKU has a “flood” of Phe in the blood from protein ingestion and the inability to breakdown the Phe into Tyrosine. The LNAA compete with Phe for transporter cells in the GI tract and later transfer across the blood-brain barrier. The LNAAs are considered “safe” amino acids for the brain and reduce the amount of Phe that enters the brain. A decrease in blood Phe levels may not be evident in the blood, however a decrease in brain Phe may help improve the neurocognitive deficits and executive functioning challenges seen in PKU.

In addition, human trials with an enzyme substitute called phenylalanine ammonia lyase (PAL) have been underway as a new treatment option. This is an injectable form of alternate enzyme found in plants and bacteria that can break down Phe into harmless components. The active compound is coated with ethylene glycol to protect it from the body’s immune system or is “pegylated.” The compound known as “PEG-PAL” must be injected daily and has been shown to lower blood Phe levels.

Significant challenges remain for individuals and families with PKU to achieve and maintain optimal blood Phe control and improved health outcomes. However, there are many more available tools for success than in previous years. Gene therapy is also a potential option on the horizon.

The CHOC Metabolic Clinic team, under the direction of Dr. Jose Abdenur, consists of dedicated staff to help patients with PKU and their families adhere to “diet for life” and other therapies. The team provides ongoing treatment, support and education for our PKU families and includes dietitians with specialized training in medical nutrition therapy for PKU and a variety of other metabolic disorders.

Learn more about CHOC’s Metabolic team.

Choosing the Right Milk for Your Family

By Rima Kandalaft, MS, RD, CSP, clinical dietitian at CHOC Children’s

Milk is the white liquid that comes out of the udder of cows and other mammals, right? Well mooooove over cows, several plants are being “milked” too. Plant-based milk alternatives have been gaining in popularity recently. Consumers can choose from soy milk, almond milk, rice milk and many others.

A quick stop at the supermarket to grab some milk is not so quick anymore. You walk down the dairy section and you are confronted with endless choices:  cow’s milk with three to four varieties of fat content, with or without lactose, plain or flavored. Not to be outdone, plant-based milk alternatives are also available in several flavors, and with varying fat contents.

Let’s take a look at the nutritional benefits of cow’s milk.

It is packed with good-for-you nutrients like protein, calcium and phosphorous. An 8-ounce cup of whole milk has about 150 calories, 8 grams of protein, 8 grams of fat, and 12 grams of carbohydrates (mostly the milk sugar known as lactose). Skim milk has all the goodness of whole milk, but no fat and only 90 calories. It is an option for those trying to cut back on calories and/or saturated fat and cholesterol.

People who are lactose intolerant don’t have enough lactase, an enzyme necessary for digesting the lactose in milk. Lactose-free milk is processed to break down lactose.

So what about the non-dairy milk beverages available?

Plant-based milk alternatives, such as soy, almond, cashew, rice and coconut milk, are good choices for vegans and vegetarians, or for those with allergy concerns. They are typically fortified with calcium, vitamin D and other nutrients. They are lower in calories than dairy milk, unless they are sweetened. With the exception of soy milk, they are quite low in protein.

You may have heard about a new product on the US market called A2 milk™. It’s produced and marketed by a company based in New Zealand, where A2 milk was introduced about 15 years ago.

Let’s look at basic dairy science. Milk proteins are 80 percent casein and 20 percent whey. Beta-casein is the second major casein protein. The two major genetic variants are A1 and A2 beta-casein. They differ by one amino acid at position 67 in the protein chain.

Regular cows’ milk contains both A1 and A2 beta-casein. The A2 milk™ brandcontains only A2 beta-casein. This is achieved through selective breeding of the dairy herd.

A few studies correlate A1 beta-casein with various adverse health effects, and suggest that for certain individuals, A2 beta-casein may be a better choice.

A pilot study published in 2014 in the European Journal of Clinical Nutrition compared the gastrointestinal effects of A1 versus A2 beta-casein, in 41 males and females. Consumption of A1 beta-casein milk was associated with looser stools than A2 milk™. Fecal calprotectin, a marker of gastrointestinal inflammation, correlated highly with subjective measures of digestive discomfort on the A1 diet but less on the A2 diet.

While the “A1 versus A2” debate continues, we will have to wait for more robust studies to validate the health claims.

In conclusion, the next time you go shopping for milk, arm yourself with a few milk facts to help you pick the right milk for you and your family-one that meets your nutritional needs and taste preference.

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