Gluten-Free Diets: Tips for How to Support Your Child

By Laura Clapper, registered dietitian at CHOC Children’s

Many people assume that since gluten can have such strong negative effects on some of us, that it would be safer if we all just avoided gluten. Wrong.

Gluten-free foods may be safe to eat, but they often come with a cost. Many gluten-free foods and snacks are higher in salt, fat and calories. Also, few gluten-free products are enriched with the essential vitamins and minerals that wheat-containing products contain. This means if you’re on a gluten-free diet not managed by a registered dietitian, you could be missing out on essential nutrients your body needs. At CHOC, our team of pediatric gastroenterologists work in tandem with registered dietitians to care for children who require a gluten-free diet.

Who needs to eliminate gluten from their diet?

Gluten-free diets are essential for anyone who has been diagnosed with celiac disease, or non-celiac gluten sensitivity. Children diagnosed with a wheat allergy are hypersensitive to wheat proteins, but generally can tolerate rye and barley. Learn more about celiac disease, gluten sensitivity and wheat allergies.

The gluten-free diet requires eliminating all foods and ingredients containing gluten. Here’s an easy checklist of foods and ingredients to avoid when removing gluten from your diet:

  1. Wheat (legally required to be declared on food labels)
    • Breads, baked goods
    • Soups
    • Pastas
    • Cereals
    • Sauces, roux
  2. Rye
    • Rye bread
    • Cereals
  3. Barley
    • Malt (malted flour, malted milkshakes, malt extract, malt syrup, malt flavorings, malt vinegar)
    • Soups
    • Cereals, snack bars
    • Brewer’s yeast (commonly used not only in beer but also in breadmaking)

Most people would know not to offer, say a traditional bagel or piece of toast to a child on a gluten-free diet. But parents and caregivers should be aware of the many hidden sources of gluten.

Hidden sources of gluten:

  • Broths
  • Chili sauce, soy sauce, salad dressings and marinades
  • Herbal supplements and teas
  • Deli meats
  • Play-dough
  • Vitamin and mineral supplements

Another important factor in adhering to a strict gluten-free diet is avoiding cross contamination.

Tips for avoiding cross-contamination in a gluten-free diet:

  • Use separate utensils, cutting boards, toaster, colanders and fryers
  • Store gluten-free items above gluten-containing products on shelves
  • Use a color-coded system so everyone in your home can easily identify gluten-containing and gluten-free products and ingredients
  • Use separate condiment jars, squeeze bottles and no double-dipping
  • Avoid bulk bins at a grocery store or farmers market, since utensils can be contaminated
  • Use caution with salad bars because toppings can easily be mixed

Another way to support your child with their gluten-free diet is to encourage them to eat naturally gluten-free foods such as vegetables, fruits, dairy, whole grains and legumes. Gluten-free grains and seeds include: brown rice, corn, gluten-free oats, popcorn, and quinoa. Gluten-free beans and legumes include: black/garbanzo/lima/pinto/kidney beans, edamame, lentils and peas.

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Ideas for Kid-Friendly Beach Food and Kid-Friendly Beach Snacks

By Gina O’Toole, clinical dietitian at CHOC Children’s

Summer is just around the corner, and soon school will be out. Beach days are a great way to spend an active day with your kids and enjoy the great weather of Southern California. With just a bit of pre-planning, you will be on your way to a healthy, hydrating and energy-packed meal plan filled with kid-friendly beach food and kid-friendly beach snacks. Avoid the hot and long lines at the beach food stand, which typically serve highly processed foods that are overpriced and can leave you feeling fatigued and dehydrated. So besides bringing the essential sunscreen, towel, umbrella and swim suit, here are a few tips to optimize your day.

Food safety at the beach

Food safety is key. Make sure you pack food in a cooler to prevent any foodborne illness for items like meat, cheeses and yogurts. You can freeze water bottles to provide ice for the food and a cold drink for later in the day or the drive home. Dust baby powder on sand-caked hands for easy removal, then follow with an antibacterial wipe before your kids dig into their beach eats.

Plan ahead the night before. Decide what snacks and lunch items you will prepare. When packing your picnic, utilize foods that are pre-packaged or easy to pre-pack and do not easily melt. Bring along an empty plastic grocery bag for trash and paper towels and plastic utensils for easy disposal.

How to keep hydrated at the beach

Focus on rehydrating with water, and avoid juices and sodas that contribute unnecessary calories and sugar to your diet.

Consider adding fruit, veggies and/or herbs to spice up plain water and make it more appealing to your kids. Try lime-mint, strawberry-basil, cucumber-blackberry or just plain orange or lemon slices. Avoid juices and sodas that contribute unnecessary calories and sugar

Or, try sparkling waters with no added sugars

Kid-friendly beach food
  • Peanut butter with sliced bananas and cinnamon on whole grain bread
  • Pasta salad: Whole wheat pasta, diced tomato, bell peppers, shredded carrots and zucchini; drizzle with balsamic vinegar and olive oil; sprinkle with salt, pepper and parmesan cheese (Best when made the night before to allow flavors to soak in)
  • Wrap it up with a whole grain tortilla
    • Rainbow wrap: Cream cheese, spinach and your child’s favorite crisp veggies (Carrots, cucumber, peppers, zucchini or summer squash)
    • Bean and guacamole wrap: Guacamole, black or pinto beans, cooked brown rice and shredded jack or cheddar cheese
    • Eggs for lunch: Sautee peppers, onions and scramble eggs, top with a sprinkle of cheddar or jack cheese
    • Herby turkey: Herbed cream cheese, nitrate free turkey, spinach or romaine lettuce, thin sliced tomato)
  • Pair your main meal with additional sliced and refreshing veggies like jicama, cucumber, celery or cherry tomatoes
  • For desert, try some ripe and sweet summer produce. Sliced watermelon, cantaloupe or honeydew and cherries are all refreshing on a hot day. Although nectarines, peaches and apricots are at their prime during beach season, they bruise easily and need to be packed carefully.
Kid-friendly beach snacks

Pair food groups (protein, fat, carbohydrate) to give you energy and keep you full longer:

  • Pre-cut cucumbers and peppers with a single-serving hummus pack
  • Pre-cut apples or celery and single-serving peanut, almond or cashew butter
  • String cheese and grapes
  • Single-serving cottage cheese and fresh cut strawberries
  • Single-serving plain Greek yogurt with fresh blueberries
  • Pre-packaged nuts
  • Fresh or dried edamame

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Benefits of a Mediterranean Diet for your Family

By Monica Evans, clinical dietitian at CHOC Children’s

If there’s one diet that most dietitians agree is healthy and good for the whole family, it’s the Mediterranean diet. Chock-full of plant-based foods like fruits, vegetables, whole grains, beans, and nuts, the Mediterranean diet has all the makings of nutritious and sustainable way of eating. Research in adults has shown that the traditional Mediterranean diet reduces the risk of heart disease, some cancers, as well as Parkinson’s and Alzheimer’s diseases. In children, the abundance of fruits, vegetables and whole grains in the diet provide important vitamins and minerals that help support growth and development.

Here are some Mediterranean diet basics to get you started:

  1. Center most of your meals on plant-based foods rather than a heavy protein food, like meat. The typical American meal is often created around a higher-fat meat. Switching that meat to a vegetable, bean or whole grain can deliver a healthy dose of fiber and take away the unhealthy saturated fats that can eventually lead to heart disease.
  2. Eat more beans! Red meat is discouraged in the Mediterranean diet, but when you’re craving something similar, try beans. They are full of protein and fiber and are low in fat.
  3. More fish please! Seafood is high in heart-healthy omega 3 fatty acids and protein. Another benefit of fish is that it typically takes less time to cook than chicken, turkey or beef.
  4. Replace butter with olive oil, which contains monounsaturated fat and can help reduce LDL (or bad) cholesterol levels.
  5. Have nuts as a snack or add them on to meals. Small amounts of nuts can help keep you full throughout the day and give your body a hefty dose of heart-healthy fats.
  6. Limit red meat consumption to only a few times per month. Beef, lamb and pork are typically high in saturated fat and the Mediterranean diet discourages consuming them often.
  7. Enjoy low-fat dairy. Dairy products can be high in saturated fat, but choosing lower-fat milk and cheese products allows you to receive the same essential vitamins and minerals important for growth and development without the high levels of unhealthy fat.

The best way to incorporate a new way of eating is to do it slowly and intentionally. Analyze your family’s diet and identify foods that you could easily swap out for healthier, more Mediterranean diet-friendly foods.

Easy ways to incorporate the Mediterranean diet into your lifestyle:

  • If you like cucumbers with ranch dressing, try dipping cucumber in hummus
  • Instead of serving spaghetti with buttered garlic toast, cook whole grain spaghetti served with bread dipped in olive oil and minced garlic
  • Swap beef tacos with tortilla chips for fish tacos with black beans

Try homemade trail mix with nuts and dried fruit for a snack

Mediterranean-friendly family recipes:

Easy Hummus Recipe

  • 1 15 oz can garbanzo beans/chickpeas, drained and rinsed
  • 2 garlic cloves
  • 2 tbsp lemon juice
  • 3 tbsp extra-virgin olive oil
  • 3 tbsp water
  • ½ tsp ground cumin
  • ¼ tsp salt

Place beans, garlic, lemon juice, oil, and water into food processor. Blend to desired consistency. Season with cumin and salt. Enjoy with whole grain crackers or fresh vegetables.

Adapted from

Fig & Honey Yogurt

  • 2/3 cup low-fat plain Greek yogurt
  • 3 dried figs, sliced
  • 2 tsp honey

Top yogurt with fig slices and honey. Enjoy!

Recipe via

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Tips for Getting Your Child to Try New Fruits and Vegetables

By Caitlyn DePasquale, registered dietitian at CHOC Children’s

Spring is upon us and this is the season that we begin to see an influx of fresh produce including fruits, vegetables and herbs in gardens and our local grocery stores. Despite the countless options you make available to your family during this time of year, do you find yourself relentlessly offering your children new fruits and vegetables just to have them turn their noses up time and time again? You aren’t alone. Most children in the U.S. do not meet their daily recommended fruit and vegetable intake, according to the Journal of The Academy of Nutrition and Dietetics.

There are numerous ways you can help to increase your children’s willingness to try new fruit and vegetables this spring by allowing them to be active participants in weekly meal planning and daily meal prepping tasks. Include your children in the following task at home.

  1. Commit to Meal Planning – Allow your children to help create your weekly grocery list. Encourage them to add one or two new fruits or vegetables to your list they will be willing to try over the next week. Younger children may enjoy being challenged to choose colorful produce that range the colors of the rainbow while your older children might enjoy searching for new, healthy recipes in your cookbooks or magazines at home.
  2. Grocery Shopping – Be sure to take your children grocery shopping with you. This will provide exposure to new foods and allows an opportunity for discussion about healthy foods and eating. Challenge your children to choose foods on the perimeter of the grocery store, as these are the areas that generally house fresh, whole foods such as fruits and vegetables. Steer away from the more processed, convenience foods and snacks most often found in the center aisles.
  3. Meal Preparation/Cooking – Encourage your children to participate in meal preparation and cooking. Appropriate tasks will depend on age. Delegate tasks such as setting the table, rinsing produce, mixing sauces or measuring ingredients.

These are all small ways to exposure your children to healthy eating and may help to increase interest in trying new fruits and vegetables. If time and space allow, gardening can also be a fun, interactive activity for children. Your children are sure to be more willing to try new fruits and vegetables after watching their food grow from start to finish. April marks National Gardening Month so now is a perfect time to create a family garden. While planting and maintaining a fruit and vegetable garden may seem like an overwhelming task, start small this spring by putting together a fresh herb garden with your children. Use a small pot to plant herbs such as basil, chives, parsley, mint, sage, lavender or rosemary. Fresh herbs are sure to be a fun way to add new flavors to meals and snacks!

Try this flavorful, nutrient packed dip for dipping vegetables. Children of all ages will be sure to enjoy picking the ingredients from their very own herb garden.

Whipped Fresh Herb Cheese Recipe


2 containers (16 ounces each) low-fat cottage cheese
¼ cup fresh chopped chives
¼ cup fresh chopped basil
¼ cup fresh chopped flat-leaf parsley
1 clove garlic, minced
3 tablespoons fresh lemon juice (about 1 lemon)
Black pepper to taste


  1. Combine the first six ingredients and mix well.
  2. Add black pepper to taste.

Recipe from

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National Nutrition Month 2018: “Go Further with Food” and Reduce Food Waste

By Vanessa Chrisman, registered dietitian at CHOC Children’s

In America, we live in the land of the plenty. Food costs are low compared to other parts of the world. Despite being the world’s biggest individual exporter of food, about 40 percent of all food produced in the U.S. does not get eaten. The foods most commonly thrown out are fruits, vegetables, dairy products, and seafood. It has been estimated that the average American household throws away over $1,400 worth of uneaten food each year. Much of this wasted food contains healthy nutrients like vitamins, minerals, and dietary fiber. So not only are we wasting money, we are wasting nutrients that benefit our health.  Despite this food waste, 41 million people in the U.S. struggle with hunger.

How do we turn this trend around? This year for National Nutrition Month® , the Academy of Nutrition and Dietetics has tackled this topic and identified that the solution needs to start at home. The first step involves fueling up wisely with food. A nutritious well-planned meal is the perfect start to a busy day of work or school. Eating the right foods will help you “go further.”  Planning and preparing your foods to go further can also help to reduce food waste. Below are some tips on how to reduce food waste in your home.

Keep Foods Fresh:

  • Place foods that spoil quickly within plain sight in the refrigerator or on the counter top
  • Store produce properly
    • Refrigerate these fruits and vegetables:
      • Apples, apricots, berries, cherries, figs, grapes, cut fruit, artichoke, asparagus, green beans, lima beans, beets, broccoli, endive, Brussels sprouts, carrots, cabbage, cauliflower, celery, green onions, leafy greens, leeks, lettuce, mushrooms, peas, radish, spinach, sprouts, summer squash, sweet corn, fresh herbs (except basil), cut vegetables
    • Ripen on counter first, then place in refrigerator:
      • Avocados, kiwis, nectarines, peaches, plums, plumcots, pears
    • Store only at room temperature:
      • Apples (for less than seven days), banana, grapefruit, lemon, lime, mandarin, mango, oranges, papaya, melons, papaya, persimmon, pineapple, plantain, pomegranates, basil (in water), cucumber, onion, eggplant, garlic, ginger, jicama, pepper, potatoes, sweet potatoes, pumpkin, tomato, winter squash
    • Separate fruits and vegetables that may quicken ripening
      • Tomatoes, bananas, and apples should be stored by themselves
    • Keep fruits and vegetables in separate refrigerator drawers
    • Only wash produce right before using
  • Buy only the amount of fresh food that you will use within three to five days.
  • Buy some perishables in frozen form:
    • Broccoli, green beans, spinach, green peas, corn, sweet potatoes, legumes (like edamame, black eyed peas, pinto beans), berries, peaches, mango

Plan Ahead:

  • Plan meals based off foods that you already have in your pantry, refrigerator or freezer
  • Use up perishable foods first
  • Find recipes that include the foods already in the house
    • Make a list of additional ingredients needed
    • Practice portion control and consider how many people will be eating when making food
  • Make your shopping list based off the number of meals that will be eaten at home
  • Prepare some meals ahead of time and freeze for later use

Get Creative in the Kitchen:

  • Turn leftovers into other meals: sandwiches, soups, salads, stews, casseroles, burritos, wraps, scrambles
  • Pack some leftovers into a container for lunch the next day
  • Freeze, dehydrate, preserve, and can foods as a way of preserving longer

Practice Good Food Safety:

  • Eat leftovers within three to four days (or freeze and keep for up to three to four months)
  • Remember to date the foods that you freeze
  • Avoid eating or drinking something that you think may have spoiled

Learning how to manage food resources at home will help you and your family “Go Further with Food,” while saving both nutrients and money. The benefits of reducing food waste don’t stop there though.  It also helps to reduce methane emissions from landfills and lowers your carbon footprint. It conserves energy and resources, as well as prevents pollution. Reducing food waste at home also supports your community by providing donated untouched food to the hungry.

If you would like more information on following a healthy diet and making lifestyle changes, please consult with a Registered Dietitian Nutrition (RDN or RD). They can provide you with easy to follow evidence-based nutrition advice that is personalized to your specific needs.

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