Tips for Healthy Grocery Shopping

By Alyce Watanabe, Dietetic Technician, Registered at CHOC Children’s

Preparing a healthy meal can be next to impossible if you don’t have the right ingredients in your kitchen. Going to the grocery can feel like a burden if you are not prepared. However, with a little preparation, shopping for healthy foods can be a breeze and save you money in the long run.

Do some prep work before you get to the store to keep from having to go back for forgotten items and to help you focus on finding nutritious foods.

  1. Clip money-saving coupons from weekly ads or use coupon apps on your smartphone.
  2. Create your menu for the week and grocery list before going to the store. Stick to your list.
  3. Shop the store perimeter first. That is generally where fresh foods, such as fruits and vegetables, meat and fish, and dairy, are located. Processed foods that often contain added salt, sugar and fat are usually found in the center aisles.

Minimize distractions to make healthy choices.

  1. Try to avoid peak hours when stores are busy. Crowds and stress often cause people to make quick choices instead of taking the time to find the healthiest option.
  2. Avoid shopping when you are hungry. A growling stomach can make it tough to resist some of those tempting treats!
  3. Consider leaving young children at home if possible. A tired or hungry child may make it challenging to take the time to read labels. Often, less-healthy items with packaging that appeals to children are kept on shelves at their eye level, making it easy for them to grab and toss in your cart.

Take time to read labels. A quick glance can help you decide between similar items.

  1. Look for whole foods as much as possible. Choose whole fruit over juices to provide fiber and help you feel full for longer.
  2. Consider canned or frozen fruits and vegetables. They last longer than fresh items and because they are picked and canned or frozen at peak ripeness, they may contain more nutrients. Watch the sodium content of canned vegetables.
  3. Foods with fewer additives, in their more natural state, tend to be healthier. Many people look for foods with a maximum of five ingredients.
  4. Watch the portion size on the package. Sometimes foods are listed as two or more servings even when you would probably eat the entire package in one sitting.

Aim for variety and try something new! 

  1. Make trying new foods fun for your family by selecting a new or unfamiliar fruit or vegetable each week. Search online to learn about the food and find recipes.
  2. Substitute something for your usual routine. Consider using sweet potatoes instead of white potatoes for a new flavor and for extra fiber and vitamin A.
  3. Familiarize yourself with the USDA MyPlate guidelines to make sure you are getting foods from all food groups. While you are planning meals and shopping, think about the foods that will be on your plate.
nutrition
The MyPlate model shows a great visual way to balance our food groups.

Some hints for a healthier table:

  • Balance Calories
  • Enjoy your food but watch portion sizes.
  • Foods to Increase
  • Make half your plate fruits and vegetables.
  • Choose 100 percent whole grains whenever possible.
  • Children under age 2 should receive whole milk because they need the fat for brain growth and development. However, children over age 2 and adults can switch to fat-free or low-fat milk.
  • Choose lean sources of protein such as lean meats, chicken, fish and beans.
  • Foods to Reduce
  • Compare labels for processed foods such as canned soups and frozen meals. Choose those with lower amounts of sodium (salt).
  • Drink water instead of sugary drinks.

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Breastfeeding: A Foundation for Life

By Alana Salcido, registered nurse and lactation consultant at CHOC Children’s

If you were to ask me back in nursing school what kind of nurse I wanted to be, I guarantee I never would have said I wanted to become a lactation consultant. I honestly didn’t even know this was a specialty at that time. Helping other moms succeed with breastfeeding is my way of giving back and my way of changing the world, one couple at a time.

World Breastfeeding Week 2018

Today kicks off World Breastfeeding Week, an annual observance to bring awareness to the importance of human milk and to offer education and encouragement to mothers, health care providers, and the community.

Breast milk is constantly changing

A mother’s milk is constantly changing. Her milk will actually change from feeding to feeding, day to day, month to month as her baby grows. For example, the first milk, known as colostrum, is rich in components that prevent and protect the newborn from common and potentially serious infections. Breastfeeding not only provides exceptional nutrition but it also promotes lifelong health benefits.

Benefits of breastfeeding: preventing disease

Breastfeeding is the most economical solution to the biggest threat against children’s health worldwide: malnutrition and preventable diseases. In developing countries, human milk can mean the difference between life or death in children under five because a mother’s milk provides necessary nourishment for babies.

Breast milk-fed infants have significantly lower rates of illness—even in industrialized countries. The longer a mother breastfeeds, the more infection fighting antibodies are passed to her infant through her milk. Just as the womb protected and nourished the developing child during pregnancy, the body was preparing to protect and nourish her baby after birth by stimulating milk production as early as 12-14 weeks gestation.

Lifelong benefits of breastfeeding

Research has shown that babies who receive breast milk have a lower risk of hypertension, type 1 and type 2 diabetes, allergies, cancer, asthma, intestinal and respiratory infections, and obesity both during childhood and adulthood. Health benefits occur not only for the baby, but for the mother as well. Breastfeeding helps reduce the maternal risks of diseases such as hypertension, type II diabetes, high cholesterol, osteoporosis, breast cancer, and even Alzheimer’s Disease. Research has shown that the health benefits, for both mom and baby, are dose dependent. This means that the longer a woman breastfeeds the greater the health benefits she and her baby receive. Because of this, the WHO (World Health Organization) recommends breast milk in a child’s diet for the first two years of life (with the addition of appropriate complimentary solid foods beginning at 6 months of age).

Lactation consultants can help mothers provide the benefits of breastfeeding

Some mothers who wish to breastfeed their babies face challenges. Statistically, 75 percent of moms in the U.S. start out breastfeeding. By the time babies are six months old, only 44 percent are breastfed.

CHOC Children’s has a team of registered nurses who are international board-certified lactation consultants. We work closely with medical teams to provide support to mothers who need assistance in producing lifesaving breast milk for children. We can also help them achieve their lactation goals which may be different for each mother and could include pumping milk for the first six months, or it might be to exclusively breastfeed until the baby is a year old. We want every child at CHOC to receive optimal nutrition. For the newborn, infant and young child, we support breastfeeding and breast milk use. We firmly believe it when we tell our families that breast milk Is medicine.

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Answers to Parents’ Most Common Questions on Healthy Eating for Kids

By Vanessa Chrisman, clinical dietitian at CHOC Children’s

Healthy eating for kids is an essential part of their overall healthy lives. For children, it’s especially important because their growth and development depends on it. Parents play a large role in providing a healthy diet for their children, as well as establishing lifelong habits when it comes to food. In today’s world of fad diets and conflicting headlines about nutrition and health, it can be confusing for parents to navigate how to feed their children appropriately. Here are some of the most common nutrition questions I get from the parents of my patients.

My child wants to eat the same food every single day. Is this okay? How do I handle this?

Typically, toddlers are the ones who go on food jags – wanting to eat the same food at every meal, day in and day out. It often is a show of independence. This can happen with older children too. While it’s okay to eat the same healthy food every day, it’s the parents’ job to choose what foods to offer at meals. As an example, maybe your child wants cereal at every meal. Rather than provide this, offer other healthy foods and tell your child that she can have cereal for breakfast the next day. Your child then gets to choose whether she eats what is offered at that meal. If she doesn’t, don’t worry. Simply be patient and wait until the next snack time to offer more food. When your child becomes hungry, she will most likely eat what is offered.

My child is a picky eater. How can I convince him to eat more fruits and vegetables?

Start by serving a fruit and a vegetable with every meal. Serve the foods that he already accepts and eats. Introduce one new fruit or vegetable at a time. Make new foods more appealing by cutting them into fun shapes and sizes. Vegetables can be spiralized to look like pasta. Fruits can be cut into stars or dinosaurs with cookie cutters. Set a good example by eating fruits and vegetables regularly as a family. As parents, you are powerful role models for your children who are always watching and listening. Let your child help pick out fruits and vegetables in the grocery store as well as wash them at home. Fruits can be added to smoothies and yogurt and cereal. Vegetables can be cooked into spaghetti sauce or added to stir-fried rice or soups. Sometimes children will want to try new fruits and vegetables if you serve them with a favorite dip or sauce. Consistently serve fruits and vegetables at your meals and be patient. Limit grazing between meals to build hunger and avoid preparing a special meal for your picky eater. Eventually your child will come around and try some of these new foods. Praise the behaviors you want to encourage and give less attention to the pickiness or refusal to try new foods.

I don’t think that my toddler eats enough protein. How much is enough?

Many parents worry that their toddler is not getting enough protein in their diet. The truth is that it is quite easy for a toddler to meet his protein needs. Toddlers ages 1 to 3 need 1.2 grams of protein for every kg of body weight. This means that a healthy 2-year-old boy who weighs 27 pounds (or 12 kg) needs about 14-15 grams of protein per day. His protein needs could be met simply by: drinking eight ounces of one percent milk (eight grams protein) and eating two tablespoons of ground turkey or one large egg (seven grams of protein) in a day. If he drinks sixteen ounces of milk, his daily protein intake increases to 23 grams of protein, which is 150 percent of what he needs. Unless a toddler is eating a very restrictive diet, it’s rare for him to consume a diet low in protein.

My child loves to drink juice and soda but barely drinks any water. How can I get her to drink more water?

This is a challenge that many parents face. The first step is to cut back on the amount of juice or soda that is offered and consumed. Ideally, cut out soda and dilute juice with water. Limit juice to eight ounces or less per day. Provide your child with their own special bottle or cup. Consider using a special straw that they can pick out for themselves. Infuse the water by adding sliced lemons, limes, cucumber, berries, or mint to make a “spa water.” Keep water cold in the fridge. Try using frozen berries instead of ice cubes. Be a role model and carry a water bottle around for yourself. Offer stickers as an incentive for every time your young child drinks a cup of water. On a typical day, kids up to age 8 should drink the number of 8 oz. cups of water equal to their age. For example, a five-year-old should drink five 8-oz. glasses of water every day.

My child is underweight so I let her snack all day long. This will help her gain weight faster, right?

While some parents assume that their child will gain more weight if they are eating all day long, this is not often the case. For underweight children, there can be a tendency for parents to offer food to the child all day long, as well as allow them to ask for food whenever they want it. This does not allow for natural hunger or appetite to build. Instead, the child grazes on food throughout the day, often eating enough to tame hunger but not enough to truly feel full. The best approach is to follow a feeding schedule with planned meals and snacks every two to three hours. Only water should be consumed in between eating times. This helps build hunger. To help with weight gain, added fats and high calorie foods can be offered or used with meals. Sometimes an oral supplement is needed as well if the child is unable to consume enough food to fuel healthy weight gain. Speak with your child’s pediatrician and a registered dietitian for more individualized advice.

My child says he isn’t hungry in the morning and refuses to eat breakfast. How do I get him to eat?

This is a common challenge for many parents. Often, their child isn’t hungry or doesn’t have enough time to eat before heading off to school. To minimize the morning rush and make time for a healthy breakfast, prepare the night before. Close the kitchen by 8:00 p.m. to prevent unneeded late-night snacking. Make sure that your child goes to bed on time so that it’s easier for him to wake up in the morning. Have quick, healthy options on hand like low-sugar cereals with low-fat milk, fresh fruit and string cheese, whole grain muffins, or whole grain toast with peanut or almond butter. Consider offering non-breakfast foods as another way of enticing your child to eat. For those who don’t want to eat, sometimes drinking a fruit and yogurt smoothie works instead. For teens who skip breakfast in the hopes of losing weight, let them know that people who skip breakfast tend to gain weight, not lose. If all else fails, send your child with a healthy snack to be eaten at school.

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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

Get important nutrition tips like these sent straight to your inbox

Kids Health, delivered monthly, offers “healthful” information for parents.

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