Show Me the Veggies! It’s National Vegetarian Awareness Month!

October is National Vegetarian Month. Vanessa Chrisman, RD, CLE, clinical dietitian at CHOC Children’s, sheds some light on the vegeterian diet.

“I’m a flexitarian. I’m vegan. I’m pescaterian. I’m vegetarian – I eat chicken only. I’m on the see-food diet. I’m on the paleo diet. I’m on the raw food diet. I’m on the carb-lovers diet.” People describe their eating styles/diets in a variety of ways & new fad diets are popping up all the time. This month – we focus on the vegetarian diet since October is National Vegetarian Awareness Month. October 1st kicks off this theme as the official World Vegetarian Day.

So what exactly is a vegetarian? The most commonly known type is the lacto-ovo vegetarian. They exclude beef, pork, poultry, fish, shellfish or animal flesh of any kind from their diet but they do eat eggs & dairy products. Lacto-vegetarians exclude beef, pork, poultry, fish, seafood, & eggs but will consume dairy products. Ovo-vegetarians exclude beef, pork, poultry, fish, seafood, & dairy products but will eat eggs.

The strictest type of vegetarian is known as a vegan who avoids all types of animal flesh, fish, poultry, seafood, dairy, eggs, as well as animal by-products such as gelatin & honey. The key to any vegetarian diet is that it is plant-based (not flesh-based). A well-balanced vegetarian diet is typically rich in fruits, vegetables, whole grains, beans, lentils, nuts, and seeds.

Currently, it is estimated that over 400+ million people world-wide follow a vegetarian diet. People choose the vegetarian lifestyle for a variety of reasons. Some follow a vegetarian diet because they want to live longer healthier lives and/or they want to preserve the Earth’s natural resources. Others may choose the vegetarian lifestyle for spiritual reasons or because they love animals & are ethically opposed to eating them. The vegetarian diet used to be considered more of a fad, but more & more research has shown numerous health & environmental benefits from following a plant-based diet.

So – what are the health benefits? According to the Academy of Nutrition & Dietetics, vegetarian diets are associated with lower blood cholesterol levels, lower blood pressure levels, lower risk of cardiovascular disease, lower risk of hypertension, & lower risk of type 2 diabetes. Vegetarians also tend to have lower body mass indexes (with lower obesity risk) & lower overall cancer rates. This is because a vegetarian diet is typically low in saturated fat & cholesterol, and is often higher in fiber, flavonoids, vitamin C & E, potassium, magnesium, carotenoids, & other antioxidants/phytochemicals. Many protective foods come from plants & can help prevent the onset of chronic diseases. It is important to consume a variety of different plant foods to get the full health benefits from this diet.

Interested in the vegetarian lifestyle? Here are some easy ways to incorporate more plant foods into your diet:

1) Go meat-free one day a week

2) Anack on dried fruits & nuts instead of candy

3) Make spaghetti using less meat (or soy meatballs) and add more veggies to the sauce

4) Grow a small veggie garden at home

5) Let your children pick out produce and help in the kitchen

6) Add grated carrot/zucchini/apple to muffin recipes

7) Replace meat in recipes with beans, tofu, lentils, or other meat alternatives

8) Be adventurous by trying new plant foods and new recipes! Make it a family affair.

Happy Vegetarian Awareness Month!

Some Helpful Websites:  or

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Happy World Breastfeeding Week 2012

By Cindy Baker-Fox, RN, IBCLC, lactation consultant at CHOC Children’s

August 1-7 marks the 20th annual World Breastfeeding Week (WBW), a yearly event which began in 2002, by the World Alliance for Breastfeeding Action (WABA). World Breastfeeding Week is now recognized and celebrated in more than 170 countries worldwide. It commemorates the joint efforts of WHO (World Health Organization) and UNICEF in their collaboration and development of the Innocenti Declaration, a policy created to protect, promote, and support breastfeeding throughout the world. The Innocenti Declaration remains a cornerstone in guiding public and private breastfeeding policies, practices, and programs throughout every continent and most countries worldwide.

World Breastfeeding Week aims to celebrate this historic event and its ongoing impact on the health of babies and mothers around the world through breastfeeding awareness, education, and support. The theme of World Breastfeeding Week  2012 is “Understanding the Past—Planning the Future.”  It is a time to reflect on the progress made in breastfeeding promotion and education and the ongoing efforts that are still to be made.

In 2002, WABA launched the first WBW with a campaign known as the “Baby-Friendly Hospital Initiative”. This campaign began a worldwide push to provide breastfeeding education, services, support, and trained lactation staff in every delivery hospital, clinic, and birthing center worldwide and to every women and newborn, despite their circumstances and resources culturally, socially, or economically. The goal was to reach every mother and newborn with proper information and skills to promote breastfeeding as a means of reducing infant mortality and morbidity worldwide.

According to UNICEF’s State of the World’s Children Report 2011, 136.7 million babies are born worldwide and only 32.6% of them are breastfeed exclusively in the first six months.  In July 2012, the WHO reported that, “poor breastfeeding rates contribute to over a million avoidable child deaths each year.”  Breastfeeding is a human rights issue that required the development of international policies and practices to assure adequate nutrition for every newborn.  This is truly a week to remember and celebrate.

At CHOC, we strive to support and promote breastfeeding for our patients.   CHOC’s lactation program began in 2001 with the hiring of a full time RN, IBCLC (International Board Certified Lactation Consultant).  Since then, CHOC’s commitment to optimal nutrition for our tiny babies and at risk patients has lead to additional funding for staff to provide lactation services throughout the hospital.  The Clinical Nutrition and Lactation program at CHOC currently employs 3 registered nurses and 2 registered dietitians who are IBCLC’s as well as 4 Certified Lactation Educators (CLE).  Throughout CHOC many staff have participated in various levels of lactation training including the completion of the Certified Lactation Educator training.

To further support our patients’ unique lactation needs, CHOC has hosted several educational opportunities for healthcare professionals, including a joint conference with the American Medical Association in 2009, the La Leche League  Conference in 2012, and the recent annual hosting of the University of California—San Diego CLE course.

CHOC’s lactation program is rich in history and our commitment to the core values and goals set forth 20 years ago by WHO, UNICEF, and WABA will continue to lead us in our pursuit for optimal nutrition for our young patients and further CHOC’s commitment to providing lactation services to all those in need. Join us in celebrating World Breastfeeding Week 2012!

For more information on World Breastfeeding Week and how you can become involved visit

For additional lactation information or services, visit the Clinical Nutrition and Lactation Department’s Web page.

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July is National Blueberry Month

By Joanne DeMarchi, MS, RD, IBCLC, clinical dietitian at CHOC Children’s

Summer is the height of berry season, and no berry says summer more than the blueberry. Blueberries contain dietary fiber, vitamins A and C and are one of the most antioxidant rich foods in the world.  Here is the scoop on blueberries.

High fiber foods benefit digestive and heart health. 1 cup of blueberries provides 3.6 grams of fiber.  Add that to a cup of oatmeal or other whole grain cereal and your meal will provide almost 20% of your fiber goal for the day.

Vitamin C
One serving of blueberries (about 1 cup) provides 25% of the daily recommended intake of vitamin C. Vitamin C is one of the most common antioxidants and contributes to healthy gums, absorption of iron and healthy capillaries, formation of collagen and a healthy immune system.

Antioxidant activity
Antioxidants work to neutralize free radicals — unstable molecules linked to the development of cancer, cardiovascular disease and other age-related conditions such as Alzheimer’s. Substances in blueberries called polyphenols, specifically the anthocyanins that give the fruit its blue hue, are the major contributors to antioxidant activity.

If you are traveling this summer, why not find a farm to go blueberry picking.  Six states account for more than 90 percent of the crop: Michigan, New Jersey, Oregon, North Carolina, Georgia and Washington.  Use this website to find blueberry farms in these and other US states where you can pick your own.

Once you’ve picked your berries pour them over cereal or yogurt, add them to fruit or green salads for a delicious, healthful taste of summer.  Keep blueberries in your diet during the rest of the year by trying this frozen blueberry smoothie recipe.  It makes a great grab and go breakfast treat.

Frozen Blueberry Smoothie recipe

  • 1/2 cup frozen blueberries
  • 1/2 cup low-fat vanilla yogurt
  • 1/2 cup 1% milk
  • 1 tablespoon honey
  •  2-3 ice cubes (optional)

Combine all ingredients in a blender and blend until smooth or to desired consistency then serve.


  • Calories: 243
  • Total Fat: 2.9g
  •  Total Carbohydrates: 43.8g
  • Fiber: 1.8g
  •  Sugars: 40.7g
  • Protein: 11.8g

To learn more about Clinical Nutrition and Lactation Services at CHOC, please visit

What is Eosinophilic Esophagitis?

In recognition of National Eosinophil Awareness Week, coming up May 13-19, Shonda Brown, RD, CNSC, clinical dietitian at CHOC Children’s, explains what Eosinophilic Esophagitis is, and how this unique condition is treated.

Imagine having abdominal pain so severe you are taken to the emergency department in fear of yourself having a heart attack, or unable to eat a meal without thinking if you are going to get food stuck in your throat.  These are a few things I have heard from patients to describe their symptoms of Eosinophilic Esophagitis (EoE).  EoE is characterized by eosinophil (a type of white blood cell) accumulation in the esophageal lining creating inflammation and a variety of adverse symptoms.  Some common symptoms are vomiting, abdominal pain, reflux-like symptoms, poor weight gain, trouble swallowing and food impaction (when food gets stuck in the throat).

Currently, the only way to make a diagnosis is by endoscopy with biopsies of the tissue lining the esophagus.  A small tube with a camera at the tip is inserted through the mouth and down through the GI tract.  The doctor looks for any signs of inflammation as well as takes small tissue samples to be examined with a microscope.

Research has shown that food allergies are the most common cause of EoE.  Once a diagnosis is confirmed, children are referred to an allergist for allergy testing to guide treatment.  Treatment options include food elimination diets, specialized formulas, and/or medication therapy (usually swallowed steroids from an inhaler).  A directed elimination diet is one dietary treatment approach that includes food avoidance of those showing a positive reaction on allergy testing.

Another approach is to eliminate the top known allergens; this is referred to as the six food elimination diet and includes elimination of milk, soy, egg, wheat, peanuts and tree nuts, and seafood.  Specialized formulas may be recommended (called elemental formulas) if a child has severe symptoms, if all food allergy testing was negative, or if previous treatment options were unsuccessful.  Elemental formulas contain proteins that have been completely broken down into their simplest form, amino acids, making them non-allergenic.

Treatment doesn’t end after foods are eliminated.  To determine the offending foods, a child must undergo another endoscopy after eliminating the possible allergens for a set period of time to see if the eosinophils have gone away.  After a clear endoscopy, foods are reintroduced in a stepwise fashion while monitoring for return of symptoms and confirmation of disease reappearance with further endoscopies.  Food and eating is much more than just providing our bodies with energy and nutrition.  The diet therapies that are used to treat and identify food allergens can radically change the way of life for a family. It’s difficult for a child to eliminate their favorite foods – think about a child who can’t even eat their own birthday cake!

The process of discovering the causative food(s) and establishing resolution of EoE can be a long, stressful and overwhelming experience.  CHOC Children’s has developed a multidisciplinary team centered approach in providing care for children with EoE.  Our clinic combines Allergy, Gastroenterology and Nutrition services so that our families receive comprehensive care for this chronic disease.

For more information on EoE, visit  (The American Partnership for Eosinophilic Disorders).

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Easy, Healthy Breakfasts Kids Love To Grab And Go!

Can you serve last night’s pizza for breakfast? Sure! Breakfast is the most important meal of your child’s day, and we’ve got easy, tasty tips to tempt your pickiest eater.

Maybe your mom would never have done it, but it’s really okay to serve leftover pizza for breakfast. What’s important is that your child eats something nutritious before beginning the school day.

“There is no reason why you can’t have dinner foods for breakfast if that is what your child will eat,” says Caroline Steele, M.S., R.D., director of Clinical Nutrition and Lactaction Services at CHOC Children’s. “Eating every three to four hours keeps blood sugar steady, which helps a child’s ability to pay attention, concentrate and learn.”

If your kids aren’t hungry when first waking up, try these “grab and go” ideas for nutritious breakfasts that may be eaten in the car or at school before class begins:

  • Whole-grain granola bar and fruit
  • Peanut butter over apple slices
  • Sliced turkey rolled up with cheese
  • Yogurt with fruit and granola
  • Scrambled eggs and cheese in a tortilla
  • Oatmeal and fresh or dried fruit
  • Homemade fruit smoothie
  • Peanut butter and jelly on whole-wheat bread
  • Cottage cheese with fresh or dried fruit

Pack along some low-fat milk and you’re good to go!

School Meals Get Higher Marks
The nutritional quality of school meals has improved since the Healthy, Hunger-Free Kids Act of 2010. School meals now provide more fruits and vegetables, less sodium, leaner meats, reduced-fat dairy products and whole grains.

For more nutritious tips, please visit the Eat Right section on

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