No more wire bristles! Keeping your family barbecue safe

With cook-out season in full swing, CHOC Children’s safety experts caution parents to be mindful of an unexpected danger lingering long after the hamburgers are eaten and the grill has cooled.

Bristles from metal brushes commonly used to clean grills can fall off onto the grate and later become lodged into food. Ingesting these tiny metal fragments can cause damage to the throat and digestive track, says Amy Frias, a CHOC community educator and Safe Kids Orange County coordinator.

If parents suspect their child has ingested these remnants, they should seek medical attention immediately.

Parents can avoid this risk by relying on alternate methods and tools to clean up after grilling, Amy says. A host of alternative products are available, including grooved wooden planks that scrape off char; brushes that use scouring pads; pumice stone-like cleaning blocks; and nylon-bristle brushes.

A more natural method uses a halved onion, Amy says. Pierce the vegetable with a barbecue fork and rub the onion’s flat end across a very hot grill. This method should easily remove debris and dirt.

Barbecue tools aren’t the only safety risks when it comes to grilling, Amy says. To ensure the entire family stays safe, she offers a few other tips:

  • Location: Keep the grill away from high-traffic areas and enclosed spaces, such as eaves, overhead tree branches and deck railings. Never grill indoors or in a tent.
  • Perimeter: Create a 3-foot child- and pet-free zone around the grill.
  • Heat sources: Keep matches and lighters away from children. Take caution when using lighter fluid, and never add more fluid to a lit fire.
  • Thorough cleaning: More than the grill’s grate needs to be cleaned. Periodically remove grease from the trays below the grill to prevent fires.
  • Supervision: Never leave cooking food unattended.
  • Tools: Use long-handled grilling instruments to keep the chef at an appropriate distance from flames.
  • Wardrobe: Close-fitting clothes and pulled-back hair are always fashionable and safe when grilling.

Get more safety and wellness tips and learn about education classes offered by CHOC’s community education department.

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Peanut Allergies: Understanding the Latest Research

The New England Journal of Medicine recently published two studies that strengthen evidence that feeding peanuts and other allergy-inducing foods to babies is more likely to protect them than to cause problems.  Given previous recommendations, focused on food-avoidance, parents may be surprised by the latest research.  In this Q & A, Dr. Wan-Yin Chan, CHOC Children’s allergist and immunologist, offers the following explanation and highlights the newest approach to preventing peanut allergies and other food allergies.

Dr. Wan-Yin Chan

How many children are living with food allergies in the United States?

Food allergies strike approximately eight percent of children in the U.S., with less than two percent dealing with peanut allergies.   These allergies can present in a child as early as infancy, with the most common reactions being hives, itching, skin flushing (redness accompanied by a warming sensation), vomiting, facial swelling, wheezing, coughing, closing of the throat and cardiovascular collapse.

What do you think about the two new studies?

I am not surprised by the findings that early introduction can lead to a decrease in peanut allergies.  The first study demonstrated tolerance to peanuts after an avoidance period of 12 months.  This study is a follow-up to an earlier study last year that found a reduction in peanut allergy at the age of 5 after introducing peanut proteins to high-risk infants from 4 – 11 months of age.

The second study looked at introducing six common allergic foods in breastfed infants at 3 months of age (alongside continued breastfeeding) versus waiting until 6 months of age. The study showed significantly lower relative risks of peanut allergy and egg allergy in the early introduction group by 3 years of age; however, the risk of milk, sesame, fish and wheat allergies was not significantly impacted.

Will your team make any changes to the way you introduce allergy-inducing foods to patients?

We plan to allergy test high-risk patients (history of severe eczema and/or egg allergy) before deciding whether to introduce peanut into their diets.

What are different ways to introduce peanut into the diet?

For low risk infants, parents can introduce peanuts at home through peanut powder sprinkled into pureed foods, thinned smooth peanut butter or Bamba (peanut puff snack). Actual peanuts should not be given to children less than age 3 as they are choking hazards.

What do you anticipate will be parents’ reactions to these new guidelines?

Parents will probably be very surprised at first, given the old recommendations.  However, the latest research results provide scientific evidence that early introduction leads to a decrease in the incidence of peanut allergies and sustained tolerance.  Parents should address any concerns with their pediatrician, who may refer them to a pediatric allergist.

What additional research would you like to see conducted?

I’d like to see more research related to other common allergenic foods such as tree nuts and seafood, which can cause life-threatening reactions.

 Dr. Wan-Yin Chan is board certified in pediatrics and allergy & immunology. Prior to joining CHOC Childrens, she attended medical school at the College of Medicine at East Tennessee State University in Tennessee. She completed her pediatric residency and fellowship training in Immunology, Allergy and Rheumatology at the University of California, Los Angeles. Dr. Chan speaks fluent Cantonese.

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Avoid Becoming Thank-“full” this Holiday

By Sarah Kavlich, RD, CLEC, clinical dietitian at CHOC Children’s 

Today, in many American households, the Thanksgiving celebration is centered on gratitude and sharing a bountiful meal with family and friends. The star of the Thanksgiving meal is arguably a stuffed turkey; and often times after a day of feasting, that may not be too far off from the way we feel. You and your family can avoid overeating this holiday season with these easy steps:

  • Eat breakfast! Although known as the most important meal of the day, it is often thrown by the wayside, especially when we anticipate a larger meal to come. Instead, have a light breakfast before your feast, which can help keep you from overdoing it later.
  • Use smaller plates. We eat with our eyes and when we see a large plate with a lot of empty space, our brain has a tendency to think we are still hungry once we are finished. Instead, serve your appropriate portions on a smaller plate. Once you’ve finished your meal, you’ll be able to listen to your stomach when it tells you you’re full.
  • Load up on non-starchy veggies like salad and green beans. These sides can offer plenty of fiber, which can fill you up with out adding extra calories. If you are the cook, try a new spin on green bean casserole (see below), with all of the traditional flavors but without all of the traditional fat.
  • Hold the gravy. Did you know that gravy alone can add up to 170 calories in a half cup? Try your meal without it this year.
  • Skip the seconds. Just because it’s a holiday doesn’t mean your health goals need to take a holiday too. Focus on visiting with friends and family and not just eating. If you are truly still hungry later in the day, have a light snack to hold you over.
  • Stay active. Use this opportunity to spend time with those you love by going on a walk together before or after your meal.

Green Beans with Shallots and Almonds
2 pounds green beans, cut into 1 inch pieces
2 tablespoons olive oil
2 cups sliced shallots (about 4 large)
2 tablespoons unsalted butter, at room temperature
1/2 cup sliced almonds, toasted

Fill a large bowl with ice cubes and water. Bring a large pot of salted water to a boil. Add green beans to pot and cook until crisp-tender, about 5 minutes. Drain and plunge beans into an ice bath. Drain beans again and dry on paper towels.

Warm olive oil in a large skillet over medium heat. Add shallots and sauté until softened and lightly browned, about 7 minutes. Add green beans and butter and cook until beans are heated through, about 2 minutes. Sprinkle with toasted almonds and serve.

Yield: 8 servings, 150 calories, 10g fat, 4g protein, 14g carbohydrate, 4g fiber, 8mg cholesterol, 164mg sodium. Source:

Learn more about CHOC Clinical Nutrition and Lactation Services.

Healthy Habits at Home

Childhood obesity remains a prominent health concern within our society. According to the 2000 Center for Disease Control and Prevention growth chart, in 2010, more than one third of children were defined as obese, meaning their body mass index (BMI) was at or above the 95th percentile for age and sex.

CHOC Children’s Community Education department, in partnership with the hospital’s Clinical Nutrition department, provides various classes to parents and children about healthy living. In recognition of National Childhood Obesity Awareness Month, we sat down with two of our educators, Michelle Lubahn and Amy Frias, to discuss this issue. Michelle and Amy advocate that parents are the primary catalysts for change, and that the road to recovery begins at home.

How is childhood obesity determined?
Michelle: Childhood obesity is determined through calculating a child’s body mass index, or BMI. BMI is a calculation that uses height and weight to estimate an individual’s body fat. While the BMI of an adult is calculated with a straight formula, children’s BMIs are based on gender and age, to allow for the change in body composition that happens as a child gets older. Like a standard growth chart, your child will be ranked in percentiles compared to his peers. If your child’s BMI is in the 85th percentile — meaning it’s higher than that of 85 percent of children his age and gender — he would be considered overweight. If he’s in the 95th percentile, he’s considered obese.

What factors contribute to becoming overweight?
Amy: There are several factors that contribute to becoming overweight, but I would say that the biggest factors are lack of physical activity, large portion size, an increase of fast food intake, an increase in sugary drink intake, and an increase in total screen time. Screen time includes all electronics- time spent on cell phones, on the computer, watching TV, and playing video games. Children should have no more than two hours of total screen time a day, which should be in conjunction with a minimum of one hour of physical activity.

What are some of the health effects of childhood obesity?
Michelle: Some of the short-term effects of childhood obesity include a decline in self-esteem, a decline in socialization, and an increased likelihood of depression. It creates a vicious emotional cycle. As the depressed feelings increase, a child is more likely to become an emotional eater, which perpetuates the cycle.

Amy: There are several long-term effects of childhood obesity. Adults who were obese as children may experience health problems much earlier in life in comparison to those adults who maintained a healthy weight through childhood. Some of these health problems include an increase in sugar levels, an increase in lipid levels, and an increase in triglycerides.

What recommendations to do you have for parents trying to implement healthy habits in the home?
Michelle: There are a lot of things that parents can do! The most important thing for parents is to model good eating habits, because they are the first and the best role models for their children. Eat as a family at the dinner table, with the TV off, as often as possible. Keep lots of healthful options available and limit the number of unhealthy options. Also, don’t enforce the “Clean Plater’s Club” at home, meaning don’t emphasize the importance of finishing the entire meal. The best thing to do is work with your child’s needs. I tell my children that they can’t have dessert unless they finish all their vegetables.

Amy: It also helps to plan meals ahead of time and encourage healthy eating throughout the day. For example, bring fruit in the car when you pick your kids up from school, so they eat that rather than choosing a less healthy option once they arrive home. Another tip that works for me is to prepare vegetables before preparing the rest of dinner, so kids can snack on those while they wait for the rest of the meal to be ready. I encourage my children to play outside while I make dinner, which gives them another opportunity to be active.

How can parents encourage a healthy body image?
Amy: Teach kids to feel good about the person they are, not what they look like. Focus on their overall health and promoting good habits rather than focusing on numbers, like weight.

Do you have any other advice for parents?

Amy: I think that the best way to create movement toward a healthier lifestyle is to promote the change as a family unit, rather than trying to encourage your child to change his individual habits. Go for a family hike, or play a game together outside.

Michelle: I think the most important thing is to keep a positive attitude. Learn from your mistakes as a parent and work with your child to make healthy choices. Know that it’s never too late to start living a healthy lifestyle!

Learn more about classes offered by CHOC Children’s Community Education department.

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