Feeding Tubes and the Trend to Blend

Children with feeding tubes traditionally receive their nutrients from commercial formulas. Recently, dietitians at CHOC Children’s have begun working with families who prefer to feed their children blenderized tube feedings (BTF), which are real foods that are blended into a consistency similar to formula.

In this episode of CHOC Radio, registered dietitian Katherine Bennett explains:

  • The reasons families and dietitians are choosing blenderized meals over formulas
  • Concerns to keep in mind when preparing blenderized tube feedings, including food safety and how to balance the nutrients that a child needs
  • How CHOC supports families who are interested in trying this method for their children.

Hear more from Katherine in this podcast.

CHOC Radio theme music by Pat Jacobs.

December 14 is National Roast Chestnuts Day

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

It’s that time of year we sing about “Chestnuts roasting on an open fire….” But, did you know that this delicious chestnut is packed with numerous health benefits?  They are moderately lower in calories and contain less fat than other nuts and seeds.  A 1 ounce serving provides 69 calories and 0.6g fat.  Sounds like the perfect snack this holiday season!

Chestnuts are the edible seeds of the chestnut tree.  The sweet, starchy seeds sit inside a prickly outer shell called the burr, which splits open as they ripen.  Chestnuts are in season and available in markets from October through March. Fresh chestnuts are often displayed and sold in the fresh produce section. You can also buy chestnuts dried, vacuum-packed, or canned.  To verify freshness look for creamy white seeds. Avoid a greenish, mold-like appearance. When preparing fresh chestnuts, they must be peeled and cooked before consuming.

Add cooked, peeled chestnuts to stuffing, rice or savory pie filling. Incorporate cooked chestnuts into soups, stews, casseroles, or vegetable dishes. Or add pureed chestnuts to mashed potatoes.

Here are additional health benefits from chestnuts:

  • Chestnuts are rich in vitamin C. They are the only nuts that contain this vitamin. They also contain B-vitamins and folate.
  • Chestnuts contain a rich source of mono-unsaturated fatty acid (MUFAs). MUFAs are part of a healthy diet and help to improve our lipid blood profile by reducing LDL (bad cholesterol) and increasing HDL (good cholesterol) levels.
  • Chestnuts are a good source of potassium, which helps in lowering blood pressure. In addition, they are good sources of copper, manganese, and selenium, which are all important components in the body’s antioxidant and anti-flammatory responses to harmful free radicals.

 Wild Rice with Water Chestnuts and Mushrooms

1 13 cup wild blend brown rice

2 23 cup 99% fat free chicken broth

1 8oz can water chestnuts (drained)

1 can (8 oz dry weight) mushroom pieces and stems (drained)

1 tbsp butter

Directions:

Cook rice in chicken broth – bring to a boil then simmer, covered for 45 minutes.  Sauté water chestnuts and mushrooms in butter. When rice is done, add together and stir well.

Nutritional Information:

Servings per Recipe: 5, Serving Size: 1 cup

Calories: 202, Total Fat: 3.9 g, Total Carbs: 41.9 g, Dietary Fiber: 4.5 g, Protein: 5.8 g

Source: www.sparkrecipes.com and http://www.healthcastle.com/chestnuts-food-month

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
Salt
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: Myrecipes.com

Learn more about CHOC Clinical Nutrition and Lactation Services.

Calories In, Calories Out? — May Not Always Be the Simple Equation to Weight Loss

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

The appreciation for bacteria living in our gut, and how it affects our health, is quickly gaining traction. Studies have shown that the 100 trillion microbes that live in and on the human body, called the microbiome, play an important role in overall health, including diabetes, celiac disease, allergy and autism.

Growing evidence over the past 10 years has even linked the gut microbiome to obesity. A study published in Science, a leading scientific journal, in 2013 contributed to this association. Researchers transplanted germ-free mice with fecal microbiota from obese and lean adult twins. They found that those mice transplanted with the obese gut microbiota had an increase in body mass and fat accumulation compared to those transplanted with lean gut microbes. One of the proposed theories is that obese microbiomes can harvest or release more energy from dietary components, such as non-digestible fiber, which contributes to weight gain. Further, this study showed that a lean gut microbiome can displace an obese one, preventing weight gain, if they consumed a healthy diet.

There are multiple influences to our microbiome at an early age, including what type of birth, (C-section versus natural birth), what type of feeding (formula versus breastmilk), and early exposure to antibiotics. Other influences include our environment and diet.

Eating a high-fiber diet, rich in fruits and vegetables and low in meats, refined carbohydrates, and artificial sweeteners has been shown to increase the beneficial bacteria in our gut.

Prebiotic foods such as asparagus, artichokes, garlic, leeks, onions, oats and lentils have been shown to keep our microbiome healthy. Fermented foods such as sauerkraut, kimchi and kefir are also beneficial.

A recent report published in the Diabetes and Metabolism Journal summarized multiple studies that demonstrate the potential benefits of probiotics – live bacteria and yeasts that are good for your digestive system — on the prevention and treatment of obesity and inflammation. It is important to realize that there are multiple strains of probiotics, and each strain has different effects. The effects of probiotics and obesity deserves further attention before specific recommendations can be made in the health care setting.

With the increasing prevalence in obesity, it is exciting that the manipulation of gut flora may be an integral part of weight loss and disease prevention in the future. So, it may not be just about how many calories you eat and how much you exercise that determines your weight, but what you eat and the health of your gut bacteria.

Learn more about CHOC Children’s Clinical Nutrition and Lactation Services.

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Quick Tips to Help Children Maintain a Healthy Weight

In a recent report, the American Academy of Pediatrics (AAP) updated recommendations on childhood obesity prevention. Along with diet modifications and reducing screen time, the AAP encourages pediatricians to work with families to identify opportunities for physical activity. Parents are also encouraged to model healthy behaviors for their children.

More importantly, healthy eating and physical activity should be tailored to the child’s developmental stage and family characteristics.

Here are a few reminders to help your family maintain a healthy weight:

  • Buy fewer sugar-sweetened beverages, high-calorie snacks and sweets. If you want to have these foods for a special celebration, buy them shortly before the event and remove them immediately afterward.
  • Healthy foods and beverages (water, fruits, vegetables and other low-calorie snacks) should be readily available and in plain sight on the kitchen table, counter or in the front of a shelf.
  • High-calorie foods should be less visible – wrapped in foil rather than clear wrap, and placed in the back of the fridge or pantry.
  • Encourage children to eat five or more servings of fruits and vegetables each day.
  • Increase physical activities together to meet the recommended 60 minutes of activity a day. Examples of activities, include: team sports, dog walking, bowling, using the stairs, going to a park, playground, or walking/bicycle trail.
  • Reduce sedentary behaviors. One way to achieve this is to remove the TV and other media from the bedroom and the kitchen.
  • Children who sleep less than 9 hours a night are more likely to be overweight or obese; focusing on bedtime and understanding how much sleep children need at various ages can help improve a child’s overall health and well-being.

For more health and nutrition tips, visit choc.org/health.

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