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Talking to Your Kids about Eating Disorders & Body Image: 5 tips for Parents

Monday, November 10, 2014

When should you start exploring eating and body image issues with kids?  

Although it's never too early to start emphasizing the importance of good nutrition, middle school and junior high are when these issue tend to start.  Between ages 10 and 14, kids' bodies are rapidly changing as they become more aware of appearance and compare themselves to peers.  It can be hard to get kids to talk about anything at this age, let alone something so personal.  Here are some tips for parents on how to approach this touchy subject.

1.  Discuss the benefits of good nutrition.  Talk about how food helps fuel the body and how good you, yourself feel after a balanced meal.  Need help determining what a balanced meal looks like?  See this handout for some useful information - Balance Your Plate.

2.  Consider going to a registered dietitian.  Visiting a dietitian together will allow you to start the conversation and provide good, solid overview of the importance of nutrition during adolescence.  Plus, sometimes having someone else communicate the information has a greater impact.  If your child wants it, give her some time alone with the dietitian to discuss any issues that she may not want to talk with you about.  If it's important for you to know, the dietitian will make sure you do.

3.  Ask about friends.  It is much easier for kids to talk about what their friends are doing.  Starting a conversation this way can open up the door to self-disclosure.  Consider reviewing some of the items on this screening tool ChEAT.  Ask your son or daughter if they know anyone who struggles with some of these issues.  Or, find an article to read together.  

4.  Watch videos & media clips.  There are some great resources available to explore media's influence on body image.  Jean Kilbourne's Killing Me Softly is an excellent one.  Here's a short clip from the movie to give you a taste.  The Dove Campaign for Real Beauty is another one.  This clip, Dove legacy is great for mothers and daughters to watch together.  Take some time to process the information after watching.  Or, it may work better to have your child write a few things down that they relate to and have you read them.  

5.  Don't pressure!  The best thing you can do for your child is to leave the door open.  Let then know you are available and interested in talking about this.  If you suspect a real problem, definitely visit a licensed psychotherapist for further evaluation.  Otherwise, just present opportunities for discussion and self-exploration.  Help your child identify several other people she can talk to if she doesn't feel comfortable talking to you.

Body image concerns are a natural part of adolescence for males and females.  Offering yourself or someone else as a support during this period can help ease any anxiety it might be causing your pre-teen or teenager.

Post-Partum Nutrition Survival Guide

Tuesday, September 02, 2014

The first six weeks after the arrival of a new baby are nothing less than hectic to say the least. All women experience this period differently but I think it’s safe to say that we all get our fair share of extreme fatigue and wide-swinging emotions. Whether you are a first-time momma or an experienced pro, taking care of your nutrition during this period is key to boosting your energy and allowing your body to heal after delivery.

Although the importance of feeding yourself can seem like a no-brainer, when you tack on exhaustion, frequent feedings, diapers, a mounting hill of laundry and perhaps an older child to take care of, you may find that caring of yourself takes a back seat to taking care of your little one(s). Here are a few quick tips on nutrition survival during the first six weeks. 

1. Quality. When your body is tired it is natural for cravings for sweets and starchy comfort foods (mac & cheese, pizza, etc...) to increase. Your body is simply looking for a quick supply of energy. Although these foods are fine in moderation, they often don’t keep your energy up in the long-term and will cause a ‘crash’ a few hours after eating. Although the double chocolate chip muffin may be calling your name, try to maximize your intake of options that will fuel your body (think whole grain toast with peanut butter OR yogurt topped with fruit and nuts). Selections like these combine protein and carbohydrate which will help your tired body feel energized for longer periods of time.

2. Reality. At the risk of now sounding contradictory, don’t go overboard and become crazed about the every meal you eat. Do your best to eat as nutritiously as possible but cut yourself some slack. If you are managing a small meal or snack every 3-4 hours, you are doing a great job. Keep easy and nutritious options handy: yogurt, fruit, cheese sticks, granola bars, whole grain crackers, nuts, cut veggies & hummus, hard-boiled eggs, etc. 

3. Protein.  Whether you had your baby vaginally or via C-section, you’ve got some healing to do. Your body utilizes protein to repair wounds so don’t skimp here. Aim to have a 4-5 oz. serving of protein at each meal (or at least 3 times daily). Protein options include: chicken, beef, fish, milk, soy milk, yogurt, cheese, nuts, seeds, beans, lentils and tofu. 

4. Vitamin C.  In keeping with the theme of healing, vitamin C is crucial to tissue as it repairs itself. No need to seek out vitamin C supplements - It’s always better to get vitamins through foods anyways. Vitamin C can be found in fruits (citrus, berries, kiwi) and vegetables (leafy greens, bell peppers, broccoli). 

5. Fluid.  Keep yourself hydrated with non-caffeinated, non-alcoholic beverages. Becoming dehydrated can make fatigue worse which is definitely not a bonus these days so aim to get a minimum of 6-8 cups (48-64 oz.) each day. 

6. Vitamins? If you are breastfeeding, definitely keep up with your prenatal vitamins in the post-partum period. If you aren’t breastfeeding, check in with your doctor on what he/she recommends. If you were taking extra iron during pregnancy for anemia, also check with your doctor about whether or not to continue this – many docs will have you continue with the additional iron until your 6-week check-up. 

7. Caffeine. It may be tempting to jack yourself up on caffeine if you are tired. If you are breastfeeding this is not a good idea because it could make your baby jittery and/or sleepless (horror!).  Even if you aren’t breastfeeding, too much caffeine should be avoided because it provides little nutritional value and can wind up keeping you from catching those zzz’s that you desperately need. 

Leslie Judge MS, RD, CSO, LDN

The EWG's 2014 Shopper's Guide to Pesticides in Produce

Tuesday, August 05, 2014
Every year, the Environmental Working Group (EWG) puts out a list of foods containing the highest amount of pesticide, "the dirty dozen" and those containing the least, "the clean fifteen" to help guide consumer choices.   The EWG is a non-profit, non-partisan organization dedicated to using the power of information to protect human health and the environment. 

These lists help inform shoppers about which vegetables and fruits to prioritize as organic and which they can save a little money on by opting for the conventional variety. 

Here are some reasons to consider limiting pesticides in the diet and in skin products:

  • They accumulate in our fat cells;  major organs such as the liver, kidneys and brain; in our glands such as the thyroid and adrenals; and throughout our central nervous system.  
  • The liver and kidneys become less efficient at removing them from the body as we age
  • The longer pesticides stay in the body, the more likely they are to build up to levels that may cause injury
  • Chemicals and pesticides can react in the body in unexpected ways

Read about how pesticide intake may impact children's IQ here.  On a more positive note, research has shown that removing pesticides from the diet decreases pesticides in the body by 98% in two weeks.  Informing yourself about the clean fifteen and dirty dozen can help reduce pesticide intake in your family.

Great Gazpachos for Hot Summer Days!

Wednesday, July 02, 2014

You can't have summer without cookouts, campfires and s'mores but on these hot summer days, let's face it, sometimes it's nice not to have to cook at all! 

BUT, before you cave and serve ice cream for dinner, try some of these refreshing, cool soups at the end of the day.  Served with some cold cut, chicken salad or tuna  sandwiches  or even crackers and cheese, they're a great meal and make use of summer's plentiful bounty.

Chilled Pea and Tarragon Soup
Cold Strawberry Soup
Melon Soup
Cucumber Soup and more!                


Watermelon Frenzy

Thursday, June 19, 2014

It's finally feeling like summer and what's better in this heat than watermelon?  My kids and I had our fill yesterday and it got me thinking.  Watermelon is delicious simply on it's own but what else can you do with it?  Then I remembered this amazing salad I'd had at 51 Lincoln; Grilled Watermelon Salad.  Yum!  This is the perfect salad for a sunny summer day.  Grilling it gives the watermelon a completely different texture that is hard to describe and the balsamic glaze and feta offer the perfect balance for the sweet fruit.  You gotta try it!   Here are some other fun ways to use watermelon this summer. 

Watermelon Keg

Watermelon Slushie

Fresh Watermelon Cake

June is National Fruit and Vegetable Month!

Monday, June 02, 2014

To celebrate this delicious and nutritious time of year, here are a few of our favorite fruit and veggie activities for you and your family.

Visit a Farmer’s Market- have children be on the lookout for a certain colored new fruit or veggie to try or make a scavenger hunt to find a rainbow of produce.

Make Fruit Wands- Stack a variety of cut up fruits on a kabob stick and top with a slice of star fruit for a magical and tasty treat.

Plant a Veggie Garden- Planting vegetables can be a great way to increase your child’s interest in trying new, healthy foods. Take a look at some of our tips here for getting started.

Veggie Builders- Make a variety of veggie buildings, animals and people out of cut up vegetables, tooth picks and cream cheese for the “glue”.

Make Fruit “Sundaes”- Layer fruit, low fat yogurt and crunchy cereal or granola in a pretty glass and enjoy!

Gluten-free, Casein-free Diet for Autism Spectrum Disorders & ADD

Friday, May 30, 2014

The Gluten-free/Casein-free diet is a relatively new, popular dietary intervention used to treat symptoms of Autism Spectrum Disorders (ASD).  It involves of completely eliminating gluten and casein products from the diet. 

Gluten is a protein found in wheat, rye, and barley, some vinegars and many processed foods. Casein is one of the proteins found in dairy products. 

Researchers hypothesize that children with autism are not able to completely break down foods containing the proteins gluten and casein resulting in opioid peptides (larger molecules than usual) being absorbed through the gut.  These opioid peptides may have an morphine-like effect on the brain, further exacerbating autism symptoms such as visual stimulation, difficulty with emotion regulation, poor eye contact and sensory processing disorder. The “leaky gut syndrome,” often present in children with autism (possibly related to earlier insults due to use of antibiotics, food sensitivities, etc), allows peptides to cross intestinal membrane, enter the bloodstream, cross the blood/brain barrier, and then affect neurotransmitter function. 

This theory would explain why a good number of children with ASD have GI symptoms such as diarrhea, constipation, abdominal pain, and gastroesophageal reflux.  Another suggestion is that since these children often have difficulty expressing or pinpointing their pain, they can react with aggressive or emotionally expressive behavior.

Research is still mixed on this diet therapy.  Nonetheless, anecdotal evidence is abundant; just talk to any parent with a child on the spectrum or with ADD who has tried this diet therapy and you will hear amazing feedback.  Recently, a psychotherapist told me her friend was ready to put her son with ADD in private school until they tried removing gluten from his diet and saw an amazing transformation.

The GFCF diet has been the most frequently researched diet approach to ASD disorders in recent years. Some research demonstrates the diet's effectiveness, however, implementation of the diet is dependent on parental and physician support as well as socioeconomic status. This is a difficult diet to implement and maintain, particularly in older children who may have resistance to new foods.  It's also particularly challenging in this population where picky eating and feeding disorders are common.  It's also important to note that nutrient deficiencies and poor bone growth can result if appropriate substitutions to the wheat and dairy components aren't included.  Often supplements are required.  Make sure to consult a physician or dietitian prior to making any changes to your child’s diet. 

How are Your Bacteroides and Firmicutes?

Thursday, May 29, 2014

I recently attended a great seminar on the microbiome - our microbiome consists of the microorganisms living in our gut, skin, lungs and other organs.  Did you know that there are 10 times more microbial cells than human cells in our body?  Pretty creepy huh?  These various microorganisms (or lack there of) have been linked to a number of current health concerns:


Allergies & Food Intolerances





Gastrointestinal Diseases

Health research is starting to look at the human body as a multi-organism colony as opposed to one.  What these researchers are finding is amazing.  For example, several studies including this one have shown an increased Bacteroide to Firmicutes ratio in the gut of obese individuals compared to lean counterparts. 

Interestingly, when the gut environment changes via diet, the microbiome also changes.  How do you change it exactly?  Eat mostly whole foods, plenty of fiber, foods that contain naturally occurring probiotics (yogurt, sauerkraut, other fermented foods) and get plenty of healthy oils (i.e. fish, olive oil, nuts, etc).  You may also consider supplementing with a prebiotic.  Prebiotics, probiotics and other nutrition supplements might help restore lost microflora as a result of antibiotics and a long period of eating mainly processed food.




Should My Child Be On a Diet?

Tuesday, May 27, 2014

First of all, N-O!

Now, let us elaborate... 

This can be a tough question parents may ask themselves after a visit to the pediatrician’s office, a BMI report from their child’s school or for some when their child asks about their weight and if he/she needs to lose weight. As adults, many of us think “diet” when it comes to getting to a healthy weight- as a pediatric dietitian; I’d like to ask that parents think of family change when it comes to helping a child get to a healthy weight.

Family change is far more effective than getting your child started on a roller coaster of fad diets where you’re cutting out carbs one day and trying weight loss shakes the next. With the support of a family that is working towards healthy change together, your little one can have the support he or she needs to achieve healthy behaviors that will last a lifetime.

Here are a few of my favorite lifestyle changes for families- all of them can be helpful for your children (no matter what their weights are) to instill healthy behaviors.

Supportive Food Environment: Of course with healthy change should come healthy foods, so stock up with the whole grains, fruits, vegetables, low fat dairy and lean protein. More than just the obvious changes, it’s important to identify foods in the house that your child may struggle with.  If your child seeks out favorite snacks such as potato chips or cookies and struggles with portion size for these foods it can be helpful to buy those foods periodically, say once a month rather than weekly.
Calorie Free Beverages: For your supportive food environment one very effective change you can make is removing the calorie-filled beverages such as juice, soda and other sweetened beverages. These drinks provide empty, excess calories to your child’s day that can lead to weight gain. Offer water, seltzer or low fat milk for daily beverages and leave the sweetened drinks for special occasions.
Family Dinners: Studies show that children from families who share a meal together at least 3 times per week were more likely to be within a normal weight range and have better eating patterns consisting of healthier foods. Make an effort to gather around the dinner table with your family (without the TV please!) and reap the benefits of this shared meal. 

Activity Time: Physical activities such as hiking, bike riding, swimming or even a walk after dinner can be a great way to spend time together and start exercise as a regular part of your family routine. Obviously this can be a challenge when the week gets busy, but even something as simple as an after dinner walk or a quick toss around of the Frisbee can make a difference. Try to work in longer periods of time on weekends for a bigger family activity such as going for a hike or long bike ride.

Family Dessert Night: Many parents struggle when they are faced with the nightly question of “can I have dessert?” It can be a tough negotiation to face after a long day and can often lead to giving into your little one’s sweet tooth a bit too often. A simple solution can be to define a family dessert night (or two depending on what works for your family). Designate a day where the entire family enjoys a dessert and on the remainder of the week offer fruit after dinner if still hungry.

B6 and Magnesium for Autism and ADHD

Friday, May 23, 2014

Beyond a healthy, whole foods-based diet, there are a few nutrition therapies that work wonders for kids on the autism spectrum.  One of these is supplementation with B6 and magnesium.  The combination of these two nutrients in therapeutic doses (i.e. above RDA) has been shown to decrease self-stimming behaviors, improve eye contact and calm a "high engine".  This article details the mechanism of action. 

If you want to explore this option with your toddler or child (or even as an adult) it is important to seek the help of a qualified dietitian.  There are some (reversible) side effects that you will want to monitor as you gradually increase the dose.  A dietitian along with your physician can help ensure that you implement this nutrition therapy safely and help you taper off of it if and when appropriate.

More on nutrition therapy for autism to come. 

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