This week I’m going to briefly discuss my weekly meal plan — and then review the 2010 Dietary Guidelines Report.  I like to keep my readers updated on public health recommendations including the latest nutrition research. I also wanted to let you know that we have a winner for our SOS cookbook giveaway — Merri Ann, mom of three from Texas. Congrats Merri Ann!

So two weeks ago I tried fish tacos for the first time.  They were good but both my husband and I didn’t love them.  My son ate up the fish (I used tilapia) and my daughter took a bite but didn’t continue.  My husband made the comment “maybe there’s a reason fish tacos are fried.”

So this week we’ll stay basic and do bean burritos on Mexican Monday.  And because it’s still June gloom I’m going to try this salsa and chicken black bean soup for the long slow cook day.  I’m also working on expanding our lunches and snacks and plan to post some soon. 

For more meal plan ideas see Org Junkie.

What’s Cooking this Week?

Monday: Bean Burritos with salsa, guacamole, cheese and lettuce.

Tuesday: Slow Cooker Veggie Lasagna with bread and spinach salad

Wednesday: Salsa Chicken and Black Bean Soup topped with avocado and served with carrots and cut-up fruit

Thursday: Potluck/leftovers

Friday: Salmon with avocado dip, mashed sweet potatoes and green beans.  Will serve with bread.

Weekend: Plan to try Rainy Day soup one reader sent in.

News! Report of the Dietary Guidelines Advisory Committee   

Quick Review Course
Since 1980,  the United Department of Agriculture (USDA) and Health and Human Services (HHS) have published Dietary Guidelines for Americans.  These evidence-based recommendations, published every 5 years, provide healthy eating advice for Americans age 2 and older. 

In 2008 the USDA and HHS appointed 13 health and nutrition experts to the 2010 Dietary Guidelines Advisory Committee (DGAC) to provide recommendations to revise the 2005 guidelines.  The DGAC released their findings in a report last week.  After the public comment period is complete, the 2010 Dietary Guidelines for Americans will be finalized.

The Report

So what did these experts find?  Here are the key takeaways:

How Americans Are Eating?

• Americans still consume too few vegetables, fruits, high fiber whole grains, low fat milk and milk products and seafood and eat too many added sugars, solid fats, refined grains and sodium.
• SoFAS (added sugars and solid fats) contribute almost 35% of calories in the typical American’s Diet which is true for all age groups/sexes – children, adolescents and adults.
• Nutrients many Americans are missing (”short-fall” nutrients) include vitamin D, calcium, potassium and dietary fiber.
• Americans consume too much sodium and not enough potassium putting them at risk for hypertension.

 
Weight Management

• Focuses on children and primary prevention (yeah!!). Any and all systems-based strategies must include a focus on children.  Primary prevention of obesity must begin in childhood.  This is the single most powerful public health approach to combating and reversing America’s obesity epidemic over the long term.
• The macronutrient intake (carbs vs. fat vs. protein) of someone’s diet is not the driving force in excess weight gain, it’s total calories and low physical activity.
• Excess weight gain before and during pregnancy is problematic as many women have trouble losing weight postpartum.
• Certain behaviors have been associated with weight gain including too much TV, too little physical activity, eating out frequently, skipping breakfast, snacking on energy-dense food and drinks and consuming large portions.

 
Key Recommendations

• The DGAC recommends a total diet approach (eating patterns over time) that is more plant-based emphasizing fruits, vegetables, whole grains, cooked dry beans and peas, nuts and seeds.  Increase the intake of seafood and low fat dairy products and consume more moderate levels of lean meats, poultry and eggs.
• Consume less sodium, 1500mg or less (down from 2300mg in 2005), and increase potassium (no levels).  See potassium food list.
• Limit saturated fat to 7% of total calories or less and cholesterol to 300mg.  Avoid trans fat and increase omega-3 fatty acids from marine sources (DHA/EPA).  Recommendations include two servings of seafood per week (4oz) for an average of 250mg/day — maternal dietary intake during pregnancy and lactation is especially important. 
• There is strong evidence that moderate alcohol intake (1-2 drinks per day) is associated with lower risk of diabetes and heart disease among middle-aged and older adults.  Excess alcohol intake is not beneficial.  Moderate means one drink for women and two for men.
• There is no evidence that multivitamins offer health benefits, and under certain circumstances may even cause harm (excluding certain population groups).  Individual mineral/vitamin supplements based on need (vitamin D, iron etc) may be appropriate. 

 
What do I think about the report?  I am a huge proponent of prevention from everything to excess weight to the development of chronic diseases, so I like that focus.  I think it’s good that we might finally have recommendations for omega-3 fatty acids (DHA/EPA), though the levels will probably be less than international guidelines. They are reducing dietary targets for sodium and saturated fat which I’m not sure is necessary for everyone.  They are taking a stand on multivitamins, which I plan to talk more about in a future post.  I don’t have strong feelings about it overall.

I’m curious, how do you feel about the Dietary Guidelines?  Do you pay much attention to them?  Once the final guidelines are here I’ll be sure to write about it.

I’m happy to say my family is no longer sick and we are finally back on regular food. The chicken noodle soup I made last week really hit the spot. I ended up using a rotisserie chicken from the store and it was incredibly easy and tasted much better than canned soup. I will definitely make it again.

I never got around to making tilapia so we’ll have it on Tuesday. So for this week at least, I’m meeting my goal of fish twice in one week.

This Monday, in addition to the weekly meal plan & challenges, I thought I’d recap some interesting nutrition news. For more meal ideas go to Meal Plan Monday at Org Junkie.

What’s Cooking This Week

Monday: I plan to spice up Mexican night with Chicken Fajitas served with tortillas and black beans.

Tuesday: Parmesan-Crusted Tilapia with butternut squash* and roasted asparagus(thanks for the tilapia recipe Deb).

Wednesday: Beef and lentil soup (from Fix-It and Forget-It Cookbook), bread with spinach* salad (dried cranberries, feta cheese and almonds)

Thursday: Potluck/leftover night

Friday: Baked Salmon with Tomatoes,** Spinach* and Mushrooms

vitamin A-rich* vitamin C-rich**

Challenges

Lately, my 3-year old has been trying to take over my job of the deciding the “what” and “when” of feeding. I jotted down some notes of one of our recent interactions:

7-7:30 It’s cereal, eggs and some fruit for breakfast. She’s off eggs right now but ate a lot of cereal and cantaloupe

8:30: Anna: “I want cheese and crackers”

Me: “we’ll have the at snack time in a little while.”

Anna: “I want milky”

Me: “We’ll have it later with lunch.”

Anna: “I want apple juice”

Me: “We’ll have some with dinner tonight. Why don’t you have some water right now?”

Anna: “I—(crying)—don’t—–want—(crying)—-water!”

Me: ” You don’t have to drink it, but I’ll put it right here in case you change your mind.”

Two minutes later Anna chugs the water and plays happily.

Nutrition News

-Super Kids Nutrition: There’s a blogging contest going on at Super Kids Nutritionfor National Nutrition Month. Fellow dietitian, Melissa Halas-Liang, has created a site that offers helpful tips and books to help kids develop healthy eating habits. I like that the tips come from registered dietitians and that there are inspirational books for children. Check it out and get a lot of great info. (If I win this contest, I’ll review one of the books!)

-Calories posted on menus:Last week the passing of the healthcare bill stirred a lot of debate. But something interesting came out that was somewhat underplayed: a new nutrition requirementfor fast food and chain restaurants. More than 200,000 restaurants will have to post the calories in their items for everyone to see (even on drive thru menus!).

We don’t eat out very often so I’m not usually concerned with calories etc. I mean, every 6 months I crave an In ‘N Out burger and my husband is out the door faster than I can say “Let’s have In ‘N Out.” But I have to admit, the nutrition facts on items at my work cafeteria do sway my decisions. When I saw the cheese enchiladas had a day’s worth of fat and saturated fat, I decided to go with the veggie burger. So maybe not such a bad thing. How do you feel about this? Do you think it will change what you order?

-Babies not getting enough vitamin D: I write a lot about the importance of vitamin D in children and adults. A new study in the Journal of Pediatrics reveals that 9 out of 10 breastfed babies and a majority of formula-fed babies do not get the recommended amount of vitamin D (400IU). In order to meet the requirement, formula-fed babies would need to get a liter of formula a day. Another surprising detail is very few parents are supplementing their babies with vitamin D.

Are you supplementing your babies (or child)? And if not, why? For more on why it’s important see Is Your Family at Risk for Vitamin D Deficiency?

Kids prefer crunchy vegetables: A new study came outtesting which vegetable preparation method was most preferred by 4-12 year olds. They mashed, steamed, boiled, stir-fried, grilled and deep fried veggies. They found kids liked the steamed veggies the best as they retained their crunchiness. I’m not sure why they didn’t include raw veggies which are the crunchiest of all. And they left out my new fav– roasted veggies. But the point is kids like crunchy.
How does your kid like (or not) like veggies?

Well that’s it for now. I have a lot in store for this week so stay tuned…

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You’ve probably heard that the first lady is taking on childhood obesity. On Tuesday she announced the development of a task force that will engage both private and public sectors to solve the childhood obesity problem in a generation.

The areas of focus include: helping parents make healthier food choices, making schools a healthier environment, increasing physical activity and making healthy food more accessable. In 90 days this task force will develop and announce a plan of action. I’ll be sure to keep you updated. For more on this, see Let’s Move.

There are some changes that will take place immediately. The American Academy of Pediatrics is joining the cause by enouraging pediatricians to keep a close eye on the BMIs (body mass index) of children. So if there’s a problem they will let you know.

But there is a part of me that is worried that some negatives may come out of all this attention on weight. So I jotted some of my concerns down just in case Michelle Obama — or her task force members– runs across my blog.

1. It’ll take more than healthy eating: Whenever I see a story on fighting obesity, it’s always talks about getting kids and adults to eat “healthier.” There is not a parent alive who doesn’t know that eating more fruits and vegetables is good for their children. So if pediatricians just spout of the same old advice, parents will still face the same barriers they had before, whether it’s getting kids to eat fruits and veggies or finding the time to prepare them.

But what if pediatricians asked families to change how they eat? Isn’t this what has really changed over the last 40 years? We no longer make feeding ourselves — and our families — a priority. Telling parents to start by having regular meals and snacks at the kitchen table is a great start. They can gradually add more variety including fruits and veggies.

But if children continue to graze on food, eat while watching TV, or are allowed to grab food out of the cupboard when they are bored, they are much more likely to get more calories than their bodies need. And why should we wait for a high BMI to give this advice?

2. Keep a watchful eye on eating disorders: According to The Alliance of Eating Disorders Awareness, eating disorders affect 24 million Americans. Young women with an eating disorder are 12 times more likely to die than other women their age. The most common behavior that leads to an eating disorder is dieting. Fifty-one percent of 9 and 10- year olds feel better when on a diet and 42% of 1st and 3rd grade girls want to be thin.

So very young children already have a desire to be thin. We need to watch the way we talk to our children and let them know that health is most important, not looks or weight. Pediatricians also need to be careful in how they relate messages when they find a child is overweight. I will be running an eating disorder prevention series this month to discuss ways parents can help prevent eating disorders in their children so stay tuned.

3. Size discrimination is a problem: The last acceptable form of prejudice is size discrimination. This movement could make people even more critical of those who carry excess weight. We need to educate our children that people come in all shapes and sizes. While BMI can be a helpful tool, some kids may be considered overweight but still be healthy because they are naturally bigger. Just the way some children fall off the growth charts because they are small. What we want to avoid is kids gaining an unnatural amount of weight for their body type.

4. Restrictive feeding practices don’t work with kids: With more pediatricians telling parents their children have a weight problem, some parents may start restricting their kids’ eating, which is really a form of dieting. Research shows such practices backfire, making children more likely to overeat and gain weight.

Encouraging healthy behaviors for the whole family is vital. Singling out an overweight child can do long-term damage to their self esteem, make them obsess about food and increase their risk of developing an eating disorder. All members of the family benefit from healthy habits, whether or not they carry excess weight.

So that’s it. Just some thoughts I wanted to get out there. Now I feel better.

What do you think about all this? Any solutions you want Michelle Obama to know about?

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I have two good reasons to write about weight today. First, it is Healthy Weight Week and second, new obesity statistics (childhood and adult) have been released.  And I want my readers to be in the know.

Obesity statistics published in the Journal of the American Medical Association have been updated to account for the decade that just ended.  Drum roll please… 

There was no change.  Children (except the heaviest boys from 6-19 years old) and adult women had no real increase while men’s numbers went up but from 2003 onward this wasn’t significant.  Still, almost 7 out of 10 adults (68%) are either overweight or obese.  So while the numbers haven’t gone up, most health professionals prefer they go down.   

At the same time these statistics were splattered all over the news, another interesting research study was reported.  According to a study in the Journal of Preventative Medicine, women who have had children are at the highest risk for weight gain over time.  The researchers studied 6478 Australian women and found that over ten years the women without children or a partner gained 11 pounds, those with a partner gained 15 pounds, and with a partner and a child gained 20. 

According to the International Food and Information Council, in the last decade media stories on obesity have skyrocketed.  I often wonder what effect this news really has on people.  Does hearing about weight make them want to jump on the treadmill or give up in defeat?

And if you have an overweight child, how does this news sit with you?  Will you be tempted to restrict your child’s intake?  Take away all his sweets?  All of which are things that backfire.

Clients have always told me “I know what to do, I just don’t do it.”  And this makes them feel bad, lazy even, for not doing what they think they should do.  (For a great reason not to “should” yourself see this article!)

But I think the key is identifying and removing obstacles – real and perceived.  Yes, those of us married with children are more at risk to gain weight.  We are so busy with children and responsibilities that we tend to put ourselves on the back burner.  But there’s so much we can do to help ourselves and our kids if we learned how to look at things differently.

Many of you said time was your major barrier to taking care of your own health.  So stay tuned for tips on how to remove barriers, save time and prove that being married with children does not make unnecessary weight gain inevitable.

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References

Ogden CL, Carroll MD, Curtin LR, Lamb MM, Flegal KM. Prevalence of high body mass Index in US children and adolescents, 2007-2008. JAMA. 2010;303(3):242-249.

Flegal KM, Carroll MD, Ogden CL, Curtin LR. Prevalence and trends in obesity among US adults, 1999-2008. JAMA. 2010;303(3):235-241.

Brown WJ, Hockey R, Dobson AJ. Effects of having a baby on weight gain. Am J Prev Med. 2010;38(2): 163-170.

Yesterday the media was bursting with news about children and vitamin D. A study published in Pediatrics revealed that 70% of children –- millions of kids — have low vitamin D levels. Nine percent of 1 to 21 year olds were found to be deficient in vitamin D and 61% had insufficient levels. I couldn’t believe it when I read that only 4% of children were taking vitamin D supplements.

Why are so many parents choosing not to supplement their kids?

I don’t think parents understand how easy it is for children to fall short on the sunshine vitamin. And I especially don’t think they understand the impact that vitamin D deficiency can have on life-long health.

Research suggests that insufficient vitamin D not only negatively affects bone mass (Rickets only occurs with a severe deficiency state) but it is linked to the development of cardiovascular disease, diabetes, cancer and multiple sclerosis. In fact, the aforementioned study showed that kids with lower levels of vitamin D also had lower blood calcium levels, higher blood pressure and lower HDL (good cholesterol). For more information on vitamin D, see Is Your Family at Risk for Vitamin D Deficiency?

To help parents like you understand this public health concern, I’ve listed 4 key reasons why 7 out of 10 kids don’t get enough vitamin D.

Born to vitamin-D deficient moms: Kids aren’t the only ones with low levels of vitamin D. Many adults are at risk for vitamin D deficiency – and that includes pregnant women. If an expecting woman stays out of the sun, has dark skin or is overweight she is at increased risk. And expecting moms can’t necessarily rely on prenatal vitamins which contain 400 International Units (IU). According to the Amercian Academy of Pediatrics (AAP) policy report:

Supplementation with 400 IU of vitamin D per day during the last trimester of pregnancy has minimal effect on circulating 25-OH-D concentrations in the mother and her infant at term. An unsupplemented infant born to a vitamin D–deficient mother will reach a state of deficiency more quickly than an infant whose mother was replete during pregnancy.

It would be wise to test vitamin D levels during pregnancy so women would know if they need additional supplementation. During my recent pregnancy I took an additional 1000 IU of D. If you are pregnant, talk to your doctor about a vitamin D test.

Not enough time in the sun: According to the aforementioned study, children who watched more TV (spending time indoors) were more likely to have low vitamin D levels. But if parents lather their children up with sunscreen every time they go outdoors, they’re faced with the same problem.

The problem with relying on the sun for vitamin D is it’s hard to determine if it’s getting the job done. According to Michael Hollick, a leading vitamin D researcher, the hours between 10am and 3pm (10-15 minutes of sun exposure is recommended) produce the most vitamin D. So relying on late afternoon or early morning sun exposure may not be enough. And most parents are worried about the risk of skin cancer.

There’s not much D in food: Fatty fish such as salmon, tuna and mackerel and fortified milk and cereal contain vitamin D but that’s about it for food sources. Many parents feel their milk-drinking kids are safe. But according to the AAP, children would need to drink 4 cups of milk per day to make it to the 400 IU they recommend. And while milk plays an important role in young children’s diet, too much of it can displace other nutritious foods.

For babies and nursing toddlers, breast milk offers very little vitamin D. This is why the AAP recommends breastfed children be supplemented with 400 IU daily starting in the first few days of life. Formula is supplemented with vitamin D. See my product review for Carlson Vitamin D drops.

Public health recommendations are too low. The Institute of Medicine’s Adequate Intake for vitamin D is only 200 IU which is why the AAP has stepped up its recommendations. Due to the mounting research, the Institute of Medicine is in the process of revising its stance on vitamin D.

There’s little doubt that vitamin D insufficiency is an important public health concern for families all over the country. Take the time to talk to your doctor and get your levels checked. Many health experts believe that 1000 IUs is an appropriate amount for adult supplementation. And remember the AAP’s recommendations for children – 400 IU daily for breastfed children and older children not drinking 4 cups of milk per day.

As more news and research breaks, Raise Healthy Eaters will be there to break it down for you.

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