Nutrition

Fruits and vegetables are an important part of a healthy diet, but getting our children to eat the right things can feel like pulling teeth. What should you do when your son gags at the sight of broccoli, or your daughter reaches for soda and candy instead of fruit?

Or, at the opposite end of the spectrum, what should you do if your child visits a local farm and vows never to eat a cow, pig or chicken again? Is it possible for a child to be healthy on a vegetarian diet?

Pediatrician Swati Pandya, M.D., answers parents’ questions about the importance of fruits and vegetables in children’s diets, how to encourage kids to eat more of these health boosters and meeting the dietary needs of young vegetarians.

How many fruits and vegetables should my child eat?

According to U.S. Department of Agriculture (USDA) guidelines, half of our daily diet should consist of fruits and vegetables, combined with smaller portions of grains, protein and dairy.

However, according to the U.S. Centers for Disease Control and Prevention, the majority of Americans do not eat nearly enough fruits and vegetables. As our kids get older, the problem worsens. A 2009 CDC report states that only 32 percent of high school students eat at least two servings of fruit daily and a mere 13 percent eat at least three servings of vegetables every day.

Why are fruits and vegetables so important, and are some better than others?

Fruits and veggies are important for many reasons. First, they contain nutrients that are difficult to find in other food sources, including folate; magnesium; potassium; dietary fiber; and vitamins A, C and K. Second, they reduce the risk of many chronic diseases. Third, they are naturally low in calories when prepared without adding fats or sugars – which helps maintain a healthy weight.

The most nutrient-rich vegetables are dark green, such as broccoli, spinach, collards, and turnip greens. Bright red and orange vegetables, such as tomatoes, pumpkins, sweet potatoes, and red peppers, also tend to have a lot of nutrients. It’s best to eat whole fruits or fresh canned, frozen and dried fruits as opposed to juice, which often contains fewer nutrients and more sugar and other additives.

How can I get my child to eat more fruits and veggies?

There are several ways you can serve up more fruits and veggies. Here are a few tips you can try:

• Serve them when your child is hungry. When your child gets home from school and is ravenous, put out a plate of veggies, such as carrots, bell peppers and cucumbers – along with hummus or another healthy dip.

• Encourage your child to try new fruits and veggies. If your child is resistant to trying new foods, implement the “try it first, then you can say no” rule. Even if your child rejects the new food after the first one or two tries, he or she may grow to like it over time.

• Market the health benefits of fruits and veggies using fun kid language. For example, tell your child carrots will give her “superhero vision” or spinach will make him “strong like Popeye.”

• Engage your kids in shopping and cooking. Many children enjoy making their own food choices and helping to prepare meals – and they are often more likely to eat what they select and cook.

• Make fruits and vegetables easy to access. Keep a bowl of fruit on the kitchen counter and stock your fridge with chopped-up, easy-to-grab veggies so that when your child goes hunting for a snack, healthy options are readily available.

• Find ways to add more fruits and veggies to your child’s favorite meals. For example, add pureed veggies to quesadillas and add chopped bananas to hot or cold cereals.

• Be a positive role model. Your child is watching everything you do, so be sure to eat a variety of fruits and vegetables as part of your daily diet.

My child wants to be a vegetarian, but I’ve heard many definitions and am not sure what it means. What are the different types of vegetarianism?

Your child may be exploring a vegetarian diet for many reasons, including concern for animals, the environment or his or her own health. People use the term vegetarian to describe a number of diets, but here are a few of the most common types:

• Vegans eat only food from plant sources.
• Ovo-vegetarians eat eggs, but no meat.
• Lacto-ovo vegetarians eat dairy and egg products, but no meat.
• Lacto-vegetarians eat dairy products, but no eggs or meat.
• Semi-vegetarians eat poultry or fish, but no red meat.

Is it possible for my child to be healthy as a vegetarian?

The simple answer is yes. In reality, the answer is a bit more complicated. Children can get all the nutrients they need from a vegetarian diet – but only if the diet is well planned and balanced. This is especially important if the diet doesn’t include dairy and egg products. And you’ll need to adjust the diet to meet the changing nutritional requirements of your child as he or she grows.

If your child or teen is going to become a vegetarian and you are unfamiliar with this diet, talk to your child’s doctor or a registered dietitian who can help you plan a healthy vegetarian diet. It’s important for the diet to include enough calories and nutrients for each stage of your child’s growth and development.

A properly planned vegetarian diet is high in fiber and low in fat. This offers many health benefits, including better cardiovascular health, lower blood cholesterol and reduced risk of obesity.

What foods should I encourage my child to eat as part of a healthy vegetarian diet?

To reap the health benefits of a vegetarian diet, your child should consume adequate calories and the following nutrients in the proper amounts for his or her stage of development:

• Protein, found in dairy products, eggs, soy products, beans and nuts
• Calcium, found in dairy products; broccoli; dark green leafy vegetables; dried beans; and calcium-fortified products such as orange juice, soy and rice drinks, and cereals
• Vitamin B12, found in dairy products; eggs; and vitamin-fortified products such as cereals, breads, and soy and rice drinks
• Vitamin D, found in milk and vitamin D-fortified products such as orange juice
• Iron, found in eggs, whole grains, leafy green vegetables, dried beans, dried fruits, and iron-fortified cereals and bread
• Zinc, found in wheat germ, nuts, dried beans, and fortified cereal

No matter how you dice it, eating lots of fruits and vegetables is important to your child’s health. So start buying, chopping, and serving up those fruits and veggies as much as possible to help your child enjoy a longer, healthier life.

Swati Pandya, M.D.

Swati Pandya, M.D., is a board-certified pediatrician at the Palo Alto Medical Foundation’s West Valley Center.

Yes, Virginia, you can keep a healthy diet during the holidays, even when sugar plum fairies are dancing in your head.

The trick? Don’t deprive yourself – have a little of your favorite treats and still maintain good overall nutrition. In this video, Linda Shiue, M.D., shares her top tips for healthy eating during the holidays, including:

• Don’t deprive yourself
• Pre-eat: have some fruit before the party
• Chose foods carefully
• Drink in moderation
• Don’t forget to exercise
• Get enough sleep

Childhood obesity – it’s in the news and the facts are startling. According to the Centers for Disease Control (CDC):

• 13.8 percent of students ate vegetables three or more times per day during the seven days before the survey
• 18.4 percent of students were physically active at least 60 minutes per day during the seven days before the survey
• 19 hours, 40 minutes is the average time per week that the American child ages two and 17 spends watching television
• Due to obesity-related illness, today’s children may be the first generation to have a shorter lifespan than that of their parents.

Jeremy Loader of the Palo Alto Medical Foundation’s Youth Nutrition Program, is determined to reverse these distressing statistics with a unique program for local schools called “5-2-1-0.”

“School-age children spend the bulk of their waking hours at school,” says Loader. “Our 5210 school curriculum is designed to give parents and educators tools to combat childhood obesity in a simple, clear and positive way.”

In the 5210 program each number represents a goal:

5:   Eat at least five servings of fruits and vegetables a day. Limit juice to small amounts of 100 percent fruit juice.

2:   No more that two hours of screen time a day. Less is better!

1:   Participate in at least one hour of moderate to vigorous physical activity every day.

0:   Aim to drink zero servings of soda and sugar-sweetened sports and fruit drinks. Instead, drink water and three to four servings/day of fat-free/skim or 1 percent milk.

The 5210 program includes:

• Lesson plans
• Activity ideas
• PowerPoint presentations
• Newsletter samples
• Goal-tracking campaigns

Each month, the students concentrate on a different number in the 5210 program. Each number is color-coded, and for the PAMF-facilitated programs, students get a wristband color-coded with that month’s number. There are also tips on how to fit these goals into real life, one at a time. Among other resources is a list of free healthy rewards for the kids – choose a favorite game, get a homework pass, have class outside – and learning what constitutes a portion size.

Engaging activities are tailored to elementary school children’s interests, and some of their favorites are the poster contest, cooking classes and a jump rope contest.

“The kids were so excited about the jump rope contest that they spent the whole week before practicing,” says Loader. “One third grade student did 96 jumps in one minute.”

According to Loader, schools that implemented the program have seen marked results, with schools that actively participated in all the activities seeing the best results. For example, one Sunnyvale elementary school that participated in all the activities in the program reported that:

• 79 percent of the students spend one or more hours being active on the weekend.
• 78 percent have zero or one sweetened drinks per day.
• Only 22 percent spend more than two hours a day in front of screens during the week.

For more information on the 5210 Program and to access the 5210 Program educational materials, visit the 5210 section of PAMF’s Youth Nutrition Program website. Under the “Schools” section you’ll find handouts, templates, presentations, and other resources that schools can download and use to implement their own 5210 program.

Any idea how far you’d need to walk to work off one, measly M&M (and we’re talking plain here, not the peanut, pretzel, double-stuffed/whatever variety)? Believe it or not, you’d have to walk the entire length of a football field for something that’s not even a full bite of food!

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Doctors Amy Lin, Sandra Wong, Vivian Tsai (l to r)

As with many holiday celebrations, it may be tempting to overeat during Chinese New Year.  However, there are ways to eat healthier and still feel satisfied.  Even small, simple changes can lead to a healthier you.

Read More about Tips on Healthy Chinese Food Options – Part 2

Did you know that 12 percent of patients who call the Palo Alto Medical Foundation their medical home are of Chinese descent?  In honor of them and the Chinese New Year, PAMF would like to share some nutritional information to help you make good dietary choices. Start the Year of the Dragon off right by eating healthy and paving the way to a long life by improving your diet.  Gung Hay Fat Choy!

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