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| Common nutrients which fall below healthy recommended levels |
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| • Folic acid |
• Calcium |
| • Vitamin A |
• Vitamin C |
| • Zinc |
• Iron |
| • Vitamin B6 |
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| TOP |
Weighty Issues:
Menus for today's
overweight world.
by Connie Guttersen, RD PhD,
author of the Sonoma Diet
With some experts claiming that up to 25% of our country's children are overweight, restaurants continue to find themselves in the crosshairs of the discussion. Whether you believe that the foodservice industry has a large role or not, the fact remains that pressure is growing on restaurants (and parents) to make--or at least offer--better food choices.
This quarter, Dr Connie Guttersen explores many of the issues at the root of childhood overweight and obesity. While some of the topics are familiar, new research always adds information, and there are new findings that require a new look at the subject.
For example, recent studies show that overweight children are more likely to be iron deficient than normal weight children. Did you know that iron deficiency not only causes fatigue, it can actually affect learning ability?
Other studies show that even while kids might be eating too many calories, many are still lacking in nutrients. This is not an insignificant problem, as nutritional deficiencies have actually been shown to cause children to have an increase in violent and antisocial behaviors.
But take heart, because these problems can actually be helped with smart--and tasty combinations of ingredients. TOP
Smart Power Choices
from Menu Design to the Plate
The unprecedented rate of obesity among children and adolescents has prompted many food professionals to take an active role for improving food choices among American children. Findings from a large survey study (NHANES III) suggest that weight issues have increased more than three fold in the last 30 years, from 4% to 15% of the population. Other researchers have estimated up to 25% of US children are overweight. As the scientific literature takes a closer look at the impact of these figures, we find that childhood obesity is not just a cosmetic problem; this trend is closely related to an increase in type II diabetes, a concern for a shorter life span, and nutritional deficiencies, which may affect immune function, memory, learning abilities, and behavioral/mood levels such as shorter attention span, irritability, and aggressive behavior.
Chefs today are rapidly completing the learning curve when it comes to merging recent advances of nutrition science with menu design--from using healthy and flavorful monounsaturated fats, to eliminating trans hydrogenated fats, and finding creative ways to add whole grains to everyday foods. Convenience, appeal, and flavor have become part of the health equation. TOP
Redesigning menus:
Not just calories & portion size.
While calorie counts and portion sizes have been addressed by many food professionals, the issue of the diet quality with nutrient rich foods is just now starting be a focus. The scientific research has shown us that while Americans, including children, are eating more calories then ever, we are not meeting the recommended dietary allowances for key nutrients (listed below), thereby increasing the risk of malnutrition.
In other words, the everyday foods consumed are energy dense (ie high calorie) but not nutrient rich choices. Daily meals of snack foods, fast food, and processed foods do not supply adequate levels of critical nutrients for growing children--and this is even more critical when it comes to the overweight and obese child. Overweight bodies have higher nutritional needs than normal weight bodies, compounding the problem for nutrient deficiencies and malnutrition. Iron and zinc deficiencies are two examples of common nutrient deficiencies found in overweight and obese individuals as compared to normal weight individuals.
A diet low in whole grains and high in processed sugary foods does not protect children from type II diabetes. And diets high in trans fatty acids cannot protect against future heart disease. So, while it is important to focus on reducing portion sizes as a treatment to obesity among children, it is even more important to provide maximum nutrients for the calories.
So, what are the key points to consider in designing a healthy menu?
Designing a healthy menu for children requires a balancing act. You want to provide adequate calories that address the increased need for nutrients for growing children, while offering a calorie level that will either maintain a healthy weight or provide safe weight loss.
A healthy menu design incorporates a core of power foods--that's foods that are nutrient rich (particularly nutrients that are a challenge to consume in adequate amounts)--combined with other healthy foods. Pay special attention to the combinations, since smart combinations of these power foods actually enhances their nutrient performance and protective qualities. (And, not surprisingly, these healthy combinations also enhance taste.) TOP
Top Power Foods for Children and Adolescents
Fighting Iron Deficiency
According to the American Academy of Pediatrics, iron deficiency is the most common type of nutritional shortfall in American children and the number one deficiency in the world. Iron helps red blood cells carry oxygen throughout the body and helps muscle cells utilize oxygen to produce energy. A deficiency causes an inability to properly carry or utilize oxygen. The main symptom of iron deficiency is fatigue.
Poor performance in school can also be a definite symptom of iron deficiency, as even a borderline deficiency can affect a child's learning ability, especially for math problems. A report found that 84% of children studied who had attention deficit hyperactivity disorder (ADHD) also had abnormal iron stores. In addition, they found the children with the lowest iron stores had the most severe ADHD symptoms.
Children and adolescents who are overweight are more likely to be iron deficient than normal weight children. A recent study, published in 2004 in Pediatrics found that although children tend to consume large amounts of calorie dense foods, they are not nutrient rich choices. Another study, published 2004, in the American Journal of Psychiatry shows that children who experience certain nutritional deficiencies demonstrated a 41% increase in aggression at age 8. At age 17, they demonstrated a 51% increase in violent and antisocial behaviors. The study concluded that the difference in comparison to children who did not reflect these behavioral traits was related to the foods they were eating and the nutrients they were missing. The four primary nutrients missing were iron, zinc, B vitamins, and protein. They were not getting enough of these nutrients to develop healthy nervous systems. A healthy nervous system is important for mental and emotional health.
 Zinc is important for maintaining a healthy immune system, but it is also linked to building better brains through thinking, memory, and attention. It can be found in lean meats, but the best source is beef. It is also in fortified breakfast cereals, nuts, and whole grains.
Both animal and plant foods provide iron. Animal products such as poultry, beef, eggs, and fish provide the heme form of iron, which is the form that the body absorbs best. The plant and grain form is the non-heme form and is found in spinach, breads, whole grains, and beans/legumes.
And, remember to use smart combos: Smart combinations for improving the body's absorption and utilization of iron would combine iron rich foods with other foods that contain vitamin C. For example lean beef with peppers (like this recipe for Puerto Rican Steak and Peppers) and broccoli or served with a fruit accompaniment.
Lean Beef is one of the best-absorbed sources of iron. Even adding as little as one ounce of lean beef per day has been shown to make a big difference in the body's ability to absorb iron from other food sources. A 3-ounce serving of lean beef is an excellent source of protein, zinc, vitamin B12, and is a good source of vitamin B6, and iron.
Beef's leanest cuts have six times more vitamin B12, more zinc and two and a half times more iron than a skinless chicken breast. Choose leaner cuts of beef such as those which contain the words "loin" and "round" for example, eye round, top round steak, top sirloin, and chuck shoulder roast. TOP
Eggs
Eggs have also been found to be important in growing children. Eggs contain choline, a vital nutrient required for memory stem cells in the brain. The big news, according to research from the University of North Carolina at Chapel Hill and Duke University, is that extra choline also seems to help improve memory.
Whole Grains
Whole grains provide kids with fiber, folic acid and B vitamins necessary for good health. Folic acid is an important nutrient, which is used to make memory cells in the brain. Folic acid's brain building effects also affects mental alertness. In addition to whole grains, folic acid can be found in oranges, legumes, spinach and fortified cereals. While so many Americans are following low carbohydrate diets today, it is not recommended for children and adolescents, even if they need to lose weight. Low carbohydrate diets can negatively impact thinking ability and rob their energy levels - energy levels required for active lifestyles and sports.
Whole grains provide fiber, which prevents constipation, controls blood sugar levels, and maintains fullness in between meals--a definite boon in the battle of the bulge.
Try the wide variety of whole grains breads, snacks and cereals in your everyday food choices. Today, many common breakfast cereals offer not just fiber, but also contain protein, vitamin B12, and folic acid. This combination of protein and complex carbohydrates are digested more slowly and provide energy in a consistent way throughout the morning. Choose these options over high sugar processed varieties. High sugar cereals set kids up for a midmorning energy crash.
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| The American Academy of Pediatrics uses a simple method to recommend daily fiber amounts. Simply add five to your child's age to determine daily fiber needs in grains. So a 13 year old needs 18 grams a day. Also, aim for at least 3-one ounce servings of a whole grain each day. |
| Here are some menu suggestions to encourage breakfast eating: |
| |
| • Offer a breakfast with old fashion steel cut oatmeal, sprinkled with raisins or other dry fruits, nuts, and bit of brown sugar. |
| • Make French toast using whole wheat toast and eggs and then topping it with fresh berries. You are getting the protein, zinc, iron, choline, fiber, B vitamins and antioxidants from this dream team of foods. |
| • Or try this grab 'n go recipe for Vegetable Breakfast Tarts. |
| • Lunch should provide 1/3 of a child's calories, vitamins, and minerals. Offer whole grains over white bread. Healthy lunch options include: whole wheat wraps/tortillas filled with black bean spreads, lean meats, and cheese . Or for a different spin, offer mini sandwiches using whole grain crackers. |
| Try these Fiesta Chicken Tortillas. |
Important Function of Fats
for Growing Children |
| |
| • Growth |
• Energy |
| • Absorption of Vitamin E and Carotenoids |
• Brain Function |
| • Formation of Hormones |
• Formation of Cells |
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| • Smart usage includes a wide variety of smoothies made with yogurt to provide protein, calcium, vitamin D and all the antioxidants of berries. Frozen berries work great when fresh are not available. Include at least 1 1/2 cups each day of berries and other fruits. |
| • Combining blueberries with salads greens also provides an added boost to brain power. Greens such as spinach contain folic acid, iron, phytochemicals and B vitamins. |
| More Flavor in your Veggies |
| Fresh wholesome vegetables cooked in the proper way don't need too much for bringing out their delicious flavors. Here are some tips for bringing out their best flavors. |
| • Seasoning during the cooking process allows for better flavor through out the vegetable rather than just on the surface. You end up actually using less salt. |
| • Fresh Herbs: thyme, basil, dill, mint, parsley, cilantro, oregano, tarragon, and chervil can be used as part of a marinade or dressing/sauce. Add a bit of lemon zest with some fresh herbs, a drizzle of extra virgin olive oil, and you have simplicity at its best. |
| • Healthy flavorful oils: extra virgin olive oil, sesame seed oil, nut oils help to retain moisture and add flavor for salad preparations, grilling, or marinades. |
| • A little acid to brighten their flavors and can be used for marinades, dressings, and sauces: wine flavored vinegars, herb infused vinegars, balsamic vinegar, fresh lemon juice, white wine, pomegranate molasses, and ginger. |
 |
| Fresh wholesome vegetables cooked in the proper way don't need too much for bringing out their delicious flavors. Here are some tips for bringing out their best flavors. |
| • Seasoning during the cooking process allows for better flavor through out the vegetable rather than just on the surface. You end up actually using less salt. |
| • Fresh Herbs: thyme, basil, dill, mint, parsley, cilantro, oregano, tarragon, and chervil can be used as part of a marinade or dressing/sauce. Add a bit of lemon zest with some fresh herbs, a drizzle of extra virgin olive oil, and you have simplicity at its best. |
| • Healthy flavorful oils: extra virgin olive oil, sesame seed oil, nut oils help to retain moisture and add flavor for salad preparations, grilling, or marinades. |
| • A little acid to brighten their flavors and can be used for marinades, dressings, and sauces: wine flavored vinegars, herb infused vinegars, balsamic vinegar, fresh lemon juice, white wine, pomegranate molasses, and ginger. |
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Two good recipe options include: Red Wine Beef Barley Stew and Minted Multigrain Salad. TOP
Smart Breakfast & Lunch Offerings
Research shows that breakfast eaters do better in school and have less behavior problems than those children skipping breakfast. The Children's Nutrition Research Center at Baylor University reports that as many as 37% of American kids routinely skip breakfast.
Healthy Fats: Olives, Olive Oil, and Nuts
Children need healthy fats to supply nutrients that are essential for growth and energy. Fats play a key role in the absorption and metabolism of many nutrients such as the fat soluble antioxidant vitamin E and the carotenoids. Fats are also vitally important to the brain, which is 70% fat.
Limiting fat in the diet is also associated with a diet that is low in zinc and vitamin E, as well as a diet high in sugar, starch, and refined carbohydrates. USDA data from the Continuing Survey of Food Intake by Individuals, shows that 95% of girls ages 6 to 19 do not meet the needs for Vitamin E intake. A low fat diet can also increase the risk of an essential fatty acid deficiency, which increases the susceptibility of eczema, hair loss, growth retardation, asthma, vision impairment and learning problems.
The smart choice is to choose monounsaturated fats as the major source of fat in the diet; this includes olives, olive oil, avocado, nuts, and canola oil. These sources of fat not only provide the healthiest form--monounsaturated--but also contain additional protective antioxidants. Hydrogenated oils, found in margarine and snack foods (using partially hydrogenated oils), are the worst types of fat for a child and should be limited as much as possible. In addition to the increased risk for heart disease as found in consistent medical research, hydrogenated oil in children predisposes them to recurrent infections, inflammatory conditions, and potential learning disorders.
This recipe has both omega 3 fatty acids and monounsaturated fats: California Salmon Burger. TOP
Berries Rule
While all fruits are an excellent vitamin and mineral choice for kids, one group stands out in antioxidant power--and that's berries. Strawberries, blueberries and blackberries offer more antioxidant power than most other fruits. These antioxidants have been shown to boost memory power and cognitive function. These fruits contain powerful antioxidants coming from vitamin C and plant chemicals such as flavonoids. Antioxidants also may an added boost to help immune systems fight off common colds.
The Rainbow Colors of Vegetables
Vegetables add plate appeal with beautiful colors and versatility. Whether they take center stage or compliment the main course, there are many reasons to love veggies. Their health benefits seem almost endless--from their vibrant pigments, which act as antioxidants, to iron, calcium, B vitamins, phytochemicals and fiber. They have been associated with protective qualities from heart disease, cancer, Alzheimer's, anti aging, and even healthy weight loss. It is not too early to teach children to love veggies and get them in the habit of eating them everyday.
A smart way to enjoy the health benefits of vegetables is to go for color. Vegetables reflect the wide variety of shades in green, yellow, white, orange, red, and deep purple. Choose and vary these colors to get your maximum amount of nutrients associated with these vegetables. USDA new dietary guidelines recommend nine servings a day of fruits and vegetables, that an increase from the previous dietary guidelines which recommended 5 a day.
Get your rainbow here: Technicolor Vegetable Sauté. TOP
Dairy May Help Achieve Healthy Weight
Dairy provides calcium, an important mineral, which maximizes bone growth during childhood and beyond. A small amount of calcium is also necessary in the blood stream for normal heartbeat, blood clotting and muscle function. The body withdraws calcium as it needs it from the bones and blood levels. Many kids do not get the adequate daily amount of calcium. Teenage girls in particular are among those with the lowest calcium intake relative to their needs. Scientific data concludes that over 60% of 6 to 11 year olds do not meet their calcium needs.
Emerging research suggests that calcium in the form of dairy foods as part of a balanced diet helps adults achieve and maintain a healthy weight; and the same may be true for children. A study in the Journal of the American Dietetic Association linked higher calcium intake to lower body fat levels in children aged 2 to 8. Milk and dairy foods were the main sources of calcium in the children's diets in this study. This study is one of the first to directly examine the relationship between dietary calcium intake and body fatness in children. Results suggest that dietary calcium may play a role in preventing childhood obesity. "Even a slight decrease in body fat during childhood may reduce the risk of obesity in later childhood, adolescence and adulthood," said Dr. Skinner. "Parents, educators and health professionals can help children develop healthy lifestyle habits early by teaching them to choose and enjoy nutrient-rich foods like dairy more often."
Dairy products are available in many reduced fat forms. It is important to not use the low fat dairy versions in children aged 2 years or younger.
A report in the June 2003 issue of the Journal of Pediatrics suggests that soda and other sugar-filled drinks are an important contributor to weight gain. The study, conducted by researchers at Cornell University, confirmed that children who drank more than 16 ounces of sweetened drinks a day drank less milk and gained more weight over two months than those who drank less than 16 ounces of sweetened drinks a day. The study, of children ages 6 to 13, found that excessive sweetened drink consumption was associated with a decrease in milk consumption, resulting in higher energy intake and weight gain, and insufficient intake of protein, calcium, phosphorus, magnesium and zinc, and to a lesser extent, vitamin A was also seen.
| Age |
Calcium Needs |
Milk Group Servings |
| 1-3 years |
500 mg |
3 servings* |
| 4-8 |
800 mg |
4 servings |
| 9-18 |
1,300 mg |
4 servings |
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Based on the National Academy of Sciences calcium recommendations, children should consume the following servings of Milk Group foods daily, to achieve calcium recommendations:
*Note: Serving sizes for children ages 1-3 are two-thirds of adult size. For example, for children ages 1-3, a serving size of milk is 6 ounces, rather than the 8-ounce servings size recommended for older kids, teens and adults. TOP
Power Foods in a Child's Real World
A new review of research in the Journal of the American College of Nutrition finds that children's eating behaviors are a direct reflection of their environment and their parents eating styles. In particular, studies have shown that children choose to eat the foods served most often and tend to prefer foods that are easy to eat (like apple wedges and carrot sticks), and that children and teens who eat meals with their family consume more healthy foods.
As more children eat fewer meals at home, it is incumbent on the foodservice industry to offer not only a good food in a good environment, but also menu choices that could help establish healthy habits that are likely to continue into adulthood. TOP |
