Qn of the Month: Do Kids Have Stress?

A: Apparently! This as an issue that never crossed my radar until I recently received some resources from a community liaison on this topic. One of the sentences on the website I was pointed to was this “The signs and symptoms of stress can often be seen in challenging behaviours. Children may be reprimanded for actions that are really stress reactions, rather than intentional misbehavior or poor cognitive ability. Lantieri, L. 2008.”  Suddenly it clicked. Sure my child has had a pretty vivid “terrible 3s” phase, so much so I was happy to celebrate her fourth birthday and leave the “3’s” year behind. But reflecting on my child’s behavior made me realize there were many times when she would stop cooperating and start fussing when she got frustrated at something, or when we were stressed ourselves as parents.

In the Kids Have Stress Too! Booklet targeted for parents of preschoolers, it was stated that “Children can experience stress at home, in child care settings, or even in play with

others. In the course of an average day, preschool children experience stress when they have to wait, when they want something they can’t have, or when they lose or break one of their toys.” The following were listed in the booklet as examples of common sources of preschool stress:

  • Early or rushed mornings, being hurried
  • Exposure to new situations
  • Too many expectations or demands
  • Separation from parents
  • Difficulties with peer friendships
  • Fights or disagreements with siblings
  • Transitioning from one activity or place to another
  • New beginnings such as starting kindergarten or child care
  • Frequent change of caregivers

Hmm, rushed mornings, feeling hurried, too many expectations? Sounds a lot like our household. This information has caused me to re-evaluate the way our household is run, and whether my child is expressing some unneeded stress with having a busy daily schedule – something that may not be totally necessary for a 4 year old.

And what can be done if a child is stressed? Apparently one simply measure is just to allow the child to have some more down time. According to one resource handout “Kids also need time to themselves – just to relax and do nothing! Sometimes the best cure for stress is just to have some quiet time. Kids need some time on their own. Listening to music, reading or playing quietly may help them feel better. Doing nothing is fine too!” Hmm, sounds like this advice is applicable to adults too. Don’t we all wish we had more down time to relax and unwind in the midst of our busy and hectic schedules? I know I do!

For this and other great resources on how to help preschoolers and kindergarteners cope and deal with stress, see this link: KHST Preschool and Kindergarten

(Sources:

  1. Kids Have Stress Too! KHST! The Psychology Foundation of Canada. https://psychologyfoundation.org/Public/Public/Programs/Kids_Have_Stress_Too/Kids_Have_Stress_Too_.aspx. Accessed February 22, 2017.
  1. Kids Have Stress Too! KHST Preschool and Kindergarten. Psychology Foundation of Canada. https://www.psychologyfoundation.org/Public/Resources/KHST_Download_Resources/Copy_of_Download_Resources.aspx?WebsiteKey=7ec8b7ce-729b-4aff-acd8-2f6b59cd21ab&hkey=0e18b555-9114-49b4-9838-084fab967f0e. Accessed February 22, 2017.)

Transitioning to a Whole Foods Plant-Based Diet – Step 1

doubleveggies1

Double Up the Nutrition! – Dietitianmom.com

In my first post on this subject (see Transitioning to a Whole Foods Plant-Based Diet – Introduction), I gave a simple overview of what a whole foods plant-based diet is, and some of the key steps involved in a transition to such a diet. Based on our family’s experience in this transition phase, we have found the following simple steps below helpful:

Step 1: Halve the Meat & Double the Veggies
Step 2: Switch to Whole-Grain Options
Step 3: Choose Smart Snacks
Step 4: Increase Beans & Other Legumes
Step 5: Try New Plant-Based Foods & Recipes!

In this post, let’s look at the first step.

STEP #1: HALVE THE MEAT & DOUBLE THE VEGGIES
This is an obvious initial step. But it takes some forethought. If you’ve been so used to having meat as the main entrée for every lunch and dinner, how do you really make the switch?

Well, it first takes a change in mindset. If you’ve been viewing meat as a key source of protein, you will likely be worried about what to replace it with. But be assured that in western developed countries such as America, one’s intake of protein is generally more than adequate and usually exceeds the Dietary Reference Intake (DRI) protein recommendations. In general it is estimated that the average person needs only about 0.8 grams of protein per kilogram of body weight. So halving the meat won’t suddenly cause you to have an inadequate overall protein intake. You will likely still be getting enough on a daily basis. Also don’t forget that vegetables, nuts, seeds, legumes and grain products provide protein too, so you will still be getting protein from these sources. For example, one avocado provides approximately 4.6 grams of protein, a cup of chopped boiled broccoli provides about 3.7 grams of protein and a cup of cooked black beans gives 15 grams of protein!

Here’s an easy way to reduce the portion of meat used in recipes. Does the recipe call for 6 ounces of ground meat? Use 3 ounces. Another way to do this is to just increase the amount of vegetables used in the recipe, which is easy to do for meals such as stir-fries and casseroles. For instance, does the recipe call for one chicken breast and a chopped bell pepper? Simply cook two or three bell peppers with the one chicken breast, then eat it over more meals. That way, the amount of animal protein per serving is much reduced. This works well for a variety of dishes such as stir-fries, casserole/lasagna dishes, pasta sauces and soups.

Here are 5 other SUPER simple ways to cut down on the animal protein intake and increase vegetables:

Increase the ratio of vegetable dishes to meat dishes on the dinner table
One method of doing this is to ensure that there are always at least 2 veggie dishes and only one meat-based dish at lunch or dinner. Vegetable side dishes could be a salad, stir-fry, roasted vegetables side dish, steamed or roasted winter root vegetables, or even vegetable kabobs.

Reduce or replace ground meat in a recipe
I’ve found that the ground beef, chicken, turkey, pork or other meat called for in a recipe can be easily reduced (to even a quarter of the recipe!) and the dish powered up with vegetables, without losing the taste of the dish. In some cases, I’ve even substituted some of the meat I removed from the recipe with lentils or beans instead, with good results. For example, one could add veggies and reduce the ground meat or eggs in a dish (e.g., adding onions, carrots and bell peppers to a traditional scrambled egg and tomato dish).

Reduce meat to once a day
Stick to just having an animal based protein source at dinner, or just at lunch, instead of having it for every meal over the course of a day.

Reduce meat to a few times a week
Have meat at a meal a few times a week, instead of every day. Just as some have a ‘Meatless Monday’ vegetarian dinner once a week, you could aim to have an animal based protein source on certain set days of the week, making it more the exception rather than the norm. Or just go for a ‘Meat Monday’ instead!

Try a weekly vegetarian slow cooker recipe
One easy way to eat a more plant-based meal especially during busy weeknights, is to cook a big vault of a bean-based slower cooker meal once a week (to last 3-4 days). So the first part of the week you could prepare a greater variety of meals. In the latter half of the week, prepare a main entrée using the slow cooker and then serve vegetable sides to go with this main vegetarian entrée over the rest of the week, along with a grain staple like rice, couscous, quinoa, barley or whole grain pasta. By the middle of the week you’re probably already feeling drained from work and cooking anyway, so why spend more time than necessary in the kitchen? Just whip up a slow cooker meal!

Some of you must be wondering: why do I say increase the veggies and not fruit? Of course fruits should also be increased with vegetable intake. But I am focusing more on the veggies because most of us tend to eat more fruits than vegetables on a daily basis anyway. And who can blame us? Fruit is usually sweet!

Of course, if you like, you can cut down on the animal based protein more drastically immediately, but dropping halfway may be a more realistic first step. After you (and your family) are used to the reduced consumption of meat and other animal based protein, then you can slowly transition further off of animal-based protein, while increasing the proportion of other protein-rich plant-based foods such as nuts, beans and other legumes. This method will also help you use up all that meat sitting in your freezer!

Qn of the Month: What Kitchen Equipment Is Needed On A Whole Foods Plant-Based Diet?

A: The best part of transitioning to a whole foods plant-based diet is that you don’t need much fancy equipment! This is because most of the foods included in this lifestyle can already be consumed in their natural raw state (like nuts, seeds, legumes, fruits and many vegetables). In fact, the two pieces of ‘equipment’ I have found the most useful so far as our family is transitioning to a whole foods plant-based diet are simply these:

* A plastic colander (without legs) with a mixing bowl that fits underneath
* A slow cooker

These plant-based kitchen friends are indispensable! Get a metal or plastic colander with a corresponding bowl that fits its size to use together, or simply purchase a plastic mixing bowl or other bowl that fits its size underneath. Why? This will allow you to fill up the colander with water and then you can easily lift it up to drain out the water quickly and easily. This makes it SO easy to soak and rinse vegetables, fruits like blueberries, canned and dried beans, split peas, lentils…you name it! Your prep work time will be quickly reduced and you can then get to cooking right away.

And the slow cooker? If it has been sitting dusty in a remote corner of your kitchen, it is time to bring it back out into the limelight again. There are many easy wonderful slow cooker recipes using plant-based foods that are hearty, filling and delicious. And the best part is that because the beans and legumes used in the recipes often need to cook for many hours in the slow cooker, I’ve found that they ended up being easier on my digestive system and we have been able to rapidly ramp up our vegetable and fiber intake without problems. You may not have such an issue but for those with sensitive intestinal systems, this is a factor to consider when transitioning over to a whole foods plant-based diet.

Eventually, as you begin to try more and more new plant-based recipes, you may find a hand immersion blender or food processor handy for whipping up vegan based desserts or bean dips or bean based soups.

Note: To those (like me) who are relatively new to the world of kitchen appliances, there IS a difference between blenders and food processors. According to a 2012 Consumer Reports news article, “A blender is better at mixing drinks and whipping up smoothies, while a food processor is ideal for chopping, slicing and shredding. You can puree foods in either appliance but crushing ice in a food processor can damage the plastic container.”

I happened to have both an immersion hand blender and a Ninja kitchen system at home. The Ninja has suddenly come in so useful (after collecting dust on the kitchen shelves the past 2-3 years as a long forgotten birthday present from my hubby). So far, I have made peanut butter and cashew nut butters, hummus, chickpea and black bean patties as well as flaxmeal muffins from the Ninja without problems. For split pea soups and making hummus and batches of baby food, I have also sometimes just used the hand immersion blender for easy and quick clean up.

You may already possess a blender or a food processor at home, which is more than adequate for your needs if you are just starting out in the world of plant-based foods. Eventually, as you try out the myriad of delicious healthy plant-based whole foods recipes out there, you may decide to fork out a little more money to purchase another food processor or blender. If so, there are many models and options out there!

(Source: Janeway K. Do you need a blender, a food processor or both? Consumer Reports News. June 20, 2012. http://www.consumerreports.org/cro/news/2012/06/do-you-need-a-blender-a-food-processor-or-both/index.htm. Accessed February 1, 2017.)

Transitioning to a Whole Foods Plant-Based Diet – Introduction

Ready to Transition? Dietitianmom.com

Ready to Transition? Dietitianmom.com

A New Year marks a new beginning, and the chance to try new things or make changes that had previously seemed daunting. Last Fall, I read the book ‘The China Study’ by T. Colin Campbell (The China Study) and it changed my whole perspective on health and disease. I wasn’t aware that there was so much research already done supporting a whole foods plant-based diet in reducing one’s risk for diseases like diabetes, heart disease, certain cancers, and in some cases even improving the health outcomes even if a person already has these medical conditions. Apparently, the lower one’s intake of animal proteins is, the lower the risk of these negative health outcomes. Our family of four has since decided to transition to a whole foods plant-based diet. This poses some challenges when you have a 4 year old, a nearly 11 month old, and a freezer packed with meat! But we have already made some (successful) changes to our way of eating and I hope to share what we’ve learned along the way and the experiences of our journey to help those who are also thinking about making similar changes but don’t know where to start.

The main tenet of a whole foods plant-based diet is to consume primarily plant-based foods such as vegetables, fruits, whole-grains, nuts, seeds and legumes, while minimizing as much as possible animal-based proteins, excess oils as well as refined and processed foods high in fat and sugar. If you can remove all sources of animal proteins from your diet, even better! One reason behind reducing refined and processed high sugar/high fat foods from one’s diet is the tendency for these foods to take the place of more healthful nutrient dense foods that you would otherwise be consuming, so reducing your body’s intake of important nutrients, phytochemicals and minerals necessary for optimal health. A key reason for reducing excess oils in one’s diet, including vegetable oils, is so that a more desirable ratio of omega-6 and omega-3 fatty acids intake can be achieved for optimal health.

It is best to go slow and make gradual changes to one’s diet. Of course you could go off meat and other animal protein products immediately cold turkey, but our family has found it more successful to make the changes gradually, as small successes empowered us to make further changes. You may find that this approach also helps your family transition more successfully to such a diet, especially if you are a busy household and don’t have much time right away to try or create completely new recipes. This method also helps you use up all that meat in the freezer anyway!

So where should you start? Successful transitioning to a plant-based diet involves five basic steps:

Step 1: Halve the Meat & Double the Veggies
Step 2: Switch to Whole-Grain Options
Step 3: Choose Smart Snacks
Step 4: Increase Beans & Other Legumes
Step 5: Try New Plant-Based Foods & Recipes!

In upcoming blog posts, I plan to touch on each of these steps in a bit more detail, and hope to also discuss a few tips for feeding children plant-based whole food diets. Stay tuned!

Qn of the Month: How Do Canola Oil, Olive Oil and Sunflower Oil Compare to One Another?

Which is the fairest of them all? -Dietitianmom.com

Which is the fairest of them all? -Dietitianmom.com

A: Have you ever wondered which vegetable oil you should be using more of and which of these three oils -canola, olive or sunflower- is the ‘fairest of them all’? Of course these oils have different smoke points and so have various uses in cooking, but which is really most beneficial to consume? I was curious about this, so decided to do some research into it, and was surprised by what I found.

Canola, olive and sunflower oil all carry the same caloric weight (1 teaspoon giving 40 calories), but there are notable differences. For example, of the three, olive oil provides the most monounsaturated fatty acids (approximately 3.3 grams per teaspoon). Olive oil also has a decent vitamin K content but can’t compare to canola oil, which has about 16 times the amount of vitamin K as sunflower oil (3.2 micrograms of vitamin K in a teaspoon of canola oil compared to 0.2 micrograms of vitamin K in a teaspoon of sunflower oil)! Canola oil also has slightly more vitamin E and slightly less monounsaturated fatty acids than olive oil. Sunflower oil has the lowest vitamin K content.

You may be wondering, “Are there any benefits to consuming sunflower oil then?” The answer is, “Yes!” Of the three types of oil, sunflower oil (with less than 60% linoleic content) actually has the highest vitamin E content (1.85 milligrams of alpha-tocopherol per teaspoon compared to 0.65 milligrams in a teaspoon of olive oil). This may not seem like a lot, but small amounts do add up. Just two and a quarter teaspoons of this type of sunflower oil would provide approximately the amount of vitamin E in one avocado! Sunflower oil also has a decent monounsaturated fatty acid content (about 2/3 that of olive oil per teaspoon), and has four times the amount of polyunsaturated fatty acid content of olive oil. The polyunsaturated fatty acid content of sunflower oil is actually about 40 percent higher than that in canola oil. Recall that both omega-3 and omega-6 fatty acids are polyunsaturated fatty acids.

So the take home message? If you ask me, it brings home the point that it is important to consume a variety of foods in one’s diet, and not just stick to one type. By consuming a variety of vegetable oils, you can maximize the nutritional benefits of each kind of oil – especially since they have different smoke points. So keep this in mind, the next time you cook, stir-fry, roast, bake or make salad dressing. Your family will benefit too!

(Source: USDA National Nutrient Database for Standard Reference. http://ndb.nal.usda.gov. Accessed December 27, 2016.)

Ready to Land? Handling Baby Jet Lag

Ready for Baby Jet Lag? - Dietitianmom.com

Ready for Baby Jet Lag? – Dietitianmom.com

This summer I traveled back from Asia with my husband. Like the other trips, this involved a long total flight time of about 16 hours with an additional 2 hour layover in Japan. This time though, I traveled with two children, one being just four months, and the other being three and a half years old. That was a challenge in itself, but I was preparing myself for the bigger challenge: that of adjusting my four month old to the time zone changes, and readjusting my infant’s bio-clock. In a previous post, I had described the excruciating process (involving nearly 2 weeks) of converting my oldest daughter (then 4 months of age) to Eastern Standard Time (EST) after we returned from Singapore in 2013. What my husband and I ended up doing was to move our child’s bedtime half an hour to one hour later every night, so that her long stretch of night-time sleep could be preserved each night. Eventually after about 12 days we got her bedtime to where we wanted it (see post Baby Jet Lag…It’s Real). However this method meant that we as an entire family had to follow her schedule, down to eating our meals at night and having black out curtains.

This time, traveling back with our second daughter to the western hemisphere, I was open to trying a different method. The baby would be sleeping in a crib in the master bedroom and the idea of the whole family following our infant’s pace of time adjustment just didn’t seem feible with a toddler. The toddler would be used to playing in daylight hours, so would be very noisy and may interrupt the baby’s sleep during daytime. It is also likely that the toddler won’t be able to sleep with a baby crying several times at night. So I decided to try a different method: going cold turkey.

So what happened? The first day we arrived home, as our baby ended up staying awake most of the daytime hours. Then that first night she woke up at least 4-5 times at night, about once an hour. Each time she started to cry I had to quickly scoop her up out of the crib and then shush her by feeding her, as I was afraid to wake up my toddler. She would feed a little bit each time and then go back to sleep. In the end I put her in the same bed as me, as it was easier to breastfeed that way since I felt so exhausted from the day’s traveling. In the morning the baby passed some gas so I suspected she was waking up and crying at night more from gas in her tummy, and was really feeding more for comfort since she didn’t feed for long each time she woke up.

The second night she woke up about 3 times. Once it was about an hour after she had slept and seemed to be more from gas or an unresolved burp. I was able to quickly pat her back to sleep. Then she woke up again about 2 hours later. This time I made sure she drank at least 10 minutes on both sides in the breastfeeding session before putting her down, in the hopes that this would settle her the rest of the night. However, I really felt I needed a place to put baby without having to worry about the baby’s crying waking up our toddler. I ended up using a spare room that was away from our toddler’s room and putting an infant bath tub with a pillow for the ‘mattress’ cushion at the bottom. When the baby then woke up a few hours later, I was able to then scoop her up quickly and take her to this other room. I could then close the door. Even though I still fed her via my breast, I noticed she didn’t seem as hungry. The spare room (in this case we used a storeroom) provided some insulation of her crying from our toddler and other neighbors in the surrounding apartments.

The 3rd night, baby woke up about 2 times. The moment the baby awoke and started crying, I took her to the spare room. There I breastfed her only 5 minutes on each side as I wanted to slowly wean her off of being fed breastmilk at night. This seemed to satisfy baby and baby went back to sleep for 3 more hours.

The fourth night was when I went cold turkey. I decided she needed to cut out feeding altogether. I made sure I fed her a lot during the day (about every 2 hours and offered both breasts each session). The baby ended up sleeping quite well, though she did wake up with brief crying spells twice in the night. When she did wake up, I put her in the bed in the storeroom, and closed the door. She cried about 10 minutes the first time and then went back to sleep. Then she awoke briefly an hour later but was able to put herself back to sleep with only a few cries before waking up another hour later this time wide awake and hungry. So by the 4th night, our infant managed to sleep a 7 hour stretch relatively well, and was able to put herself back to sleep without much intervention on my part. In the end our infant got over her jet lag in just 4-5 nights…truly a miracle! The dark storeroom and the white background noise I created likely also helped.

The rest of the family survived relatively unscathed. My eldest daughter managed to get over her jet lag within 3 days. This involved some intentional steps of not allowing her to have an afternoon nap or a minimal one at best, lots of physical activity and waking her up in the mornings at the desired time. I think she would have gotten over it faster if her sister didn’t wake up wailing at certain times in the night the first few nights causing her to wake up and then have difficulty falling back asleep. My husband had broken sleep the first few nights but was able to sleep well by the 4th night, and quickly resumed his working during the daytime. As for me, I ended up just having a few sleepless nights!

I am writing this post to share my experience. Of course every baby is different and the age of the baby as well as the traveling circumstances (e.g., how long the flights are and the duration of travel) will also affect how quickly he/she gets over jet lag. Hopefully as you travel during this winter season, your baby will be able to adjust smoothly to each location and time change! Merry Christmas!

Qn of the Month: Intakes of Baby-Led Weaning Infants & Traditional Spoon Feed Infants – Are There Nutritional Differences?

Pureed or Baby Led? - Dietitianmom.com

Pureed or Baby Led? – Dietitianmom.com

A: Yes, according to a study published in the British Medical Journal. Led by Morison and colleagues, this New Zealand based study looked at the intake of 51 age-matched and sex-matched infants at 6-8 months of age. One to three day weighted food records and questionnaires were collected from those in the baby led weaning (BLW) group and those in the traditional spoon feeding (TSF) group, which were then analyzed. The result? It was found that while infants in both groups had relatively similar caloric intake, those in the BLW group may be consuming higher fat and higher saturated fat intakes, along with possibly lower iron, zinc and vitamin B12 intakes.

Although the research finding results are exciting, it is important to note the strengths and limitations of the study. Strengths include analysis done by a registered dietitian blinded to which group an infant belonged to, the use of weighted food records and detailed questionnaires, and the age and sex matching of infants. The limitations of this study however include the fact that a small sample size was used, the use of estimated breast milk volumes, and the fact that there was no standard definition or classification used in the study of what constituted a baby led weaning infant.

As mentioned in my previous post on BLW (Qn of the Month: How is Baby Led Weaning (BLW) Really Defined?), research on BLW is complicated by the fact that there is no standardized definition of baby led weaning, with research studies using different definitions. In this study, parents self-reported and classified themselves which group their infant fell into. Also, the lower iron intake levels observed in the BLW group compared to the TSF group may be due to the fact that the BLW infants consumed less iron fortified infant cereals, and were breastfed for much longer (approximately 8 more weeks) than TSF infants. Hence infants in the BLW group would have received less iron fortified infant formula.

It is unclear whether this study looked at the potential differences in nutrients contributed by use of iron fortified infant formula and breast milk intake, which could have a big impact on the final nutrient intake of infants in either group.  Also, since estimated breast milk volumes were used, this study cannot accurately determine the exact differences in caloric and iron intake levels between the BLW and the TSF groups. A future study needs to not only control for potential confounding in terms of the length of breastfeeding in both groups, but may also need to include biochemical tests to determine more accurately the iron status of infants in both groups.

 (Sources:

  1. University of Otago. “Dietary intake differs in infants who follow baby-led weaning.” ScienceDaily. ScienceDaily, 17 May 2016. www.sciencedaily.com/releases/2016/05/160517094206.htm. Accessed Nov 26, 2016.
  1. Morison BJ, Taylor RW, Haszard JJ, et al. How different are baby-led weaning and conventional complementary feeding? A cross-sectional study of infants aged 6–8 months. BMJ Open 2016;6:e010665. http://bmjopen.bmj.com/content/6/5/e010665. Accessed November 26, 2016.)