Friday, May 16, 2014

Healthy Eating for Kids - Meals

I went to a diner this weekend whose kids menu included a sandwich, cheetos and a soda.  Why do restaurants all seem to have the same concept of kids food: peanut butter and jelly, grilled cheese, (fried) chicken fingers with french fries, macaroni and cheese and juice or soda?

At what point did we give up on kids eating nutritious food?  As I asked in a previous post, why do we swap pureed good-for-them baby foods for salty, not good-for-them, kid foods?
Yes, I am aware that kids go through a picky phase.  But you can minimize the impact of this phase.  You can continue to offer nutritious foods after your kids are finished with baby food and until you are no longer feeding them.  If they never know foods like mac and cheese and french fries, or if they are largely unfamiliar with them and know them only as treats, then they won't fight you (or they'll fight you less) on the roasted chicken with green beans and potatoes.  

Of course, kids, like adults, have their likes and dislikes, and some kids just don't like green beans.  For those kids I say, don't offer green beans (provided of course you've offered them 10 times in a nonchalant, no-pressure way as I mentioned in a previous post.)  And for the kids whose list of dislikes is more extensive, here are some suggestions: 

Tips for Picky Eaters
  1. Persistence:  Continue to offer the foods they don't currently like on an occasional basis in a nonchalant, no-pressure way.
  2. Creativity:  Expand your own food horizons by offering them vegetables and other healthy foods that you are not in the habit of cooking, and that are not on their list of dislikes.  Use variety in spices and cooking methods.  Some kids just want variety (as do most adults). 
  3. Emotion-free eating:  Remember everything I mentioned in "Growing Healthy Eaters." Release your emotional attachment to their eating.  Keep providing varied healthy food, in a non-attached, nonemotional way. One day, they will surprise you. 
  4. Rules:  Don't be a short order cook.  Set the expectation that the whole family eats the same meal.
  5. Reliability:  Make sure the family meal includes some foods they do like and will reliably eat.
Also, yes, I have met the child who can go for days surviving on one bite of peanut butter toast and an orange.  I've heard them called air-etarians, or air-ivores.  It can be very stressful for parents to feel that their child is not eating enough.  But trust me, kids will eat when they need to.  Of course, there are exceptions to every rule, and if you have a child who has any sort of special circumstance or need, or if your gut tells you something is wrong, then please, make an appointment with your child's provider for an evaluation.  Otherwise, here are some suggestions for the child who just doesn't eat:

Tips for Food Avoiders
  1. Persistence:  Continue to host meals at the table, at routine times, away from the TV.  Have as many family members as possible at the table for meals.  The more the family all eats together, the better.  I don't believe a child should feel tortured by having to sit at the table, so make it engaging for them.  Talk about how everyone's days went, and include her in the conversation.  Talk about the food you're eating and where it came from.  Talk about gardening, farming, ranching, and the culture and history of the food you're eating.  (Note: for older children, doing a little research before dinner into these subjects can trigger interest and more fruitful conversations).  You'll have to find the balance that works for your family as far as how long your child should sit if she's not hungry, and how far to go to make it engaging for her.  I do not advise bringing books or toys to the table.  Keep it about food and family.
  2. Nutritious Snacking:  Snacks are an important part of a growing child's life, but they can blossom out of control.  Make snacks part of the daily routine.  Once or twice a day, sit down with your child at the table (or at the picnic table if you're at the park), and have a nutritious snack.  Do not let your child wander around or play while snacking.  Minimize snacks eaten in the car or otherwise on the go.  Do not fill her with empty calories.
  3. Swapping Meals For Snacks:  In regards to #1 and #2, if your child is consistently jumping up from the table at meal time claiming she's not hungry, only to come back 45 minutes later for a snack, then some trouble-shooting needs to occur.  She needs to eat that meal rather than that snack, so start by altering the schedule.
  4. Reliability:  At meals and snacks, offer foods you know she likes (as well as some she doesn't, as mentioned in the previous set of suggestions).  Be creative to maximize variety.  New spices, new foods, and new cooking methods can be very helpful.
  5. Involvement:  Continue to involve her in food shopping, food preparation, and food culture (see below).

1.  Food shopping:
  • Set yourself up for success:  go at a time of day when you both are at your best, not tired, and not in a rush
  • Make shopping fun: go to a farmer's market, a produce stand, or a store you don't always go to
  • Ask your child what he wants to buy (while you're in the produce section, not the candy section!)
  • Give your child a choice: e.g. "We need a vegetable for tonight, would you like to pick it out?"
2.  Food preparation:
  • Have your child sit down with you on Sunday and plan the week's meals together; then make the grocery list together
  • Place your child in charge of clipping coupons, or looking online (supervised of course!) for good deals of the week
  • While cooking, have your child stir, dump foods from a bowl into the pan, tear lettuce, cut soft foods with a plastic knife, operate the salad spinner, etc.
  • Garden with your child (even if it's just growing basil in a pot in the window) 
  • Make it fun: make your own pizza night, pasta bar, etc - prep everything together in the kitchen, and bring it all out for everyone to assemble as they like (don't forget to include veggies!)
3.  Food culture:
Sneaking Nutrients In
Sometimes you may want to experiment with stealthily boosting your child's nutrition. Most kids will reliably eat marinara or pizza sauce, so puree some vegetables and add them in.  Find other sauces you know they will eat and do the same.  Make zucchini bread instead of banana bread.  Add raw greens to a smoothie (as long as they will tolerate a green smoothie!)  There's a book called Deceptively Delicious that you might want to sneak a peek at.  

Most importantly, breathe.  Take my suggestions, but make changes slowly; don't stress yourself or your family out.  There's enough stress in life; I do not want to add to yours.  But I would be so happy to see restaurants change their kids menus to include healthy choices because consumers start demanding it!

I have no affiliations or financial interests to disclose.

Friday, May 2, 2014

The Principles of Naturopathic Medicine, or How Red Sorrel Taught Me What I Already Know

I was recently diagnosed with a serious problem: red sorrel in my yard.  I knew it was there; I watched it spread from the parking area last summer to my yard this spring.  I saw those blades of beautiful red flowers waving in the breeze all over my yard.  But I had no idea that I had a problem.  When my neighbor came over and gave me the diagnosis, I tried not to panic.  I did what any good patient does - I got on the Internet.  I found some optimistic and cheery sights touting its great culinary and medicinal uses.  But mostly I found sites that were frightfully useless.  They were all about the same: a description of the weed and a picture (thanks, but I got that part), a description of where it likes to grow (anywhere and everywhere), and an explanation of how to manage it (you can't - just forget it; give up before you even try).  These web sites always mentioned that you could try this or that weed killer, but only in spot treatments.  I'm not certain what constitutes a "spot," but I'm pretty sure it's smaller than half my yard.  You could probably guess that I'm vehemently anti-weed killer, but these guys are telling me that even if I were up for using it, I can't because it's only a spot treatment?  So do I have any options?  Should I sell my house?  Rip up the top 2 feet of yard and start over?

Red Sorrel: Photo by Jacob Enos; downloaded from Flickr without amendments

Alas, I have not found a miracle cure to rid my yard of the dreaded red sorrel. But, being certain that I didn't want this noxious, invasive weed taking over the rest of my yard and the strawberries I just planted, I decided I had to maintain hope.  Why am I telling you this story?  Because this terrible weed is reminding me of valuable lessons I already know about life and medicine.

Again, like any great patient would, I looked deeper into the Internet. (Do you hear the sarcasm in my voice?  Maybe soon I'll write a post about Dr. Google and its followers).  I hit the jackpot: two different blog posts outlining attempts to kill red sorrel organically.  One says the only thing she did was add nitrogen to her soil and the following spring, problem (almost entirely) solved.  The other says she's about to try adding sawdust and manure mulch, which she has heard can work.  Sadly, this one gave no follow up posts, and has not replied to my inquiries.  No matter; I will believe.  I will continue my quest with vigor.  I will dig out the sorrel, replenish the soil, plant native plants, and start nurturing my yard (something that has not happened in at least 2 years since I've been busy with other parts of my life).  I will believe that I can get past the sorrel fiasco, even if the Internet tells me otherwise. 

This story of restoring land health is strikingly similar to that of restoring human health.  It follows the principles of naturopathic medicine and the therapeutic order of healing so well that I just had to write about it. 

Principles of Naturopathic Medicine

The Healing Power of Nature
Naturopathic medicine believes that nature, and the human body, have an innate healing power.  Given the proper foundations of health, and the appropriate support, the human body has the ability to heal itself of illness.  Someone who is ill and eats a diet of strictly processed foods, drinks nothing but diet soda, and lives with an abusive spouse may not experience this power.  But if that same person begins to eat fresh vegetables, drink clean water, and amend emotional health, nature may now be uncovered and allowed to work toward healing.  I believe that once I provide my lawn with the foundation of health (water and nitrogen) and the appropriate support (strong native plants), that it will heal itself of the red sorrel. 

Identify and Treat the Cause
We NDs don't just say "well you've got constipation, here's a prescription for a laxative."  We dig into the root cause of the constipation - why is your body responding this way?  Is it diet?  Is it emotional? Is it a genetic syndrome?  Is it an anatomical malformation? 

Why do I have a sorrel infestation?  Because I wasn't paying attention.  I let it grow without finding out what it was.  I was focused on everything in my life other than my front yard.  I was putting it off for later, when I had time.  My yard was not watered once last summer.  It was about half grass half dandelions and moss at the time the sorrel came to town.  I planned to dig it out and replace it with native plants one day.  But in the mean time, I was completely ignoring it.  Just as we so often ignore our health.  We know one day we will start exercising, increase our veggie intake, or start making time for ourselves.  But when does that day ever come?  Often it comes when there's a major problem.

First Do No Harm
Drugs?  This is a question I ask a lot when I see patients.  Will they help?  Will they harm?  Are they immediately necessary or can we try something else first?  Sometimes, drugs are immediately necessary; often they are not.  Drugs, as well as any intervention, can cause harm.  The question should always be, do the benefits outweigh the potential harm? 

Weed killer?  My 2 year old plays in this yard, digs in the dirt, rubs it on his face, breathes the air that comes off of it, and sticks his fingers in his mouth before we can get inside to wash them.  Do I really want residue of something designed to kill left on this lawn?  And what about the watershed?  Weed killer runs off our lawns and straight into our rivers and streams.  This is not an insignificant problem (see links below).

Doctor as Teacher
You better believe I have become the greatest anti-invasive plant evangelist there ever was.  Sometimes I think I just might have the time and energy to pursue a side career in landscaping specializing in native plant restoration. 

Treat the Whole Person (Yard)
Rather than seeing a patient with symptom X and prescribing drug Y, we NDs like to get a list of all the symptoms, determine why the body is expressing these symptoms, and address the root cause of these symptoms with natural interventions.  So, for constipation in a child, I don't jump to prescribe a laxative.  I find out what the child eats and drinks; I ask about emotions and emotional support - is this a child who can't let go of anything, or who can't use a public bathroom?  I ask about other symptoms.  I might prescribe increased water consumption and diet improvements.  I might prescribe counseling.  I might uncover emotional stress at school and prescribe cooperating with teachers to address it.  The prescription will be individualized and address the child as a whole person.  What I've found with the dreaded sorrel is no different.  I can't solve this problem with a single solitary action.  I'm going to have to remove the offending agent, nourish the health of the soil, add strong native plants that can fight off the sorrel (probiotics?) and continue to promote health in the future. 

Prevention and Wellness 
Generally, the best way to prevent illness is to promote wellness.  A well fed, well watered, happy, emotionally attached, cared for human who exercises, gets lots of fresh air, and relaxes and sleeps well, will typically be healthier than one who does not, and will often be sick less often, less severely, for less time.  Apparently, the same is true for my lawn.  A lawn that goes an entire summer and then some without water, that is growing in soil that has never been nourished, seems to be a bull's eye for a hostile take-over.

The Therapeutic Order

NDs prefer to use the lowest intervention possible for each patient's treatment plan.  Here is the order: 
  • Determinants of Health - Are the following needs being met for the patient: adequate clean water, fresh air, exercise, adequate nutritious food, emotional and mental health?
  • The Healing Power of Nature - Is something preventing the body from healing itself?
  • Tonify Healing Systems - E.g. series of structured sweats, hydration, and increased exposure to fresh air.
  • Correct Structural Integrity - E.g. is the gut lining damaged by years of exposure to a poorly tolerated food?
  • Symptom Based Naturopathic Treatment - A specific natural product that treats a specific symptom of illness without addressing the root cause; e.g. licorice for heart burn or calendula for mouth sores.
  • Symptom Based Pharmaceutical Treatment - A specific pharmaceutical that treats a specific symptom of illness without addressing the root cause; e.g. Ibuprofen for headaches.
  • High Force Interventions (e.g. surgery)

With each patient, we choose where we need to come in on the Therapeutic Order, based largely on the extent of the illness at hand, but also on the patient's abilities and desires.  

With my red sorrel, I considered, for about a half a second, coming in at symptom based pharmaceutical treatment: weed killer.  But, I learned it wasn't an option, and I would have been unwilling to do it in the end anyway.  So, I'm coming in at determinants of health, the healing power of nature, and correct structural integrity. 

Sadly, you can't always cure a disease.  Some patients will die of their diseases, and some will live with them chronically.  But you can always help a patient, if you seek the opportunity.  At this moment, I have to believe that I will cure the disease, that I will beat the sorrel, that I won't still be battling it in 5 years.  But I may be.  And at least, the patients (me and the lawn) have been helped.  I think it's obvious how my lawn has been helped (sparkly new plants!)  As for this patient, I've seen how the idea of foundational health applies to the earth.  And I've been reminded of the tantamount importance of these foundations of health for the wellness of my family, my friends and their families, and the globe.  Okay sorrel, lesson learned.  Thank you, you may go away now!

Roundup linked to health problems
Roundup's inert ingredients kill human cells
Weed killers in our water
Pesticides as Water Pollutants

I have no affiliations or financial interests to disclose.