Going Nuts.

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Most parents are aware of the benefits of nuts, particularly almonds, peanuts and pecans, for our health and our kids’ health. These powerful pieces of nutrition provide essential fatty acids, proteins, fiber, and Vitamin E and help raise good cholesterol, known as HDL. However, the one drawback to this nutritious diet staple is that nuts can also cause a potentially fatal allergic reaction, known as an anaphylactic reaction.

Due to the potential seriousness of allergies, many schools have started to enforce restrictions on the kinds of foods students are allowed to bring to school. This raises some complicated questions for parents hoping to send their children off to school with healthy, nutritious food. What do we do as parents when our child’s school has banned nuts? For some kids, going without nuts means missing their vegetarian protein source. Should we pack our kids dairy every day and risk raising their LDL cholesterol? Should we send tofu and soy butter, which are more processed than natural nut butters? Should we send sunflower butter, which is also highly allergenic and can also cause anaphylaxis? Should we focus on peanut-free and not tree nut-free?

In addition to the immediate challenges these kinds of bans place on nutrition, they also have the potential to affect the ways our kids interact with one another.  Do we advocate for a nut-free table in the cafeteria, which would set kids with allergies apart? While a “nut-free” table would be organized with students’ safety in mind, in enforcing this rule we risk ostracizing them from their classmates. I have heard some moms in Connecticut are fighting with their children’s schools to allow their child with a nut allergy eat with the other kids. Do we go along with the nut -free school zone? Do we recommend establishing this nut-free zone on a class-by-class basis, pending if someone has an allergy?

Where do we draw the line? I understand this is a sensitive subject, and should be — the risks are very high. I do think a nut free elementary school is advantageous. However, when my son’s school proposed a ban on all food products made in a factory that may be in contact with peanuts (at a school where the children eat lunch in their classroom and there may be no allergy in many classrooms) I felt at a loss. I am a mom, RD, CDE and I am now going to have to take on the responsibility of feeding my kids as if they had an allergy, possibly decreasing their immunity to such foods. Busy parents are challenged enough as it is to feed their kids healthy, let alone nut- free food, and our choices are narrowed even further when we are expected to avoid products from facilities where peanuts may have been processed. I would gladly comply if a child in the class had a documented allergy, but to go through hoops and hurdles when it may not be necessary seems overboard.

This excessive caution seems all the more extreme when we consider how allergens and contamination are regulated (or aren’t).  Avoiding food processed in the same facility as nut products is not always effective. According to a recent article by a panel of experts from the National Institute of Allergy and Infection Diseases:

The FALCPA does not currently regulate voluntary disclaimers such as “this product does not contain peanuts, but was prepared in a facility that makes products containing peanuts” or “this product may contain trace amounts of peanut.” Such disclaimers can leave consumers without adequate knowledge to make objective decisions.

The EP identified 10 studies that examined whether standards for precautionary food labeling are effective in preventing food-induced allergic reactions. No study explicitly attempted to infer a cause-and-effect relationship between changes in frequency of severe symptoms from unintentional exposure (for example, to peanut) as a consequence of implementing food labeling. The identified studies mostly assessed knowledge and preferences for food labeling.1

If this labeling is voluntary, unregulated, and therefore possibly inaccurate, does it make sense for schools to use the kinds of labels to inform their policies regarding allergies? Many of my clients with peanut allergies still have tree nuts, and even peanut butter, in their homes and simply know how to prevent cross-contamination. Many of my clients with these allergies still eat foods processed in a facility that may share equipment with nuts, wheat and other common allergens.   So are our schools being too authoritarian? Are they smart for playing it safe, or is there such a thing as too much caution? Should sweets be forbidden from schools for fear of hyperglycemia or hypoglycemia, conditions that are just as threatening for someone with Type 1 Diabetes? Should grapes be forbidden since they are a choking hazard?

Instead, I recommend schools practice peanut/nut free or safe policies.  Focus on education, emergency plans for allergic reactions and having the epi pen to administer if there is an allergic reaction. Avoiding nuts or rather nut free facilities is not the best answer. Yes, precaution is necessary but we also need an action plan for as we know with voluntary labeling, kids still may be exposed and have an allergic reaction.

What do parents think? Do you believe in nut-free schools?  Do you believe in nut free schools banning food products made in a facility made that may have processed nuts?

 

1. “Guidelines for the Diagnosis and Management of Food Allergy in the United States” Report of the NIAID-Sponsored Panel.”  The Journal of Allergy and Clinical Immunology 126.6, Supplement (2010): Pages S1-S58.

The Light at the End of the Tunnel

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President’s Weekend marked a milestone in my home. Typically, my youngest, Billy, only eats bananas from fruit vendors on the streets of NYC, but on Saturday he surprised me by eating one while sitting at the dining room table. The produce trend continued when the boys watched me peel butternut squash as I prepared dinner. Bobby recalled peeling carrots and cucumbers with me when he “was little” and also told Billy he needed to eat some form of protein with his pretzels. My husband and I just looked at each other and smiled.

I was eager to see how the boys would react to a little taste test I prepared for them that evening. Billy will only eat pasta in yogurt (it sounds disgusting but is actually quite tasty), so I thought it would be fun to let the boys try different kinds of pasta sauces.: pesto, yogurt and natural tomato sauce. Test One: Billy spit the pesto and pasta right out; Bobby did the same. Test Two: Bobby went on to try the pasta with red sauce. He described it as awful, yet ate it anyway, and when I offered more he took another bite. We even performed a Bonus Test–sprinkling Parmesan cheese on top of the pasta– and amazingly, Bobby liked it better without it.

I was heartened by the boys’ willingness to try the little samples I had prepared. The changes were small, but as any mom knows, any sort of openness to new foods is a step in the right direction. It gave me hope.

In an attempt to continue this adventurous streak, on Monday night I prepared a meatloaf made by the butcher at Whole Foods. If you remember, Bobby loved Whole Foods’ turkey meatloaf but the store rarely has it and when I tried to make him a homemade version he refused to eat it. (My husband and friends loved the homemade meatloaf, by the way.) Bobby asked where this meatloaf came from, and  I told him it was from Whole Foods. I hesitantly handed him a plate of meatloaf served with whole-wheat pasta and apple slices, worried that he’d know it was beef and not turkey. Astonishingly,  Bobby never inquired. His only request was that I cut the hard edges off, which I obliged. “I love turkey meatloaf!” he proudly declared, as he proceeded to finish his portion. I didn’t want to ruin the moment by correcting him, so I just let it be and happily watched my son enjoy a new food. This was the first time Bobby ate beef since he was 12 months old.

I’m happy to share that the apple slices were a huge success too. While the boys played chess on the iPad with their dad, I had sliced an organic apple using an apple corer and set them on a nice plate. I left the plate near the boys on the table without saying anything. Suddenly, Bobby declared loudly, “I love apple slices!” and proceeded to gobble them up while Billy licked one slice. He even asked for more, which prompted me to cut up extra and serve it with his meatloaf dinner.  I don’t think I did anything particularly remarkable that afternoon when my boys were suddenly excited to eat fruit—it wasn’t magic. Rather, I think that the boys were under the influence of their cousins, Lily and Sophia, whom they saw eating apple and orange slices the day before. The girls ate the fruits with such zest that they made it look appealing to the boys, and they’ve been eating apples ever since.

Just this morning the boys tried blueberries again. Bobby ate buckwheat pancakes. And although Billy didn’t actually add anything to his small ingredient repertoire, the weekend was still a success simply because he was willing to try new foods. Bobby’s apprehension about trying new foods has definitely been decreasing as he matures— these President’s Weekend taste tests are evidence of that. All of the small changes this weekend lead me to conclude something pretty big: There is a light at the end of the picky-eating tunnel. I’m proud of the progress we’ve made so far and I’ll continue to encourage my boys to have fun and try new foods during the meals and snacks to come. My boys may become adventurous eaters and share a love of yummy food like their parents after all!

Guest Blog: Breastfeeding versus Bottle-feeding

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Moms may differ in their opinions and or choice to breastfeed or bottle-feed. I personally think it should be the woman’s right to choose. Breastfeeding and bottle-feeding both have pros and cons. We hear the many pros of breastfeeding such as less illness, possible greater intelligence of the child and so on. Many organizations including the Academy of Nutrition and Dietetics (formerly known as the American Dietetic Association) promote breast-feeding here in the USA and abroad. However, I question whether this is always appropriate especially if the mother is deficient in micronutrients, deficient in essentially fatty acids, malnourished, stressed, had multiple births in a short period of time or perhaps is not the right choice for the mother. I was breast fed for 3 months and choose to bottle feed my children.

Below, guest blogger Allison Brooks shares her point of view at an international level. Allison studies biomedicalization in Bolivia. Here she presents an example of biomedicalization on breastfeeding versus bottle-feeding in third world countries. Allison shared with me that she too was bottle-fed.  Feel free to comment and share your opinions as well. All are welcome.

Biomedicalization of BreastFeeding: What is healthy here, might not be healthy for all

Biomedicalization is a term used to describe the way in which natural life processes, human conditions and problems are defined and treated as medical conditions. Aging, childbirth and breastfeeding are good examples of normal life processes which have come under the authority of doctors. Biomedicalization may bring benefits, but there are also costs. Philosopher Ivan Illich was one of the first to use the term “medicalization,” which he argued actually caused an increase in social and medical problems as a result of medical intervention. One example is the drive by manufacturers of baby formulas to supplant breastfeeding with formula.

When a mother dies in childbirth or cannot breastfeed for some reason, infant formula may be the only choice. However, in the underdeveloped nations of the world, breastfeeding serves a number of critical purposes. Breastfeeding protects babies from infection, provides them with near-perfect nutrition and acts as a natural birth control for the breastfeeding mother. Breastfed babies are less likely to develop diarrhea, bacterial meningitis, ear infections and respiratory infections than infants who are fed formula. Breastfeeding also triggers beneficial hormone secretion in the mother, and the milk changes in amount and constituents to meet the needs of the individual infant.

The Nestle baby formula promotion of the 1970s urged mothers in less-developed countries to forgo breastfeeding in favor of formula, stressing convenience and nutrition. Nestle used strategies such as sending a new mother home with free samples; once the samples ran out, the child was habituated to formula and the mother’s milk had dried up, so the family had to buy formula.

Problems with this sort of infant nutrition quickly became apparent. Formula must be mixed with water and water in poor countries is often contaminated. Mothers could not read the instructions on water sterilization, or did not have the means to boil the water. Formula-fed babies were much more likely to die of diarrhea or pneumonia as a result of infections. Poor mothers would often mix inadequate amounts of formula for each feeding to make the expensive formula last longer, resulting in malnourished babies.

Nestlé’s marketing activities were considered so unethical that a boycott was launched by a group called the Infant Formula Action Coalition. In 1981 the World health assembly adopted Resolution WHA34.22, which bans the promotions of breast milk substitutes. Although Nestle agreed to accept the code, in 1988, formula companies were accused of repeating the unethical tactics and the boycott, which was still in force as of 2011, was launched. Other companies such as Borden, Similac and Wyeth have come under similar criticism for marketing methods that imply formula and breast milk are nutritionally equal. Most physicians and international organizations such as WHO and UNICEF recommend now breast milk exclusively for the first six months of life.

But the effects of biomedicalization do go way beyond the idea of breastfeeding. Pharmaceutical companies push new rules on societies regardless of their cultures, everyday. This is easy to see in America, because we are the only country that allows pharmaceutical companies to run ads and develop an image for people to follow. Without regards to the culture, the environment and so on, sometimes these “better” medications/therapies can actually be harmful for the people. With new drugs entering the system to promote beauty or health, or a better life-expectancy for cancer, traditional practices are be dropped by the wayside, and people and cultures are being negatively affected.

 

About Guest Blogger Allison Brooks:

Allison says “I was bottle-fed too, that’s why I say what is healthy to you might not be healthy to others (cultural relativism). Thats why I don’t push my beliefs onto people, I state what I know and allow you to do what you please, with no judgment.”

Allie went to the University of Mississippi. She earned her degree in biomedical anthropology and  is now studying in the field to finish an ethnography on the effects of biomedicalization on Bolivian cultures, but as it relates on other societies as well. She loves to guest blog on her time off to past time and spread the word. When she is not at her computer, Allie enjoys riding her  horse, Lilly and playing with her ducks, Alvin and Shirley.

 

 


A note to my readers:

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A note to my readers

 

As I continue to share my stories, experiences and other “food for thought,” I am realizing that at times my entries extend beyond the experiences of my personal family. Each lesson is, however, always relevant to my family, since I am constantly applying what I learn toward raising my children.

 

I see my blog as an opportunity for all moms, dads, and caregivers to unite, bond, and learn to become moderate in our parenting and the feeding of our children. The goal is to raise happy, healthy, moderate children who eat all food in moderation, respect their bodies no matter what shape they may be, and enjoy life. Health promotion and disease prevention are of course at the core of what I do too.

 

So, instead of limiting our children’s perspectives on food and life to that of a black and white way of thinking (i.e. good and bad, skinny and fat, right and wrong), we should be pioneering this mindset of moderate parenting and feeding.

 

Thank you for your support over the past few months. I look forward to sharing more entries, and I hope you too will contribute your experiences, lessons, and “food for thought” on the trials and tribulations of raising “moderate” children. I would love to have at least one guest blogger a month. Please email me if you are interested: cipulloRD@gmail.com.

 

Hints for Halloween from the RD in this mom.

What are you giving out for Halloween?

Written by Laura Cipullo, RD, CDE on October 18, 2011 · From www.LauraCipulloLLC.com

Trick-or-Treat: Keeping Halloween Healthier Yet Fun.

With Halloween around the corner, why not think outside the box? We can’t trick our Halloween visitors but we can treat them to new Halloween delights. Read on to get some healthier options, unconventional goodies, and finally a run down at the candy counter.

New Delights:

Clif Kid Twisted Fruit Rope, Clif Z Bar (granola bars), Organic raisins, Blue Diamond mini nut packs – almonds, Bearito’s No Oil No Salt Microwave Popcorn or Earth’s Best Organic Puree (fruit and veggies pureed like applesauce in squeeze pack)

Unconventional Goodies:

Tattoos, bouncy balls, yo-yos, stickers, pencils, chalk and mini coloring books

Candy Counter:

For those that adhere to moderation the top 5 Halloween candy picks: Smarties, Tootsie Pops, York Peppermint Patties, Twizzlers and Milk Duds

**Just know I will be giving out Reese’s Peanut Butter Cups because they taste so yummy and a variety of the above!!

Optional Reading – nutritional information listed below:

  1. Smarties: 25 calories, 0 grams of fat, 6 grams of sugar (per roll)
  2. Tootsie Pop: 60 calories, 0 grams of fat, 10 grams of sugar (per lollipop)
  3. York Peppermint Patty: 60 calories, 1 gram of fat, 0.5 grams of saturated fat, 10 grams of sugar (per snack size patty)
  4. Twizzlers: 160 calories, 1 gram of fat, 0 grams saturated fat, 19 grams of sugar (4 pieces)
  5. Milk Duds: 170 calories, 6 grams of fat, 3.5 grams saturated fat, 20 grams of sugar (13 pieces)