A little food, interesting conversations, and meaningful connections — that’s what the family table is all about! So today, I’m sharing a book that I love and some really good food. I only wish that we were all sharing it around an enormous table filled with friendly conversation and lots of laughs. I hope you enjoy and as always look forward to hearing from you.
Are you the parent of a tween or teen? Do you worry about your child’s weight? Does your child worry about their weight? Have you ever heard your child say “Ugh! I’m so fat!”? Did it leave you speechless and panicked? Are you worried that your child has an eating disorder or is over-weight? Are you at a loss when it comes to talking to your child about health, weight, and the importance of being active? Well, then I suggest you grab a cup of tea, get comfy, and have a listen to this wonderful conversation I had with Dr. Dianne Neumark-Sztainer, a researcher and professor at the University of Minnesota. She is the author of “I’m, Like, SO Fat”: Helping Your Teen Make Healthy Choices about Eating and Exercise in a Weight-Obsessed World.
Over the summer I read an article in the NY Times which hi-lighted the importance of avoiding commentary on your child’s weight. Dr. Neumark-Sztainer was featured in the article, and it reminded that I had read her book a while back. I decided to reach out to her to see if she would be willing to chat with me. Of course, I was thrilled when she said yes, and excited to share our conversation with you. We discuss how to talk to your teen, how to create a health-promoting environment at home, how to approach teens that want to be vegan, the importance of family meals (of course!), and much more.
I hope you enjoy our conversation, and as always, I welcome your comments, feedback, and suggestions.
Last week I had the pleasure of attending The International Plant-Based Nutrition Healthcare Conference in Anaheim, California and wanted to share some hi-lights from the meeting. If you’ve seen the movie Forks Over Knives, you may already be familiar with the topics and presenters from the conference. In essence, the whole meeting supports the notion that we have the power to alter our state of health and well being through the food that we eat. Specifically, that eating a whole food, plant-based diet is the path to not only a longer life, but a more healthful and vibrant one. Physicians, dietitians and researchers presented evidence and case after case of how this health promoting way of life can be truly transformative. For some, the transformation came on the heels of an emergent medical problem (heart attack) and for others it was in the face of years of suffering with chronic conditions and their associated complications (diabetes, hypertension, arthritis, etc.). The list of presenters read like a whose who in the plant-based world and was beyond impressive. I found the meeting to be (both personally and professionally) inspiring and motivating. I’m not a huge fan of writing in short-hand list format but I did want to share some hi-lights from the meeting with resources if you wanted to do some more exploring (p.s. read to the end for a quick and easy pickled beet recipe!).
Prescription for heath from Dean Ornish, M.D.: eat well, stress less, move more, love more. He offers a compassionate approach and suggests that “shame, guilt, and humiliation” have no useful purpose in this conversation. He presented research supporting how lifestyle changes can make a powerful difference in disease processes such as prostate cancer, diabetes, heart disease and even gene expression. From a health and environmental stand-point, he summed up by stating that a plant-based diet is “the power of love made manifest”.
While these lifestyle changes may be a disruptive process, they represent a paradigm shift. One in which we are no longer “mopping up the floor (medications, surgery, etc.), but actually turning off the faucet (via lifestyle changes)”.
Gut health and the gut microbiome, (including the benefits of fermented foods and and the deleterious effects of antibiotics) were covered. The nature and diversity of our microbiome is thought to affect metabolism, inflammation and immune health. Though research on the gut microbiome is still in its early stages, it is clearly a topic to follow. As many researchers have stated, we are only at “the tip of the iceberg” when it comes to our understanding of the gut microbiome but its effects may be as far reaching as diabetes, heart disease and even autoimmune conditions.
Dr. Esselstyn and others discussed the importance of our endothelial system and how what we eat impacts our cardiovascular health.
Dr. Greger (If you haven’t checked out his site, it’s an absolute must! An incredible database of information supported by research) gave a phenomenal talk that covered a plethora of topics that supported a whole food, plant-based diet.
Just a few articles and links that might be interesting for you to review:
And now, the promised pickled beets! The following recipe (once again, inspired by my coursework at Rouxbe!) is so simple and makes a great addition to salads, as a condiment on sandwiches or side dish. The most “difficult” part of the recipe is actually just the time that it takes to roast the beets. At the farmer’s market this past week, I spotted a bunch of Cylindra beets, which are heirloom beets named for their long, cylindrical roots. They have a sweet flavor and their tops (greens) tend to be a bit less bitter than round beets (don’t throw away with greens!). I also found them to be easier to peel (score a slit down the length of the beet and then just peel away) and slice more uniformly. Either variety works for this recipe. You can even use golden beets but I would cook them separately so that you keep their vibrant color.
Wash the beets thoroughly. In a medium bowl, toss the beets with the vegetable stock, orange juice and thyme sprigs.
Using a double layer of aluminum foil to create a small "boat" and place the beets along with the liquid and thyme, in the center of the boat, being careful to keep the liquid inside the boat. Tightly wrap the foil into a packet.
Place the beet packet on a rimmed baking sheet and bake for approximately 45 minutes, until the beets are tender.
Let the beets cool slightly and carefully open up the packet, being careful not to burn yourself with the released steam.
Remove the skin and slice the beets into 1/4 inch slices.
Lay the beets in a glass baking dish and pour the sherry vinegar over the beets. Season with salt and pepper to taste.
Allow the beets to marinate for about 1/2 an hour and then store the beets along with the liquid in a glass mason jar. Refrigerate and use liberally on salads, sandwiches or just as a snack!
If you happen to have a lot beets and don’t think you will use them up, you can create a simple beet soup but sautéing some shallots in a bit of olive oil (optional)and then adding the roasted beets, chopped fresh thyme, a squeeze of orange juice, vegetable broth and salt and pepper. Simmer the mixture for a 10 to 15 minutes and then purée in a blender. They are especially nice served as little shooter appetizers and garnished with finely diced cucumber and orange zest.
A lot of information and still more to discover. I’d love to hear your thoughts on the topics that are interesting to you and hope to delve a bit deeper.
This weekend’s NY Times article Is E-Reading Story Time, or Simply Screen Time?, again raises the question of how much screen time for our littlest tots is too much? The article talks about the use of e-readers as a substitute for paper books and whether such early exposure will have a detrimental effect. Despite the fact that the American Academy of Pediatrics advises against screen time for toddlers, for many families, story time is now often on a tablet. While most agree that early exposure to reading provides a myriad of benefits including the development of language and social skills, there is still much debate over how that reading should occur.
The proponents and publishers of e-books claim that the interactivity of such devices actually provides educational benefits rather than serving as mere distractions. On the flip side, some researchers have shown that parents who read conventional books, engage more in “dialogic reading” (the back and forth discussion of the story) that has been shown to be critical in a child’s language development. They contend also that children can become so focused on the technology aspect of the device that parents are constantly having to redirect them back to the story and way from swiping or pushing buttons on the screen. Another concern that was raised was that parents may ultimately end up abdicating their reading responsibilites to e-books and that they merely become the tv babysitters of this generation. In reality, the truth of how digital technology will affect the process of learning to read is largely unknown. These devices have not been around for long enough to know exactly what effect they will have on learning.
Limit the amount of total entertainment screen time to <1 to 2 hours per day.
Discourage screen media exposure for children <2 years of age.
Keep the TV set and Internet- connected electronic devices out of the child’s bedroom.
Monitor what media children are using and accessing, including any Web sites they are visiting and social media sites they may be using.
Co-view TV, movies, and videos with children and teenagers, and use this as a way of discussing important family values.
Model active parenting by establishing a family home use plan for all media. As part of the plan, enforce a mealtime and bedtime “curfew” for media devices, including cell phones.
Establish reasonable but firm rules about cell phones, texting, internet, and social media use.
I think the issue is complicated. I’m a lover of books and my kids still prefer paper books to e-readers. I have to confess that I actually feel lucky to have had both of my children before the iPad even existed (can you believe it’s only been around since 2010!). I never had to face the decision of whether or not I would distract my 2 year old with a hand-held device. Today’s parents face much greater challenges. Though they may make a commitment to adhere to the AAP recommendations on limiting screen time, it’s all around us. If you’ve ever seen a toddler with a hand-held device you know that it has a stunning capacity to captivate them. And whether, as the article mentions, it’s keeping a 2 year old from jumping in the pool during big sister’s swim lesson or allowing you to make your way through the grocery store, the temptation to whip out a device is strong. I’m not exactly sure what the “right” answer is and as I often say, the answer may look different for different families. Here is what I have found works for us and might be helpful for your family:
Hold off for as long as you can. Whether it’s television, an iPad or an iPhone. Once you introduce the device, it’s hard to go back. Despite knowing how challenging it may be, I recommend avoiding the use of technology for kids under age two. It will require more effort and patience, but packing books, blocks, and crayons are great alternatives. By offering these options to our children, we can promote creativity, self soothing and even patience. As they get older, I like to think of technology time as a treat — special when it’s available, not all the time and even better if it’s shared.
We have to walk the walk. It continues to be a challenge for me as well, but how often do we, ourselves, turn to our phones and iPads while waiting for swim practice to be over? It’s tempting to answer a few emails and texts or get some work done but when we turn to our devices the minute we find ourselves idle, we also show our children how to be around technology. I’m not advocating that we never use these opportunities to tackle our to do list or even to simply have some down time but rather, that we be more mindful of the example that we set. I try to carry a book and a deck of cards in my purse most days. The book for me and the deck of cards should one of my children complain of boredom while waiting for the other. I still find myself answering messages and emails but I’m hoping to appreciate more the stillness between waiting times.
If there is an opportunity to engage with your child, put away the devices. I don’t mean all the time. But when it’s really not that important, just sit together. I’m sure we’ve all had that experience of watching a toddler try to get the attention of the adult near them to point out a dog or bird, only to find the parent affixed to their self phone. It makes me pause, not only because I see a missed opportunity for that parent to engage with that child but because it makes me wonder how often I have done the same.
Find ways to engage with your children using technology. I remember my when my son first started playing games on the iPad, I was very conflicted. On the one hand, I knew that it was fun for him and something he and his friends would talk about and even bond over. On the other hand, I didn’t want the technology to replace face to face interactions and interfere with normal social skills. While I had little understanding of the games he was playing, my husband grew up playing video games and saw it as an opportunity for fun and as a way to spend some time together. So even when they are not in front of a screen they talk about the worlds that they have built, what level they’ll get to next or how many gems they’ve mined. Instead of using technology as an isolating activity, by actively participating with him, my husband has been able to share in the experience with him and it’s something they enjoy together.
Don’t be afraid to say no. There is a lot of pressure for kids to engage in technology and it offers some amazingly creative ways to learn (the first time I saw a smart board in my kids’ class rooms I was blown away!). But there is a time and a place for it. I support you in your efforts to provide guidance for your kids surrounding the use of technology.
Whether they are 2 or 12, each age presents its challenges when it comes to technology. It’s hard to imagine that when I was growing up there was no internet let alone cell phones and other digital devices. Our challenge is to embrace all of the wonder and creativity of technology while maintaining our values and helping our children to thrive.
October is right around the corner. That means pumpkins, the changing color of leaves, Halloween and yes, the start of flu season. It’s probably no surprise that as a pediatrician I’m going to recommend that you get your flu shot. But, in addition to telling you about why it’s important to get your flu shot, I also wanted to hi-light some of the differences for this year’s recommendations from the CDC.
Fast facts about flu and why getting the shot is important:
Every flu season is different, with some being milder than others. Each year, though, influenza can lead to severe disease, hospitalization and even death. According to the CDC, Influenza is the most frequent cause of death from a vaccine-preventable disease in the United States.
The more that people are vaccinated, the more they protect the community as whole including the most vulnerable (like infants under 6 months of age who are too young to get the flu shot, people with compromised immune systems and the elderly).
It’s important to get a flu shot each year because the strains usually change from year to year and because our immunity to the vaccine declines over several months after getting the vaccine.
It takes roughly 2 weeks for your body to make antibodies after getting the influenza vaccine, so the earlier in the flu season that you are immunized, the better.
The vaccine does not provide 100% protection; though some people may get the flu despite being vaccinated, the illness is usually much milder if you have received the flu vaccine.
The vaccine DOES NOT cause the flu. The injectable vaccine has NO live virus and cannot result in influenza infection. The nasal spray does contain weakened live virus. The virus, however is cold-adapted, which means that it only causes infection in cooler temperatures (such as in the nose) but cannot cause infection in warmer temperatures (such as the lungs). Though you will not have severe symptoms from the nasal spray, milder symptoms such runny nose and fever may develop (see below to see who should/should not receive the nasal spray).
Recommendations for the number of doses, which type of vaccine you or your child should receive, concerns about allergic reactions (to eggs or any component of the vaccine) and any questions you have about the flu vaccine should be discussed with your pediatrician.
What’s new for this year?
The recommendations for children with an egg allergy have changed slightly and state that if a child has only experienced hives after consuming eggs that it is relatively safe for the child to receive an injectable flu vaccine. Even children with more severe allergies are able to receive the flu vaccine but I would recommend consulting with your allergist to determine which vaccine would be safest. Allergies are a serious consideration, so it’s critical for you to consult with your physician prior to getting the vaccine. I would recommend receiving the vaccine under the supervision of someone who feels comfortable managing an allergic reaction (this is not the time to be using a drop in flu clinic at your local pharmacy!).
For healthy children between the ages of 2 and 8 years, the CDC for the first time, recommends that when available, the live attenuated (nasal spray) is the preferred form of the vaccine. The nasal spray is believed to be more effective in this age group. You should not delay the flu vaccine if the nasal spray is unavailable and certain children (those with an egg allergy, asthma and a few other conditions) should not receive the nasal spray.
Finally, there are several forms of the vaccine available this year. The two basic versions are the live attenuated vaccine (nasal spray) and the inactivated influenza vaccine (injection). Both of these vaccines come in a trivalent (meaning 3 strains of the influenza virus) and quadrivalent (4 strains) forms. The quadrivalent vaccines will only be available in limited supply and your child’s office may only carry certain options. Currently, the CDC makes no specific recommendations as to which vaccine is preferred with the exception of the nasal spray for healthy kids ages 2 to 8 years as mentioned above.
The algorithms get quite complicated. Even as a pediatrician, I have to refresh myself with the recommendations from year to year. I hope that this helps to clarify any questions you may have had about this year’s flu vaccine. I’m happy to answer any questions you may have and encourage everyone to talk to their health care provider about getting their flu shot this year. Stay healthy!