Is your child getting enough Vitamin D?

As we say goodbye to daylight savings time, it’s a great time to think about vitamin D, dubbed the “sunshine vitamin.”  While adequate amounts can be attained by spending some time with Mr. Sun, current practices including application of sunscreen and infrequent exposure to midday sun make it more difficult than you might think for children to meet these requirements.  Food sources of vitamin D can make up the gap, but knowing how much and which foods to include is essential.   Food allergies, intolerances or eating behaviors can make this challenging in some children.  While “food first” is an excellent mantra, supplements do have application to treat and prevent deficiency.   

Vitamin D requirements for children under 12 months of age are 400 International Units (IU) and older children and adolescents require 600 IU per day.  A deficiency of vitamin D can lead to rickets, a bone-softening disease which is most often reported in infants under the age of two.  The American Academy of Pediatrics recommends that breastfed infants receive a liquid supplement that meets the daily requirement.  For infants receiving formula, 32 ounces per day is required to meet the recommended amount and supplementation should be provided if intake is below the recommended amount.  A comprehensive review of vitamin D is available here.

For older children food sources of vitamin D should be included in the diet.  Vitamin D is not found naturally in large amounts in many foods. The flesh of fatty fish, egg yolks and mushrooms contain high amounts of vitamin D, but may not be commonly consumed by children. Most of the foods that provide vitamin D in large amounts are fortified, and milk (whole, skim, lowfat) is the best example of fortification.  Each 8 ounce serving of milk provides about 120 IU of vitamin D.  Other foods such as orange juice and breakfast cereals are often fortified with vitamin D. 

Determining the adequacy of vitamin D intake can be challenging as food labels are not required to list the amount of vitamin D per serving in IUs.  Often, vitamin D is listed as a percentage of daily value, such as 20%.  Reading food labels and considering your child’s usual intake of fortified foods can help you to determine adequacy of intake.  If your child has limited food selections or does not consume foods fortified with vitamin D, consultation with a registered dietitian for a comprehensive nutrition assessment and customized plan can help to ensure adequacy of intake. 

Disclaimer: Megan Boitano, MS, RDN, LDN, CNSC is a registered dietitian nutritionist. The materials and content contained on this site (meganboitano.com) are for general educational purposes only and are not intended to be a substitute for professional medical advice, diagnosis or treatment. Persons with serious medical conditions should consult a physician before beginning or modifying any diet, exercise or lifestyle program. The use of any information provided on this site is solely at your own risk.

How my picky eater brought joy back to mealtimes

As a Registered Dietitian and mom of a picky eater, I sometimes feel like a fraud.  How can I possibly help other parents if I'm not successful in getting my own child to eat adventurously?

I have 2 boys, and their eating habits and preferences couldn't be more different.  One eats everything in sight and seeks out complex flavors and new textures.  He is naturally curious about new foods and is always willing to try something new.  I didn't "teach" him to be adventurous.  He just is!  My other son is an incredibly choosy eater.  Even the wrong brand of string cheese is quickly identified and he will always just skip eating entirely if foods served don't appeal to him.  To appease my picky eater, I found myself doing the typical cajoling, bartering and cooking of multiple foods.  My educational background and professional experience told me that it wasn't the "right" thing to do, but my exhausted and worried mom self had me doing something quite different.  The experience left me feeling drained at meal times, focusing on how many bites, running around the kitchen like a whirlwind and generally feeling frazzled.  Meals were not joyful for our family.  They were like a pressure cooker and often I was just trying to "finish" and move on to the next, more pleasant task.  

After some unexpected family loss, I had a lot of deep thoughts and most of them centered around being present and being joyful.  I realized that I was squandering the opportunity mealtimes presented.  My best intentions had created a environment that wasn't routinely joyful.  I immersed myself back in my resources and primarily the work of Ellyn Satter.  I let go of expectations about if and how much my picky eater consumed at mealtime.  Instead I gauged my success by the number of laughs and stories he shared at the table.  I began to focus on feeling positive about the environment I was creating and not just the foods he ate.  A funny thing happened.  My picky eater relaxed.  In our now calm and often full of laughter mealtimes, he nonchalantly samples new items.  I don't even ask him to.  While I wouldn't describe his meal choices as wildly adventurous, it doesn't matter!  I would describe his attitude and our mealtimes as joyful, and to me that is all that matters!

My perceived "failure" as the mom of a picky eater used to be something I didn't like to share with others, out of fear of being judged or damaging my credibility as a Registered Dietitian.  In reality, the experience gave me great insight into the complex feelings of guilt and frustration that parents of picky eaters can feel.  Through my personal experience, I've developed great passion for working with families to implement sustainable nutrition strategies that focus not on "fixing" issues like picky eating, but instead put the spotlight on ensuring that eating challenges don't remove the joy of eating and family mealtimes. 

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Grocery Delivery Service: Hacks and Tips to Save Money

Grocery shopping.  It just isn't a task that I look forward to gleefully.  Usually it involves trying to keep a squirming toddler in the shopping cart or explaining to my gradeschooler why we can't buy every salty snack or sweet treat we walk by.  By the time the task is completed and I arrive home, I'm exhausted, realize I somehow missed a few items on my list and have many extras I didn't want to buy.  I came home with 2 pool noodles last time. =)

Grocery delivery seems like a frivolous expense and I resisted it for a long time.  However, I now use it regularly and find it to be an incredible time saver and have found some creative ways to make it cost effective.   I'm going to share my 3 favorite cost-saving "hacks."

1. Try out a few services and see what fits best with your needs.  You may use different ones depending on the week and/or items you're shopping for.  I have utilized Amazon Fresh, PeaPod from Stop and Shop and Instacart. Some allow you to purchase from a variety of grocery or stores while others are a service for a specific grocer.  Take advantage of the special discounts they repeatedly offer you if you play hard-to-get and don't sign up.  Also, each service has different benefits and depending on your week or schedule, one might be a better fit.  For example, I often use Instacart if I haven't been great about pre-planning my weekly meal.  I can just order in the morning and items arrive in the afternoon.  If you find one is just perfect, feel free to sign up for their special membership programs and enjoy extra savings. 

2.  Each service has different features and pricing.  For example, PeaPod provides a steep discount on delivery if you order 4 days in advance and more than $75.  Also, it offers a further discount if you choose a larger delivery window.  I can get delivery for $2.99.  That is well worth it to me.  PeaPod allows you to update your order until the day before and sends you reminders about cutoffs.  My little "secret" to save money is to create an order with $75 worth of items (I often just put in 30 gallons of milk), choose the delivery day and window with the best price.  The day before the delivery, I update the order with my "real" list of items.  This allows me to have the low cost delivery AND the day before ordering.

3.   Delivery services do cost extra and often the prices aren't eligible for the in-store discounts.  However, I find that I actually save money because I only order what I need.  I can sit in a comfortable place, look in my cupboard, refrigerator and review my cookbooks or Pinterest board and plan my meals.  It prevents those "buy it just in case" situations and buying things because "you think you'll use it" and it's a good price. 

Grocery delivery can save you time and not break the bank.  You might just start looking forward to a stroll down the grocery aisle from time-to-time. 

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Lunchbox how-to's that will make your kid's lunchbox an A+

Breakfast might be the most important meal of the day, but lunch runs a close second.  Studies have shown that children who eat a well-balanced lunch often do better in school and are more alert.  It can be difficult to get a child to eat, even when they’re at home.  But while they’re at school, you have to up your game to make sure your carefully packed lunch doesn’t end up traded or trashed.  Here are a few tips to help kids be happy and healthy at lunchtime:

  • First of all, remember that it’s not your lunch.  If you pack broccoli, and your child hates it, they won’t eat it.  Let your kids weigh in on what they want to pack in their lunches, and offer them a few healthy choices so they feel like they’re in control.
  • Avoid pre-packaged, processed foods for your kids’ lunches.  They might seem tempting with their convenience and kid-friendly sizes, but they are also expensive and loaded with sodium and preservatives.
  • Make a smarter sandwich.  Always choose whole grain or whole wheat bread, but feel free to mix it up with whole wheat tortilla wraps or whole wheat pita pockets.  Besides lettuce, try shredded carrots or avocado slides with turkey or lean roast beef.
  • Include protein.  If your child isn’t a fan of meat, that’s okay.  There are plenty of ways to get protein into their lunch.  It’s important to include protein because it will help keep your child fuller longer.  As long as your child is old enough to eat nuts and there are no allergen concerns, experiment with forms of nut butter.  Beyond peanut butter, there is cashew, almond, sunflower, soynut and even hazelnut butter.  You could also include a hard-boiled egg in their lunch, or make a tuna salad.  Hummus or black bean dip is also full of filling fiber and protein.
  • Think outside the lunchbox.  Did your kids love last night’s roasted chicken and vegetables?  Pack some in a thermos to eat the next day.  Pack leftover meatballs into a whole-grain hotdog bun for a sandwich.  Mix leftover rice and vegetables and top with chunks of pork or chicken.
  • Skip the chips.  Try healthier side options like cheese sticks, whole grain snack crackers, dried fruit, fruit salad, nuts, baby carrots and vegetable dip, or low-fat yogurt. 
  • Don’t forget the drink.  Water, milk and 100 percent fruit juice are the healthiest drink options to pack with a lunch.  Avoid sodas, energy drinks, and fruit-flavored juice pouches, which can quickly decrease the nutritional value of your child’s meal.
  • Be safe.  Pack lunches properly to ensure food safety and freshness.  Invest in a reusable ice pack to keep perishables cool, a thermos to hold warm foods, and a variety of different sized containers.

Check out my Pinterest board here for some great recipes/checklists, packing tips and my favorite brands of lunchboxes.

Can Takeout Buy You Happiness?

We want to be happy AND healthy, but if planning and preparing meals is a task you dislike, take heart!  Meal planning services such as www.gatheredtable.com and www.superhealthykids.com may be more than a tool to improve your family's health, it may make you happier!  A recent study has shown that spending money to save time may reduce stress about life's time constraints and result in greater happiness.  Navigating the options and choosing a meal planning service that fits your budget, family schedule and is tailored to your health goals isn't easy. Consider an expert that listen and understand your priorities and create a plan that works.

What is "Eating Competence?"

What is "Eating Competence?"

No, it’s not the ability to properly hold a knife and fork; or to know which spoon to use; or to know how to fold a napkin into a swan. People who are competent eaters have positive attitudes about eating. They enjoy food. They are confident that they will have enough food to eat and they trust their bodies’ internal regulators to signal when they are hungry and when they are full. Children move toward eating competence as they learn to acknowledge their own internal cues. Development of eating competence – or the lack of – begins in infancy and continues through life.