Fitting in Family Meals

When you dish up nutritious food and share a meal, you serve as a powerful role model for positive eating habits and set the norm for how your children view both food and family.

Family meals provide much more than a nutrient delivery system. Your child’s overall development is spurred by a positive mealtime atmosphere and the traditions shaped through mealtime togetherness offer young children a sense of security.  By sharing the day’s events, expressing feelings, and listening to one another, children learn to communicate effectively in a non-threatening environment.

Studies show that mealtime rituals also add up to better health. Children and teens who eat with their families have higher intakes of vegetables, calcium, fiber, calcium, magnesium, potassium, iron, zinc, folate, and vitamins A and B6. Studies show that kids who eat family meals several times each week not only have healthier overall eating habits, they also perform better at school and are more likely to attain a healthy weight. Teens and tweens who eat three or more weekly family meals even have fewer high risk behaviors such as depression, substance abuse and disordered eating. According to research from Project EAT (Eating Among Teens) at the University of Minnesota, family meals are also related to higher academic performance, greater psychosocial well-being and a reduced risk of unhealthy weight control behaviors.

Sadly, too many American families opt out of the shared family meal experience.  According to the Centers for Disease Control & Prevention (CDC), more than 30% of kids ages 12-17 rarely eat with their family.

Families often bypass sit-down, home-cooked meals because of stressed out schedules and impossibly busy lives. Drive through dining, eating on the run, or grabbing mall or ballpark food soon becomes the norm. A home cooked meal starts to seem like a Herculean task!

The good news is that preparing a tasty, healthy family meal doesn’t have to take hours. Simple, fresh, easy-to-prepare foods can make it to the table in minutes.


Clearly, those who eat together must also plan and organize together – it doesn’t just happen.  For families used to grab-it-‘n-go eating, freeway dining, or TV dinners with the TV, a return to the family table requires renewed priorities and commitment by all members.  Below are some tips for making it happen.

  • Even families with impossibly hectic schedules can squeeze in quick meals.  Hold a family meeting each week, deciding on the days and times that will work around soccer practice, piano lessons, concerts, night classes, and work schedules.  Jot down meals on the family calendar, just as you would any other scheduled event. It’s not just dinner that counts – shared breakfast, weekend brunch or even bedtime snack sharing all count.
  • Consider “faster” food at home. Keep ingredients on hand for quick, easy, healthy meals. For instance, stir-fried vegetables with lean meat, chicken, shrimp or beans over brown rice, quinoa, or whole wheat couscous can be prepared in under 30 minutes. Whole grain pasta with a marinara sauce, Parmesan and salad is a quick, simple supper solution. Keep healthy “quick grab” foods such as a container of fruit sections, raw sliced vegetables or bagged salad on hand for easy side dishes. Another strategy is to make extra when you prepare favorite soups, stews and other healthy dishes and freeze ahead for later use.
  • To keep mealtime positive, establish rules about proper topics and appropriate conversation.  Bringing up the broken lamp, call from the principal, or tantrum at preschool will inevitably lead to conflict (and indigestion).
  • Focus on each other, not the food.  Allow children to eat until they are full without forcing “one more bite” or a clean plate.  Most experts agree that children develop healthy eating attitudes when they can choose from a variety of nutritious offerings – and not by force or coercion.
  • While most discipline should be reserved for another time, it is OK (and sometimes necessary) to deal with unacceptable mealtime behavior.  Asking a disruptive child to leave the table for a short period says to the family that you care about the ritual of eating together in a positive, peaceful manner.
  • Don’t forget to make mealtimes fun!  Laugh together, share funny stories, wear quirky clothes, celebrate your cultural/ethnic heritage, or start your own silly traditions.  Aside from the joy that mealtime sharing brings today, you will also fill your child’s memory bank with the special thoughts that only family togetherness can bring.

If you are interested in more information and materials that promote shared meals, be sure to check out the Oregon Shared Meals Initiative launched by the Nutrition Council of Oregon.

Source: Blogs | Pediatric Associates of the NW

It’s Apple Time!

I recently wrote about two of my favorite fall foods – apples and butternut squash.  So I was delighted to receive samples of a new variety of apple grown here in the Pacific Northwest.  The Autumn Glory apple is a healthy treat that somehow has naturally achieved subtle notes of caramel and cinnamon.autumn-glory-fall

I was curious to see how this variety was developed so I did a bit of apple genealogy research. Autumn glory’s “parents” are Fuji (a sweet and crisp cultivar) and Golden Delicious (yellow and sweet).  This also explains the vibrant red and yellow colors of the Autumn Glory.

The Autuautumn-glory-with-pbmn Glory apple pairs well with nut butters, resulting in the perfect fall snack for kids.  In my work with families, I like to emphasize the importance of using snack time  as an opportunity for adding to the daily fruit or vegetable tally. Most kids require at least 2 cups total fruit each day and a medium sized apple will meet half this requirement.  Apples are also a great way to add much-needed fiber to the diet so make sure to enjoy the skin as well as the flesh.

Are you an educator interested in featuring apples as part of your curriculum? The California Ag in the Classroom has a great list of apple themed books for use in elementary classrooms.

Disclosure:  I received a sample box of Autumn Glory apples.  All opinions are my own and I received no cash compensation for writing this blog.

Tricks for a Healthy Halloween

Is indulging in candy the reason kids love Halloween? Or is it more about dressing up in funny or scary costumes, decorating, parties and socializing that make the day? My view is that kids love having fun and the treats and sweets are simply a bonus.

To prove this point, I once used my neighborhood trick-or-treaters as a science project. In addition to offering a bowl of the smaller “fun-sized” candy, I also offered a bowl filled with items such as stickers, pencils, colorful shoelaces, arcade tokens, sugar free gum, bubbles, small packs of nuts, trail mix and lower sugar cereal bars. I asked the trick-or-treaters to choose one item from each bowl. I kept a record of how the kids responded and how many actually took something from the non-candy bowl.

My first trick-or-treater of the evening was so excited about the bubbles, he almost forgot to take candy. He actually ran from my house screaming “I got bubbles!”

By the end of the evening, 43 total kids had visited my house. All of them made a selection from both bowls. The most popular items in the non-candy bowl:

  1. Bubbles (by a landslide!)
  2. Cornnuts
  3. Sparkle stickers
  4. Low sugar cereal bars
  5. Crayons

The young children were especially thrilled by the non-candy “treats” & some even had to be reminded to take candy! I declared my experiment a success and have continued this Halloween tradition ever since.

Below are a few more tricks that parents can use to encourage healthy habits and cut down on the candy “goblin.”

  • Make sure kids eat a balanced dinner prior to trick-or-treating. Eating candy instead of a meal often results in upset tummies and crabby moods. Your child may be more interested in eating if you cook a hearty soup or stew in your “cauldron” and call it Witch’s Brew.
  • Don’t send kids out trick-or-treating with a pillowcase! Instead, use a smaller bag or bucket. If kids can’t lift their bag at the end of the night, that’s a sign they have too much candy.
  • Set a policy for eating trick-or-treat candy. In my view, it’s better to eat candy moderately over several days as a substitute for dessert or one or two pieces along with a healthy snack. It’s also been my experience that the kids get bored and actually forget about their candy after a few days.
  • At Halloween parties, include healthy snack choices such as air-popped popcorn flavored with pumpkin pie spice and a light coating of honey, roasted pumpkin seeds (see below), whole grain pumpkin muffins (recipe below), whole grain crackers and hummus, baked tortilla chips and guacamole, punch made from a mixture of 100% fruit juice and seltzer water, fruit chunks, and cocoa made with fat free or 1% milk. The healthy choices will help balance out the treats.
  • To get into the Halloween spirit, try one of the following fun food activities with your kids:
  1. JACK-O’-LANTERN Cutouts
    Using either light and dark breads (e.g. light and dark rye), white and orange cheeses, or thin melon slices (e.g. cantaloupe and honeydew), create contrasting designs with cookie cutters. Carefully cut identical sections out of both slices of cheese or bread. Insert the dark cutout into the light piece and the light cutout into the dark piece.
    Save the seeds when you clean out your pumpkin. Rinse the seeds well. Mix 3 T. of olive oil, 1/4 tsp. garlic salt and a dash of Worcestershire sauce. Mix together with the seeds. Spread out on a cookie sheet. Bake at 350 degrees until the seeds are brown and crispy.
    Offer delicious savory dips such as hummus, guacamole, salsa or cheesy bean dips as an alternative to sweet treats. Pair with carrot strips, orange pepper strips and baked whole corn tortilla wedges cut in fun Halloween shapes. To make crispy corn tortilla wedges, spray both sides lightly with olive or canola oil spray and bake 5-7 minutes in a 400º oven.

Source: Blogs | Pediatric Associates of the NW

Apples & Butternut Squash are Fall Favorites

As the leaves change color and the evenings become chilly, I’m reminded that it’s the season for farm fresh apples and delicious butternut squash. Versatile and delicious, both apples and squash are packed with nutrients and antioxidants.


The antioxidants found in apples have been shown to promote lung health while the fiber in apples keeps you feeling full longer. An apple a day may eveapplen help control your weight, especially if eaten before meals.

Although there are more than 7500 varieties of apples grown in the world, we normally see just 10 or so varieties in the grocery store. Instead of choosing the same tried and true apple this fall, be adventurous and bite into some of the newer varieties such as Honey Crisp, Melrose, Jazz or Pink Lady. Delicious as a snack or dessert, you can also use apples as an ingredient to enhance both the nutrition and flavor of your favorite meals and dishes. Here are a few ideas:

  • Cut up apples and sauté in a teaspoon or so of butter or canola oil. Toss in a few walnuts and a sprinkle of cinnamon and you have the perfect topping for oatmeal or whole grain pancakes, French toast or waffles.
  • Spread a whole grain tortilla or flatbread with light cream cheese or a nut butter, top with thin apple slices, and roll it up.
  • Add crunch, variety and flavor to your favorite brown rice, whole wheat couscous, or quinoa pilaf by mixing in diced tart apple chunks prior to cooking.
  • Fold diced apples into muffin batter right before baking. Check out my recipe for apple butternut squash muffins below.
  • Serve fresh apple slices with a dip such as honey yogurt, almond butter or the butternut squash dip below.

Butternut Squash

10639536_831846573513095_853539471992153049_n.jpgRich in fiber, beta-carotene, potassium and a number of antioxidants, butternut squash is a nutrient-rich vegetable that can enhance dishes ranging from soups, stews and pasta to smoothies, muffins and desserts.

I grow butternut squash in both my home and community garden and prefer it over pumpkin for ease of use, consistent sweetness, and also a larger ratio of flesh to seeds. Roasted squash seeds – just like pumpkin seeds – are rich in protein and contain heart healthy fat.

To roast butternut squash seeds, clean and rinse, then spray with oil, place on a baking sheet and place in 325 degree oven for 20-30 minutes. After they cool, place in an airtight container for storage.

The dip below is a great way to entice kids to eat more fruit. Pair with fresh cut apples, banana chunks, pineapple chunks or pear slices.

Butternut Squash Dip

6 oz. vanilla Greek yogurt
2 tbsp. whipped cream cheese
1/2 cup pureed butternut squash
1 tsp. pumpkin pie spice
Mix ingredients well and serve with fresh fruit.
Servings: 2
Nutritional Information Per Serving: 132 calories; 4 g fat; 8 g protein; 16 g carbohydrate; 100 mg sodium; 2 g fiber; Calcium 23% DV; Vitamin A 198% DV; Vitamin C 4% DV; Iron 5% DV

Butternut Squash Apple Muffins

2 cups whole wheat pastry flour
1/2 cup sugar
1 Tablespoon pumpkin pie spice
1 teaspoon baking soda
1 teaspoon baking powder
1/4 teaspoon salt
2 eggs
2 cups pureed butternut squash
1/3 cup canola oil
1 large apple, peeled and chopped
¼ cup chopped walnuts
Nonstick spray

Preheat oven to 350°. Lightly oil 2 baking tins (18 muffin cups total) or line with paper baking cups.. Mix flour, sugar, spice, baking soda, baking powder and salt in large mixing bowl. In another bowl, slightly beat eggs and mix in pureed squash and oil. Stir into dry ingredients and mix lightly. Gently fold in the chopped apple and chopped walnuts. Fill muffin cups 3/4 full. Bake 25-30 minutes until done. Loosen muffins and serve warm.

Servings: 18 medium muffins
Nutritional Information Per Muffin: 150 calories; 6 g fat; 3 g protein; 22 g carbohydrate; 8 g sugar; 140 mg sodium; 3 g fiber; Calcium 4% DV; Vitamin A 70% DV; Vitamin C 4% DV; Iron 6% DV




A New Look for the Nutrition Facts Label

The Nutrition Facts food label is getting a much needed makeover. More than twenty years since its debut, the label is catching up to current thinking in nutrition science. Expected to be phased in by 2018, consumers will have better, more eye catching information to guide their food choices. Below are some the highlights of the new label design.

Added Sugars
Dietitians are generally thrilled to see the new call-out for added sugars. While whole, unprocessed foods such as fruit, some vegetables and milk contain natural sugars, most of the sugar in our food supply comes from added sugars. Added sugars include the various sweeteners added to beverages, processed and prepared foods. For more about added sugar sources, visit

The Dietary Guidelines for Americans 2015-2020 advise limiting added sugars to no more than 10% of total calories. For a typical 2000 calorie diet, that adds up to 12.5 teaspoons (50 grams) of sugar. Even though that sounds like a lot, most Americans of all ages far exceed this limit.

When kids fill up on sugary foods, there is little room left for nutritious choices such as whole fruits, vegetables, whole grains, dairy and protein foods. Exposing teeth to sugary foods and drinks over the course of the day also leads to tooth decay. Because calories from sugar-sweetened beverages don’t fill us up or satisfy us like solid foods do, they are often just “add-on” calories that contribute to excess calories and weight gain.

Using today’s labels, it takes some diligent detective work to come up with an estimate of added sugars. The current Nutrition Facts label doesn’t distinguish between natural and added sugars. For instance, there are 12 grams of naturally occurring lactose in one cup of milk so if you are looking at a container of chocolate milk with 23 grams of sugar per cup, that means 11 grams are from added sugars. A cup of fat-free Greek yogurt has 9 grams of natural sugars so anything above that in a flavored yogurt is considered added sugar. If a product is 100% fruit, vegetable or juice, all of the sugar on the label is naturally occurring. (With fruit juice, even though the sugars are natural, they are highly concentrated so it’s important to limit to 4-8 ounces daily and choose whole fruit most of the time.)

Serving Size Reality Check
Serving sizes on the new label will more accurately reflect typical portions eaten by Americans.  According to FDA, “serving sizes will be more realistic to reflect how much people typically eat at one time.”

Bigger Calorie Number
A new big, bold number will leave no doubt about the calories contained in one serving of a food product.

Fats as a group are no longer vilified and the Dietary Guidelines for Americans 2015-2020 instead place emphasis on choosing reasonable amounts of healthier fats (think olive and canola oil, nuts and seeds, fatty fish, avocado). As a result, the “calories from fats” line on will disappear from the new label.

Updated Micronutrient Information
The four micronutrients that are mandatory on labels will be tweaked. While Americans’ intake of vitamins A and C was once problematic, this is no longer the case. Potassium and vitamin D are more important “nutrients of concern” and will replace A and C, while calcium and iron will remain. Consumers will also see the actual amounts of these four nutrients in addition to the % daily value.

Food manufacturers have until July 2018 to phase in the new labels (and smaller companies will have an additional year).  But consumers may begin to see some labels reflect the new changes prior to the deadline.

The information and graphic presentation of the new label will help families to choose more wisely, serve as an awareness tool for consumers, and assist health professionals in deciphering the key nutrient contribution of packaged foods.


All images are from the FDA website. Below is a comparison between the current label and the new label:

Source: Blogs | Pediatric Associates of the NW

Fueling up for Summertime Fun: Survival Tips for Car Trips

When our children were young, we had our own version of the Oregon Trail adventure, many times over.  We live in Oregon and both sets of grandparents live in Western Nebraska near the Oregon Trail landmark, Chimney Rock. While we didn’t have the same physical hardships of the early pioneers, we had our own stress-inducing mental hardships each summer involving three kids, two parents, and one automobile.

“How many more miles? I’m hungry! I have to go – now! She’s on my side! He’s the middle-ist kid so he sits in the middle.  I’m thirsty. He (fill in the blank) touched me/pushed me/hit me/looked at me!” And so on and on, for 1300 miles (and back again!).

Sound familiar? Too often, desperate parents pull into the nearest convenience store and raid the candy and chip aisles, grab a sweet drink and hope the food will quiet the kids, at least for 30 more miles! Of course, that strategy soon fails, because children end up cranky, tired, and of course, in need of a rest stop.

There is an easier, saner and healthier way to survive long road trips. After all, aren’t vacations supposed to reduce stress?

Planning ahead is the key to making long car trips more enjoyable. Providing stimulating games and activities, healthy snack choices and frequent opportunities to stretch, walk and burn off energy are all positive steps towards preventing friction and promoting fun. Quality break time helps families endure the long hours on the road. Looking forward to a scenic rest stop or a fun roadside attraction is better than the standard gas station and cafe, which is just another place to sit. Taking time to walk, stretch, hike or even swim in the local town pool is often the best remedy for tension and boredom.

To save time, money and stress, pack healthy picnic food and snacks. Aim to eat most snacks and at least one nutritious “picnic meal” from the cooler each day. The tips below will help you get organized for the big trip.

Pack Smart
Just like when you pack groceries, be sure to put the more durable items such as water bottles on the bottom and the more fragile items such as fruits and vegetables on the top of the cooler (another advantage: kids will see the fruits and veggies first when opening the cooler). Save your back by packing all perishables in easy-to-tote soft-sided coolers. Put the nonperishable items in separate shopping bags.

Food Safety
The last thing you want on a car trip is a sick kid or two! Be sure to keep plenty of ice or refreezable ice packs in your cooler and make sure you enforce the use of hand washing or hand sanitizer before eating.

Packing Guide
Include family favorites from all five food groups. Below are ideas to get you started.
Beverages: water bottles, milk in individual plastic containers, small (4-6 oz.) 100% fruit juice boxes
Grains: whole grain crackers and mini-bagels, sandwiches made with 100% whole wheat bread, baked whole corn tortilla chips, individual bags of popcorn
Fruit: dried apple rings, dried mango, raisins, orange wedges, grapes, packaged apples slices, strawberries, fresh cut-up fruit (melons, pineapple, mango, etc)
Vegetables: baby carrots, whole pea pods, grape tomatoes, pepper strips   , broccoli and cauliflower florets, kale, sweet potato or other veggie chips
Protein: nut butters, hummus, lean fresh deli meats, tuna in pouches or pop-top cans, jerky (beef, turkey or salmon), pistachios, almonds, walnuts, peanuts, sunflower seeds, peeled hard boiled eggs
Dairy: sliced cheese, string cheese, yogurt, bottled smoothies
Other Items: Plates, napkins, plastic tableware, condiments, hand sanitizer, refreezable ice packs, sun screen, bandages and other first aid items you may need

Finally, it is vacation so a treat or two each day adds to the fun. Just make sure the kids have plenty of opportunity for movement and active play.

Happy travels!

Source: Blogs | Pediatric Associates of the NW

Creating a new nutrition culture for children

I recently participated in a webcast with Susan Bagby, MD, who is currently the chair of the outreach committee at the OHSU Bob and Charlee Moore Institute for Nutrition & Wellness.

The Moore Institute’s central commitment is to reduce the prevalence of chronic diseases across the lifespan in current and future generations by promoting healthy, nutrient-rich diets based on whole-foods in early life – before conception, during pregnancy and lactation, and in infancy and early childhood.

Dr. Bagby discussed research on the Developmental Origin of Health and Disease and why it is important to begin with children in directing a positive multi-generational nutrition flow. I provided an overview of children’s nutrition and discussed how to engage kids in a meaningful way.

Webinar Overview:transgenerational nutrition flow

  • A snapshot of our children’s health
  • The Developmental Origin of Health and Disease (and why it’s important to reach children with this message)
  • How to engage children and elicit behavior change
  • Lots of fun examples!
  • How YOU can be a part of creating change
Click here for the slide deck that accompanies the webinar.
View the webinar.

webcast screenshot