Kids Health

Health foods get a bad rap. Once the word "healthy" is attached to something, it's likely to get the thumbs down from most kids. So instead of trying to serve them "healthy stuff", let's just go with a goal of not serving them junk food.

You see, if we can just make food that seems pretty cool, instead of obviously nutritious, our kids will be less likely to go running for the nearest drive thru after school. Take these pizza tacos for example. Made with ground chicken, California Ripe Olives and green peppers, they're full of familiar flavors that kids already love, without all of the added fat and preservatives that they can do without. In fact, they're so delicious, I'm thinking they're a little too cool for school. Serve them at dinnertime with a side salad or steamed broccoli so the whole family (including mom) can enjoy 'em!

[recipe-show template="recipe-embed" recipe="pizza-tacos"]

The information on this page has been compiled and edited from previously published articles, by Dr. Connie Guttersen. The articles are not intended as health advice, nor do they necessarily reflect the views and opinions of the California Olive Committee. Always consult your physician on matters of health and wellness.

by Connie Guttersen, RD PhD.

There is a lot more to eating for competitive sports than just focusing on a quick fix of energy bars, sports drinks, or even carbohydrate loading the night before. Peak performance in teens is all about balancing the right foods into an appropriate training program and healthy lifestyle.

Like adults, teen athletes need adequate nutrition to maintain health and optimize performance. Unlike adults, their nutrition needs must provide for physical growth and development. Children and teens use more energy per kilogram of body weight than do adults (Nelson—Steen, 1986). Therefore adult based tables for estimating energy expenditure in any given sport may underestimate the actual caloric needs (Bar—Or 1983). Depending on how active, teen athletes may need anywhere from 2000 to 5000 total calories per day to meet their energy needs. Teen athletes, who do not take in enough calories, compromise their ability to perform at their best and may not be able to maintain a healthy body weight. Extreme calorie restriction could eventually lead to an increased risk of growth problems and other serious issues (Bar—Or 1983). This concern typically arises in sports where weight is emphasized such as wrestling, swimming, dance or gymnastics.

Currently there is no research available suggesting that healthy active teens need significantly different proportions of energy from carbohydrates, protein, and fat than those proposed in the 2002 Institute of Medicine (IOM) report from the Food and Nutrition Board on Dietary Reference Intakes. This information is summarized in the table below.

Planning A Teen's Diet.

There are some important points to consider in planning the teen’s diet. First, eat a wide a variety of foods rather than just focusing on one food group, ie carbohydrates. The mix of fuel (protein, carbohydrate, fat) burned during exercise primarily depends on the intensity and duration of the exercise performed, one’s level of fitness, and the individual’s nutritional status. Eliminating one or more food group may affect nutritional status. As exercise intensity increases, the use for carbohydrate as energy will also increase. (Hebestreit et al, 1996) If blood glucose can not be maintained and/or stores of glycogen become depleted, the ability to perform exercise will be compromised. Fat can also be used as alternate fuel in combination with lesser amounts of glucose when the intensity is at a moderate level and for longer periods of time. This can be worded in an understanding that “fat burns in the flame of carbohydrate.” Meaning, once the carbohydrate stores in the body are depleted, it becomes almost impossible for the body to continue the exercise solely on fat as fuel. The end result is an exhausted athlete. Protein can also be used for energy at rest and during exercise, however, in well fed individuals, it provides less than 5% of the energy expended. (Melby et al, 1998)

Choosing whole grains can provide a competitive edge for athletic teens. In addition to the energy source of carbohydrates, key nutrients such as fiber, selenium, folic acid, vitamin E, and B vitamins boost the nutrient density of the meal. Sugary carbohydrates, such as those found in many snack energy bars or beverages, may provide a quick burst of energy at the beginning, but often lead to a drop in energy levels very quickly.

To cover the needs of growth and development, the daily protein requirement per unit body weight are higher in teens than for adults, but it is unclear whether child and teen athletes need more protein than their inactive counterparts (National Research Council, 1989). However, exercise increases the need for protein to repair exercise-induced damage to muscle fibers, supports the gains of muscle mass which occur as a result of training, and provides an energy source during the activity (Tipton & Wolfe, 2004) . Teen athletes typically get a sufficient amount of protein through the regular diet and do not require high protein shakes or supplements. Excessive intakes of dietary protein can actually increase the risk of dehydration, calcium loss, and even kidney problems (Lemon, 2000). Special attention must be given to athletes who restrict caloric intake to maintain or lose body weight. Such athletes may incur a loss of body protein and lean mass, which may compromise their health and sports performance (Roemmich et al, 1991). A protein rich diet would include a wide variety of plant sources of protein from beans, soy, nuts, and legumes with animal sources from lean meats, eggs, and dairy.

Active muscles quickly burn through carbohydrates and thereby require longer lasting energy. The IOM recommendations suggest that diets should be low in saturated and trans fats, while providing adequate amounts of essential fatty acids (linoleic and linolenic acid) (Institute of Medicine, 2002). A wide diverse diet would include a wide variety of dietary sources of unsaturated fats including nuts, seeds, olives, and plant oils. Fat provides energy and essential elements for cell membranes and is associated with the intakes of the fat soluble vitamins E, A, and D. Low fat intakes (15 - 17% of energy) are generally not recommended for active individuals and do not appear to offer any health benefits when compared to a more moderate fat intake (Horvath et al. 2000)

Eating a balanced diet will also provide other vitamins and minerals which will help the body in energy metabolism, building and repair of muscle tissue, protection from oxidative damage to tissues, and adequate immune function. (Manore & Thompson, 2000). Most teens do not get enough of two important minerals: calcium and iron; more importantly, their needs for these two nutrients may be even higher than those of other non-exercising teens. Calcium helps build strong bones that athletes depend on. Calcium from dairy and some greens such as in spinach and broccoli is critical for protecting against stress fractures. Iron, is another important mineral which carries oxygen to the muscles. Iron is obtained in the diet from lean meats, green leafy vegetables, and iron fortified cereals. Those individuals who restrict their caloric intake or use severe weight loss practices are the ones at greatest risk of poor micronutrients status.

Due to the higher energy cost of exercise, children produce more metabolic heat per unity body mass than do adults (Bar-Or, 1989). Evaporation of sweat is the main avenue for dissipating the heat, particularly in hot climates. Replacement of the fluid and electrolytes is critical to prevent dehydration. The main strategy is to enhance thirst and educate athletes, coaches, and parents to drink frequently, even when thirst is not present. Children and teens are more apt to drink if the fluids are palatable and chilled. (Wilk & Bar-Or, 1996). A good rule of thumb is to strive to hydrate before exercise, throughout the activity, and re-hydrate once the activity is finished (American College of Sports Medicine, 1996). Approximately 2 hours before a practice or game, 6 - 18 oz water can be consumed. During exercise, active teens can drink approximately 4 - 8 oz water. If the duration is longer than one hour or the activity is in a hot climate, a sport drink containing carbohydrate and sodium can be used. Review the nutrition labels so that these drinks do not contain caffeine or excessive amounts of sugar (less than 100 calories per 8 ounce serving) but do contain some electrolytes such as sodium and potassium. Signs and symptoms of dehydration during exercise include muscle cramping, feeling lightheaded, nausea, headache and faint.

Most of the research on sports nutrition has been done on adults. While many of the physiological responses of children and teens to exercise are similar to adults, there are some differences that may have implications for the young athlete’s nutritional requirements. Coaches, parents, team physicians and athletes should be sensitive to protein requirements, daily energy intake, and means of enhancing fluid intake during exercise to prevent exercise-induced dehydration, particularly in hot climates. Keeping a weekly regimen of nutrient rich foods ensure that Thursday’s meal — “game meal” can be a motivating factor to ensure awareness among athletes that what they eat can make a difference.

REFERENCES:

Nelson-Steen, S. (1996). Nutrition for the school-aged child athlete. In: O. Bar-Or (ed.) The Child and Adolescent Athlete. Oxford, England: Blackwell Scientific, pp. 260-273.
Bar-Or, O. (1983). Pediatric Sports Medicine for the Practitioner. From Physiological Principles to Clinical Applications. Berlin: Springer-Verlag.
Hebestreit, H., F. Meyer, Htay-Htay, G.J.F. Heigenhauser, and O. Bar-Or (1996). Plasma metabolites, volume and electrolytes following 30-s high-intensity exercise in boys and men. Eur. J. Appl. Physiol. 72: 563-569
Melby, C.L., S.R. Commerford, and J.O. Hill (1998). Exercise, macronutrient balance, and weight control. In: D.R. Lamb and R. Murray R (eds.) Perspectives in Exercise Science and Sports Medicine, Vol. 11, Exercise, Nutrition and Weight Control. Carmel, IN: Cooper Publishing Group,
pp. 1-60.
National Research Council (1989). Recommended Dietary Allowances, 10th ed. Washington, D.C.: National Academy Press.
Tipton Kd, Wolfe RR. Protein and amino acids for athletes. J Sports Sci. 2004;22:65-79.
Lemon PWR. Beyond the Aone: Protein needs of active individuals. J Am Coll Nutr. 2000;19(5):513S-521S.
Roemmich, J.N., W.E. Sinning, and C.A. Horswill (1991). Seasonal changes in anaerobic power, strength and body composition of adolescent wrestlers. Med. Sci. Sports Exerc. (abstract). 23: S29.
Institute of Medicine ( IOM). Dietary Reference intakes. Washington, DC: National Academy of Press, 2002
Horvath PJ et al. The effects of varying dietary fat on the nutrient intake of male and female runners. J Am Coll Nutr. 2000;19(1) 42-51.
Manore MM, Thompson JL. Sport nutrition for health and performance. Champaign, IL: Human Kinetics Publisher, 2000.
Wilk, B., and O. Bar-Or (1996). Effect of drink flavor and NaCl on voluntary drinking and rehydration in boys exercising in the heat. J. Appl. Physiol. 80: 1112-1117.

We're all dealing with a huge issue right now and it's called childhood obesity. Whether it's your kid or the one down the street, it's something that we need to address, and the time is now. Do you realize the experts are saying that they expect the number of obese kids to double to 287 million by the end of this decade?

Kids need vitamins, minerals, whole grains, healthy fats and proteins to function at their best and grow to their potential. Just like adults, they need to limit their intake of refined sugars and avoid foods loaded with trans fats and high fructose syrup.

With the breadth of fresh fruits and vegetables available year round and the predominance of convenience foods on the market, it's simpler to make nutritious food for your kids than it ever was before. Unfortunately, the convenience of fast food and processed alternatives can blind us to our options. Don't let it happen to you.

Start with familiar foods that your kids enjoy and build from there. Even old stand-bys like pizza, tacos and pasta are nutritious if you focus on the right ingredients. Gravitate towards whole grains, provide plenty of fruits and vegetables and flavor with reliable sources like California Ripe Olives which add monounsaturated fats. Just remember, whatever you choose, everyone's going to notice a huge difference when meals are homemade.

by Connie Guttersen, RD PhD.

Experts continue to confirm that overweight is the most critical public health threat facing children today. According to recent forecasts by the International Obesity Taskforce, the rate of childhood obesity is set to double by the end of the decade. By their alarming figures, almost 287 million kids will be obese by 2010; and the overall obese population could rise to 700 million by 2015.

Without intervention, these children become obese adolescents and young adults, which leads to concern about an emergence of cardiovascular disease, due to the synergistic effects of other components of metabolic syndrome and low-grade inflammation. Who would have ever imagined that our children would be experiencing groups of health risk factors common to adults as early as four years old?

As a health professional, I believe it is important to help consumers gain a better understanding of Metabolic Syndrome and how it can be reversed. A recent study, published by Malin Garemo, a researcher from Gothenburg University in Sweden, found that a higher intake of dietary fat is associated with lower body weight in children. The research also correlated a higher BMI with higher intakes of sugar. This study offers an alternative side to the role of fat intake in the rise of obesity and insulin resistance--one which is often misunderstood and interpreted that all dietary fat is a risk factor for obesity among children.

The study focused on 180 healthy four year olds in Gothenburg and examined eating habits and lifestyles. Twenty percent of the children were classified as being overweight based on their BMI (greater than 25 and less than 30), and two percent were obese (greater than BMI of 30). Risk factors for metabolic syndrome, such as central obesity, hypertension, and abnormal blood glucose and insulin metabolism were also diagnosed in many of the children.

Diet, socioeconomic lifestyle, and health questionnaires were completed by the parents of the children; and there was an analysis of the children's body measurements. Interestingly, one fourth of the children's energy requirements were being met by "junk food", (candy, chips, ice cream, cookies and sweet beverages), despite the overall energy intakes being in accordance with the Nordic nutrition recommendations. A closer look at the nutrient intakes revealed higher amounts of sugar and saturated fat intake, while the intake of unsaturated fats, especially omega 3 fatty acids, iron, and Vitamin D were lower than the recommended amounts. The children who had a higher body weight consumed low amounts of omega 3 fatty acids. This supports other studies that show that obese children have shortages of omega 3.

“Good” Fat Sources

Children need "good" fats to supply nutrients that are essential for growth and energy. Fats play a key role in the absorption and metabolism of many nutrients such as the fat soluble antioxidant vitamin E and the carotenoids. Fats are also vitally important to the brain, which is 70% fat.

Limiting fat in the diet is also associated with a diet that is low in zinc and vitamin E, as well as a diet high in sugar, starch, and refined carbohydrates. USDA data from the "Continuing Survey of Food Intake by Individuals" shows that 95% of girls ages 6 to 19 do not meet the needs for Vitamin E intake. A low fat diet can also increase the risk of an essential fatty acid deficiency, which increases the susceptibility of eczema, hair loss, growth retardation, asthma, vision impairment and learning problems.

The smart choice is to choose monounsaturated fats as the major source of fat in the diet; this includes olive oil, avocado, nuts, and canola oil. These sources not only provide a good form of fat--monounsaturated--but also contain additional antioxidants. Hydrogenated oils, found in margarine and snack foods (using partially hydrogenated oils), are the worst types of fat for a child and should be limited as much as possible. In addition to the increased risk for heart disease, as found in consistent medical research, hydrogenated oil in children predisposes them to recurrent infections, inflammatory conditions, and potential learning disorders.

How to Enjoy Healthy Foods in a Child's Real World?

The research also correlated a higher BMI with higher intakes of sugar. A new review of research in the Journal of the American College of Nutrition finds that children's eating behaviors are a direct reflection of their environment and the parents' eating styles. In particular, studies have shown that children choose to eat the foods served most often and tend to prefer foods that are easy to eat (like apple wedges and carrot sticks), and that children and teens who eat meals with their family consume more healthy foods.

Establishing a good eating environment not only makes eating enjoyable, it establishes healthy habits, which are most likely to continue into adulthood.

REFERENCES:

Garemo MH. Nutrition and health in 4 year olds in a Swedish Well Educated Community. Published by the Swedish Research Council http://www.omegor.com/_vti_g1_obesità_aspx_rpstry_32_--omega-3-obesità-infantile.sphtml
Garemo MH. Metabolic markers in relation to nutrition and growth in healthy 4-year-old children. AJCN Vol 84, no5. 1021-1026, 2006
Gable, S. et al. Television watching and frequency of family meals are predictive of overweight onset and persistence in a National Sample of School Aged Children. J AM Diet Assoc. 2007;107:53-61.
Patrick H, et al. A review of family and social determinants of children's eating patterns and diet quality. Journal of the College American Nutrition. 2005; 24(2): 83-92.

by Connie Guttersen, RD PhD.

Fighting Metabolic Syndrome with Whole Grains

Scientific literature is emphasizing that what is important for preventing and managing metabolic syndrome is not just the total amount of carbohydrate but the type of carbohydrate we eat. For consumers who have relied on white bread and potatoes to meet their Food Guide Pyramid's recommendation of 6-11 servings of bread, cereal, rice, and pasta per day, this may be a challenging issue. Researchers from Tufts University found that individuals who eat three or more servings of whole grains a day, especially high fiber ones, had better insulin sensitivity and were less likely to have metabolic syndrome.

Whole grain intake has been shown to be inversely related to body mass index (BMI) and waist to hip ratio for adults and adolescents. In an investigation based on participants from the Framingham Offspring Study which computed an average whole grain consumption of 8 servings per week to 20 servings per week of refined grain found astonishing results. As more whole grains were consumed, insulin levels went down. So did cholesterol levels, LDL levels, and the waist-to-hip ratio, which is a known risk factor for cardiovascular disease.

Clearly, it is necessary to look beyond the concept of weight loss as a cosmetic issue for children and take a look at smarter food choices and their combinations to achieve healthier children.

Sample Menu
One way to help fight childhood overweight and obesity is by providing better menu options. Consider creating a menu for minors with natural appeal using the following suggestions as a starting point.

BREAKFAST

1 large egg, scrambled
1 slice of whole wheat toast with peanut butter
1 cup of low fat milk, skim or 1%
1 serving of fruit, i.e., blueberries or strawberries

Additional ideas include steel cut oatmeal or whole grain waffles instead of the toast

LUNCH

Chicken salad which includes black ripe olives, apples and celery or Swiss cheese served in a whole wheat pita, stuffed with baby spinach leaves
Raw veggies, such as mini carrots or broccoli
Fruit serving
Low fat yogurt
Water or diluted fruit juice

DINNER

3 ounces of grilled flank steak
1/2 cup of pinto beans
1 cup or more of grilled veggies or salad made with extra virgin olive oil
Whole wheat wraps
Fruit

SNACKS

Whole grain crackers with peanut or almond butter
Almonds, walnuts, peanuts
Air popped corn
Fruit with yogurt
Dark chocolate, occasionally for sweets

SUMMARY: EACH DAY AIM FOR THE FOLLOWING GUIDELINES

3 servings of low fat dairy
At least 9 servings of fruit and vegetables, aim for more color and variety
4 servings of whole grains
4-6 ounces of lean protein
3-4 servings of added good fats such as nuts, avocado, olive oil, omega 3 fatty acids

REFERENCES:

Sinha R, Fisch G, Teague B, et al.: Prevalence of impaired glucose tolerance among children and adolescents with marked obesity. N Engl J Med 2002, 346:802â€“810.
Type 2 diabetes in children and adolescents. American Diabetes Association [no authors listed]. Pediatrics 2000, 105:671â€“680.
Kavey RE, Daniels SR, Lauer RM, et al.: American Heart Association guidelines for primary prevention of atherosclerotic cardiovascular disease beginning in childhood. Circulation 2003, 107:1562â€“1566.
American Diabetes Association: clinical practice recommendations 2002 [no authors listed]. Diabetes Care 2002, 25(suppl 1):S1â€“S147.
Steinberger J, Daniels SR: Obesity, insulin resistance, diabetes, and cardiovascular risk in children: an American Heart Association scientific statement from the Atherosclerosis, Hypertension, and Obesity in the Young Committee (Council on Cardiovascular Disease in the Young) and the Diabetes Committee (Council on Nutrition, Physical Activity, and Metabolism). Circulation 2003, 107:1448â€“1453.
Sinaiko AR, Steinberger J, Moran A, et al. Influence of insulin resistance and body mass index at age 13 on systolic blood pressure, triglycerides, and high-density lipoprotein cholesterol at age 19. Hypertension 2006; DOI:10.1161 /01.HYP.0000237863.24000.50.
Morrison JA, Aronson-Friedman L, Harlan WR, et al. Development of the metabolic syndrome in black and white adolescent girls: A longitudinal assessment. Pediatrics 2005; 116:1178-1182
Duncan GE. Prevalence of diabetes and impaired fasting glucose levels among US adolescents. Arch Pediatr Adoles Med 2006; 160: 523-528.
Weiss, R. et al. Obesity and the metabolic syndrome in children and adolescents. NEJM 2004 Jun 3; 350(23):2362-74
Hirschler, V. et al. Archives of Pediatrics and Adolescent Medicine, August 2005; vol 159:740-744.
McCarthy, H. European Journal of Clinical Nutrition, 2001;vol 55:902-907. Circulation, April 2006; 113:1675-1682
Nicola McKeown et al. Carbohydrate nutrition, insulin resistance, and the prevalence of the metabolic syndrome in the Framingham Offspring Cohort. Diabetes Care, February 2004; vol 27:538-546
Steffen LM, Jacobs DR Jr, Murtaugh MA et al. Whole grain intake is associated with lower body mass and greater insulin sensitivity among adolescents. Am J Epidemiol. 2003; 58(3):243-50.
McKeown NM, Meigs JB, Liu S, Wilson PW, Jacques PF. Whole-grain intake is favorably associated with metabolic risk factors for type 2 diabetes and cardiovascular disease in the Framingham Offspring Study. Am J Clin Nutr. 2002; 76(2):390-8.
Newby PK, Muller D, Hallfrisch J, Andres R, Tucker KL. Food patterns measured by factor analysis and anthropometric changes in adults. Am J Clin Nutr. 2004; 80(2):504-13
Sahyoun NR, Jacques PF, Zhang XL, Juan W, McKeown NM. Whole-grain intake is inversely associated with the metabolic syndrome and mortality in older adults. J Nutr 2006;83(1):124-31.

by Connie Guttersen, RD PhD.

The magnitude and the prevalence of childhood obesity have increased at unprecedented levels over the past decade. This has renewed an interest in the study of metabolic syndrome in children. Researcher Dr. Ram Weiss states that metabolic syndrome is far more common among children and adolescents than previously reported, and its prevalence is directly related to the degree of obesity.

The NHANES III study, conducted between 1988 and 1994, estimated the prevalence of metabolic syndrome at 6.8% among overweight adolescents and 28% among obese adolescents. The occurrence reached 39% in moderately obese and 50% in severely obese youngsters. Furthermore, Weiss found that biomarkers of an increased risk of adverse cardiovascular outcomes are already present in obese youngsters.

Health professionals have been aware of the epidemic of obesity among children and sensitive to the epidemic of diabetes among adolescents. Now, on the horizon, is the prediction of cardiovascular disease for this generation. Weiss comments, "A dramatic increase in the incidence of type II diabetes may represent the tip of the iceberg and may herald the emergence of an epidemic of advanced cardiovascular disease due to the synergistic effects of other components of the metabolic syndrome, as well as chronic low grade inflammation, as obese adolescents become obese young adults."

The astonishing factor is that this may be occurring at an earlier age than most would imagine. A study led by Katrina DuBose, presented at the 53rd annual meeting of the American College of Sports Medicine, shows that out of 375 second and third graders, 5% had metabolic syndrome and 45% had one or more risk factors for it. The most common risk factor to be diagnosed was hypertension.

Researchers from Tufts University found that individuals who eat three or more servings of whole grains a day, especially high fiber ones, had better insulin sensitivity and were less likely to have metabolic syndrome. Similar implications were found in the New England Journal of Medicine, led by Sonia Caprio, MD. She concluded that obese children, some not yet attending elementary school, are already displaying warning signs of cardiovascular risk factors that in past generations took years to develop. In her study, researchers found that 40 – 50% of children who were moderately to severely obese had metabolic syndrome. Caprio tracked 20 normal weight children, 31 overweight children, and 439 obese children between the ages of 4 and 20. Overall, the heavier the children the more likely they were to have hypertension, dyslipidemia and insulin resistance, lower levels of good HDL cholesterol and higher blood markers of inflammation associated with heart disease. In children as young as 4-6 years old, one in every three studied developed significant health risks very quickly, in particular for high blood pressure. There were no reported differences for ethnicity as Caprio concludes, "being obese is dangerous for children and adults, no matter who you are."

Early Treatment of Childhood Obesity Offers Healthiest Future

The compelling message from this study is that there is a dose response effect. For each step increase in body weight and obesity, there is an increase in cardiovascular risk factors. Many times people will say that children will grow out of their obesity as they get older and taller, but unfortunately for the 15% of children who are classified as clinically obese this will not prove to be true. Treating obesity in children before puberty is important since the success rate is better than treating them as adults.

The number of prescriptions for type II diabetes drugs taken by children ages 5 – 19 years doubled between 2002 and 2005, according to an analysis by one of the nation's largest pharmacy benefit management companies. The increase in the use of the diabetes drugs was most pronounced in children 10-14 years, rising 106% during the study period. What may be compelling is that the study may have underestimated the prevalence of diabetes in children, since the disease is often undiagnosed for 5 to 10 years. The next phase of this study may examine diabetes related complications, such as cardiovascular disease related to the increase in childhood obesity.

BMI Calculator Determining Childhood Cardiovascular Disease Risk

In the March 2006 issue of the American Journal of Cardiology, a group of investigators revealed that children who met the criteria for metabolic syndrome had significantly greater stiffness of the carotid artery and higher levels of C-reactive protein than those without the condition. Researcher Weiss and his colleagues in a separate study also found biomarkers of inflammation (C-reactive protein and interleukin-6 levels) and potential predictors of adverse cardiovascular outcomes to increase as obesity increased. In addition, adiponectin, a biomarker of insulin sensitivity decreased as obesity increased. Adiponectin is a cytokine secreted by adipose tissue, which has been shown to improve insulin sensitivity, regulate glucose and lipid metabolism, and to have pronounced anti-atherosclerotic effects. Other studies have also shown that lower plasma adiponectin concentrations are associated with insulin resistance and cardiovascular disease.

Waist Circumference Identifies Metabolic Syndrome Risk

Measuring a child's waist could be a simple way to identify kids at risk of metabolic syndrome. Waist circumference is a strong predictor for the risk factors associated with metabolic syndrome. Below are some examples of risky waist sizes for children.

* 5 year old girl or boy with a waist size of 22 inches or more

* 10 year old boy with a waist size of 26 inches or more

* 10 year old girl with a waist size of 25 inches or more

* 15 year old boy with a waist size of 31 inches or more

* 15 year old girl with a waist size of 28 inches or more

Metabolic Syndrome in Childhood

Obese children, some not yet attending elementary school, are already displaying warning signs of cardiovascular risk factors that in past generations took years to develop. A decreased response to insulin in late childhood, along with the degree of change in insulin resistance between ages 13 and 19, is significantly associated with insulin resistance in early adulthood and is highly correlated with a clustering of cardiovascular risk factors, according to the results of a new study by Sinaiko et al. Although investigators showed that childhood insulin resistance significantly predicts these future risk factors, the effects of childhood insulin resistance were independent of the effects of obesity. In the multiple-regression analysis, insulin resistance at age 13 significantly predicted systolic blood pressure, triglyceride levels, and the insulin-resistance metabolic-syndrome. The change in insulin resistance between late childhood and early adulthood also significantly predicted future triglyceride levels and insulin-resistance metabolic-syndrome score. "The message is that while obesity is really important, it might not be the whole answer," said Sinaiko. "There are other things that are important in establishing risk and we need to be looking at them."
Continued »

REFERENCES:

Sinha R, Fisch G, Teague B, et al.: Prevalence of impaired glucose tolerance among children and adolescents with marked obesity. N Engl J Med 2002, 346:802â€“810.
Type 2 diabetes in children and adolescents. American Diabetes Association [no authors listed]. Pediatrics 2000, 105:671â€“680.
Kavey RE, Daniels SR, Lauer RM, et al.: American Heart Association guidelines for primary prevention of atherosclerotic cardiovascular disease beginning in childhood. Circulation 2003, 107:1562â€“1566.
American Diabetes Association: clinical practice recommendations 2002 [no authors listed]. Diabetes Care 2002, 25(suppl 1):S1â€“S147.
Steinberger J, Daniels SR: Obesity, insulin resistance, diabetes, and cardiovascular risk in children: an American Heart Association scientific statement from the Atherosclerosis, Hypertension, and Obesity in the Young Committee (Council on Cardiovascular Disease in the Young) and the Diabetes Committee (Council on Nutrition, Physical Activity, and Metabolism). Circulation 2003, 107:1448â€“1453.
Sinaiko AR, Steinberger J, Moran A, et al. Influence of insulin resistance and body mass index at age 13 on systolic blood pressure, triglycerides, and high-density lipoprotein cholesterol at age 19. Hypertension 2006; DOI:10.1161 /01.HYP.0000237863.24000.50.
Morrison JA, Aronson-Friedman L, Harlan WR, et al. Development of the metabolic syndrome in black and white adolescent girls: A longitudinal assessment. Pediatrics 2005; 116:1178-1182
Duncan GE. Prevalence of diabetes and impaired fasting glucose levels among US adolescents. Arch Pediatr Adoles Med 2006; 160: 523-528.
Weiss, R. et al. Obesity and the metabolic syndrome in children and adolescents. NEJM 2004 Jun 3; 350(23):2362-74
Hirschler, V. et al. Archives of Pediatrics and Adolescent Medicine, August 2005; vol 159:740-744.
McCarthy, H. European Journal of Clinical Nutrition, 2001;vol 55:902-907. Circulation, April 2006; 113:1675-1682
Nicola McKeown et al. Carbohydrate nutrition, insulin resistance, and the prevalence of the metabolic syndrome in the Framingham Offspring Cohort. Diabetes Care, February 2004; vol 27:538-546
Steffen LM, Jacobs DR Jr, Murtaugh MA et al. Whole grain intake is associated with lower body mass and greater insulin sensitivity among adolescents. Am J Epidemiol. 2003; 58(3):243-50.
McKeown NM, Meigs JB, Liu S, Wilson PW, Jacques PF. Whole-grain intake is favorably associated with metabolic risk factors for type 2 diabetes and cardiovascular disease in the Framingham Offspring Study. Am J Clin Nutr. 2002; 76(2):390-8.
Newby PK, Muller D, Hallfrisch J, Andres R, Tucker KL. Food patterns measured by factor analysis and anthropometric changes in adults. Am J Clin Nutr. 2004; 80(2):504-13
Sahyoun NR, Jacques PF, Zhang XL, Juan W, McKeown NM. Whole-grain intake is inversely associated with the metabolic syndrome and mortality in older adults. J Nutr 2006;83(1):124-31.

Want your kids to snack right? Instead, of handing them bag of sweet or salty snacks, introduce them to whole grains and try to keep their processed foods to a minimum. Snacks like California Ripe Olives, nuts and whole grain cereals are totally munchable (dare I say addictive?). Think healthy choices can't compare? Tease your teens' tastebuds with this after-school treat. A knock-off on nachos, these whole wheat pita chips are equally delicious with a healthy balance of fat and carbs and no guilt attached.

Whole Wheat Pita Chips and Dip

1/4 cup Cream cheese*
1/2 cup Sliced California Ripe Olives
1/4 cup Salsa
2 Tablespoons Canned chopped green chilies
2 pieces Whole wheat pita bread, cut into wedges and toasted

Heat cream cheese in microwave until warm (about 15 seconds). Stir in California Ripe Olives, salsa and chilies. Serve with toasted pita. Serves 2-4 kids (depending on age).

*Try substituting lowfat cottage cheese for even healthier results. Just skip the heating...Oh, and as for lowfat cream cheese, we've got to draw the line somewhere!

by Connie Guttersen, RD PhD.

Studies, such as those cited on this page, have documented that undernourishment impacts the behavior of children, their school performance, and their ability to concentrate and perform complex tasks.

A child's learning ability and behavior greatly depends on what nutrients the brain uses as fuel. Across the spectrum of mildly disruptive behaviors, such as concentration and mood difficulties, to the clinical diagnosis of attention deficit or autistic disorders, it is possible to categorize the biochemical imbalances, which most often contribute to these disorders. The four main areas include essential fatty acid deficiencies, blood sugar control, vitamin and mineral deficiencies and food allergies.

Balancing Fats for Better Brainpower

Sixty percent of the brain's weight is made up of fat. Choosing the smartest balance of dietary fats is critical for both the growing and aging brain. Two of the most important fatty acids comprising this weight are eicosapentanoic acid (EPA), and docosahexanoic acid (DHA), both omega 3 fatty acids. The EPA and DHA fatty acids are important for proper communication between the neurotransmitters in the brain and are necessary for structural and functional roles in the brain cells. A deficiency in omega 3 fatty acids has been associated with hyperactivity, learning disorders, and behavioral problems. Furthermore, as studies look into ADD and ADHD they find that the brain chemistry related to neurotransmitters function is out of balance and may be related to how fatty acids are metabolized. A recent study involved 117 children between the ages of 5 and 12, all of whom were attending mainstream school found significant improvements in reading, writing and symptoms of attention deficit hyperactivity disorder, (ADHD) after three months of supplements containing EPA and DHA.

Dietary sources of omega 3 fatty acids include oily fish such as salmon and trout. Plant sources such as flaxseed, walnuts, and canola oil also provide the essential fatty acid alpha linolenic acid (ALA), which the body converts to EPA, however, not as efficiently as if it were from the marine source. The conversion, as well as the utilization of omega 3 fatty acids in the brain, is challenged in the presence of high intakes of omega 6 such as corn oil, soybean oil and trans fats from partially hydrogenated oils. The average ratio of omega 6 to omega 3 intake is approximately 15:1, far from the recommended 1-4:1 estimate.

Use of partially hydrogenated fats and trans fat compromises the delicate balance necessary for optimal use of omega 3 fatty acids and changes how brain levels of dopamine work as neurotransmitters. Researchers worry that trans fats, like saturated fats, compromise the blood flow in the blood vessels of the brain which is reflected in studies that examine the increased risk of dementia and Alzheimer's disease later in life. The intake of monounsaturated fats, such as from olive oil, avocado, nuts, and canola oil can provide an optimal balance as it does not compete for absorption and utilization of omega 3 fatty acids in the cells. Adequate consumption of omega 3 food sources and the proper balance of fatty acids emphasize the importance of the quality of fat in the diet rather than just the quantity.

Young Minds Need Vitamins and Minerals

There are also key minerals and vitamins, which are important for young minds. Magnesium and zinc are two minerals, which appear to be gaining more attention as their levels become deficient within children who have poor diets. Magnesium deficiency can be associated with low mood, hyperactive behavior, and insomnia. A zinc deficiency is associated with low mood, poor learning skills, and frequent infections which lead to more missed days at school. B vitamins are also important co-factors in many biochemical pathways related to energy levels. Low levels are associated with low mood and energy levels, anxiety, irritability and learning difficulties.

Another prevalent nutritional problem of children in the United States is iron deficiency. This deficiency is characterized by fatigue, shortened attention span, reduced resistance to infection, and impaired learning ability. Consequently, anemic children tend to do poorly on vocabulary, reading and exams. Choline, a nutrient found in eggs and nuts, has a positive effect on brain and memory development. Antioxidants from flavonoids found in blueberries, strawberries and vitamin C rich foods may also provide additional benefits. Studies continue to suggest that the role of antioxidants in preserving brain function and reducing risk associated with oxidation is promising.

There has been much discussion regarding the type of carbohydrate and the amount of sugar children consume each day. It's been estimated that today's American child ingests approximately 50 teaspoons of sugar each day. In addition, many kids are not eating breakfast, eating more processed foods, and not getting enough exercise.

Foods that contain fast releasing carbohydrates, such as sweets lead to a temporary and excessive hyperglycemia followed by a drop in blood sugar. This can lead to behavioral changes, especially in sugar sensitive children, which could predispose them to learning difficulties. Researchers at Yale University gave 25 healthy children a drink containing the equivalent amount of sugar found in a soda can. As adrenalin levels rose and blood sugar levels fluctuated, most of these healthy children had difficulty concentrating and were irritable.

There is no doubt that children's brains function better with a constant and even supply of nutrient rich foods. Undernourishment impacts the behavior of the children, their school performance, and their ability to concentrate. As health professionals we need to provide easy-to-follow guidelines for brain food tips which school aged children can adopt as part of a healthy lifestyle.

Fueling A Healthy Kid

1. Start the day with a healthy breakfast.
Children who eat breakfast have a general increase in math grades and reading scores, increased attention, reduced nurse visits and improved behaviors. Children who do not eat breakfast pay less attention in the late morning, have a negative attitude towards schoolwork, and retain less in class. Start the day with a Rise and Shine burrito of eggs, whole grain tortilla, olives, and a favorite salsa for a well-balanced start. Whole grains with peanut or almond butter or eggs are also an easy recommendation. Try whole grain steel cut oats topped with toasted nuts and brown sugar.

2. Eat brain friendly carbohydrates.
Low glycemic foods such as whole grains, beans, and legumes can provide the brain with the necessary nutrients and help keep the blood sugar at a steady control. Fueling children on empty calories from sweets and refined snacks only displaces the opportunity to eat nutrient rich foods.

3. Feed your brain the right fats.
Focus on the essential fatty acids from alpha linolenic, EPA and DHA found in the various sources of omega 3 fats. Keep them in balance with delicious choices of monounsaturated fats from nuts, olive oil, avocados, and canola oil as well as the polyunsaturated sources. Moderate saturated fats from animal fats and tropical oils while eliminating trans fats from partially hydrogenated oils.

4. Stay hydrated with water.
Blood is 80% water. As it flows through the body it eliminates toxins and allows good nutrition to reach different body parts, such as the brain. Proper hydration is critical for concentration and alertness. Moderate or eliminate sugary beverages.

5. Take vitamins and minerals as an insurance.
If children are eating a balanced adequate diet, supplements are not usually necessary. However, in these busy times with hectic eating schedules a child's vitamin and mineral supplement may provide that necessary insurance to ward off any deficiencies. The critical nutrients to consider include vitamin C, B12, B6, Folic Acid, Calcium, iron, and zinc. (But be sure to check with your doctor first.)

6. Serve smart snacks.
Healthy mid-morning and afternoon snacks keep energy levels up. Choose snacks that have a small amount of protein along with whole grains and "good" fats. Snack time may be an optimal time to include a handful of nuts, a small container of black olives, or even crackers with nut butters. Refined sweets or excessive processed foods lack the nutrients to keep kids alert and hunger satisfied.

7. Perk up the brain with protein.
Proteins in the diet provide amino acids from which neurotransmitters can be made. Two of the most important are tryptophan and tyrosine. Tryptophan is the precursor to serotonin, which relaxes the brain and tyrosine is the precursor for dopamine, epinephrine, and norepinephrine, collectively they are referred to catecholamines. Catecholamines rev up the brain.

8. It is all about balance.
The company these nutrients keep is what makes it all work. The right carbohydrates in balance with protein, colorful fruits and vegetables, and mono and polyunsaturated fats make for a nutrient rich balance that works collectively. Encourage children and parents to apply the themes of balance and moderation to recommended portion sizes for their age groups.

REFERENCES:

Hammad TA et al., Arch Gen Psychiatry. 2006;63:332-339
Jones T et al, 1995, J Pediatr,126(2), pp 171-7
Haapalahti M et al, 2004, Eur J Clin Nutr, (58)7, p1016-1021
Dykman R and Pivik RT, 2002, Pediatric Academic Society, Vol 5, p. 453
Morris N and Sarll P, 2001, Educational Research, 43(2), p 201-207
A Richardson & P Montgomery, Pediatrics, 2005, 115(5):1360-1366
Tufts University, Center on Hunger, Poverty, and Nutrition Policy, Statement on the Link between Nutrition and Cognitive Development in Children, Medford, MA: 1994. Pollitt, E., "Does breakfast make a difference in school?" Journal of the American Dietetic Association, October, 1995; 95(10): 1134-9.
Troccoli, K.B., Eat to Learn, Learn to Eat: The Link Between Nutrition and Learning in Murphy, J., Pagano, M., Nachmani, J.,Sperling, P., Kane, S., and Kleinman, R, "The relationship of school breakfast to psychosocial and academic functioning." Archives of Pediatric Adolescent Medicine, 1998, 152, 899-907.
Vaisman N, Voet H, Akivis A, Vakil E. "Effects of Breakfast Timing on the Cognitive Functions of Elementary School Students." Archives of Pediatric and Adolescent Medicine 1996 150:1089-1092.
Barton BA, Elderidge AL, Thompson D, Affenito SG, Striegel-Moore RH, Franko DL, Albertson AM, Crockett SJ. "The relationship of breakfast and cereal consumption to nutrient intake and body mass index: the National Heart, Lung, and Blood Institute Growth and Health Study." Journal of the American Heart Association 2005; 105(9):1383-1389.
Fiore H, Travis S, Whalen A, Auinger P, Ryan S. "Potentially Protective Factors Associated with Healthful Body Mass Index in Adolescents with Obese and Nonobese Parents: A Secondary Data Analysis of the Third National Health and Nutrition Examination Survey, 1988-1994." Journal of the American Dietetic Association 2006;106:55-64.

Swapping sandwiches is so prevalent in the school cafeteria, it's practically part of the curriculum. For the kids it's all about getting the tastiest treats. It's us parents who have to figure out how to fuel 'em up on things that not only look and taste delicious, but are good for them too. Nearly impossible right? No way. Remember, we're the adults here. We can figure them out.

Start with foods that your kids already love and work from there. I'm not talking orange cheesy puff sandwiches, but take something else, say ketchup and run with it… Since it has the antioxidant lycopene, ketchup "counts" in the veggie category in my book. Incorporate it into and on top of these "Meatloaf Minis" and you've got some delicious delights for the tots, tweens and teens. What they do know is that they're yummy. What they don't is that they're getting protein from low fat ground turkey, whole grains from rolled oats and monounsaturated fats from California Ripe Olives. Now that's using your thinking cap!

[recipe-show template="recipe-embed" recipe="meatloaf-minis"]

No, I'm not saying you should run out to your favorite superstore and purchase the biggest plates in stock. More is not always better! Instead, create delicious meals full of interesting flavors, textures and colors and your family will fill up on enough of the good stuff to keep the cravings in check. Make sure to serve well-balanced meals or at the very least serve foods from all the major food groups (no, chocolate is not one of them) throughout the day. Start young and tots will gravitate towards foods that their bodies need, not those that marketing mavericks want them to have.

Old and young, we all seem to love pizza. Whether it's the gooey cheese or the zesty sauce, I'm not quite sure. Bottom line is, if you disguise healthy foods with pizza flavors, your kids will feel like they're getting a treat and you'll feel pretty good, knowing that you've steered their little hands in the right direction...(Away from the junk food drawer for once). Seasoned with your favorite sauce, California Ripe Olives and parmesan cheese, and fortified with spinach and chicken breast for vitamins and protein these Parmesan Chicken Pizza Rolls make the most of any plate in the house.

[recipe-show template="recipe-embed" recipe="parmesan-chicken-pizza-roll"]

Sometimes I think our kids should be called "generation snacks". It's not their fault. We bring snacks to the playground, send them to school with snacks and offer up even more when they return home. Snack foods are just so convenient these days that it's easier to reach for the nearest bag, rather than making a whiny kid wait it out 'til the next meal.

That's not such a huge problem if we're offering them fruits, veggies and whole grains between meals-then it's more like grazing, right? The problem stems from the fact that most of us are more lenient with nutritional value when it comes to snack foods.

So now that we've trained our kids to think that the next meal is just around the corner, it's time we made that meal count. That means stocking up the pantry with foods with a little oomph. Think protein from nuts, monounsaturated fats from California Ripe Olives, vitamins and minerals from apples, oranges and baby carrots.

Here's a recipe that takes an all time favorite and gives it a little twist. Hidden beneath layers of cheese, tomato sauce and California Ripe Olives, the kids will never notice the whole grain crust. Cook half the recipe now and freeze the rest, believe me, they'll be clamoring for more soon enough!

Pizza Twirls

1 (1 lb.) prepared whole grain pizza dough
3/4 cup pizza sauce
2 cups Italian cheese mix
1/2 cup chopped California Ripe Olives

Roll pizza dough into a 12-inch by 15-inch rectangle on a lightly floured surface. Spoon pizza sauce in a thin layer over the top. Sprinkle with cheese and California Ripe Olives. Roll widthwise into a long tube shape.* Slice roll crosswise into 1-inch discs and place each onto a lightly greased baking sheet. Bake in a 425-degree oven for approximately 20 minutes. Make 10-12 snack sized servings.

* For easier slicing you may place roll into the freezer for 15 minutes until dough stiffens slightly.

by Connie Guttersen, RD PhD.

The prevalence of overweight among children and adolescents has been increasing at an alarming rate. In addition to the increased prevalence, the degree to which children and adolescents are overweight has also dramatically increased. Data from the National Longitudinal Survey of Youth indicates a marked increase in the severity of overweight among children 4 to 12 years of age in the past 20 years.

As the scientific literature takes a closer look at the impact of these figures, we find that childhood obesity is not just a cosmetic problem related to excess calories. This trend is closely related to an increase in type II diabetes, a concern for a shorter life span as an adult, and nutritional deficiencies which may affect immune function, memory, learning abilities, and behavioral/mood levels such as shorter attention span, irritability and aggressive behavior.

Iron and zinc are two examples of common nutrient deficiencies found in overweight and obese individuals.

Americans, including children, are eating more calories then ever, while not meeting the recommended dietary allowances for key nutrients such as folate, calcium, vitamins A, C, B6, zinc, and iron. In other words, the everyday foods consumed are energy dense but not nutrient rich choices. Daily meals of snack foods, fast food, and processed foods do not supply adequate levels of critical nutrients for growing children. These concerns are even larger when it comes to the overweight and obese child. Overweight bodies have higher nutritional needs than normal weight bodies, compounding the problem for nutrient deficiencies and malnutrition. Iron and zinc deficiencies are two examples of common nutrient deficiencies found in overweight and obese individuals as compared to normal weight individuals.

Obesity related to increasing incidence of iron deficiency

Children and adolescents who are overweight are more likely to be iron deficient than normal weight children. A recent study, published in 2004 in Pediatrics found that although children tend to consume large amounts of calorie dense foods, they are not nutrient rich choices. In this study, 9,698 children were examined. Overall, the prevalence of iron deficiency increased as BMI increased from normal weight to at risk for overweight to overweight, ( 2.1%, 5.3%, and 5.5%, respectively).

In summary, the multivariate regression analysis concluded that children who were at risk for overweight and children who were overweight were approximately twice as likely to be iron deficient as those who were not overweight. The association between iron deficiency and overweight may have important public health and clinical implications. The screening may need to be modified to pay special attention to those individuals with higher BMIs.

Dietary Sources of Iron

Red Meat — Red Wine Beef Barley Stew
Dark Poultry — Sephardic Simmered Chicken
Eggs — Olive Salmon Scramble
Tofu — Tex Mex Tofu
Enriched Grains — Minted Multi-grain Salad
Dried Beans and Peas — Roasted Corn and Bean Salad
Dried Fruits — Apricot Olive Chicken
Leafy Green Vegetables — California Ripe Olive, Rainbow Chard and Tomato Gratin
Iron-fortified products such as cereal can be a great way to incorporate more iron in your child's diet. Offer your child whole-grain, low-sugar varieties. Although it's tempting, banning sugary cereals could make your child feel deprived. Instead, offer them only once in a while.

The impact of these findings brings together the gap we must address behind the cosmetic, medical, and social aspects of obesity among children and adolescents. A deficiency in iron not only results in poor energy levels and decreased immune function; it can affect learning abilities, especially those related to memory, attention span, and math. Research shows that even mild, short term iron deficiency affects academic performance. A recent study found that 84% of children studied who had attention deficit hyperactivity disorder, ADHD, also had abnormal iron stores. In addition, they found the children with the lowest iron stores had the most severe ADHD symptoms. Some of the best food sources of iron are lean beef, pork, enriched whole grains, and beans.

Research shows that even mild, short term iron deficiency affects academic performance.

Nutrient rich choices in daily foods prevent borderline deficiencies of other common nutrients, which are a challenge for children. Another study, published 2004 in the American Journal of Psychiatry shows that children who experience certain nutritional deficiencies demonstrated a 41% increase in aggression at age 8. At age 17, they demonstrated a 51% increase in violent and antisocial behaviors. The study concluded that the difference in comparison to children who did not reflect these behavioral traits was related to the foods they were eating and the nutrients they were missing. The four primary nutrients missing were iron, zinc, B vitamins, and protein. They were not getting enough of these nutrients to develop healthy nervous systems. A healthy nervous system is important for mental and emotional health.

REFERENCES:

Nead, K. et al. Overweight children and adolescents: a risk group for iron deficiency. Pediatrics. 114:104-108, 2005
Pinhas-Hamiel, O. et al. Greater prevalence of iron deficiency in overweight and obese children and adolescents. Int J of Obes Rel Metab Disord. 2003;27:416-418.
Pollitt, E. Iron deficiency and cognitive function. Ann Rev Nutr 13,521-537. 1993
Golub, MS. Et al. Developmental zinc deficiency and behavior. J Nutr. 125 (supple) 2263s -2271s;1995
California Project Lean. Successful Students Through Healthy Food Policies. Healthy Food Policy Resource Guide.
Janssen, et al. Associations Between Overweight and Obesity With Bullying Behaviors in School-Aged Children. Pediatrics. 2004; 113: 1187-1194.
Institute of Medicine of the National Academies. 2004. Fact Sheet: Schools Can Play a Role in Preventing Childhood Obesity.
Liu et al. Malnutrition at Age 3 Years and Externalizing Behavior Problems at Ages 8, 11. Am J Psychiatry.2004; 161: 2005-2013.
Childhood obesity and a diabetes epidemic, New England Journal of Medicine, v. 346, no. 11, March 14, 2002
Overweight and obesity, Office of the U.S. Surgeon General
Childhood obesity on the rise, The NIH Word on Health, National Institutes of Health
Increased incidence of non-insulin dependent diabetes mellitus among adolescents, Journal of Pediatrics. May 1996, v. 128, no. 5
Obesity and overweight in children, American Heart Association
Rajeshwari R, et al. Secular trends in children's sweetened-beverage consumption (1973-1994): The Bogalusa Heart Study. Journal of the American Dietetic Association. 2005; 105: 208-214.
Kranz S, et al. Adverse effect of high added sugar consumption on dietary intake in American preschoolers. Journal of Pediatrics. 2005; 146: 105-111.
Patrick H, et al. A review of family and social determinants of children's eating patterns and diet quality. Journal of the American College of Nutrition. 2005; 24(2): 83-92.
Penland JG, Lukaski HC, Gray JS. Zinc affects cognition and psychosocial function of middle school children. Abstract presented at the American Society of Nutritional Sciences, Experimental Biology 2005 Conference. April 4, 2005; San Diego, CA.
Sandstead HH, Penland JG, Alcock NW, Dayal HH, Chen XC, Li JS, Zhao F, Yang JJ. Effects of repletion with zinc and other micronutrients on neuropsychological performance and growth of Chinese children. American Journal of Clinical Nutrition 1998 Aug; 68(2 Suppl):470S-475S.
Fisher, J. et al. Parental influences on young girls fruit and vegetable intakes. JADA 2002, 102:58-64.

Don't bore your kids with that same ol' same ol' sandwich. Offer a little variety so that their brown bag doesn't end up in the trash and their "milk money" in the nearest vending machine. With nutritious foods seasoned with a little zest and you'll see their taste buds grow, while their waistlines remain unchanged.

Mexican Chicken Salad Wraps

2 cups Chopped, cooked chicken breast
1 cup Salsa
1 cup Sliced California Ripe Olives
4 Romaine lettuce leaves, trimmed to about 8-inches
4 10-inch tortillas

Combine chicken, salsa and olives in a small bowl. Place one lettuce leaf on each tortilla. Fill the center of each leaf with a line of chicken salad. Turn ends of tortilla inward and roll up around filling to enclose. Tightly wrap with plastic wrap and toss in lunch bag. Serves 4 kids.

If you're going to do one thing to give your kids the edge, do it when they wake. Kids who eat a wholesome breakfast have an increase in reading and math scores, increased attention span, reduced illness and improved overall behaviors. They'll also be less likely to snack on garbage and more likely to have extra energy for a little physical activity during recess. Talk about getting a bang for your buck.

As with any meal, a combination of whole grains, fruits and vegetables and some kind of protein makes for maximum impact. Also note that kids need a whole lot of calcium, so include dairy products into their well balanced diets.

Next time you want them to wake up with a little spring in their step, give this one a try. If you're a little slow in the morning, you can always prepare the eggs the night before and reheat and wrap in the A.M. With red peppers, California Ripe Olives and Monterey Jack cheese, you may want to sneak one for yourself!

Rise 'N Shine Burrito

3 eggs, beaten
3/4 cup canned pinto beans, rinsed and drained
1/2 cup diced red bell peppers
1/2 cup sliced California Ripe Olives
1 tsp. olive oil
1/2 cup shredded Monterey Jack cheese
2 large whole grain tortillas, heated
prepared salsa as needed

Combine eggs, beans, peppers and California Ripe Olives in a large mixing bowl. Heat oil in a medium sized sauté pan over high heat. Pour egg mixture into pan and allow to cook for 3-4 minutes, stirring and shaking pan occasionally until eggs are well scrambled and cooked through. Remove from heat and fold in cheese. Divide into center of each tortilla. Fold edges inward and roll up into burrito shape. Serve with your favorite salsa.* Serves 2.

* If eating on the go, pour a little bit of salsa into each burrito rather than using as a dip.

The thing about feeding kids is that it's always a balancing act. It's important to feed them what's necessary for proper growth and development, while teaching them healthy habits that will stick with them for life.

We all know that kids need lots of calcium for their bones to grow, but did you know that they also need plenty of fats, including saturated and unsaturated fats, to absorb vitamins and nutrients and develop a good head on their shoulders…That's pretty important too, wouldn't you say?

Why not take advantage of this? Particularly when paired with whole grains, fruits and vegetables, good fats-monounsaturated fats and a controlled amount of saturated fats- can round out a healthy diet. (And get your kids to eat a lot of foods that they'd otherwise oppose!)

Take this recipe for instance. Hidden within this rich creamy sauce that no kid can resist are broccoli florets, peas and whole grains. Of course, California Ripe Olives float around giving them a little extra treat in every bite. The best part is it won't take you any longer to prepare than that plain ol' blue box of mac 'n cheese you've been using for years. I told you new is newsworthy!

[recipe-show template="recipe-embed" recipe="mac-n-cheese-with-olives-and-peas"]

Grazing is o.k. for adults, but with kids it can quickly become all-day snacking, which is not a healthy habit. Does this sound familiar? Try creating a snack-time (not in front of the TV) with substantial, healthier choices that will sustain your kids for longer. Keep processed food to a minimum in favor of those filled with proteins, carbs and vitamins, which will give your kids more energy to hit the jungle gym, instead of the couch.

Want to satisfy a sweet tooth? Try raisins, dates and other dried fruits. Savory all-natural foods like nuts, California Ripe Olives and canned beans are also really quick and easy. If you have a few more minutes, get into the kitchen with your kids and teach them how to make a wholesome snack of their own. With a few ingredients that kids love and a toaster oven, these Toaster Tuna Triangles can't be beat.

[recipe-show template="recipe-embed" recipe="toaster-tuna-triangles"]