Sunday, August 25, 2013

How to Cook Healthy Food for Kids : Why Bread is Bad For Kids

School Lunch

When I was a kid, lunchtime in my school cafeteria had very little to do with enjoying a nice meal.  Instead, lunch was a social scene where I was predominantly preoccupied with sharpening my social skills and making sure I fit in with the crowd.  If I packed something too unconventional into my lunch, I risked social ostracism and null value on the lunch food trading block.  If I brought Doritos, I suddenly had a lot of friends; carrot sticks and I mine as well have crawled into a ditch.

Why Processed Bread Is Unhealthy

As far as the main entree was concerned, sandwiches were the norm in my school cafeteria.  In my day, white bread was king and brown bread was considered odd.  Now, brown is king and white is out, but bread remains a pervasive staple.  Indeed, sandwiches are a hallmark of American lunch cuisine.  But how healthy are those two slices of bread we oblige ourselves to on a regular basis?  Because bread conjures up images of healthy, wholesome grains, it's natural to assume that the processed bread loaves you buy at the grocery store are healthy for you.  I'm here to tell you that they aren't.  Processed bread is not only one of the most overlooked examples of food processing, it is one of the most  unhealthy things you can give your kids to eat! 

Blasphemy you say!  How dare I besmirch the name of the pillars of wheat that our great nation rests upon!  While most parents accept that excessive amounts of sugar are bad for kids, it is hard to believe that bread could be bad for kids.  However, because processed bread is so rapidly broken down into sugar, it practically acts like sugar.  On average, processed bread has a glycemic index of seventy-five, inducing three-quarters the amount of blood glucose elevation as pure glucose!    

But I am by no means the first to draw attention to the harms of processed bread.  In fact, a cardiologist named Dr. William Davis has dedicated an entire book to the subject matter.  In his book, Wheat Belly: Lose the Wheat, Lose the Weight, and Find Your Path Back to Health, Dr. Davis argues that wheat such as wheat bread is the single biggest contributor to the American obesity and diabetes epidemics.  One of the most intriguing positions he takes in his best selling book is that all wheat products--even whole wheat bread have deleterious effects on our health.  

A Flour By Any Other Color

In my last post, I discussed that while grains are generally high in glycemic index, whole grains are lower in glycemic index compared to processed grains because whole grains have the intact bran layer which is rich in fiber and delays the absorption of the starchy endosperm.
For instance, rolled oats, wheat, barley, and rye grains are digested and absorbed at a slower rate compared to when they are ground up and eaten as a flour product.

And there's the rub.  Because most processed breads are made out of flour that has been finely ground by commercial mills, most processed breads have a high glycemic index.  This is the case even for breads that are made from 100% whole wheat flour containing all parts of the wheat berry including the bran.  For instance, the average glycemic index of white bread is seventy-five and the average glycemic index of whole wheat/whole meal bread is seventy-four.  

The problem is particle size.  Bread used to be made from coarsely ground flour, which is absorbed more slowly.  Now, modern commercial mills grind grains to such a fine degree that it doesn't matter if it contains the bran.  The exposed surface area for digestion increases with decreasing particle size and the architecture of the fiber is so obliterated that it doesn't effectively delay the absorption of the starchy endosperm.  That's why I don't recommend most processed breads, regardless if they are white, brown, or whole.  The following clip discusses the evolution of modern day mills:

But don't despair!  You can have your bread and eat it too!  You can lower the glycemic index of the breads you and your kids eat by:

  1. Baking your own bread. 

  2. Homemade bread has been demonstrated to be digested and absorbed at a slower rate than commercial bread.
  3. Baking or buying sourdough bread.
                                                                                                                                                      Breads made from sourdough starter have undergone a process of lactic acidosis by bacteria, which delays the absorption of the starch and results in an average glycemic index of around forty-eight.  To read more about making your own sourdough starter, see the following link:  Here is a recipe for basic sourdough bread:

  4. Baking or buying sprouted grain bread.                                                                                                                                            
    Sprouted grain bread uses no flour.  Instead, whole grains such as wheat berries are soaked and allowed to germinate.  These sprouted grains are then ground up and baked to produce a hearty bread.  Sprouting grains improves the digestion and absorption of the minerals and starches in the grains.  However, because the whole grains are not ground into a fine flour, sprouted grain bread has a lower glycemic index compared to most other processed breads.  In the following video, I explain why sprouted grain bread is a "top bun" and demonstrate how to make your own sprouted grain bread.                                                                                                                                      

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To make the sprouted grain bread in this video, I used the recipe in the following link:(Tip: try adding a little water to the pulsed wheat berries to create a dough like consistency)                                                                                        
You can also buy sprouted grain bread such as Ezekiel bread made from Food For Life:


Snow P & O'Dea K.  Factors affecting the rate of hydrolysis of starch in food.  Am J Clin Nutr 1981;34:2721-2727.

Atkinson FS et al.  International tables of glycemic index and glycemic load values: 2008. Diabetes Care 2008 Dec 31(12):2281-3.

Heaton KW et al.  Particle size of wheat, maize, and oat test meals: effects on plasma glucose and insulin responses and on the rate of starch digestion in vitro.  Am J Clin Nutr 1988;47:675-82.

Najjar AM et al.  The acute impact of ingestion of breads of varying composition on blood glucose, insulin and incretins following first and second meals.  Bri J Nutr 2009;101:391-398.

Liljeberg HGM & Bjorck IME.  Delayed gastric emptying rate as a potential mechanism for lowered glycemia after eating sourdough bread: studies in humans and rats using test products with added organic acids or an organic salt.  Am J Clin Nutr 1996;64:886-93.

Fardet A et al.  Parameters controlling the glycaemic response to breads.  Nutrition Research Reviews 2006;19:18-25.

Sunday, August 18, 2013

How to Cook Healthy Food for Kids : Healthy Breakfast Quinoa Recipe

Carbs Gone Bad

Popular diets such as the Atkin's diet have given carbohydrates a bad reputation.  So what is a carbohydrate?  Carbohydrates are macronutrients which are made up of carbon, hydrogen, and oxygen.  They are found in a great many foods: sugars, alcohols, grains, fruits, beans, dairy, nuts, and vegetables.  Despite their reputation, carbohydrates aren't inherently bad for you or your kids.  However, eating excessive amounts of highly processed carbohydrates is bad.  

Carbohydrates range in their chemical complexity. Single sugars include the fructose found in fruit and the glucose that circulates around in your bloodstream. Complex starches include the chains of sugar molecules found in bread. When you eat a slice of bread, your body digests it and breaks it down into smaller and smaller units until you are left with the single sugar glucose, which then gets absorbed into your bloodstream. It was previously thought that more complex carbohydrates like starchy grains were generally good for you. Now, data shows that the chemical complexity of the carbohydrate is less significant than the rate at which that carbohydrate is broken down into glucose and subsequently absorbed into your bloodstream.

The Glycemic Index

One way of quantifying how rapidly a particular carbohydrate is digested and absorbed into your body is the glycemic index. The glycemic index was pioneered by Dr. David Jenkins in 1981. To establish a standard reference point, he assigned a value of 100 to the degree of blood glucose elevation after eating a fifty gram carbohydrate load of pure glucose. He then fed an equivalent load of carbohydrate from a variety of sources of cooked foods to healthy volunteers and measured the subsequent rise in blood glucose. The glycemic index of a given food was calculated based on the percent rise in blood glucose relative to the reference standard. For example, if the elevation in blood glucose from eating fifty grams of lentils is 30% of the elevation compared to eating fifty grams of pure glucose, then the glycemic index of lentils is thirty.

One of the most important discoveries that Dr. Jenkins made was that two foods made up of equivalent grams of carbohydrates may have vastly different physiologic effects on blood sugar.  You can find a list of the glycemic indices of various foods in the following article:

In general, non-starchy vegetables, nuts, and beans have a glycemic index less than fifty, and are considered low in glycemic index.  On the other hand, starchy grains like breads, breakfast cereals, rice, and many snack products have a glycemic index greater than fifty and are considered to have a high glycemic index.  Because foods with high glycemic indices are rapidly converted to sugar, a diet heavy in high glycemic carbohydrates is effectively a high sugar diet!

What's the big deal?  Well, higher rates of absorption of a carbohydrate correspond to higher peaks of blood glucose and longer periods of elevations in blood glucose.  Additionally, eating a diet that is heavy in carbohydrates that have a high glycemic index has been associated with:
  1. Weight gain
  2. A more than doubling of the risk of diabetes
  3. An unhealthy blood cholesterol pattern
  4. As much as a doubling in the risk of heart disease  
Low glycemic eating is not only relevant to diabetics!  Choosing carbohydrates that are low in glycemic index is a critical strategy for life-long health and diabetes prevention.  You can help your kids to choose carbohydrates that are low in glycemic index by substituting processed snack foods with nuts and seeds and encouraging them to eat non-starchy vegetables and beans.  You can read more about the nutritional advantages of beans in my previous post:

Whole Grains

Grains are a prevalent source of high glycemic carbohydrates.  One way to lower the glycemic index in your child's diet is to replace processed grains with whole grains.  All grains are naturally available in their whole form, which contains all the original layers of the grain, including the starchy endosperm, the germ layer, and the outer bran layer, which is high in fiber.  When grains are eaten in their whole form, the bran slows the absorption of the starchy endosperm. 

Most of the grains in the typical American diet have been processed by mills. Processing removes the bran to improve shelf life and produce a finer texture to the end product. Unfortunately, processing also results in a refined grain that is rapidly absorbed and has a high glycemic index. Many sweet rolls, cakes, desserts, bagels, cold breakfast cereals, pancakes, waffles, pizza, muffins, pasta, rice, and breads have gone through processing in this manner. 

Examples of whole grains include oats, quinoa, farro, bulgur, barley, popcorn, wheat berries, rye berries, spelt, amaranth, buckwheat, and kasha. In the following video, I discuss how changes in the American diet have been associated with an increasing prevalence of diabetes, expand on the topic of the glycemic index, and show you an easy substitute for cold breakfast cereal using whole grains that you can prepare for your kids. 

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Here is a link to the recipe I used in the above video.  I modified the recipe by simply cooking the quinoa in water and using unsweetened applesauce instead of apple juice.


Jones AW & Jonsson KA.  Food-induced lowering of blood-ethanol profiles and increased rate of elimination immediately after a meal.  J Forensic Sci 1994;39(4):1084-93. 

Jennkins DJA et al.  Glycemic index of foods: a physiological basis for carbohydrate exchange.  Am J Clin Nutr 1981;34:362-366.

Atkinson FS et al.  International tables of glycemic index and glycemic load values: 2008.  Diabetes Care 2008 Dec;31(12):2281-3.
Aston LM et al.  Determination of the glycaemic index of various staple carbohydrate-rich foods in the UK diet.  Eur J Clin Nutr 2008;62(2):279-285. 
Liu S et al.  Relation between changes in intakes of dietary fiber and grain products and changes in weight and development of obesity among middle-aged women.  Am J Clin Nutr 2003;78:920-7.  
Salmeron J et al.  Dietary fiber, glycemic load, and risk of NIDDM in men.  Diabetes Care 1997;20:545-50. 
Salmeron J et al.  Dietary fiber, glycemic load, and risk of non-insulin-dependent diabetes mellitus in women.  JAMA 1997;277:472-7.
Shikany JM et al.  Association of glycemic load with cardiovascular disease risk factors: the women's health initiative observational study.  Nutrition 2010;26(6):641-647.
Ebbeling CB et al.  Effects of a low-glycemic load vs low-fat diet in obese young adults.  JAMA 2007;297(19):2092-2102. 
Ding EL & Malik VS.  Convergence of obesity and high glycemic diet on compounding diabetes and cardiovascular risks in modernizing China: An emerging public health dilemma.  Globalization and Health 2008.
Hardy D et al.  Association of glycemic index and glycemic load with risk of incident coronary heart disease among Whites and African Americans with and without type 2 diabetes: the atherosclerosis risk in communities study.  Ann Epidemiol 2010;20:610-616.

Sunday, August 11, 2013

How to Cook Healthy Food for Kids : What to Give Your Kids for Breakfast

What's healthier--an egg a day or a bagel a day?  Considering that eggs are high in cholesterol and bagels are both fat free and cholesterol free, the answer to this question may surprise you.  One study randomized dieters to either an egg breakfast or a bagel breakfast consisting of equivalent calories over eight weeks.  Compared to bagel eaters, egg eaters experienced 65% greater weight loss, 16% greater reduction in their percent body fat and 34% greater reduction in their waistline.  Because decreased belly fat is correlated with improved cardiovascular health, I'll give the egg a point and the bagel a bagel.

Eggs are rich in folic acid and vitamins A, E, and B12.  Eggs are also a cost-effective and complete source of protein.  Despite being rich in nutrients, some recommendations continue to advise limiting egg consumption due to concerns over the cholesterol content in eggs.  However, in a previous post, ,
I pointed out that dietary cholesterol does not elevate blood cholesterol levels as much as once believed.  So let's eggs-amine the eggs-perimental evidence shall we?  

Using rigorous statistical methodology, a recent analysis including over 250,000 subjects found no association between egg consumption and risk of heart disease or stroke.  These results may be partly explained by findings from studies that show egg consumption increases the amount of cholesterol carried on good HDL particles.  Egg consumption also increases the size of bad LDL particles, shifting the cholesterol profile towards a healthier pattern.

A final explanation for why egg consumption has not been shown to increase heart disease or stroke is based on the original question of whether a daily egg or a daily bagel is healthier.  Findings from a large survey called the Third National Health and Nutrition Examination Survey reported that people who ate at least 4 eggs per week actually had a significantly lower average cholesterol level than those who ate one or less eggs per week.  The question is, what do non-egg eaters eat instead of eggs, and how do those dietary habits adversely impact blood cholesterol levels?  I'll examine this and more in the next series of posts, entitled "Carbs Gone Bad".

Until then, check out this video featuring an easy recipe that you can use to prepare eggs for your kids.  In this video, I show you how to use eggs to incorporate vegetables into your child's diet and I debate the age old question of which came first, the chicken or the egg?

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Veggie Baked Eggs


  • 6 eggs
  • 6 grape tomatoes, thinly sliced
  • 3 basil leaves, chopped
  • 1/2 cup spinach
  • 1/4 cup grated parmesan cheese
  • salt and pepper to taste
  • canola spray
  1. Preheat oven to 350 degrees Fahrenheit
  2. Spray wells of muffin pan with canola oil
  3. Whisk eggs with salt and pepper
  4. Fill wells of muffin pan half way with spinach, tomato, cheese, & basil
  5. Pour whisked eggs into wells of muffin pan
  6. Bake for 10 minutes, then broil for another 5 minutes.  

Vander Wal JS et al.  Egg breakfast enhances weight loss.  Int J Obes 2008;32(10):1545-51.

McNamara DJ.  The impact of egg limitations on coronary heart disease risk: do the numbers add up?  J Am Coll Nutr 2000;19:540S-548S.

Hu FB et al.  A prospective study of egg consumption and risk of cardiovascular disease in men and women.  JAMA 1999;281:1387-1394.

Rong Y et al.  Egg consumption and risk of coronary heart disease and stroke: dose-response meta-analysis of prospective cohort studies.  BMJ 2013:1-13.

Kanter MM et al.  Exploring the factors that affect blood cholesterol and heart disease risk: is dietary cholesterol as bad for you as history leads us to believe?  Adv Nutr 2012:711-717.

Song WO et al.  Nutritional contribution of eggs to american diets.  J Am Coll Nutr 2000;19(5):556S-562S.

Sunday, August 4, 2013

How to Cook Healthy Food for Kids : Mussels Recipe

"You're nothing but skin and bone."  Growing up, that's what one of my aunts would always say to me whenever she saw me.  That's aunt-speak for, "Kid, you look like a puny wimp."  I used to wear baggy clothes in an attempt to appear larger.  It took me until college before I realized that doing so only accentuated the lack of bulk.  All around me, I saw guys coming out of the gym with huge muscles, which further enhanced my own insecurities about my body.

To this day, when I see my aunt, she still makes a comment that I'm too skinny and I need to eat more.  I don't take offense, because it's her way of expressing her love for me.  It's a Taiwanese thing.  But as an adult, I made a realization about myself.  What do I need huge muscles for?  I'm able to do everything I need to do with my small muscles.  And, I already nabbed the woman of my dreams.  Today, I am a happy and secure man who wears his sports jackets proudly...over a nicely padded, thick sweater.

As far as my children are concerned, I don't care if they grow massive, bulky muscles.  However, I do care about supporting their bodies with lean protein so they can grow normal, healthy, lean muscle.  One fantastic source of lean protein is seafood.  Seafood is nutritionally dense, quick to cook, low in saturated fat, and a good source of essential omega 3 fatty acids.  To read more about omega 3 fatty acids, see my previous post:       

After fish, mussels are one of the best sources of omega 3 fatty acids amongst seafood.  Mussels are rich in essential vitamins and minerals and are a particularly good source of vitamin b12.  Mussels also provide the same high quality protein as red meat, but much less saturated fat.  Studies show that people who increase their intake of lean meat actually increase their muscle mass.  So eat mussels for muscles!  In the following clip, I demonstrate an easy and tasty recipe for mussels:

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Here is a link to the recipe I used in the above clip: 

However, one of the concerns with seafood is it tends to be high in cholesterol.  This creates a lot of confusion because people don't know if they should eat something that is otherwise good for them but high in cholesterol.  In the early 1970s, dietary guidelines were put forth to limit our cholesterol intake.  These guidelines were based on the premise that cholesterol in food increases blood cholesterol and clogs arteries.  However, although dietary and blood cholesterol are chemically similar, they are not the same thing. 

While cholesterol in food can raise blood cholesterol levels, the impact of dietary cholesterol on blood cholesterol is not nearly as significant as once assumed.  For instance, a review of the 167 published cholesterol feeding studies involving 3,519 subjects dating back to 1960 concluded that an increase in dietary cholesterol of 100 mg/day corresponds to an average increase of only 2.2 mg/dL in total blood cholesterol levels. 

Furthermore, it is now evident that total blood cholesterol is not as important as where blood cholesterol is going and what it is doing.  Cholesterol that is being carried on Low-Density Lipoprotein (LDL) particles is considered bad because that cholesterol is transported to arteries and elevations in LDL cholesterol have been associated with higher risk of heart disease.  On the other hand, cholesterol that is being carried on High-Density Lipoprotein (HDL) particles is considered good because that cholesterol is being removed from the bloodstream and low levels of HDL cholesterol are associated with higher risk of heart disease.  The previously mentioned analysis found that dietary cholesterol actually increases both LDL and HDL cholesterol levels.  The addition of 100 mg of dietary cholesterol per day increases LDL cholesterol by 1.9 mg/dL and HDL cholesterol by 0.4, leaving the ratio of LDL:HDL and Total:HDL cholesterol practically unchanged.     

Thus, although seafood is high in cholesterol, the impact of dietary cholesterol on blood cholesterol needs to be put into perspective.  Considering that seafood is otherwise a nutrient dense, lean protein that is low in saturated fat, it should be considered as part of a healthy balanced diet.


Mozaffarian D & Rimm E.  Fish intake, contaminants, and human health: evaluating the risks and the benefits.  JAMA.  2006;296:1885-1899.

Lejune MPGM et al.  Additional protein intake limits weight regain after weight loss in humans.  Br J Nutr 2005;93:281-289.

Westerterp-Plantenga MS et al.  High protein intake sustains weight maintenance after body weight loss in humans.  Int J Obes Realt Metab Disord 2004 Jan;28(1):57-64.

McNamara DJ.  The impact of egg limitations on coronary heart disease risk: do the numbers add up?  J Am Coll Nutr 2000;19:540S-548S.

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