Saturday, October 26, 2013

How to Cook Healthy Food for Kids : Make Chicken Satay Recipe

My first day of school was a scary experience.  I remember feeling anxious about riding the school bus and I didn't even want to step foot into my elementary school.  When I finally worked up the courage to enter that foreign building, I instinctively clung to my older brother and followed him into his class.  He shooed me away like I was some sort of gnat, pointed towards another class and said, "Those kids look about your height.  Go join that class!"  On the other hand, when I dropped Colin off at his new preschool, he cheerfully turned to me and said, "Goodbye!  See you later!"  It seems as if everyone is all too eager to get rid of me.

Like going to school for the first time, trying new foods can be a scary experience for kids.  Kids may find new foods to be unfamiliar, intimidating, or scary looking.  The important thing to realize is that just because your kid rejects a new food item on the first attempt, it doesn't mean you can't try again. 

In fact, multiple studies show that repeated exposure to a particular food increases acceptance to that food amongst children an infants.  For example, studies have found that infants eat significantly more of a particular pureed vegetable after repeated exposure over a period of eight or nine days.  Additionally, the more variety you expose your kids to, the more familiar their palate will become to different tastes.  This will further enhance their acceptance of new foods as kids are more accepting of novel flavors if they already have experience with flavor variety. 

In the following Halloween video, I show you another tip you can use to make foods less scary for your kids.  I suggest you mummies try this out on your little gremlins this Halloween for a howling good time!  Incidentally, I don't find this video to be scary, but your kids might.  Viewer discretion is advised.

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Here is the link to the recipe used in the above video:


Forestell CA & Mennella JA.  Early Determinants of Fruit and Vegetable Acceptance.  Pediatrics 2007 Dec;120(6):1247-1254.

Mennella JA et al.  Variety is the spice of life: Strategies for promoting fruit and vegetable acceptance during infancy.  Physiol Behav 2008 April 22;94(1):29-38.

Mennella JA & Trabulsi JC.  Complementary Foods and Flavor Experiences: Setting the Foundation Ann Nutr Metab 2012;60(suppl 2):40-50.

Sunday, October 20, 2013

How to Cook Healthy Food for Kids : Healthy Mushroom Soup Recipe


Deadly White Powder

What do you consider to be a deadly white powder?  Obvious toxic substances like cocaine or anthrax may come to mind.  But what about common white powders we ingest every day?  In my previous post, I argued that added sugars should be considered lethal:
In still another post, I argued that any highly processed grain such as commercially produced flour should be considered unhealthy:
But what about salt?  Should salt be considered a deadly white powder?  Is salt itself deadly or is it deadly by association? 

Salt And Blood Pressure

The words salt and sodium are often used interchangeably because 90% of the sodium we consume is in the form of salt.  One gram of salt contains 400mg of sodium.  The average American eats about 3400 milligrams of sodium or about nine grams of salt per day.  Many consider salt to be a dietary evil because population studies have demonstrated an association between increased dietary sodium intake and elevations in blood pressure.  Based on this, the American Heart Association recommends keeping sodium intake to less than 1500 milligrams per day.  However, guidelines like these are not only impractical, they are also based on mistaking association for cause and effect. 

Salt Restriction

Because salt intake is associated with blood pressure, it is tempting to conclude that elevating salt intake causes elevations in blood pressure and lowering salt intake lowers blood pressure.  However, studies of lowering salt intake as a means to reduce blood pressure have yielded equivocal findings.  For instance, multiple studies show that salt restriction in healthy children has no appreciable effect on blood pressure.  And while some studies in hypertensive adults have demonstrated reductions in blood pressure with salt restriction, a recent review using the strongest statistical methodology available found that the benefit of salt restriction on blood pressure is actually quite small.  On average, reducing salt intake to less than 2 grams per day was associated with only a 3.47 and 1.81 millimeter drop in systolic and diastolic blood pressure numbers (top and bottom numbers in blood pressure measurement). 

Furthermore, although elevated blood pressure contributes to heart disease, a recent critical review of multiple studies found no evidence to show that reducing salt intake prevents heart disease or helps you to live longer.  In fact, some evidence actually shows that extreme salt restriction is associated with more heart disease and lower life expectancy!  (However, sodium restriction is important for certain populations who are susceptible to fluid retention such as people with kidney, liver, or heart failure.)

Salt in Processed Foods

Why is salt restriction only weakly effective at lowering blood pressure?  Could it be because salt intake is not itself deadly but instead is associated with the intake of something much more sinister?  65% of salt intake comes from processed foods and another 25% comes from eating out at restaurants.  In particular, amongst the top ten foods that contribute the most sodium in the American diet, half come from processed grains such as bread, rolls, pizza, sandwiches, and savory snacks (i.e. chips, popcorn, and pretzels).  Additionally, ready-to-eat cereal ranks in the top ten dietary sources of sodium amongst kids ages two through nineteen.

Because so much of our salt intake comes from eating processed foods, the salty American diet is really just a high processed food diet.  The association between salt intake and blood pressure may not be a causal relationship but instead be related to a third variable--processed grains that are high in glycemic index.  For instance, studies show that diets that are high in glycemic index are associated with elevated blood pressure.  So while salt often gets the blame, the problem may not be the salt itself, but that salt comes packaged with another deadly weapon. 

This is an important distinction to make.  Rather than shun salt, health conscious individuals should shun the processed foods that are high in salt.  Not only is most processed food bad for your kids, but the inherent high salt content makes processed food more palatable so they want to eat more of it.  On top of that, all that salt in processed foods make kids thirsty for sugary beverages like soda, which compounds the problem.   So while salt may not be causing America's health problems, it certainly drives us to eat the processed foods that do cause health problems.  

A Home Chef Worth Their Salt

Distinguishing between salt as the problem versus salty processed foods as the problem is especially important so that home chefs don't develop a fear of using salt in their meals.  Processed food giants inherently know that salt enhances flavor.  By the same token, you can get your kids to eat healthy food that you prepare for them simply by using salt to enhance the flavor of home cooked meals.  If you judiciously use salt to bring out the natural taste of the foods you prepare at home, your kids will be more likely to enjoy real food.  By eating more good stuff and less processed junk, your kids will head down a much healthier path.   

One great way of using salt to flavor food and increase your kid's vegetable intake at the same time is to use vegetable or chicken broth to make a homemade soup.  In the following video, I demonstrate an easy mushroom soup recipe that your kids are sure to crave. 

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The recipe featured in this video can be found at the following link:

Hopefully this post encouraged you to do more home cooking and eat less processed foods so that you and your family will no longer be victims of assault with a deadly weapon! 


1. Intersalt Cooperative Research Group.  Intersalt: an international study of electrolyte excretion and blood pressure: results for 24 hour urinary sodium and potassium excretion.  BMJ 1988;297(6644):319-28. 

2. Tzoulaki I et al.  A nutrient-wide association study on blood pressure.  Circulation 2012;126(21):2456-2464. 


4. Miller JZ et al.   Blood pressure response to dietary sodium restriction in healthy normotensive children.  Am J Clin Nutr 1988;47:113-9.  

5. Gillum RF et al.  Changing sodium intake in children : the Minneapolis children's blood pressure study.  Hypertension 1981:698-703.

6. Sacks FM et al.  Effects on blood pressure of reduced dietary sodium and the dietary approaches to stop hypertension (DASH) diet.  NEJM 2001;344(1):3-10.

7. Cook NR et al.  Long term effects of dietary sodium reduction on cardiovascular disease outcomes: observational follow-up of the trials of hypertension prevention (TOHP).  BMJ 2007:1-8

8. Aburto NJ et al.  Effect of lower sodium intake on health: systematic review and meta-analyses.  BMJ 2013:1-20. 

9. Taylor RS et al.  Reduced dietary salt for the prevention of cardiovascular disease.  Cochrane Database Syst Rev.  2011;(7).

10. Stolarz-Skrzypek K et al.  Fatal and nonfatal outcomes, incidence of hypertension, and blood pressure changes in relation to urinary sodium excretion.  JAMA 2011;305(17): 1777-1785. 

11. Ekinci El et al.  Dietary salt intake and mortality in patients with type 2 diabetes.  Diabetes Care 2011;34(3):703-709. 


13. Vital signs: Food categories contributing the most to sodium consumption -- United States, 2007-2008.  MMWR 2012;61(5): 92-98.

14. Jalal DI et al.  Increased fructose associates with elevated blood pressure.  J Am Soc Nephrol 2010;21 (9): 1543-1549.

15. Gopinath B et al.  Influence of high glycemic index and glycemic load diets on blood pressure during adolescence.  Hypertension 2012;59(6):1272-7.

Sunday, October 13, 2013

How to Cook Healthy Food for Kids : Healthy Spaghetti Recipe

Most people intuitively know that vegetables are healthy.  But sometimes it can be difficult to objectively compare the nutrition value of one food compared to another.  Classifying food based on calories doesn't reflect the content of essential vitamins and minerals in foods.  Dr. Joel Fuhrman, author of Eat For Health and Eat To Live classifies food according to the Aggregate Nutrient Density Index (ANDI) score.  
The ANDI score assigns foods a point value based on their ratio of micronutrients to calories.  ANDI scores range from zero to 1,000, with zero being the least nutrient dense and 1,000 being the most nutrient dense.

For example, kale and other dark green leafy vegetables have ANDI scores of 1,000.  In general, vegetables, fruit, beans, whole grains, and nuts have higher ANDI scores while highly refined sweets have very low ANDI scores.  When it comes to feeding your kids, choosing foods that have higher ANDI scores and cutting out foods with low ANDI scores is a great way of maximizing their nutrition.  In fact, the ANDI scoring system was adopted by Whole Foods Market grocery stores so you can use it the next time you go grocery shopping.

Unfortunately, despite some improvements in labeling to promote healthier eating like ANDI scores, many Americans today still choose foods based on brand recognition and commercial advertising.  Old habits are hard to break.  In the following clip entitled, Bok Choy To The Future, I go back in time to promote healthier eating.

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Somewhat paradoxically, dark green leafy vegetables are the most nutrient dense foods available to kids, but they also the most challenging foods for kids to accept.  One study found that hiding pureed vegetables into foods is an effective strategy to increase vegetables intake in young children.  I used this trick in the above clip to incorporate dark green vegetables into a flavorful spaghetti sauce.  In other words, the secret is in the sauce!  The recipe for this sauce can be found at the following link:


Spill MK et al.  Hiding vegetables to reduce energy density: an effective strategy to increase children's vegetable intake and reduce energy intake.  Am J Clin Nutr 2011;94:735-41. 

Sunday, October 6, 2013

How to Cook Healthy Food for Kids : Frozen Banana Popsicles

Who doesn't like a frozen pop?  They're cool and refreshing treats enjoyed on a hot day.  The problem is that most ice pops are essentially frozen liquid sugar on sticks--even those made from fruit juice.  To read more about the harms of sugar, fruit juices, and sugary beverages, see my other post:

Whole fruits are healthy snacks for kids.  One way you can make fruit even more appealing on a hot day is to freeze it.  Multiple studies have demonstrated that cooking increases the glycemic index of foods.  Alternatively, does freezing lower the glycemic index of foods?

In one study, bread that was eaten after a period of freezing and defrosting caused significantly lower elevations in blood sugar than fresh bread.  The study investigators proposed that freezing induces starch retrogradation which delays the absorption of the starch of the bread.  Starch molecules are like crystals.  Cooking starch at high temperatures is like reaching a melting point that induces gelatinization and disintegration of the crystals.  To read more about this, see my other post:
Alternatively, cooling starch is like reaching a freezing point that enhances the crystallization of starch molecules, resulting in slower digestion and absorption of the starch. 

In the following video, I show you a really easy recipe for frozen bananas that I learned from Kristen Leidelmeijer, the personal chef that works with my patients.  By using whole frozen fruit instead of frozen fruit juice, you can substitute a good carb for a bad carb.  If you dads make this frozen treat for your kids, they are sure to think you are one cool "pop"!

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Burton P & Lightowler HJ.  The impact of freezing and toasting on the glycaemic response of white bread.  Eur J Clin Nutr 2008;62:594-599.

How to Cook Healthy Food for Kids : Make Frozen Banana Popsicles Recipe

Frozen Banana Popsicles

  • popsicle sticks
  • 2 bananas
  • 1/2 cup plain 0% greek yogurt
  • cinnamon to taste
  • chopped almonds or silvered almonds
  1. Line tray with parchment paper. 
  2. Mix the Greek yogurt and cinnamon together.
  3. Peel the bananas.                                              
  4. Cut off an end off from each banana and then insert the popsicle sticks.  (For smaller pops, cut bananas in half)
  5. Coat the bananas in the yogurt and almonds. 
  6. Lay the banana pops on the parchment paper and freeze for 45-55 minutes.  The bananas will be creamy and firm, but not completely frozen.  (You can make these ahead of time, then defrost at room temperature for 10 minutes before serving)    
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