Friday, December 18, 2015

How Smoothies Saved My World (For Awhile...) (Guest Blogger Cathy Franklin)

One of my favorite group sessions to lead was Toddler Nutrition. I’d enter the room to find a half-dozen or so harried mothers busy redirecting their toddlers — “No crayons up the nose Josie!” “Give the baby back her binkie, Marcus!”

I would start, “Have any of you noticed that your child isn’t eating as much as they used to?” Nods.

“Have you noticed that they just want to eat one food over and over?” More nods.

“They loved spaghetti last week, but hate it this week?” They began to look at me as if I was a mind reader.

“They want grilled cheese sandwiches with the crusts cut off, every day, and it has to be on the Mickey Mouse plate or else it goes sailing across the room?” Vigorous nods.

“Congratulations, your kids are normal!”

Eyebrows would perk up and smiles would break out. I recall one mother sighing, “Thank goodness, I just thought she was spoiled!”


Picky-eating and food jags are a normal part of toddler development. It turns out these are normal parts of adolescent development, too. Just as Picasso went through his Blue Period, his Rose Period, and his Crystal Period, I think of my budding teen geniuses as going through theirs. The Coffee Period. The, “I am a Vegetarian but I Still Eat Hamburgers and Sausage Period”. And my favorite, the Smoothie Period.

My kids spend a week every summer with family friends in the San Juan Islands — a retired couple (this is key). When they came back last August my daughter waxed eloquent about the fantastic smoothies they made every morning. She described the organic kale and carrots lovingly grown in their huge garden and the six other fruits and vegetables (of course, organic) that made up this glorious elixir. I briefly considered trying to duplicate the effort, envisioned the daily shopping and clean up routine needed, and gave up the idea within minutes.

On my next shopping trip, I found smoothies in the refrigerated case near the produce section. I bought the one called, “Green Goodness.” It wasn’t organic, yet it had basically everything else. No added sugar. 100% juice. No preservatives. Slightly more than two servings of fruit and vegetables in each delectable serving. Plus this product has spirulina, barley grass, and Nova Scotia Dulse. Take that, retired friends in Bellingham! I bet your smoothies don’t have that stuff! Actually, I’m not sure what that stuff is, but still…

It was a hit! Compared to the time and hassle involved in making it, $6.00 for a bottle with six servings was worth it. I was pleased with myself. A serving or two a day that would provide four servings of fruits and vegetables seemed like good insurance in the teen world of skipping breakfast and lunching on cheese crackers and marshmallows at 3:00 (I kid you not).

However, just like Picasso, my teen genius went into frenzy mode. She was drinking one bottle a day. Ninety-one servings of fruits and vegetables per week. $42 per week = $180 per month for Green Goodness =Yikes!

I had to have a little chat with myself. Wasn’t I happy she was at least drinking Green Goodness for breakfast instead of skipping breakfast entirely? Did I ever think I’d have a chance of getting her to eat this amount of fruits and vegetables versus drinking it? What was she missing by drinking instead of eating? OK, I am a dietitian; I know the answer to that one. But still, isn’t this a good problem? Over-loading on fruits and vegetables?

PB&J - A Classic
I used the excuse of not shopping every day as a way to explain why there wasn’t more Green Goodness in the fridge to feed her addiction. There was some grumbling but like a typical teen other parts of life distracted her. She actually forgot about Green Goodness for a few days, and when she went to pour it, it had separated. I showed her how she could shake the bottle to mix it up again, but nope, that was the end of the Smoothie Period. 

The toasted cheese had sailed.

Tuesday, November 24, 2015

Supporting the One You Love…In the Face of Diabetes (Guest Blogger Cheryl Farmer)

Marriage is a beautiful union shared between two people who love each other. As part of our marriage vows, we said we would love and care for each other in sickness and in health until death do we part. I love my husband and I know that he loves me. Our love has inspired me to share how diabetes affects our personal life.

Being a medical professional helped me understand this chronic condition, diabetes, but it didn’t protect my heart from the emotional heaviness that comes from seeing him struggle to maintain his health. As a doctor, I’ve cared for many people with diabetes. In my practice, I followed a prescribed treatment regimen to support people with diabetes by discussing lifestyle changes and prescribing medications, with lab work every three to six months. It’s different when it’s someone you love.

As my loved one works to control this chronic medical condition, I’m often aware of the adversity, loneliness, sadness, sorrow, and shame he feels. We talk about where these feelings come from and why they exist. He says that he feels that he has somehow failed himself and me, because of his diabetes. He blames himself. I assure him that he has not failed. My words, eyes, and touch express how proud I am of him in his continuous unrelenting pursuit to control and manage this condition. Living with diabetes is work. It requires being aware of what you eat, when you eat, always taking your medicines as prescribed, and daily physical activity to support a healthy weight.



When I’m not at work, my husband and I spend our time near each other, close together. We truly enjoy each other’s company. Every day in the evening, he says he’s going to take his evening meds and walks away — and I can feel his loneliness, sadness, and separation. He shares with me that he leaves because he feels shame. As his partner, I tell him of the emotions and thoughts that are evoked within my heart and mind. Because I know what he’s going through, I now make a conscious effort to be with him, supporting, and touching him when he does his insulin injections. My hope is that my support will help ease his shame and sense of personal failure.


As we work to lift his spirit, it’s important for me to let him know how important his voice is to me. Being aware of his emotional state keeps me alert to his actions, and supports his continued work to manage his disease.

In addition to offering emotional support, I’ve changed my eating and exercise patterns to help him manage his health. As a result of eating more whole fruits and vegetables, increasing our physical activity, sleeping between 6 and 8 hours nightly, reducing our alcohol intake (one drink every two to three weeks), and consistently taking medications, his blood glucose (blood sugar) numbers have reduced significantly. His fasting blood sugar numbers previously ranged from 170 to 230. Now his fasting blood glucose ranges from 60 to 85! We’re excited about his improvements. His doctor has hinted that as he continues to improve, we may be able to reduce his medication doses. We’re encouraged to continue with our work together.

I love my husband and I know he loves me, and I want to spend many more years together with him in good health. It’s important for us to remember that chronic conditions like diabetes can affect us all — directly and indirectly. Let’s use this time in November to remember National Diabetes Month and think about ways that we can support our love ones in their quest to control and manage this disease.

Wednesday, November 18, 2015

Lunch right with every bite (Guest Blogger Cathie Tedrick)

Lunch right with every bite… That was the motto for this year’s National Healthy Lunch Day, celebrated by people across Washington yesterday, November 17th. So, the idea is to eat a nutritious, balanced midday meal every day. Sounds easy enough, right? Not always!

If you’re anything like me, busy lives often make it hard to take the time to make healthy choices. Picking up lunch from some fast food joint that’s just minutes away is just too dang convenient and tempting. But when my waistline started growing and I often found myself with more month left than money, I started thinking I should change my ways.

Then, in mid-July during a routine checkup my doctor told me my blood pressure was high and that she was concerned about my increased weight. Combined with my age and family history of diabetes, she recommended blood tests. When I went back a couple weeks later, my blood pressure was still elevated and the tests showed that my cholesterol was high. But what took my breath away was when the doctor said I had prediabetes. Working in the Department of Health’s Heart Disease, Stroke and Diabetes Prevention Program, I knew full well what that meant. Still, I listened numbly as she talked about lifestyle changes I could make to prevent, or at least slow down the progression of getting type 2 diabetes. She said I’d have to get my weight down, and the best way to do that is:

1: Eat a healthy diet. 2: Increase physical activity.

My body had spoken and it was time to do something!

Not wanting to overwhelm myself by trying to do it all at once, I decided to tackle increasing physical activity. With our amazing summer weather, getting up early and walking my dog three days a week was pretty easy to do. I soon found myself looking forward to getting up every morning to enjoy the peacefulness of the cool morning air. As an extra bonus, my energy level stayed up longer throughout the day. My “doggie alarm” now faithfully goes off every morning around 5:30. In the four months since I increased my walking, I’m down 25 pounds, have dropped three pant sizes, and notice more muscle tone. Yay!

But of course, I cannot attribute my success just to walking. On August 1, I made a commitment to eat healthier. First, I started by cutting out all types of fast food and easy to prepare packaged foods. I resolved to cook everything from scratch and make sure I’d have enough to take leftovers for lunch the next day. It was fun trying new recipes out on my kids and seeing which got thumbs up and which were, “nope!” After a few weeks of getting back into the swing of cooking, I decided it was time to cut down on sugar, and replace highly processed grains like white bread and pasta with whole grains. At the same time, I increased fruits and vegetables at meal and snack time. I’m not gonna lie, it was tough for the first couple weeks, but now it’s a breeze. And even though buying fresh fruits and vegetables can be more expensive than processed foods at the grocery store, I notice that I have a lot more money in my checking account from cutting out the fast food lunches.


MY recipe for success…prepare your healthy food ahead of time!
I love salad, especially when it’s full of a variety of veggies, fruits, and nuts. So, every Sunday I grocery shop and then chop up all my favorites, dividing the salad into six servings – one for dinner that night, and five containers that I can just pull out of the fridge and pop into my lunch bag. I throw-in a low-sugar Greek yogurt, apple, and cheese stick for snacks, and one of my favorite homemade salad dressings, along with a cold pack and away I go! At work I always have some unsalted sesame seeds, almonds and walnuts, no-sugar-added-canned fruit, and canned chicken or tuna to add to my salad, along with some high fiber/low-sodium crackers in case I get the munchies. 

Now you may be thinking…umm, that’s sounds like you’re eating the same thing for lunch every day. And, yes, for the most part I am. But for me, that’s how I’m able to stick to my plan to eat a healthy lunch during the work week. However, I do enjoy shaking it up a little, so I will often add other things to my salad to give it a different flair – such as peppercini’s, kidney beans, avocado, a little shredded cheese, and even grapes! I’ve also become more adventurous when I eat out – ordering the most creatively put together salad on the menu.

The American Diabetes Association’s Healthy Living Resources has great healthy lunch ideas. Let’s use National Healthy Lunch Day to start having “lunch right with every bite” every day.




Wednesday, November 4, 2015

21-Year Diabetiversary (Guest Blogger Sara Eve Sarliker)

Guest Blogger Sara Eve Sarliker shares her story about being diagnosed with type 2 diabetes.

In June 2015, I had what some people might regard as an odd anniversary. It was my 21 year “diabetiversary” – marking 21 years since I was diagnosed with type 2 diabetes. About a year before that diagnosis, I had gone to a family planning clinic in California (Planned Parenthood) to get a prescription for birth control pills since I was a newlywed who had no immediate plans for pregnancy. At the time, I was given an Oral Glucose Tolerance Test, that “fun” test that nearly every pregnant woman remembers not so fondly: rapidly consuming a sickly sweet, cola-like drink and then having blood drawn afterwards. I was told that I had “borderline diabetes,” or in other words, prediabetes. I sat in my car, mad at myself, and unsure what to do next, with little advice other than “lose weight.” So I changed nothing, continued to gain weight, smoke cigarettes, and do little-to-no physical activity.

After another women’s health-related visit I was diagnosed with diabetes in June of 1994, at the age of 25. I burst into tears. The first question to come out of my mouth was, “will I be able to have children?” My health care provider was surprised at my intense reaction to the diagnosis, and reassured me that it was possible for me to manage my diabetes and have a healthy pregnancy, when I was ready. That time didn’t come for another 10 years, when, thanks to a great team of health professionals, healthy eating and physical activity, and frequent, regular blood sugar testing and insulin injections, I gave birth to my kiddo, who was a healthy, full-term, baby just under seven pounds.

 
 
These days, I’m a busy, working, single mom with 20 years of diabetes self-management experience under my belt. I focus on eating plenty of vegetables, and using the savings I anticipate from my Smart Health incentive, tracking my physical activity on my personal wearable activity tracker. Sometimes I wonder what I would have done with the extra time, money, and brain-space I used to address and self-manage diabetes in these past 20 years if I’d been able to prevent or at least delay the onset of type 2 diabetes. I don’t blame myself, or anyone else that has developed type 2 diabetes, and I understand that there’s no known way to prevent or delay type 1 diabetes. But I wonder, if I had been able to participate in a Diabetes Prevention Program back then, would I have more time and resources now? (State Employees and spouses enrolled in PEBB can get more information about Diabetes Prevention Program classes with no out-of-pocket costs).

I encourage anyone who finds out they have prediabetes to look into the Diabetes Prevention Program. Getting screened for diabetes is easy, and in many cases, covered by insurance as part of your preventive health care. And for people like me who work every day to keep blood sugar, blood pressure, and other measures in the ideal range, I encourage you to seek out the help you need – supportive health care providers (including diabetes educators and mental health professionals), friends, mobile apps, walks, cups of hot tea, and deep breathing exercises – whatever keeps you on track and helps you stay afloat. Having diabetes isn’t easy, and it’s yet another twist in life’s winding path. but I have found it is manageable, and I’m able to say that 21 years since I was diagnosed, I’m lucky to not yet have any diabetes-related complications.



Thursday, October 1, 2015

The Plate Unknown

When my daughter was born in 2012, Washington was in the middle of a whooping cough epidemic. (It is on the rise again). A staff person in the baby room at the center my son was attending refused to get her booster shot for whooping cough, so I switched child care providers. All the centers that I called said they couldn’t guarantee that their staff had their shots, so I decided on an in-home child care.

I wasn’t happy about uprooting my son; he was three at the time and not fond of change. In the end, of course, it turned out fine. My daughter, now age three, is still in the same daycare. I love her caretaker, and I know she is well cared for. The rooster greeting me in the morning and the lovely garden are incentives as well.

Home-based childcare programs have different regulations than the larger centers. A huge difference between the two (for Nutrition Mom at least) is that centers are required by state law to post their menus; in-home providers are not. As a result, I have no idea what my daughter eats all day. I know she eats a lot, so it’s not enough of a concern to pursue this. If I asked, my provider would give me a run-down, but I don’t want to add to an already long work day (for either of us!).

Chopping Veggies
Our provider follows national guidelines called the Child and Adult Care Food Program, called CACFP in my work world. Unfortunately, the program hasn’t been updated since the 80’s, so its recommendations are very outdated. And really unfortunately, that’s what child care providers have as their gold standard — the state regulation for centers is based on CACFP guidelines, which are undergoing a revision, and the state law may soon go through a revision as well.

Since one of my team’s priorities is healthy food and drinks at childcare, I give this a lot of thought. We recently worked with Public Health — Seattle & King County and the University of Washington to survey child care providers throughout the state. We got a good response, and the results have given us a good baseline and our first glance at what foods, drinks, and physical activity opportunities kids are exposed to in child care.

So, for now, I chat with our provider about food intake now and again, and make sure we offer her healthy foods she likes at home — whole grain pasta with parmesan, whole wheat tortillas, little tomatoes, small amounts of meat, cooked beets, frozen (yes, frozen) green beans, low sodium noodle soup, and any fruit are on the current list of healthy daughter–approved foods. I won’t go into her “unhealthy” approved foods now; more on that in a future post!


More information: 




Thursday, August 13, 2015

Office Baby (Guest Blogger Marissa VanHoozer)

I was worried when I found out I was going to have my first child. I had relocated to Washington from Hawaii when I left the military and had no family around. I found a great job working for the Washington State Department of Health, and really enjoyed it! The problem was, I had just enough leave saved up to get me through appointments during my pregnancy, and didn’t know what I was going to do after that. The Family and Medical Leave Act (FMLA) entitled me to six months with my son, but without a salary. It was scary. Then, I got the opportunity to pilot the health department’s new Infants at Work policy.

Being a pilot mom for the policy allowed me to spend time with my son, Gavin, continue working to help support my family, and balance work and family without any conflict or guilt. I was a proud new mom, and it didn’t have to keep that pride at home. I saw my son grow (quickly) from a little baby into a little boy, and my coworkers were there to share in all of the fun, amazing, and yes, sometimes gross, moments. I watched him smile for the first time at work. Giggle at someone’s silly face. Crawl. For those moments, I can’t explain enough how grateful I am to the Department of Health team here who saw an opportunity to marry our work to our policies.



This agency does a lot for the families of Washington, and this policy is yet another example of innovation and its desire to help raise healthy families. In addition to piloting this program, I received Environmental Public Health materials that explain healthy fish consumption during my pregnancy and while I was nursing. Child Profile brochures kept me up to date on milestones, gave advice on how to interact with my changing baby, and explained why so much blood was taken out of his little foot for the newborn screening test. Immunization information sent directly to my house helped inform me of those dreaded doctor visits. I also got advice — a lot of advice — from many kind-hearted parents and grandparents who shared their stories with me.

Gavin has had a wonderful start to what I hope is a very happy and healthy life. The work that is done by my coworkers every day is special, and watching it all come together to help me, my son, and my family has been a blessing. We’re grateful to have been a part of this successful pilot, and we hope we can pave the way for more new mothers to benefit from this ideal back to work situation. Gavin is now nine months old (he “retired” from state service at six months) and is now at home with his dad, who just retired after 20 years in the military.

One of the best and most unexpected gifts from the program was the extended family that the agency provided. Now, Gavin isn’t with us in the office every day, yet he has a lot of people who will always care about his welfare, and I will always be thankful for their support. I hope organizations in our community see this for the wonderful opportunity it is and use the lessons we learned to create work environments that provide economic, health, and other benefits, long after babies reach six months of age.

If you are interested in learning more about the program, how it was implemented, or the details of the policy, please feel free to contact me at Marissa.Vanhoozer@doh.wa.gov or 360-545-2945.

Friday, July 24, 2015

Kid on the Run

I was at the convenience store near the school my son attends the other day, and right behind me was the vice principal. We struck up a conversation about my son, and I was very warmed that he knew my kindergartner, and that he helped out with the running club that takes place in gym class. The gym teacher and the vice-principal encourage my son to get those laps in – he’s not very enthusiastic about physical activity if there is no game or chasing as a part of the activity. It’s important for gym classes to keep the kids active instead of conducting lesson plans with the kids being inactive, which is why I was excited to learn about this running club.

Starting at age six, children and adolescents should get 60 minutes or more of physical activity each day. Studies have shown that active kids learn better.



To help kids get enough activity, experts recommend that elementary schools provide 150 minutes of physical education each week, and secondary schools provide 225 minutes per week.  Although our state laws do not meet those guidelines for physical education, a lot of schools may meet and exceed the guidelines on their own. Many schools do great things before, during and after school – as well as in physical education class – to get kids active. Recess before lunch; incorporating physical activity into lesson plans throughout the day; and Safe Routes to School are a few popular ways to help kids get their hour of activity each day. SHAPE America has developed model standards for physical education at each grade level, and Washington is rewriting its standards to help teachers and administrators make it easier for students to meet their activity recommendations.

That’s a lot to keep track of when I’m trying to make sure my son kindergarten graduate gets enough activity. We’re not quite into the 6-17 category covered by 60 minutes-a-day national recommendations, but this summer we will officially be in that category! We better get moving…

For more information:
·         Let’s Move Active Schools
·         Active Living Research
  Office of Superintendent of Public Schools Health and Fitness page

Tuesday, May 26, 2015

To Amy: Thanks! Love, Your Body and Mind

I don’t like working out. I do it anyway because my body and mind thank me afterward. Like a lot of other busy people, my ability to get much-needed physical activity outside of work hours is not ideal. Maybe because I have an older kid who isn’t stroller-bound, or maybe because there are now two of them, my evening neighborhood walks have dropped-off a lot in the last few years. And time seems to go on fast forward in the 30-45 minutes between the end of dinner and the start of bedtime rituals.

So, I thank my lucky stars that my work environment supports physical activity. My boss is super supportive of walking meetings. We have an empty room with a DVD player, some yoga mats, weights, and workout DVDs. The room has the list of exercises for the 7 minute workout – sometimes I just do that two or three times in a row and get pretty sweaty doing so. We even have some classes starting. My supervisor supports employees to flex our schedules to have time for physical activity. We have showers and locker rooms in our buildings, and bike racks for bike commuting. Our stairwells have music and are well-lit. Senior leaders send supportive messages to staff, encouraging physical activity. The state government wellness initiative worked with insurance carriers to give employees a discount in our deductible if we take part in a web-based program that individuals can tailor to their health needs.


Workout room- nothing fancy, but it as everything I need!

Between running around with the kids and a walk or workout for 25-30 minutes per day, I actually think I get the recommended 2 ½ hours of moderate physical activity or 1 ¼ hour vigorous level each week because of all this support. I can accomplish this on most, but not all weeks — the downside of counting on doing this at work is that sometimes I’m just too busy. On those weeks I participate with the kids in the evening doing gymnastics shows, tag, dancing, running around outside, or Simon says. I’ve had dreams of creating a seven minute workout that parents can do with kids…they make great weights until about age two.

When I first started here 10 years ago, none of this existed — and I didn’t need it because I had time to go the gym or walk after work (I didn’t like going to the gym, either, but I did it anyway). At that time, I didn’t understand the potential impact of worksite wellness on physical activity, especially for those with limited time due to a long commute, family duties, or a multitude of other reasons. This hasn’t happened overnight — it’s taken a lot of effort by internal wellness teams to create policies, and support from employees and leadership to develop a culture that accepts and even encourages us to be active at work.

For more information on physical activity and worksite wellness, check out these links:

Thursday, May 14, 2015

Concert Clothes (By Cathy)

My son has been waiting for his growth spurt since first grade. That’s when he realized  he was smaller than other boys his age. He was diagnosed with delayed bone growth at age three. The doctor confirmed that yep, he stopped growing for a while, and his wrist bone X-ray showed a two year delay. There’s nothing to worry about, he’ll just be small throughout childhood. He would be one of those kids who would suddenly amaze everyone with a growth spurt, but it will be later than his friends.

Among the many joys of having a string duet in the household (daughter on cello, son on viola) is that every couple of months they have to dress-up in concert clothes, totally transforming them from their day-to-day look. I get to take a few pictures, which usually involve them mugging for the camera, but they look spiffy even so. Since they started playing instruments in fifth grade and I’ve been taking pictures of the concert clothes, I have a nice montage of the two of them growing, always with big sister a good 10 inches taller than little brother, even though they’re only 13 months apart.

December 2013 – we’re heading out to their 6:30 start time for the 7:00 concert. My girl is in the car, saying we’ll take the concert picture after, because we’re going to be late, late, late! (She hates being late, but only if it is someone else’s fault). I’m waiting, tidying-up the kitchen, waiting. And waiting. Finally, I go to my son’s room. “What’s up honey? We need to go” says I. “I can’t go. I can’t get these pants on.” He’s struggling to button-up and close the zipper. I start to help, and soon his sister joins us. The three of us pull and push as he jumps up and down and holds his breath. Finally we get him buttoned and zipped in. I see two inches of bare leg between the pants leg and his shoes. I bade him put on long black socks and we’re off. I wonder if the zipper and seams will hold for the entire concert, but he’s unconcerned, although he looks a little uncomfortable. I make a mental note for next time to have him try on the concert clothes before the night of the concert.

Spring, 2014 – the new size 12 concert clothes I buy the weekend before fit perfectly, which is a happy thing since he just turned 13. Up to now he’s been two sizes below his age (that is, he wore size six when he was eight, and so on). As he emerges from his room with his new finery and goes to put on his shoes, he stops. “I can’t go. My shoes don’t fit.” Concert shoes have to be regular shoes, and he never uses them except for concerts. He puts on his tennis shoes and says he’ll put the concert shoes on when we get there. He hands me his tennis shoes when we get in the gym, then proceeds to walk around on his toes, his heels not in the shoes. He looks like he is walking in high heels, but I don’t tell him that. Finally right before the concert starts he crams his feet in the concert shoes. He complains for the next week about his sore feet.

Fall 2014 – OK, buy new shoes. The weekend before the concert I have him try on the size 12 concert clothes that fit so well four months ago. His 45 minutes of PE and 120 minutes of after school soccer every day for three months have resulted in the pants now being too big. I remedy that with a belt I buy the next day. I think I have this under pretty good control. When I line them up to take the concert photo that night I realize he’s now up to his sister’s chin. Sister’s growth spurt has come and gone, and she has settled in nicely around 5 foot 3. They eye each other suspiciously, and then she says, “I think you’re going to be taller than me by the next concert.” He grins, really big. I take the picture.

Thursday, April 2, 2015

Chocolaty Conundrum


My son started kindergarten in September. After his first week at school, he very sweetly said, “Mom, can you please pack me a drink?” I had completely forgotten about a drink in his cool new lunchbox! Rookie move, Mom. This conversation resulted in a dash to the store to find shelf-stable, non-flavored, low-fat milk that he could take with him. Nope. I could only find chocolate milk in single servings, and even if I found white milk it would be much too expensive to pack on a regular basis. So, I asked a friend what she does. She packs a small re-usable water bottle, which I heartily adopted as my own practice.

When I asked my son what he had been drinking during the “big lapse,” he said his wonderful teacher had bought him milk for a few days. He had chosen chocolate (of course!). I promise – I did not extol him on the virtues of white milk. But we did talk a little – just about 30 seconds –about how chocolate milk is a treat.

Here was what was going through my head during our chat. Milk provides a lot of nutrients that kids need – namely calcium, vitamin D, potassium and protein. But one cup of low-fat chocolate milk has more calories (190 versus 110 calories), and sugar (31 g versus 12 g) than low-fat white milk. For reference, one cup of soda has 95 calories and 26 grams of sugar. So it is not really about the chocolate, it is about the added sugar. It is about setting him up to make healthy choices. How do I encourage him to buy milk at school and give him freedom of choice knowing he’ll most likely choose chocolate milk?

National nutrition guidelines for all foods and drinks in schools that take part in the USDA School Foods Program allow schools to offer chocolate milk. Years ago, before these national guidelines, I worked on a set of model nutrition guidelines for schools in Washington. I remember many conversations about whether or not chocolate milk should be allowed.

One side of the debate says that schools should offer flavored milk because kids are more likely to drink milk if flavored milk is offered. Removing flavored milk from schools may decrease kids’ intake of those key nutrients (protein, calcium, vitamin D, potassium).

Another perspective is that schools should adopt wellness policies that restrict flavored milk, and kids will simply buy non-flavored milk. Still another view taking hold in recent years is that, rather than banning chocolate milk, schools should use a behavioral economics strategy to increase the likelihood that kids will choose white milk. For example, make white milk appear more convenient and normal by making sure at least half of the milk cartons in the cooler are white milk, and put the white milk at the front of the cooler.

Ideally, school would make this a non-issue for us, or industry would offer a lower sugar product, but in reality, here’s where I land: most mornings, I ask if he wants water or if he’s going to buy milk. If he says milk, I can tell by his tone if he means chocolate (there is a smile in there), but I ask anyway. If it is chocolate, I don’t pack cookies or yogurt, and he knows the chocolate milk is the treat in his lunch.

Given the recent flood of treats on Valentine’s Day and St. Patrick’s Day, I have a feeling this is just the beginning of food and drink conundrums at school!


Resources: 



Monday, February 23, 2015

Peer Pressure (Cathy)

“Wow Mom, you would have been so proud of me today!” My 14 year old daughter bounds up to me outside her school. These are words that give a mother pause. I’ve learned to rein-in my reaction before jumping to conclusions — positive or negative. I smile and paste an attentive look on my face. She continues, “I was hanging out with my friends at lunch time at the store next door (me — hmm), and they were putting a lot of pressure on me to try this particular drink (me — double hmm). I told them no, but they kept pushing me.” She continues in a mocking, sing-song, snide voice, “Just try it, a little sip won’t hurt. What are you so worried about?”

Now my mind is racing as I continue to tamper down any reaction. I would hope the store wouldn’t sell alcohol to 14 year olds, but maybe not all of her friends are actually 14. What if they have fake ID? She continues, “I told them no, even a small sip of that stuff would send me into a tailspin, and I even had to go to the hospital once because of it.”

I stop. The only time she went to the hospital was the day she had a panic attack in the movie theater. My girl had leaned over to me that day in the theater and whispered, “Mom, I can’t breathe.” I dragged my eyes away from the big screen where the vampires were ripping off each other’s heads and peered at her. She was pale and sweating. I could hear her rapid breathing. I coached her to breathe deeply and asked if the movie scared her; she looked at me like I was nuts. We went to the lobby, where she seemed to calm down, but I decided to get her to the emergency room anyway. By the time we got to there she seemed perfectly normal again, even somewhat cheerful. They checked her pulse, temperature and so on, and asked a few questions including, “Did you have any caffeine, like in coffee or an energy drink?”

“No,” I said firmly. “My kids don’t get that stuff.”

Wait. There was the large diet cola we bought at the theatre, of which my daughter had imbibed the lion’s share. At home when we have soda, its caffeine free, but the theater doesn’t have that. Dang.

Back to the matter at hand. I ask, “What was it your friends were trying to get you to drink?”

An energy drink and I didn’t do it.”

“Good for you honey, I am proud of you.”

“I told them how sensitive I am to caffeine, but they wouldn’t let up, so I finally just walked away.”

I watch her dash back to her gaggle of friends. They look like cookie cutter versions of each other with their black skinny jeans, bracelets from wrist to elbow, flowing hair with bangs, tee shirts with logos and pictures of their favorite bands.

She may not be immune to peer pressure, but I’ll take what I can get.

More information on peer pressure: 

Monday, January 12, 2015

Introducing Cathy the Brave

Believe it or not, sometimes my brain gets overtaxed with work duties and home life, leaving me with very little time or creative energy to write articles for Adventures in Health. That’s why there’s been a three month hiatus since the last entry. Thankfully, my friend and colleague Cathy Franklin has offered to step in with some guest blogs. Cathy is a Registered Dietitian who serves as the nutrition coordinator of the Women, Infants, and Children (WIC) program at the state Department of Health. She’s smart and funny, and she is very brave – raising two teens as a single mom. Her perspective will add a new dimension to Adventures in Health. I’m looking forward to taking a leap in time to see what’s in store for me in (gulp) seven short years. And I’ll be back soon; meanwhile, please welcome Cathy.

The Older Your Children Get... (by Cathy)

As the mother of a 13 year old boy and 14 year old girl I have discussions about teen health — and see them in action — daily at our house. And as a dietitian at the state Department of Health and long-time advisor/advocate on maternal and child health, I’m continually surprised how the things I do and the things I know intersect — or not. More to the point, it’s surprising what my kids do, and of course, they know everything, so that’s not in question.

I enjoy reading the blog of my friend and colleague Amy. It’s fun remembering the challenges of having young kids — the chaotic trips to the grocery store, the decisions about what to offer the kids to eat in hopes they won’t just chuck it in the floor. Those memories make it a delightful opportunity to post on Amy’s blog.

There are remarkable similarities between parenting a four year old and a 14 year old. Those four years, between 0 and 4 years and the time from 10 to age 14 are a time of similar incredible brain growth. Think about the difference between what a newborn can do and what a four year old can do. Now apply that metamorphosis to the 10 year old. It’s a similar amount of brain growth, but in different parts of the brain. Between 10 and 14 they go way beyond being able to talk, they can tell you what they think of your bright ideas. They can no longer be wrestled into their winter coats, but must be carefully negotiated with to take their sweatshirts when the temperature dips below 40 degrees. (Nope).

Another reason I look forward to posting on Amy’s blog is to get things out of my mind where they tend to revolve like hamsters on the wheel at 3 a.m. Did I really think my daughter would spend the money I gave her for lunch on lunch? Did I really believe my son would think twice before leaving his wet soccer clothes in his backpack for four days? And where could the bag of oranges have ended up? (In the freezer – small mis-communication during the grocery unloading swirl).

I look forward to posting on Amy’s blog. It’s cheaper than therapy.