TAKEAWAY
I will give you a quote from Michael Pollen, who has written many books on food and the food industry: “Eat real food, mostly plants, and not too much.”
CHAPTER 6
focus foods: fats, fiber, and protein
IN OUR SOCIETY, MANY of our children are overfed yet undernourished. Diets high in simple carbs, dairy, and meats leave little room for the healthy foods I prefer your children eat. The nutrient-rich foods we are talking about in this chapter include vegetables, seeds, nuts, and beans, along with fats, fiber, and protein options aplenty.
In chapter 5, I asked you to eliminate a myriad of tasty, sugary foods with the promise that I’d provide you with plenty of alternatives. Little by little, your child’s taste buds will begin to enjoy different foods. (You’ll find some of my favorite kid-friendly recipes in section III.)
What’s that I hear you saying? Your child is a picky eater who will never try new foods? Cassie’s case will inspire you to give the HKHM program your best effort.
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CASE STUDY
CASSIE
SYMPTOMS: ECZEMA AND A PICKY EATER
Cassie was about two-and-a-half years old when her mom first brought her to see me. Cassie was this super-bright, mischievous girl with a huge smile, light brown hair, pale skin, and profound dark circles under her eyes. She also had significant eczema and constipation and was an extremely picky eater.
Her parents had already figured out she was allergic to milk before coming to see me, so she wasn’t drinking cow’s milk. Instead she was drinking thirty-two ounces of soy milk daily. When she originally went off the cow’s milk, months before they came to see me, her eczema improved but didn’t fully resolve. She’d had skin prick testing for environmental allergens and was allergic to cats, dogs, dust mites, and pigweed and was such an extremely picky eater (she only ate about seven or eight foods) and had so many food allergies (here is her list: egg whites, almonds, Brazil nuts, cashews, coconut, hazelnut, peanuts, pecans, pistachios, and walnuts) that the GI doctor did an endoscopy on her to be sure she didn’t have something called eosinophilic esophagitis (EE), an allergic condition of the esophagus, an ulcer, or celiac disease. She did not have any of those, and despite the limited foods she would eat, she continued to grow and gain weight beautifully.
Fortunately, Cassie stayed on her growth curve each year at her pediatric well visits, and I think she was likely sustained by the volume and calories she was getting from the soy milk. I mention this here because if your child is underweight or losing weight, this program is not the right fit for you at this time. You don’t want to decrease their calorie intake unless they are being closely monitored by your child’s doctor and possibly a feeding therapist or a registered dietician.
Before making any changes with Cassie, I did some lab work and started her on the foundational supplements. The bloodwork was to look for nutrient deficiencies. Her hemoglobin was normal, so she was not anemic, but her iron stores (as measured by a ferritin) and iron saturation were quite low. Therefore we could deduce that she was not eating an adequate amount of iron and that her body was not absorbing what she was eating efficiently.
We also looked at her zinc; magnesium; copper; vitamins D, B12, and B6; as well as her blood counts. Her zinc was surprisingly normal given the fact that zinc levels tend to be lower with ‘picky eaters.’ I did not start iron with her at this time because we needed to first decrease the inflammation in her gut and begin to optimize digestion with the foundational supplements (probiotic, digestive enzymes, omega-3 fats, a whole foods supplement, and vitamin D). Otherwise, she likely would not absorb the iron from the supplement well either.
Cassie began to have small improvements with the supplements, but I knew we needed to get her off the soy milk. I suspected that was also part of her systemic inflammation and might be part of what was still triggering her eczema. I also wanted her to begin eating more nutrient-rich foods instead of drinking so many calories through a plant-based beverage.
Over the next several months, Cassie’s mom was able to wean her completely to water plus eight to ten ounces per day of some of other plant-based beverages. Cassie still was not eating a whole lot of fresh foods; she subsisted on packaged snack foods that were mainly carbs and the omega-6 vegetable fats. The inflammatory/sick cycle was not going to be broken until we could get her ingesting (through food and supplements) more omega-3 fats, vitamins, and minerals. As we decreased her calories from the soy milk, her appetite picked up slightly because she was starting to feel hunger cues. It’s another disco ball moment when the gut-brain connection wakes up. The gut-brain wakeup happens as cellular health improves. The wakeup is when your picky eater says they’re hungry and will actually eat something besides their go-to packaged snack.
cow’s milk vs. soy beverage (soy milk)
A high percentage of kids who are allergic or sensitive to cow’s milk may also be sensitive to soy (at least initially when their systems are so inflamed). I learned this the hard way, unfortunately. When I first started working with families to remove cow’s milk from their children’s diets, we would invariably switch kids from cow’s milk to a soy beverage. Then six weeks later, the kids would come back to the office with diarrhea, irritability, or a different type of rash. For this reason, when I remove dairy from kids’ diets, we don’t replace twenty-four ounces of cow’s milk with twenty-four ounces of soy beverage (or another type of non-dairy milk). Rather, we switch them to water if possible, and then, if the child loves drinking milk, they can drink eight to ten ounces per day of a non-dairy plant-based beverage (such as hemp, coconut, oat, or tree nut).
Timing is key. You can’t force the timing of this wakeup. We let the supplements do the work at first (primarily the probiotics and digestive enzyme) so the child feels better, in part because their bowels are working better. The gradual decrease in soy milk allows us to decrease calories safely and without too much emotional stress that you might feel when taking away a primary food source from your child. Using this method gives everyone ample time to figure out what the kids will eat.
When Cassie had a slightly better appetite, we partnered the family with Haynes, the health coach in our practice. Haynes met Cassie and her mother at the farmer’s market and talked through different ways to start inspiring Cassie to try some new foods. Haynes went over some of the recipes in section III (many of which Haynes contributed!).
I got a message later that day that Cassie sat down and ate almost an entire tray of baked kale. She had never touched anything like that before: it was one step on a journey to getting her to eat nutrients so she would be able to supply her cells with what they needed instead of having to rely so heavily on the supplements. She continued to eat more and more foods and mom learned new ways to encourage Cassie to eat more vegetables and high-fiber foods. If we had pushed the vegetables on Cassie too soon, her system might not have accepted them so readily.
Once Cassie was fully off the soy milk, the eczema on her body cleared. However, despite being on great supplements and improving nutrition, she continued to have an area just around her mouth that would flare up several times a month. And during the rest of the month, she just had small pinkish papules scattered around her mouth. We eventually figured out they had some previous water damage in their home and mold had grown in that area. Once we realized that, the parents brought in a certified mold expert who tested the mold first and then had a different company, also mold-certified, do the remediation. Once that was complete, the flares around her mouth resolved, as did several of mom’s health issues. We were able to pull Cassie off most of her supplements other than the foundational ones and she continues to do great to this day! No further eczema, peri-oral mouth rash, or constipation, and she is a much more adventurous eater—no sushi and caviar, but she eats more veggies! (See the appendix and my website for further information if you suspect any water damage or mold in your home.)
CASSIE’S CUP OF INFLAMMA
TION
HEALTHY FATS, HEALTHY KIDS
Cassie is a good example of a child who was not eating many of the right fats initially, so her cell walls were not as healthy as they could have been. If our cell walls do not contain the right balance of fats (enough omega-3 fats), it is much more difficult to get our skin and guts into balance because they depend upon the health of each of the individual cells. This brings me to discuss a much-maligned food group: fats.
When the processed food industry talks to us about fats, they bury us under a deluge of words like saturated/unsaturated and even monosaturated and polyunsaturated. It’s not as complicated as we’ve been led to believe. When talking about fats, we need to talk about the balance of fats in our diets. The standard American diet is heavy in omega-6 and -9 fats and low in omega-3 fats.
Foods rich in omega-3 fats are never marketed to children. It’s a short list, and your kids probably don’t eat many of these foods regularly.
OMEGA-3 FOODS
Coldwater fish: salmon, mackerel, herring, trout, char, sockeye, sardines
Flaxseeds, flax oil
Chia seeds
Hemp seeds
Walnuts
Almonds
Berries: blackberries, blueberries, strawberries
Brussels sprouts and other green leafy vegetables
Eggs (free range)
Grass-fed beef, lamb, and wild game such as venison
Some of these foods contain both omega-3 and omega-6 fats.
While fats have gotten a bad rap, they’re extremely important for all of us, especially the developing brain of a baby, both in utero and after birth. Every cell in our body has a fat layer called a phospholipid bilayer, and many of the health issues I see in kids, from eczema to asthma, are related in part to a lack of healthy fats in the child’s diet.1
Because fats make up our cell walls, they are responsible for proper cellular integrity so nutrients can move in and out of the cells fluidly.2 Healthy cell walls also facilitate cell-to-cell signaling, directly or indirectly through neurotransmitters, hormones, and even medications. Cell signal transmission is critical for almost every system of our body, from our nervous system, doing math homework and being able to calm ourselves down, to sending hormonal messages (going through puberty, muscle growth), to our beating heart cells and our immune system.
To better understand cell-to-cell signaling, think about your internet connection: when there is a storm, your internet connection is not as good because the signal gets dampened by the weather. It is the same in the body: If we have too much inflammation, the chemical signals have to wade through excess body inflammation and we don’t get great signal transmission.
Improving the makeup of the cell walls happens over time. In our practice we affectionately refer to this shift as an oil change for the kids’ cell walls. It can be a slow process, but if we stick with it, we see the long-lasting results. For Cassie, she was eating fats but too many of the wrong type of fats from the abundant omega-6 vegetable oils in the packaged snack foods. I see this in most of my little patients. Today’s kids eat so many of these processed foods that it leaves little room in their diet for the good stuff. But have no fear, as you go through the Mini Cleanse, it will open up an enjoyable path in your child’s daily intake for more of the beneficial fats.
healthy fats and ADHD
If you have healthy cells with the correct omega-6 to omega-3 ratio and need to be on any medication—from steroids, to antibiotics, to anti-anxiety meds, or stimulants for ADHD—the medication will likely be able to do its job more easily, at the lowest dose possible, with the fewest side effects.3,4
I’m not going to spend a lot of time discussing attention issues in this book, but perhaps you see the connection I’m making among healthy fats, healthy brains, and a child’s capacity to calm down and to focus. I recommend omega-3 fat supplements for most of the children in my practice who are on stimulant medication for attention deficit and hyperactivity disorder to optimize their ratio of omega-6 to omega-3 fats.
Has your child ever had to go on an antibiotic for an ear infection, and it didn’t clear up on the first round of medicine? And you subsequently had to go back to the pediatrician and get one, maybe two or more rounds of more potent antibiotics? This may be due to antibiotic-resistant bacteria, but if your child’s cells have the correct balance of fats (with enough omega-3 fats) and minimal systemic inflammation, her immune system may be better equipped to clear the infection.
Understanding cellular health and inflammation in this way, consider how you might begin to change the course of your child’s health and immune system. Eating a balanced diet will allow her immune system to work like the beautiful and complex orchestra that it is. The medication then doesn’t have to wade through all that inflammation to get the job done. Imagine that if your child’s immune system is so effective and efficient because of adequate fats and the other nutrients we’ll review in this book, she wouldn’t even succumb to the ear infection in the first place. Isn’t that an exciting prospect?
SPECIAL FAT CONSIDERATIONS FOR CHILDREN WITH ASTHMA
As I write about the role that healthy fats play in reversing the inflammatory cascade, I see the sweet faces of children I have seen over the years with significant asthma and dark circles under their eyes. Their systems at baseline have a genetic predisposition to overreact to invaders (viruses, secondhand smoke, allergens, or whatever their individual asthma triggers are). When you add processed foods and lots of inflammatory fats on top of these triggers, the dangerous combination results in frequent asthma attacks that require higher and higher doses of steroids to bring them under control, and subsequently higher doses of daily inhaler medications to hold their excessive baseline inflammation at bay.
Many kids who have stuck to the HKHM program have gone from frequent asthma attacks, frequent oral steroid courses needed—and even frequent hospitalizations—to enjoying months without ever having to use their rescue inhalers while we gradually decrease the amount of daily inhaled steroid they needed in order to keep their inflammation at bay. We wean them from their medications slowly, safely, and in conjunction with their pulmonologist or allergist. Altering your child’s asthma medications is absolutely not something to do on your own.
The cup of inflammation for a child with asthma is quite full. The inhaled or oral steroids keep the inflammation at bay, but they don’t actually decrease the cup of inflammation, which is why these medications are needed on a daily basis. A child who is no longer living in fear of an asthma attack around every corner, and whose body has minimal inflammation, is a different child from the one requiring a rescue inhaler several times a week. I use the integrative approach by using medications to hold inflammation at bay, while we decrease the child’s systemic inflammation using food and supplements. In time, dark circles under the eyes improve, eczema improves, the steroid bloat resolves, and their coloring is better.
The intangible shifts are actually the ones that I think about as I write this. When a child has an asthma attack, it is like going from breathing through a big fat straw to breathing out of a cocktail straw in a matter of minutes. The gift of working with these children and their families through their illness is beyond any professional satisfaction I could have ever imagined.
GET FIBER FROM PLANT-BASED FOODS
Fats require strong digestion to break them down into their component parts so that they may be repurposed into the many critical functions I listed above. Fiber will help rebuild the body’s digestive power and is a key component to gut health.
Fiber is classified into two types, soluble and insoluble. Both are vital. Fiber lowers cholesterol, manages blood sugar, keeps the bowels regular and, best of all, it ferments in the colon and provides prebiotics—food for the healthy bacteria in the gut. As a culture, we have gotten so far off this beaten path that we resort to giving ourselves and our children fiber supplements. There is a better way.
a word about fiber supplements
Please pay special attention here if your child is constipated, and your pediatrician or GI doctor has prescribed a popular fiber supplement that is marketed for constipation and GI issues in children. It contains 3 grams of dietary fiber and 3 grams of soluble fiber in two teaspoons. This is slightly less than what you’d get in two teaspoons of chia seeds, which would be closer to 3.5 grams of fiber. For many of my patients who have been suffering from long-term constipation, we gradually wean them off of fiber supplements and add natural fiber, from foods like the ones we’re discussing—especially chia seeds since they’re a fiber powerhouse.
Soluble fiber dissolves in water and turns into a gelatinous substance, which slows the transit time of our digestion. This makes us feel full longer and slows the absorption of sugar into our bloodstream, which is particularly helpful for anyone with diabetes. Soluble fiber is found in vegetables, fruits, and legumes, such as beans, lentils, and chickpeas.
Insoluble fiber doesn’t dissolve in water. It adds bulk to the stool and helps it move through the colon. Insoluble fiber is found in dark leafy green vegetables, green beans, celery, and carrots.
Many foods contain both soluble and insoluble fiber, especially fruits, vegetables, and seeds. Here are some of my favorite ways for kids to get fiber in their diets:
VEGETABLES FRUITS SEEDS NUTS LEGUMES
Asparagus
Broccoli
Brussels
sprouts
Cauliflower
Eggplant
Onion
Sweet potato
Sugar beets
Turnips Apples
Avocado
Berries
Grapefruit
Oranges
Pears
Prunes Chia
Flaxseed
Healthy Kids, Happy Moms Page 9