Hemp
Psyllium seed
husk Almonds Beans
Lentils
Peas
Our gut bacteria need plants! They provide the food for these microscopic creatures.5 Fiber also increases species diversity, which is protective of the gut and leads to a more resilient immune system and lessens inflammation that can contribute to chronic illness.6 People with the healthiest, most diverse microbiomes consume thirty or more different types of plants each week.7 Don’t worry, we will take this one step at a time!
LET’S MAKE FRUITS AND VEGETABLES YOUR PRIMARY SOURCE OF FIBER
How exciting is this . . . both fruits and vegetables are full of vitamins, minerals, and fiber. They also contain phytonutrients, which are only found in plants. Phytonutrients are the powerful anti-inflammatory and antioxidants in foods such as blueberries and dark leafy greens.
Plants have natural pigments called flavonoids that give them their color. Flavonoids are also antioxidants that play important roles in DNA protection, cellular repair, liver function, brain and eye health, decreasing inflammation, and preventing chronic conditions such as asthma (in kids), heart disease, cancer, obesity, and possibly diabetes.8
a word about legumes
Legumes (beans, lentils, and peas) can be a great source of fiber. However, they may cause gas and bloating until the GI system is in a better place. There are ways to prepare legumes (soaking them for several hours or overnight, then rinsing them before you cook them) which make them somewhat easier to digest. If you do well with things like lentils, black and red beans, mung beans, chickpeas, green peas, and lima beans, by all means incorporate these into your diet and enjoy the many GI benefits of high-fiber foods.
Generally speaking, the darker the plant, the higher the antioxidant concentration. This means that the more colorful your child’s plate, the better. Most kids will eat more fruit than vegetables because they taste sweet. A great number of the patients I see on their first visits are eating only one, possibly two vegetable servings per day; sadly, some eat none at all. The recipes in section III, especially those for smoothies, will help you get a strong start.
Adding vegetables to the diet can be gradual. I don’t want anything in this book to make you feel guilty or ashamed about the state of your child’s health right now. We’re all doing the best we can at every moment in our lives. Each time you open your mouth to eat is the opportunity for a new start.
PROTEIN
Proteins are an essential food group that serve as structural support for almost all of our systems. They make up our organs, blood vessels, muscles, bones, nails, and hair; they support the immune system and nervous system; and they facilitate the communication between all of our cells that make hormones and neurotransmitters (meaning they help with our moods, focus, the ability to fall asleep and stay asleep, and the ability to pay attention in school).
We need strong digestion to break proteins down into their basic building blocks, amino acids, so that they can be absorbed into the bloodstream. Once absorbed, amino acids are repackaged and used to make all the things I just listed above.
We often make the subject of protein a lot more complicated than it needs to be. An integrative cardiologist and friend says, “The important thing to keep in mind about protein and fat is understanding the company they keep.” Let’s unpack that by looking at animal proteins and fats. If animals are exposed to antibiotics and other chemicals, including fertilizers, those chemicals are absorbed by the animals and stored in their fat tissue. We can also expect the food the animals eat to impact their muscle and fat tissue. Those of you who eat wild game, such as venison, are eating meat that grazes on grass and has a higher omega-3 content. This is also why I would prefer your kids eat grass-fed beef, if you eat meat in your family. In general, it is ideal to buy meat from a local farmer or farmer’s market, where you can talk to the farmer about how they grow their produce and feed their animals, or from a grocery store that carries organic beef, lamb, pork, chicken, and free-range eggs.9,10
Something we tend to forget is that we also get protein from foods other than meat. In many countries meat is only eaten a few times a week, or on special occasions. When they do eat meat, it is often from animals raised in a more natural setting.
Now, let’s look at some plant-based protein options. These foods will retain whatever nutrients were in the soil where they were grown.
START ADDING PLANT-BASED PROTEINS
Some plant-based protein options include quinoa, soy (if your child tolerates soy), hemp, and chia seeds. One great meal example that is filling, delicious, and satisfying is the combination of rice and beans. Add a slice of avocado, chopped pepper, spinach, and herbs, and you have a great meal with protein, fat, and added vitamins from the vegetables and fruit. (Yes, avocado is a fruit!)
People frequently ask me about giving kids protein powder. I’m not a huge fan of processed protein powders for kids. Some select companies make quality protein powders, but as of the this writing, I’m still on the lookout for one that I love and enjoy the taste of. I’d much rather you put chia, hemp, or flaxseed into your child’s smoothies. Two tablespoons of hemp seeds have 10 grams of protein, which is perfect for a protein boost in a yummy morning smoothie. Also, one ounce of pumpkin seeds has 5 grams of protein, not to mention a great deal of magnesium. See if you can make up your own protein drink, au naturel.
Given the fact that many children who have a sensitivity to dairy may also have a sensitivity to soy, when I begin walking parents through eliminating dairy from a child’s diet for three weeks, we limit soy at the same time. We don’t do a strict elimination, we just don’t replace all the dairy they were consuming with a bunch of soy products. We do this until the child’s symptoms have improved significantly. If the family wants to make fermented soy and edamame a part of the diet, we add it back in and monitor for symptoms.
A NATURAL WAY TO GET OMEGA-3 FATS, FIBER, AND PROTEIN ALL IN ONE
I will wax poetic here about chia, hemp, and flaxseed because I love them for so many reasons. When my patients eat these seeds, I’m assured that they’re getting fiber, protein, and omega-3 fats.
Flaxseeds have almost 5,000 mg of omega-3 fats per 3 tablespoons (1 ounce); they’re also high in fiber (8 grams per tablespoon), protein (5 grams per tablespoon), and calcium (71 mg per tablespoon).
Chia seeds have almost 5,000 mg of omega-3 fats, 11 grams of fiber, 4 grams of protein, and 177 mg of calcium per 3 tablespoons. They also contain several other minerals: phosphorus, potassium, zinc, copper, and magnesium.
Hemp seeds contain a balanced ratio of omega-6 to omega-3 and omega-9 fats. Three tablespoons contain about 5 grams of fiber and 10 grams of protein. Like chia seeds, hemp seeds contain other minerals and vitamins, including iron, potassium, zinc, magnesium, and vitamin A.
CHIA SEEDS PER OUNCE FLAXSEEDS PER OUNCE HEMP SEEDS PER OUNCE BEEF, GRASS-FED, 3 OUNCES BEEF, GRAIN-FED, 3 OUNCES
Calories 137 150 162 213 213
Omega-3 4.9 g 6.4 g 2.8 g 0.03 g 0.2 g
Omega-6 1.6 g 1.7 g 7 g 0.23 g 0.3 g
Protein 4 g 5 g 10.3 g 21 g 21 g
Fiber 11 g 8 g 3 g 0 g 0 g
Calcium 177 mg 71.4 mg 38.9 mg ~10 mg ~10 mg
TAKEAWAYS
We’ve made healthy eating more complicated than it needs to be. If we’re eating foods grown from the earth or picked from a tree, or animals that live and eat in their natural setting, we’ll make giant strides toward improving health.
A good rule of thumb is this: eat close to the source. Pick fresh produce, nuts and seeds, eggs, and healthy meats, and cook them at home. Make cooking a fun family occasion. If you engage the kids and get them to help, they might eat healthier foods far more readily than you anticipate!
Real food doesn’t have an ingredient list!
CHAPTER 7
rethinking dairy: science vs. marketing
IF YOU HAD TOLD me fifteen years ago that removing dairy from some children’s diets could elimin
ate or significantly improve many of the common pediatric issues I was seeing on a daily basis, I would have told you that you were crazy. But I saw child after child improving after we removed dairy from their diet. I couldn’t deny what I was seeing, but I thought it must be a coincidence, otherwise surely somebody would have taught me about this during my medical training, right?
On top of my never having heard of any dairy connection with illness during training, most of us have a deep-seated notion that dairy is critical for growing children and healthy bones. The recommendations of my own professional organization, the American Academy of Pediatrics (AAP), state that children should consume at least two to three cups daily.
My dilemma: removing dairy from a child’s diet goes directly against everything I had learned—and what the AAP recommends. If I was going to recommend kids take dairy out of their diets, I had an ethical responsibility to be 100 percent confident that I could provide them with the nutrients they needed for optimal brain, bone, and cognitive development.
When I started to comb through the scientific research on bone health, I couldn’t find compelling evidence that high amounts of dairy intake alone build healthy bones or ensure overall health in children. In fact, I found the opposite. Adequate calcium is needed for healthy bones, but is dairy the only reliable source? In this chapter I will share with you what I learned during my quest to discern where truth lies between science and marketing.
DAIRY ADVERTISERS DID THE JOB THEY WERE PAID TO DO
We discussed the role of special interest groups in our nation’s dietary recommendations over the past two chapters. So my first step in discerning dairy’s role in bone health was to listen to the slogan in my head, “Milk, it does a body good.”
milk marketing
1980s: “Milk: It Does a Body Good.” This campaign positioned milk as necessary for healthy, strong bones and to prevent osteoporosis.
1993: “Got Milk?” This campaign featured celebrities with milk mustaches, promoting milk as a healthy part of our diet. By the mid-1990s, 91 percent of adults surveyed in the US were familiar with the campaign.3
2004: “3-a-Day. Burn More Fat, Lose Weight.” The campaign claimed that consuming three servings of milk or other dairy products daily could aid in weight loss. A 2007 lawsuit filed by the Physician’s Committee for Responsible Medicine effectively shut this campaign down.4
2006: “Got Milk?” This campaign featured the star of the Superman Returns movie, Brandon Routh. The ad’s caption read, “Super. That’s how milk makes you feel. The calcium helps bones grow strong, so even if you’re not from Krypton, you can have bones of steel.”
One of the most successful marketing campaigns for dairy was “Got Milk?” It was organized in California between 1993 and 1996 as milk consumption was declining.1 The state had $27 million to spend on generic milk advertising, and one of the television ads they ran was named one of the best campaigns by Ad Week. Who else was in the running? Coke, Pepsi, the Eveready Battery, and Absolut Vodka.2
Yes, despites its downfalls, milk is still healthier than vodka, but I am showing you this comparison because this type of advertising isn’t necessarily about health. It’s about selling more product. When there are significant funds and talented marketing agencies, the sky’s the limit on what people can be convinced to eat, drink, or smoke. Imagine if we put that kind of organized effort and money behind ensuring our kids are eating vegetables and fruits?
NOTE WHO FUNDS THE STUDIES FOR OUR DAIRY RECOMMENDATIONS
Here is a direct quote from a scientific report about healthy beverage consumption in early childhood from key national health and national nutrition organizations, including the AAP. Note the bold font to highlighted that the study was funded by the dairy industry.
Plain cow’s milk is a common, familiar beverage in US diets, and its availability, affordability, and nutrient density make it a good choice for healthy, growing children. An analysis, funded by the dairy industry, indicated that milk was the number one food source of nine essential nutrients for children two to eighteen years of age based on data from NHANES 2003–2006: protein, calcium, potassium, phosphorus, vitamins A, D, B12, riboflavin, and niacin (as niacin equivalents).5
CAN CHILDREN HAVE STRONG BONES WITHOUT DAIRY?
My next research task was to verify whether science upholds the dairy advertising claims that if you drink enough milk, you can have bones of steel (metaphorically speaking). I could not find compelling evidence to back this claim. I found two of the leading physicians and researchers in nutrition at Harvard and Yale grappling with this same question: Are our recommendations based upon science or marketing?
different countries’ recommendations on dairy intake
Dietary Reference Intakes for Calcium from the Institute of Medicine10 (the guidelines we follow in the US)
0 to 6 months 200 mg/day
6 to 12 months 260 mg/day
1 to 3 years 700 mg/day
4 to 8 years 1,000 mg/day
9 to 18 years 1,300 mg/day
19 to 50 years 1,000 mg/day
51 to 70 years (F) 1,200 mg/day
51 to 70 years (M) 1,000 mg/day
71+ years 1,200 mg/day
United Kingdom11
1 to 3 years 350 mg/day
4 to 6 years 450 mg/day
7 to 10 years 550 mg/day
11 to 18 years (F) 800 mg/day
11 to 18 years (M) 1,000 mg/day
19 to 70 years 700 mg/day
Walter C. Willett, MD, of Harvard is the most-cited nutritionist internationally. He not only has been very outspoken about questioning the necessity of dairy but points out that the countries with the highest intakes of milk and calcium tend to have the highest rates of hip fracture.6,7,8 He also points out that one reason we have such strong dairy recommendations in the US is to meet our high calcium recommendations, which are almost twice what they are in the UK and are based upon studies that were less than two weeks long. This means that they may not be indicative of what is needed over a lifetime.9 He also talks about the importance of adequate vitamin D for bone health.
Another giant in the world of US nutrition research is David Katz, MD, MPH, of Yale, who graciously wrote the forward to this book. He points out the following:
Most populations around the world actually consume less calcium than we do in the US, yet have fewer cases of osteoporosis. This may be due to more weight-bearing exercise elsewhere, less protein and acid in the diet, and more sun exposure—and thus higher levels of vitamin D.12
Please note the importance placed on vitamin D by both of these researchers. I will walk you through how to be sure your child is getting adequate amounts of vitamin D in the supplement portion of section II.
WHAT FACTORS ARE IMPORTANT FOR HEALTHY BONES?
We look again to Dr. Willett and his colleagues at Harvard. It turns out, there are several factors that contribute to healthy bones in addition to calcium. The number one factor is physical activity.13,14 We must get our children off the screens and outside!
The Four Main Contributors to Bone Health15
Weight-bearing activity. Do whatever it is that your child loves to do, playing outside, climbing on monkey bars, any type of ball sports, gymnastics, martial arts, or safely jumping on a mini-trampoline. All of these are good physical activities that help build strong bones.
Maintaining adequate levels of vitamin D. This means getting some sunshine in the summertime without burning the skin and adding a vitamin D supplement in the wintertime, unless you eat a lot of coldwater fish like mackerel and sardines. Vitamin D also helps the gut absorb more calcium, and it helps the kidneys hold onto more calcium (otherwise, we lose it through our urine).
Eat enough calcium-rich foods that keep our bodies from having to “borrow” calcium from bones in order to keep our heart pumping and our nerves signaling one another normally. Milk in small quantities can offer some health benefits to those who are not sensitive to it or who are not lactose intoler
ant. However, if you are reading this book, your child is likely suffering from some type of unchecked systemic inflammation and removing dairy may play a role in improving her health. See the list of high-calcium foods in the appendix.
Eat adequate amounts of vitamin K. Foods like dark green leafy veggies (kale and collards), broccoli, and Brussels sprouts not only contain calcium, but they are also rich in vitamin K. One serving or more of these veggies per day reduced the likelihood of breaking a hip by 30 percent in older women.16
THE FOUR MAIN CONTRIBUTORS TO BONE HEALTH
Weight-bearing activity
Maintaining adequate levels of vitamin D
Eating foods rich in calcium and other minerals such as magnesium
Eating adequate amounts of vitamin K
As I hope you understand now, in addition to the above factors, another significant way we can support your child’s body in absorbing the nutrients necessary for bone growth is to decrease their overall systemic inflammation. This will enhance absorption of calcium plus all the other critical nutrients required for bone formation that often seemed to be left out of the equation. Key nutrients include magnesium, phosphorus, potassium, fluoride, manganese, copper, boron, iron, zinc, and vitamins A, B, C, and K. We need a constant and consistent supply of these nutrients to support bones and the other metabolic processes related to bone growth.17
MAGNESIUM, THE OFT-FORGOTTEN MINERAL
Magnesium is so often left out of the equation in conventional medicine. Magnesium works in conjunction with calcium. It is the mineral that makes things relax. It allows our muscles to relax and our heart to beat. It activates over three hundred different enzymes and plays a significant role in bone health.18 If calcium is Superman, magnesium is the cape. Superman cannot fly without his cape, and calcium cannot do its job without an adequate supply of magnesium. Green leafy vegetables and pumpkin seeds are the two powerhouse foods that contain magnesium—and yes, I hear you, your children eat very little of those. They are not alone. Half of the US population does not get adequate amounts of magnesium—even though it is one of the most abundant minerals in our bodies and is extremely important to many different systems.19 Pay close attention to the supplement portion of section II, where I give specific instructions on supplementing magnesium for those kids who need it.
Healthy Kids, Happy Moms Page 10