Posted tagged ‘diet’

Slim Fast for kids

August 9, 2009

The Pediatric Insider

© 2009 Roy Benaroch, MD

Josie’s wondering if sharing her Slim Fast shake is a good idea: “My son is almost 2 (2 months shy) and ever since I let him have a sip of my Slim Fast shake (those chocolate milk drinks in a can), he cries and cries for one everyday. I understand that they are completely insufficient at providing him with the fat, protein, vitamins and minerals he needs on a daily basis, but my question is, is it horribly wrong for me to let him have one every once in a while?  The whole point in those shakes are to give you the minerals and vitamins you need, minus the fat, right? Other than the times I do let him have one, he eats plenty and has a very well balanced diet.”

From their web site, here’s a list of typical Slim Fast ingredients: fat-free milk, water, sugar, gum arabic, calcium caseinate, cellulose gel, canola oil, potassium phosphate, soybean lecithin, mono and diclycerides, artificial flavors, carrageen and dextrose. (Most of the flavors are more-or-less like this, with some variations.) After those items are a long list of added vitamins and minerals. I don’t see anything offensive in the list, though this wouldn’t be appropriate for those with milk or soy allergies.

Looking further at the label, an 8 oz Slim Fast has 220 calories, including 3 grams of fat, 35 grams of sugar, and 10 grams of protein. For comparison:

(all per 8 oz)


Fat, grams

Protein, grams

Sugar, grams

Slim Fast





Apple Juice





Skim Milk





Whole Milk





To me, the striking thing about Slim Fast is how high it is in sugar—higher than any of these other choices. It sort of has the protein content of milk, the sugar content of juice, and the fat of low-fat milk. It’s also very calorie-dense, much more so than even whole milk.

So: there’s nothing inherently wrong with Slim Fast, though if you use it as a substitute for milk (even whole milk), your child will get far more calories than you might expect. It’s meant to be a substitute for food. A little now and then will do no harm, but regular consumption of it as a beverage may end up putting your child at risk for overweight. A more cynical person might say that the manufacturer thinks that’s not such a bad idea.

They’re Grrreat…big lying weasels

May 4, 2009

In a national ad campaign, Kellogg claimed that their Frosted Mini-Wheat cereal was “clinically shown to improve kids’ attentiveness by nearly 20%.” Now, I’ve got nothing against Frosted Mini-Wheats (though they do taste like sugared bird’s nests), but that claim isn’t actually supported by their research. In court documents, Kellogg states that their own studies showed about an 11% improvement in attention, on average, among children who had Mini-Wheats for breakfast compared to children who had no breakfast at all. That’s right—not only did they lie about the magnitude of the effect, but the ads were especially deceptive because their research didn’t support any special effect of Mini-Wheats over any other cereal, just for Mini-Wheats over nothing at all. It turns out that hungry kids who don’t eat breakfast have trouble concentrating. Imagine that.

In April 2009, Kellogg– without admitting wrongdoing– agreed to stop making this and similar claims about their cereal.

So: encourage your kids to eat a good breakfast, but don’t fall for any ad hype that one cereal is any better than any other. A good breakfast should include some carbs for fast energy, plus a source of fat and/or protein as a longer-lasting energy source for the whole morning. Just about any cereal with milk is fine, or an egg, or peanut butter on toast, or a cheese quesadilla. Even a bird’s nest might just be worth a try.

Preventing and managing overweight: A family approach

April 21, 2009

Gretchen is becoming concerned about her daughter’s weight: “She has always high on the height/weight charts (weight a little higher than height), but now she is almost off the weight charts. I think she generally eats healthy foods, but she does eat a lot! So are there any suggestions as to how I should treat this issue? I really don’t want to make things worse by focusing too much on food.”

Weight concerns are common, and rightly so: about 1 in 3 school aged children are overweight, and most of these kids will remain overweight or become more obese as adults. Our children live in a toxic environment with excessive calories galore and far less routine physical activity than kids enjoyed in prior generations. Our portions are too large; we eat too often at restaurants with huge serving sizes; and we inundate our children with media imagery and advertizing that glorifies calorie-dense (and nutrition poor) foods. Few children walk or bike to school, and few children spend their afternoons playing outside.

The good news is that for a preschooler, parents have many years to help form good healthy eating and activity habits. We’re not talking “diet” here—that’s a term that’s never been any help to anyone. The very concept of “going on a diet” implies that you’ll someday “go off a diet.” What you want to instill are healthy habits that will last a lifetime, not a diet that will last two weeks.

As you say, you don’t want to go overboard with this, and you don’t want to over-emphasize food and eating issues to the point where your daughter gets self-conscious. So do not mention weight, and don’t set any sort of “weight goals.” The best ways to help a child learn healthy eating habits don’t focus on individual foods, “diets,” or weight, but rather on healthy habits for the whole family.

Family meals are essential. We know that children who eat with their families make healthier food choices and are far less likely to become obese adults; they’re also more likely to get good grades, and less likely to experiment with drugs.

Beverages can be a hidden source of many calories. Children should routinely drink only skim milk (by age 2, and maybe earlier) and tap water. Save soda and fruit juices for snacks. If you can’t live without flavored drinks, go with a no-calorie substitute. Some people are leery of artificial sweeteners, but I promise for most people they’re far less harmful than high fructose corn syrup. Drink water before, during, and after meals.

Do not watch TV while eating. Kids will absentmindedly eat more, and they won’t even notice or enjoy the food. Eating should not occur anywhere other than at a table in the kitchen or dining room.

Try to cover as much of the plate as possible with foods that have less caloric density. This includes whole grains, fresh fruit, and vegetables. The highest-calorie foods are meats, cheeses, peanut butter, and other protein- and fat-rich items. These should not be the “centerpiece” of any meal.

Eat slowly, and have a nice conversation during dinner. Don’t talk about the food, other than to compliment the chef. Don’t use language that puts extra value on eating and food, like “You’re such a good eater!” People eat far more if they eat quickly—slow it down!

Avoid food contingencies, like “If you eat the broccoli, you’ll get a brownie.” In the long run, these kinds of statements elevate the brownie (making it more attractive) and denigrate the broccoli. What you’re saying sounds like “No one would ever eat that yukky broccoli unless they got a yummy brownie afterwards!” Kids who grow up in households with food contingencies are very unlikely to continue to eat the healthy food, but will continue to crave the reward food.

Snacks are fine, as long as they’re the same healthy kinds of foods offered at mealtimes. Avoid using the phrase or buying into the marketing concept of “Snack Food.” There is no snack food—it’s just food. Unfortunately, the term “Snack Food” really means “Crap Food”, and you don’t need to help the advertising companies get your children addicted to it.

Think about portion sizes when you shop. Huge bulk purchases may seem like a money-saving idea, but not if they encourage parents to prepare and serve more food than is healthy to eat.

This may sound looney, but it works: use smaller plates. A normal-sized portion on a dinner plate will look small, especially to those of us used to restaurant portions. Studies have shown that people will serve themselves less, eat less, and be fully satisfied with eating less if they use a smaller plate.

What other healthy eating tips have been helpful for your family? Post a comment here!

Eating your curds and …

April 3, 2009

Poornima, an official blog regular, asked, “I have a question on whey proteins. I see it everywhere now- everyone talks about it. Do you think it is a good idea to give whey protein to kids?”

This is the second time it’s come up in one day, so I might as well tackle what seems to be an evolving food fad: whey. There’s even a website, www dot wheyprotein dot com, extolling whey’s many virtues. Apparently it’s been popular among body builders for years, and according to that site the manufacturers are working hard to popularize whey for the rest of us.

Whey is one of the major proteins in milk—it’s the watery stuff that holds cottage cheese together, the stuff between the curds that Little Miss Muffet enjoys. As such, it’s a perfectly good protein, and dairy products are a good part of a balanced diet. It’s certainly not essential, but it’s a reliable and tasty source of protein, calcium, and vitamins A&D (in fortified milk.)

There’s nothing I can find that looks especially unique or powerful about whey. It’s just the latest in a string of food fads—remember soy? green tea? How about dark chocolate, pomegranates, or red wine? All of these are good for you in their own ways, but none of them is a substitute or improvement on a good, balanced, healthy diet.

We’re all looking for simple solutions, magic pills, or the one food that’ll cure obesity and hair loss. But a healthy diet is one that relies on a mix of healthy items from many different sources. You want healthy? Avoid trans-fats and fats from animal sources, eat unprocessed whole grains, and (most importantly) don’t consume more calories than you need. That’s it.

There is no “superfood.”

Except maybe the dark chocolate. Mmmmm……..

We’re going to pump (clap!) you up

February 22, 2009

Shelly had a question: “My 14-year-old’s football coach wants him to take at least 120 grams of protein a day. Isn’t this too much? Is this the best way to ‘bulk up’?”

It is a good idea for adolescents looking to increase their muscle bulk to consume a diet rich in good quality protein. However, it sounds like this coach may be pushing this idea to the extreme, and may be over-emphasizing a very specific diet rather than encouraging a well-balanced, healthy regimen.

Growing adolescents need to consume about 50 grams of protein a day. The precise number depends on many factors, including the kinds of protein eaten and in what combination, but 50 grams is a pretty good estimate for most kids. It’s not very difficult to get that much protein, especially from meat sources—50 grams of protein can be found in six ounces of lean meat or fish. Rich plant sources of protein include soy (tofu), nuts, and beans. There are several good tables available showing more precise measurements of the protein content of foods.

Proteins are digested in a broken-down form, called amino acids, that are used in part to make muscle tissue. So it does make sense to adolescents looking to increase their muscle bulk, or “lean body mass,” to have a diet that offers plenty of protein building blocks for growing tissues. But there is no evidence that extra-high protein loading makes muscles grow any faster or bigger.

Super-high protein intake can stress the kidneys, and can lead to a loss of calcium and other nutrients in the urine. Though, again, the exact number depends on many factors, most exercise physiologists recommend a daily protein intake of no more than 2 grams per kilogram body weight per day. For an average 14 year old adolescent male (let’s say, 140 pounds), that’s about 125 grams. Larger kids could probably tolerate more than this, as long as plenty of water is consumed and the remainder of the diet is well-balanced. However, this is an expensive way to eat, and won’t really help build muscle any better than a good balanced diet with a more modest amount of protein.

There is absolutely no advantage to using hi-protein shakes or bars over good quality, protein-rich foods. Some vegetarians (or kids who just don’t like meat) may find it easier to get a high protein intake using these products, but they’re a very expensive source of protein. I would much rather encourage a teenager to consume lean meat, eggs, fish, and nuts at every meal rather than rely on a special, processed protein source.

Beyond diet, there are other essential elements to increasing lean body mass. One is resistance exercise—that is, weight training. Muscles must move against “extra resistance” in order to grow. I suggest that adolescent who wish to weight train do this with the help of a qualified coach or trainer, to teach them how to use the equipment safely and effectively. Maximum lifts should not be attempted until after puberty is complete. Younger adolescents should do exercises using small enough weights that at least 20 repetitions can be done at each set; older adolescents may wish to push the weights higher and reps lower than this to get maximum bulk. Resistance training should occur with a day of rest in between each session, using alternate muscle groups each day or using alternate days for cardiovascular training.

After diet and exercise, the third essential element needed for effective lean body growth is something that’s often overlooked: sleep. Muscle tissues grow most efficiently during sleep, and adolescents who skimp on sleep will find that even a vigorous exercise program will not get them the bulk they’re looking for. Teenagers need nine hours of sleep each night, and there is no short-cut for adequate sleep.

Cancer, diabetes, and vegans

August 16, 2008

A post from EH: “Recently I have been hearing about a link between dairy protein and diseases such as cancer and diabetes. What are your thoughts on this and can a vegan diet be healthy for small children?”

I haven’t seen any good data that supports a strong link between dairy products and either cancer or diabetes. The press likes to report things as if there is a single cause—a “smoking gun”—that’s the root cause of these problems, it’s unlikely that either disease is the result of one kind of food or exposure. As with many health conditions, they’re complex, poorly understood, and difficult to sum up for a 45 second sound bite on the news.

Nonetheless, this is the Pediatric Insider site, and I’m going to take a stab at it: in 45 seconds, what are the best ways to prevent cancer and diabetes?