Dear Reader,
Many people who adhere to strictly vegetarian diets risk certain deficiencies in protein and iron, which are abundantly available in animal food products, but less so in plant foods. Since you mention only iron deficiency as a problem in your case, let me focus on this one issue.

Iron is an essential mineral and important component of certain proteins. Most of the iron in the body is found in hemoglobin, which is a protein in the red blood cells responsible for the transport of oxygen throughout the body. A small portion of iron remains stored in the body and can be mobilized in times of acute deficiencies. Women who experience heavy bleeding during their monthly period are prone to significant loss of iron. Adult men and post-menopausal women much less so.

Under normal circumstances, the body maintains naturally a healthy level of iron through a balanced diet. There are two forms of dietary iron, called heme and non-heme. A diet that includes meat, fish and poultry provides sufficient amounts of heme iron. Non-heme iron is present in plant foods, such as vegetables, beans and lentils. Unfortunately for vegetarians, plant-based non-heme iron is not as easily absorbed by the body as meat-based heme iron.

However, if you suffer from iron deficiency due to an exclusively vegetarian diet, you still can make dietary adjustments that do not require meat consumption.

For example, flour, cereals and other grain products that are enriched and fortified with iron can add more non-heme iron. Other rich sources are dark green leafy vegetables, like spinach, collard greens and kale. To enhance non-heme iron absorption, it is important that you add to your meals foods that are rich in Vitamin C (e.g. a spinach salad with a few slices of orange or mixed berries).

On the other hand, a concentrated presence of calcium can inhibit the absorption of non-heme iron. Phytates, which are found in legumes, rice and some grains, can have adversary effects as well, and so can certain proteins from soy.

Discuss your options with your doctor or a clinical dietitian who can monitor your iron level on a regular basis. Prolonged iron deficiency is not harmless. Besides causing you to feel chronically fatigued, it may also compromise your immune system, making you more vulnerable to any number of diseases.

Dear Concerned Mother,
Yes, I think you should be quite concerned about your kids’ weight gain and you should do everything in your power to turn this unhealthy situation around as quickly as possible. Too many people readily accept the idea that their physical health is a matter of genetics and therefore beyond their control – and responsibility. While family history must be taken into account, it is too simple to blame your genetic makeup to explain away the serious but preventable health problems your kids are facing.

There are a number of factors that can set a child on the path of obesity in the early stages of life, and the roots may go back further than you think, even before birth. There are indications that women who are obese and/or suffer from diabetes before and during pregnancy are more likely to pass their health problems on to their offspring, even in the womb. Exposure to certain pollutants, smoking and drug use during pregnancy have certainly an impact. Paradoxically, some children become obese in later years, even if they were underweight at birth.

Events and omissions occurring during the first few months may factor in as well. For example, babies who are not breast fed or don’t get enough sleep are more likely to suffer from weight gain later on.

Traditionally, parents have been discouraged to restrict their children’s calorie intake before the age of five, even if weight problems developed. Today, we are more concerned with baby fat over the age of two, simply because not all children outgrow the extra weight but, instead, grow up obese.

I personally believe that the social and environmental conditions in which children are brought up are much more significant than their genetic predisposition when it comes to nutrition. Your kids may have a tendency toward weight gain based on their metabolism. But the quality and quantity of the food they eat is largely controlled by you, the parents – at least while they are still this young. If you are concerned about your kids’ health, the best you can do is to change their environment, starting with your home. And leading by example is always the best way to direct their behavior. I wish you the best of luck for your entire family.

Dear Reader,
Yes, you should, and here’s why: Being thirty or more pounds overweight puts you clearly at risk for heart disease, stroke, hypertension, diabetes and also cancer. You may not suffer from any weight-related effects on your health right now, but the risks will increase over time. You say that you generally adhere to a health-conscious lifestyle. So, my guess is that your portion sizes are probably too generous, and you may want to start cutting back your servings and see what happens.

Whatever the reasons for your weight gain may be, you should try your utmost to turn things around right now, before more serious damage is being done. Extra weight puts stress on your body, especially your joints, and also your organs. If you reach the point down the road where you have to take medication against hypertension or diabetes, you have to expect an array of other related health problems – including the inevitable side-effects from the medication – all of which could be avoided, if you took decisive action.

Since you are otherwise in good health, you have the luxury of time and can afford to take small, incremental steps toward lasting weight loss. I recommend that you consult with a nutritionist or dietitian, and perhaps a fitness trainer as well, to work on a comprehensive weight loss plan that gets you slowly but surely back on the right path.

Dear Concerned Traveler,
Congratulations! Among all my travel experiences, Africa ranks very high up.

You are not at all crazy to bring your grandchild along on a trip that will leave a significant impression on her young mind. But I agree with you. It is prudent to consider the concerns you’ve mentioned.

Malaria is indeed a problem in many parts of Africa. Zanzibar is off the coast of Tanzania and has a different climate. Malaria is much less prevalent there. A beach resort sounds just perfect to give a child a first taste of Africa and keep her reasonably safe as well.

For vaccinations, however, you must consult with a tropical disease institute (most likely to be found at a University clinic). Don’t just go to your family doctor or a pediatrician with little or no first-hand knowledge of tropical diseases. Especially malaria medication can be hard on the liver and kidneys and may not be suitable at an early age.

Also, to prevent any number of diseases, you must be careful with your water supplies at all times. Don’t ever be tempted to drink water from a faucet and don’t use water from anything but sealed drinking water bottles, not even to brush your teeth with. Don’t put ice in your drinks. I only buy or order carbonated water, because I can be sure it has not been opened and resealed before.

Precautionary measures such as these should be taken in many parts of the world, not only in Africa.

Similar rules apply to your food. Cooked meals are preferable to salads and raw fruits. You can enjoy fruits as long as you cut and peel them yourself.

Generally speaking, keep your thinking cap on and avoid as many hazards and dangers as you can foresee.

Besides the medical considerations, let me assure you that Africa is a great country to visit, including with children. Since you are already in the area, you should take time to visit the famous wildlife parks, like the Masai Mara in Kenya and the Serengeti in Tanzania. They offer once in a lifetime experiences. Most safari camps are perfectly safe and some allow children under 12 and have special programs for them.

Last but not least, have fun! Don’t get overanxious. Keep in mind that having a good attitude is an important part of your health protection too. If you are fearful and stressed out, your immune system may respond in kind. And your granddaughter may also be affected.

Enjoy your trip. It will be a wonderful experience.

Are Vegetarians at Higher Risk for Iron Deficiency?
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Baby Fat – Natural Occurrence Or Cause for Concern?
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Health Concerns of Families Traveling With Young Children
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Overweight But Otherwise Healthy – Still At Risk?
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I’m Trying to Lose Weight, But I’m Not Getting the Support I Need
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Crash Diets – Do They Work?
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What’s Wrong With Carbonated Sodas?
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Kids Can Gain Weight in Response to Stress
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Picky Eaters – How Concerned Should You Be if Your Child Refuses to Eat Right?
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Jet Lag, Not as Harmless as You May Think
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Food in a Pill, How Important Are Vitamins and Supplements?
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Fruit Drinks, A Cause for Concern?
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Is Fast Food Especially Bad For Young Kids and Teenagers?
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How Safe Are Water Bottles and Plastic Food Containers?
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“Organically Grown Produce” – Is It Worth the Extra Money?
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Strictly Vegetarian, Too Radical?
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Children With Food Allergies
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Is There a Right Way to Diet?
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Fasting for Weight Loss and What Else?
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Multivitamin Supplements for Children
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How Safe is Your Refrigerator?
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Dear Reader,
No, in fact you should be worried about giving your kids sodas. The whole tax issue aside, I believe that sodas, especially when consumed in large quantities, are indeed harmful for our kids’ health – and not just because they contain lots of empty calories from sugar. Unfortunately, it is only the issue of weight gain in connection with sodas that drives the current discussion. What bothers me as much, however, is the fact that almost all diet and regular sodas are carbonated.

Carbonated drinks have high levels of phosphoric acid (phosphate) and carbonic acid. Elevated acidic levels can cause an imbalance of calcium (an alkaline mineral) in our blood stream. Under normal circumstances, our body’s natural mechanism maintains a steady ratio of calcium to phosphate in the blood (also known as “acid base balance” or “blood pH”) with the help of a healthy diet.

However, if we overindulge in foods and beverages that throw off the delicate acid-alkaline balance, the body has to struggle hard get it back by adding calcium. The more phosphate from carbonated drinks is ingested, the more calcium is needed. If that calcium is not supplied in sufficient quantities from food products, such as milk, cheese, salmon and sardines (with bones), dark green leafy vegetables and the like, calcium that is already stored in the body will be “pulled” from bone mass and teeth, thereby damaging their density. Severe osteoporosis and premature loss of teeth may result in later years.

For growing kids, an acid-alkaline imbalance is especially harmful, because potentially serious damage to their bone structure is being done at a critical time when they build up their bone mass that has to last for a lifetime. The consumption of large amounts of carbonated drinks can jeopardize this process. And once the damage is done, it is very hard to reverse.

For me, as a dietitian and health counselor who has worked with children for many years, carbonated drinks rank almost as high as tobacco products and alcohol in their potential to cause great harm, especially at a young age.

In absence of any government regulations to speak of, we consumers have to educate ourselves about the facts of carbonated drinks, so we can make better informed choices for ourselves and on behalf of our children.

Dear Reader,
Jet lag, also called desynchronosis, affects many air travelers who travel across different time zones. The cause is the inability of the body to adjust fast enough to a new schedule. This can lead to fatigue, insomnia, irritability as well as digestive discomforts, such as constipation or diarrhea. Most people can adjust their circadian rhythm to a new situation within a few days, depending on the geographical distances they travel.

Direction also matters. Travelers flying north or south stay close to the same time zone and therefore experience fewer problems. Those going east, on the other hand, “lose time” by flying against the clock, if you will. Respectively, those flying west “gain” time. By traveling to the Far East, depending on the route you’re taking, you may unfortunately experience the severest symptoms of jet lag.

You are right to be apprehensive about your reaction to jet lag. Frequent flyers like you are at risk of developing chronic symptoms of jet lag, which then indeed may become cause for concern. Here is a reason: A small part in our brain, called the hypothalamus, is in charge of activating a number of diverse body functions, such as hunger, thirst and sleep. It also helps to regulate body temperature, blood pressure, blood sugar and certain hormones. If the hypothalamus acts out of sync with the environment, it causes the kind of problems we experience when we’re jet lagged. If this inner “confusion” continues for a long time and without reprieve, it may lead to a series of potential health problems, such as elevation of blood pressure, blood glucose and hormonal imbalances.

Assuming that you cannot simply change your work schedule or find another line of work, I can only advise you to apply any means necessary to minimize the effects of your jet lag before things get worse. I suggest you start with the most obvious remedies at your disposal. First and foremost, stay in shape. A physically fit body can handle a lot more abuse than a frail one. So, exercise, eat nutritious food and rest as much as you can whenever you find some downtime. Second, don’t add toxins to your system, such as alcohol, nicotine and caffeine. Drink plenty of water instead. Third, spoil yourself as often and as much as possible. If you can afford it, travel first class or business class where the seats are wider and give you enough leg room to bed down. Be discriminating about your hotel accommodations. Your sleep is interrupted enough without additional disturbances from noisy streets and the likes.

There are also a number of “anti jet lag diets” you may want to look into. I personally find most of them rather cumbersome and hard to follow, though.

The effectiveness of hormonal treatments of jet lag, e.g. with Melatonin, is still disputed among the experts. Melatonin is the hormone released by the hypothalamus to promote sleep. You have to start taking it days before your departure, but it may make your symptoms worse if you don’t get the timing right.

I also advise strongly against taking sleeping pills to fight jet lag – especially before or during your flight. Sleeping pills put you in a comatose state during which you will remain more or less immobilized for long periods of time. Such prolonged immobility in an uncomfortable position may lead to the forming of blood clots with potentially fatal results.

If your jet lag symptoms keep getting worse, you should definitely consult with your physician and see what else can be done in terms of medication. The worst you can do is to ignore the messages your body is sending you. Safe trip!

Dear Reader,
Most kids go through phases where they test your strength and resolve as well as their own. The dinner table is just one of the battlefields. And it is not always about food, even when food is the issue of contention. If you don’t take the bait and don’t make a big deal out of it, it will eventually subside. Keep offering your son a variety of healthy foods, and don’t ever try to bribe him with treats of lesser nutritious quality, such as candy or ice cream. It’s a myth to think that kids have naturally a sweet tooth.

In the section of this blog titled “Kids Love Healthy Foods,” I express my belief that kids learn to love healthy foods as much as they learn to love anything. All preferences in a child’s life are learned, including eating preferences. It’s up to you as the parent to channel that learning process in the right direction. The best way to go is by example. If you  practice what you preach, e.g. eat a healthy diet yourself, buy wholesome foods, keep to regular meal times, sit down for dinner with the entire family, etc. – your kids will naturally adopt. Once they reach the age where they make lifestyle decisions for themselves, your influence will be gone. So, you better lay the tracks now.

Dear Reader,
Kids respond to stressful situations in similar fashion as we adults do, except that they have a more pronounced sense of helplessness added. When dramatic changes occur in a child’s life, such as their parents getting a divorce, their whole world gets turned upside down. So they reach for the few tools they have at their disposal to cope with the situation as well as they can. Dysfunctional and destructive behavior can result in response to the traumatic impact events like these have. Reaching for food may give them comfort and help them to calm down their anxieties. It may also be a cry for help. Some children blame themselves for their parents’ actions and seek ways to punish themselves out of misguided feelings of guilt. And there is also the turmoil that comes with the dissolving of a household. Sit-down family dinners give way to irregular eating habits. Unsupervised kids are not likely to maintain a healthy diet regimen on their own. If pizza delivery and fast food joints are the most convenient options, parents will be tempted to go for the easy road when they already have a hard time holding things together.

As a grandparent, provided you live nearby and you’re in a position to offer any help, you can prepare a few “extra healthy” dishes for your grand-daughter or invite her to share a sit-down meal with you every so often. Perhaps you can take her to a nearby farmers market or health food store and initiate a conversation about the benefits and pleasures of eating fresh, tasty and nutritious foods. At twelve, she can be treated like an adult in these matters and as a grandparent, you may be in a better position than her parents to bring a little stability into her life when she needs it the most. If nothing else, you let her feel that she is still being loved and cared for.

Of course, it would be naive to think that insisting on good nutrition could take anything away from the pain a child goes through in a situation like this. However, weight issues and other potential health problems only add to the damage that is being done to this young life. Therefore, I wish to encourage you to take appropriate action along the lines I mentioned, based on your observations and hopefully in agreement with the parents, if that is at all possible.

Dear Reader,
You are not the only one who is getting mixed signals on this subject. There are indeed conflicting messages from the food manufacturing industry as well as the medical science community.

High-fructose corn syrup was developed in the 1970s as a sweetener, not just for sodas but also for countless other food products. In fact, high-fructose corn syrup serves not only as a sweetener, but more predominantly as a preservative. It is made by changing sugar, which is glucose, in cornstarch to fructose, which is another form of sugar. The end product consists of a mixture of both, fructose and glucose. Because it helps to extend the shelf life of processed foods and drinks, and because it is much cheaper than natural sugar, high-fructose corn syrup has become extremely popular among food and drink manufacturers. You will find it not only in sweet tasting products, but also in bread, cereal, pasta, soups, canned vegetables, salad dressings, ketchup and even in supposedly “healthful” items such as flavored yogurt.

So far, researchers have not been able to come up with irrefutable evidence that high-fructose corn syrup is harmful to our health. There is suspicion that our body processes the fructose from corn syrup differently than it does cane or beet sugar, and that this may alter the metabolism. It may be that this process also makes the liver release more fat into the bloodstream.

Most experts on the subject agree, however, that it is mostly the omnipresence of high-fructose corn syrup in processed foods that may promote weight gain which, in turn, can have many other negative health implications. In other words, it is perhaps not so much the quality but the quantity of the fructose we consume that is unhealthy.

For example, a single 12-ounce can of soda contains as much as a dozen teaspoons of sugar in the form of high-fructose corn syrup. According to the U.S. Department of Agriculture (USDA), the average American consumes more than 62 pounds of sugar every year. Especially children and teenagers may be at risk. A few years ago, The American Journal of Clinical Nutrition reported that since 1965 milk consumption among teenagers has continuously declined – although milk is an important source of calcium which a growing body needs – while the consumption of sodas and fruit drinks has more than doubled. Our kids are overloaded with sugar from early on by a diet that is dominated by sodas and processed foods. Today, we lament an epidemic growth of childhood obesity, type-2 diabetes and hypertension. And the adults are not better off. Most of us eat too much sugar, whether we intend to or not, and the results are plain to see.

So, if you want to escape the sugar trap, limit your intake of processed foods as much as possible, stick to fresh produce, stay away from sugary drinks and, most importantly, cut down on your portion sizes no matter what you put on the table. Good luck!

Dear Reader,
Vitamins and minerals are essential nutrients in charge of regulating bodily functions, such as energy generation, muscle contraction, and fluid balance, to mention a few. They don’t supply any calories and are only needed in small quantities. Supplements cannot and should not be taken in lieu of a well balanced diet. However, having said that, a daily multivitamin with 100% of vitamins and minerals  is a good way to cover your bases, whether your diet is balanced or not.

Overdosing on water-soluble vitamins (vitamin C and B-complex) is possible but unlikely. Excessive amounts pass through the system and get eliminated in the urine. Fat-soluble vitamins (A, D, E, and K), on the other hand, are stored in fat cells and can build up to toxic levels if consumed in large doses.

Minerals (calcium, chloride, chromium, copper, fluoride, iodine, iron, magnesium, manganese, molybdenum, phosphorus, potassium, selenium, sodium, and zinc), are absorbed in the body as well. Excess amounts can be harmful to the liver and the kidneys. This is especially important if you are on medication that may interfere with the metabolism of nutrients, or if you follow a restricted diet for medical reasons.

Here is a short list of some important vitamin and mineral functins:

• Vitamins A, C, E, the mineral selenium (all antioxidants), B-complex vitamins, iron, and zinc strengthen the immune system.

• Vitamins B-6, B-12, and folic acid lower high homocysteine levels – one of the risk factors for heart disease.

• Thiamin, riboflavin, niacin, B-6, B-12, folic acid, biotin, and pantothenic acid (all B-complex vitamins) play an important role in energy metabolism.

• Calcium, phosphorus, magnesium, and vitamin D help to build and maintain strong bones and teeth.

• B-12, folic acid, and iron are key in preventing anemia. Folic acid can also protect against neural tube birth defects like spina bifida. 400 mcg/day are recommended during childbearing age.

• Vitamins A, C, E, and the mineral selenium (antioxidants) decrease the risk of heart disease and certain types of cancer.

• Iron, a trace mineral, is essential in the formation of hemoglobin (carries oxygen in the blood) and myoglobin (carries oxygen in muscle). Deficiency symptoms include microcytic anemia, fatigue, and decreased immune function.

• Potassium, a major mineral, helps maintain the body’s acid-base balance, muscle contractions, and nerve impulses. It also aids the regulation of blood pressure and water balance in cells.

• Zinc, a trace mineral, is necessary for cell division, growth, wound healing, and proper functioning of the immune system. It also plays an important role in carbohydrate metabolism, DNA replication, taste and smell acuity.

Some known risks and side effects with prolonged overdose are:

Vitamin A  – Liver damage, headache, fatigue, nausea, vomiting.
Vitamin B-6  – Nerve damage, weak and numb muscles.
Vitamin C  – Diarrhea, kidney stones, urinary tract abnormalities.
Vitamin D – Kidney, heart, and blood vessel damage.
Folic acid – High doses may mask B-12 deficiency symptoms.
Calcium – Constipation and an increased risk of kidney stones.
Iron – Tissue damage in the liver with prolonged overdose.
Niacin - Liver damage and abnormal gastrointestinal function.
Potassium – Cardiac arrest.
Selenium – Tissue damage in selenium-concentrating organs.
Zinc – Intestinal irritation, impaired copper status, impaired
immune function.

Source: USDA Food and Nutrition Information Center

Dear Reader,
Daily servings of fresh fruit are a good idea at any age and certainly beneficial for kids. Fruit is high in fiber and carbohydrate and has practically no fat, except for coconut and avocado (yes, that is a fruit too). The greatest benefits come from vitamin C and beta carotene and also from plant chemicals found in citrus fruits, berries, watermelons, grapes and apples.

Potentially negative side-effects of blenderized fruit drinks may be caused by the high sugar and calorie content. High quantities of fruit sugar can increase blood sugar levels to a degree that insulin secretion becomes elevated. This, in turn, may cause a “rebound drop” of blood sugar to a new low. The result is more intense craving for sugar. Overindulgence in high sugar drinks is one of the leading causes of obesity today. My advice to you: Everything in moderation – even the healthy stuff.

What about those Juice Smoothies?

Same thing. Made with fresh ingredients, smoothies are nutrient-dense and high in vitamins, minerals, phytochemicals and fiber. The downside is that when you blenderize fruit this much, you do essentially the stomach’s digestive work in advance by breaking down the fiber and the chemical structure of the fruit. Therefore, the nutrients become more readily available for absorption. If the digestive process is cut short, a higher concentration of sugar from the fruit reaches the blood stream and elevates the blood sugar level quickly. The same effects occur that I described above.

Also, most smoothies contain additional ingredients other than fruit, such as milk or soy. Typically, they are 20 to 32 ounces in size and can contain as many calories as a full meal. Some have a high fat level from added milk or yogurt. Read the ingredients list carefully before you buy commercially produced fruit drinks and smoothies and watch the serving sizes.