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September 08, 2004

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Palo Alto Online

Publication Date: Wednesday, September 08, 2004

Packing a nutritional punch Packing a nutritional punch (September 08, 2004)

Nutritionists emphasize importance of teaching kids healthy habits by packing their lunch

by Alex Doniach

Penny Gertridge's two children, eighth and 11th grade, have been eating her brown-bag treats since their first day of kindergarten.

But even though Gertridge has a good idea of what her kids like to eat, the seasoned pro is no stranger to lunchtime challenges.

"My son swims and plays water polo and eats about 4,000 calories a day," she said. "He needs a lot of energy and it can be a challenge to figure out the best sources for those calories."

Gertridge, along with many other parents, confront this daily dilemma: How do you pack a lunch that ensures your child the most out of their mid-day meal?

For kids, lunch is more than energy in a brown bag. According to local moms and nutrition experts, a well-balanced lunch can help pave the way for good eating habits down the road.

While childhood obesity and poor eating can't be blamed entirely on lunch, how parents handle food sets the stage for their children's dietary habits, said Darcie Ellyne, a registered dietician for the Palo Alto Medical Foundation.

"Parents have an obligation to provide a variety of healthy foods for their children," she said. "Then it's up to the child to decide what to eat."

What's for lunch has become a hot topic in Palo Alto schools. The district recently approved a nutrition policy for elementary and middle schools restricting kids' access to sodas, sweets and foods high in saturated fat. May Wong, a member of the Healthy School Lunches Committee, a public health nutritionist, registered dietician and mother of three, said this policy will -- at its most basic -- be a role model for students. Gertridge, a co-chair of the same committee, agreed that students should have a variety of healthy food options at school.

While both women argue that schools should support healthy lifestyles, they maintain that good eating habits begin at home.

"Our kids watch what we eat and parrot everything we do," Gertridge said. "Our dietary habits are no different than how we feel about religion or our neighbors. Is the lunch you are packing your child something you would want to sit down and eat yourself?"

When it comes to lunching, most nutritionists start with some basic advice: include a taste from all the major food groups. According to the U.S. Department of Agriculture, growing children need about six servings of grain, five servings of fruits and vegetables, two servings of protein and two servings of dairy.

Grains should be whole wheat because they are higher in nutrients and fiber, according to Monica Holt, a pediatric dietician at the Lucille Packard Children's Hospital.

"At the point where you refine wheat down to white and you start to add back sugar, vitamins and minerals, you are losing a lot of natural nutrients," Holt said. Fortified bread, like "Iron Kids," is white bread with iron, vitamin B and other minerals added back to create a whole grain product in snow-white packaging.

While Holt discourages such an option, "sometimes it's the only thing kids will eat," she said. "If your kid absolutely won't eat wheat bread, fortified bread is the next best thing."

Protein is another important component of a lunch. Whether in the form of turkey breast, yogurt or peanut butter, Holt ranks protein high on the list of brown-bag must-haves. A peanut-butter-jelly sandwich has become a lunchtime staple for good reason. Peanuts are an excellent source of protein and healthy fat -- both of which are needed to help kids fill-up and concentrate. Other suggestions include bean-and-cheese burritos made with corn tortillas, turkey breast or tuna sandwiches, and leftovers from dinner the night before.

Gerda Endeman, nutritionist, mother and member of the Healthy Lunch School Committee, recommended sending homemade chili in a thermos. Chili is full of protein from meat, beans and veggies.

Vegetables and fruit are another lunchtime necessity, but sometimes the hardest item to get kids to eat, according to Ellyne.

"The more colorful the meal, the prettier but also healthier that meal is," she said. "Different pigments in fruits and vegetables have vito-chemicals that growing kids need." Popular suggestions include apples, bananas, oranges, berries, carrots, celery and broccoli.

While most parents push the vegetables, many kids are quick to reject them. Gertridge suggested packing veggies with dips and healthy salad dressings.

"Kids love to dip things," she said. "Carrot sticks with some ranch, peanut butter or low-fat dressings are popular."

Holt said her kids love things in little pieces. She sends along cut-up apples and already-peeled orange slices so that fruit becomes an easily accessible snack. Other suggestions include small cans of fruit with cottage cheese for some protein and dairy.

Wang sends along Tupperware full of fried rice from the night before because she can bury lots of hidden vegetables.

Dairy should be another lunchtime priority. Ellyne said the benefits of dairy extend beyond strong bones.

"What we're finding is that children don't get enough dairy nowadays," she said. "Not only does dairy have calcium but it is beneficial for overall health. This includes strong bones and weight management." New studies indicate that dairy may play a vital role in helping to maintain a healthy weight. A few dairy-filled suggestions include yogurt, milk, cheese (in a bean-and-cheese burrito, for example), or even calcium-fortified orange juice, said Holt.

Packing a balanced lunch is good and well, but how do you make sure your kid eats the nutrient-rich lunch that you've carefully designed?

Cindy Zedeck, a pediatric weight control program manager at Lucille Packard Children's hospital, said involving the child is the best way to make sure he or she eats the contents in the lunch box.

"If children are involved in their meal prep, they are more likely to eat it because they feel like they chose it," Zedeck said. "Take your child shopping and encourage them to sample the fruits and veggies they want to try."

Both Holt and Endeman suggest making a list of healthy foods and taking your children to the farmer's market or the grocery store and letting them pick out what looks good to them.

"Even though we're really busy, we take the time to shop and cook," Endeman said. "My son loves the farmer's market and both my kids love to cook."

Wang agreed that listening to your children's concerns is essential if you want their desires to meet yours.

"Be flexible," she said. "When you have teenagers, you need to listen to them. My oldest was embarrassed when I packed her lunch in a plastic container or fabric bag. She would only eat her lunch out of a paper bag. It may not seem logical to me but it makes sense to her and you need to listen to that."

Gertridge agreed that communication is key. She never gives her eldest son fruit and vegetables for lunch because she knows he won't eat them.

"My son gets a huge fruit smoothie in the morning and he eats a big salad at night," she said. "That's how I make sure he gets his fruits and veggies. What he does during the day is up to him."

Many kids actually develop a preference for the healthy foods their parents like if they are exposed to it repeatedly. It takes about 15 times for a person to try new foods before they develop a liking for it, Ellyne said.

Wang said her kids actually prefer healthy stuff over chips and soda, even if they may not admit it.

"I'll buy chips and soda for parties or special occasions, but what I have found is that the leftovers just sit in the garage untouched until the next party," she said. "The kids don't even touch it. I think they know it's not the healthiest thing to eat."

Still, most moms will admit to giving in every once in a while.

Holt maintained that compromise is important. She packs a healthy lunch for her own children, but usually includes a small treat, like a fun-size Milky Way or a fruit roll-up.

With a sandwich and fruit as the central focus of the meal, the sweet stuff just becomes a taste. "If I gave him chips and soda he would eat that and leave everything else," she said. "I just send the treat as an afterthought, never as the main course."

The bottom line: "Parents have an obligation to provide a variety of healthy foods in a structured way at specific times," Ellyne said. "Then it's up to a child whether he or she eats it or not."


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