Tip #30 Constipation (in kids)

Hey, we're talking about poo here- so be warned and don't read right after dinner.  Constipation in kids vs adults can be pretty different things.  You usually can't make a kid eat or drink what you want them to, so even when you know the solution to their problem, it can be horribly frustrating because you can't fix it easily.  Let's start with the basics:

• Fiber- there are 2 types.  Insoluble and soluble (I know, they sound so much a like!  it gets confusing).  Think of insoluble as a scrub brush, going through the insides of your intestines, scrubbing (and pushing) everything out.  These are fibers your body can't break down in fruits, vegetables, whole grains, legumes (think celery fibers, raspberry seeds, wheat germ).  Soluble fiber absorbs water and makes a gel, so while it adds bulk to your stool, it softens it as well.  Most fiber supplements have a lot of soluble fiber in them.  Foods high in soluble fiber are oatmeal, applesauce, blueberries (if you know about pectin in fruit- pectin is a soluble fiber).  There are all kinds of fiber supplements out there you might be able to add to your children's food or persuade them to eat. I know there is a clear, tasteless one that would work in most any food.

So, which type of fiber helps with constipation?  Both.  And most fruits, veggies, whole grains and legumes have a combination of both fibers.  The scrub brushes scrub out the intestines and the gelling soluble fiber softens everything up.  When someone has diarrhea, they are told to eat applesauce, white rice, bananas, tea and toast.  The foods are high in soluble fiber so that water will be absorbed and slow the transit of the nutrients through the intestines so your body can get the nutrients from the food instead of it rushing right through.  If your child is having problems with constipation, try and find fruits and veggies and whole grain foods they like and encourage lots of intake, even buying the same kinds in mass quantities if that helps their intake.  The exception to this is fruits like apples, bananas and pears- they shouldn't be eaten exclusively because they are extremely high in soluble fiber and if you take the skin off, they have little insoluble fiber to help scrub those intestines out.  HERE is a good chart that lays out how much fiber there are in some common foods.  Dietary fiber is the total of insoluble and soluble added together.  THIS chart is my favorite, but only lists total fiber together, not soluble and insoluble separately. 

• Fluid.  Maybe I should have put this bullet first.  Whatever you can do to increase your children's fluid intake, try it.  Fruit juices watered down are also great to help with constipation.  Recommended by WebMD are prune, pear, apple and grape juices. Your kid won't drink much?  Try popsicles, watermelon or soups as ways to increase fluid intake.
• Here is another tip that helped me with Franklin- probiotics seemed to help loosen things up for him.  There are several probiotic supplements out there that you can add to your children's food.  These should be refrigerated when you buy them, I am not an expert on these, but most probiotics I know of need to be kept refrigerated.
• The foods to avoid are salty, processed foods and dairy- especially cheese and ice cream.  Other foods that constipate are foods high in fat and low in fiber.  Think hamburger and french fries, chicken nuggets, white pasta and white sauce (ahem- macaroni and cheese).  If your kid will only eat these types of things, you can increase the fiber in these things in the following ways- whole wheat buns, skin on fries, whole grain coating on chicken nuggets, romaine lettuce and tomato on the hamburger, no cheese, whole grain pasta and red sauce with chunks of veggies with the skin on (you are starting to get the picture, right?)  The hard part is that if you want these healthy changes in kid friendly food, you will probably have to make them yourself or pay a higher price.
• Some children are very sensitive to lactose or gluten.  You might want to experiment and try 2 weeks without dairy or 2 weeks without gluten and see if their constipation issues resolve during one of these periods of time.  Important during any time period where you take a major food group out of a child's diet- make sure they are getting plenty of fat from other sources and taking a multivitamin to make up for loss of minerals/vitamins.  
• If you try all these things and you still are having problems, it might be a condition you need to get medical help with.  I don't encourage the use of laxatives, even in their most organic and low dose forms, but of course there is a time and place for them.  I would only take them when needed most or for small time periods.  When I worked in the hospital, there was a woman who had had bowel obstruction because she had taken laxatives and bowel relaxers for so long, her bowels had stopped knowing how to go poop by themselves.  While of course that won't happen to everyone, I just think of it as a cautionary tale to not force your body to do something it should be trying to do on it's own.  If you need more information, go to THIS website by WebMD on toddler constipation.

~Here's to Healthy Eating (and eliminating)

Tip #26 Holiday Eating

I've already shared my most valuable holiday eating tip, but let me go into more detail on that point:  only eat what is worth it.  I am not on Weight Watchers, but if you want to lose weight, that's the safest and best program I can recommend.  They use a calorie system that in effect makes you "budget" your calorie choices.  You can do some of the same on your own without knowing how many "points" or calories items are.  You know you are faced with lots of food choices during the holidays and many of them are high in calories.  Ask yourself before you take a bite.  "How much am I going to enjoy this?"  "Can I have this any time of the year or do I only indulge in it around the holidays?"  (I would never waste my calories on a donut around the holidays unless that was the only time of year I allowed myself to have one, but eggnog and artichoke dip, I only buy or make once a year).  I also don't try and take my favorite recipes and make them healthy- they don't taste the same, they don't satisfy the craving and leave me wanting more.  If I am going to commit to something that I feel is worth it, than it better be good and I can be happier with less.
So, that's the simple rule- don't wast calories on something that's not worth it.  If you are gifted a plate of goodies and they aren't simply divine, are they worth the calories they are costing you?  If you feel bad about throwing away someone's hard work, just tuck it away out of sight for a week, then chuck it when feelings aren't so fresh.  That is part of the plan- get those goodies OUT OF SIGHT.  Better WASTED than on your WAISTLINE.  And remember, ask yourself if it's worth it- if it is, enjoy!

Follow up: eggs/day

So, in the last post, I referenced the Mayo Clinic article on eggs and cholesterol.  It said that in the study they ate 7 eggs/day without it affecting their cholesterol.  A couple of you caught that because it seemed like a ton of eggs!  The recommendation used to be 3 eggs a WEEK.  After hunting around, all I can pretty much find is that  the recommended intake of cholesterol shouldn't exceed 300 milligrams/day (we don't actually need any, so you can have as little as you like . . . ) and that eggs contain about 213 mg/egg yolk.  So one egg a day is going to pretty much use 2/3 or more of the recommended amount.  So even if the study found there weren't harmful affects from eating 7 a day, I think the basic recommendation would be 1 per day (although I never did find it in no uncertain terms and didn't access the original article about the study).

Tip #25 Eggs

I had a few good suggestions for blog entry ideas.  One of those was eggs.  Many of you probably know I have 7 laying hens.  We eat a lot of eggs.  I am definitely in favor of eggs.  Let me tell you why.  Back in school I remember my professor calling eggs the golden standard for protein.  They are a complete protein, meaning they contain ALL the essential amino acids we humans need.  A lot of foods have great protein and a variety of amino acids (needed for the successful functioning of our bodies) and so when you eat a wide variety of foods, you cover your bases and get all the amino acids you need (more on protein combining later).  But few foods hand you them all at one time- and eggs are that food.  Think of it like this- you need to complete a jigsaw puzzle by the end of every day and most foods give you a few pieces of that puzzle at a time and by the end of the day- you have your puzzle.  Or you can eat an egg and get all the pieces at once.  I know it's not that simple and one egg is probably not enough, but you get the gist, right?  HERE is a fun website about eggs.
So, cholesterol- right?  I never told people to stop eating eggs.  I might have told them to cut back, but never avoid them completely.  Here is why.  Blood cholesterol levels are usually more affected by your intake of saturated fat, exercise and your HDL (or good cholesterol) levels than it is by dietary cholesterol.  It's true- your body will make all the cholesterol it needs for cell functioning, so you don't need to eat ANY.  But it's also true that only a small % of the population is drastically affected by their dietary intake of cholesterol, it's usually saturated fat and exercise that play a bigger role.  Here is a part of a WebMD article that I just read about dietary cholesterol- it repeats some of what I just wrote, but oh well.  By the way, I trust WebMD with my health and nutrition questions.  HERE is the link to the whole article if you want to read it.

Cholesterol and the Great Egg Debate

"One source of confusion has long been eggs. A typical egg contains about 200 milligrams of cholesterol, but only 1.5 grams of saturated fat. When researchers first linked high blood cholesterol levels to heart disease, eggs got a bad rap.

But there's never been good evidence that eggs are a major factor in high blood cholesterol levels or a contributing cause of heart disease.

In fact, when researchers at Harvard Medical School analyzed data from almost 120,000 men and women, they found that eating the equivalent of an egg a day did not increase the risk of heart disease or stroke. A more recent Harvard Medical School study, published in 2008, also found that otherwise healthy men could eat up to seven eggs a day with little risk. The only danger showed up in men with diabetes, which is known to increase heart disease risk.

Indeed, studies suggest that only about 30% of people are particularly susceptible to the effects of dietary cholesterol on blood cholesterol levels.

And overall, the effects of dietary cholesterol are relatively small compared with saturated fat and trans fats.

In a review of studies in which volunteers were fed eggs, researchers found that lowering the amount of dietary cholesterol by 100 milligrams a day resulted in only a 1% reduction in blood cholesterol levels. Replacing saturated fat with unsaturated fat had a much more beneficial effect on cholesterol."

Having said all that- I still cut out the occasional egg yolk.  I like it better that way anyway- we have scrambled eggs a lot and I think they are lighter and a better texture when I take out one yolk for every 4 or 5 eggs I use.  Not too many- too many good nutrients in those yolks!

~Here's to Healthy Eating

Tip #17 Get more water

Yesterday I did a little Senior nutrition presentation at a retirement home in Ballard.  We talked a bit about water- it's so important and for seniors, their thirst signal diminishes as they age.  I always like to point out one way I know hydration is so important- in the hospital it seems that they routinely give everyone fluids as soon as they are admitted.  Yes, it's the easy way to give medications, but I think it also speaks to how often sick people are dehydrated as well. Your body works best when well hydrated- it's such a huge part of your immune system.  Your very first defense against germs is your mouth, lungs, intestinal system, etc.  If you are dried out, that defense system doesn't work as well.  Recently I heard that they no longer push for you to get 8 glasses of water a day.  Apparently our thirst keeps us pretty well hydrated.  I still think we need to remind ourselves to drink more- place a cup at your desk, keep water bottles in your bag or purse, have a glass in the bathroom.  Remember- if  you drink coffee or caffeinated soda, you need even more water because caffeine acts as a diuretic- taking more water off our bodies.