Sunday, November 28, 2010

Blog #20 Toddler Crack

This week three parents asked me how to stop their second child from becoming a picky eater. In two of the cases, I am helping deal with said picky eating older child and the third was the mother of a baby with other red flags for developmental issues. Is there anything they could do to prevent the picky eating debacle?

The best suggestion I have is to not introduce the three C’s or what I call toddler crack. Everybody knows these three oh-so-friendly kid foods. One of them is in a container in practically every diaper bag/mommy purse in the country because they are universally adored. They are crackers, cookies and cereal and once kids discover them, they are as addicting as crack.

And why shouldn’t they prefer salty or sweet crunchy foods they can pick up with their own hands verses a non-descript mush mix spooned in by daddy? At two, the toddler has just discovered there is a connection between action and consequences and he wants to see what he controls. Eating looks promising so he wants to feed himself when possible. Utensils can be challenging so finger foods are better. Crackers, cereal and cookies fit the bill perfectly.

Once in the mouth, baby mouths can find the crackers because they are crunchy but as soon as the saliva hits them, they dissolve without much chewing. In the feeding world, these foods are called meltables. They are extremely convenient because the little ones do not have a full component of teeth yet but want eating independence.

The final attribute sealing the addictive quality of toddler crack is the taste. Face it. Chicken and peas cannot compete with highly flavored crackers and cookies. David Kessler has written extensively about how food companies use these ingredients heavily to encourage people to prefer and overeat empty calorie food. (See, The End of Overeating.)

This is how kids get hooked right from the cradle. You are out at the park in the afternoon and two and a half year old Seth is starting to get cranky. It has been several hours since lunch so clearly he is hungry. Carrying around a bean burrito for such occasions is impractical and tough for him to eat so you hand him a container of dry cereal that is perfectly fine after a month laying at the bottom of your diaper bag. Seth calms down immediately because he can pick up the little pieces and feed himself. (“He is building self esteem and self care skills,” you tell yourself.) There is an additional bonus of keeping him occupied for a full five minutes so you can get him in the car/stroller without screaming.

Once home, you make a lovely dinner which he does not want to eat because his tiny toddler tummy is full. Twenty minutes of coercion and three bites later, you give up only to have him tell you he is hungry right before bed. You already put away the salmon and green beans so you hand him, just this once, a few fish crackers which he eats happily. It is straight downhill from here.

It all sounds so innocent but crackers and dry cereal are like crack to babies. Most toddlers love them to the exclusion of anything else given the choice. If you want to raise a child who will eat fruits, vegetables and a variety of healthy foods, DO NOT BUY CRACKERS, LITTLE COOKIES OR DRY CEREAL, period. They have little if any nutritional value.

What to do instead? You have to think ahead a little but pack up cold cooked peas and carrots, bananas, grapes cut in half, ¼ of a sandwich or little pieces of cheese. In the heat of the summer you may have to throw in an ice pack. Eating pieces of fruit and vegetables also require more supervision, as they are not meltables. Small children can choke more easily as developmentally they have not completely mastered eating skills. When planning for snacks, think real food instead of empty calorie treats.

A recent October 2010 study found that 40% of the calories in children’s diets now come from empty calorie foods. The most common was grain desserts or cookies and granola bars. According to several articles reporting on the study, despite the horrifying state of children’s diets in this country, nobody seemed surprised by the findings.

Monday, November 22, 2010

Blog #19 Topsy Turnips

My husband, Jeff, and I would not survive well as farmers. Despite having a nice organic garden, we have poor crop planning skills. Left to his own devices, Jeff plants mostly tomatoes that he loves but I cannot eat. When they failed this year, I stepped in and we attempted a second cold crop of peas, lettuce, carrots, radishes and turnips. It was too late for the peas which climbed about half way up the trellis before the cold set and arrested their development at mid adolescence. The carrots were delicious but the size and width of a fountain pen. I ate a head of lettuce a day for several weeks and Jeff had plenty of radishes but the turnips…… The turnips went wild.

They grew in crowded clumps because we did not thin them properly. Ignorant suburban farmers that we are we thought how many turnips can a few seeds produce? It turned out to be enough for an army of underfed groundhogs. There were so many that they pushed each other out of the ground where we could just scoop them up rather than pull them out. Some were the size of soft balls.

Jeff gamely ate one or two every day and I gave them away to all of our friends/neighbors who liked them which was a grand total of one person. Nobody seemed to know what to do with them and they were starting to pile up. Finally, I decided to make a big turnip dish for Thanksgiving and invite a lot of people. The first challenge was finding a decent dish. After some experimentation, I decided on pureed turnips because I had them once at a fancy restaurant and deemed them to be a potential crowd pleaser.

Playing around with several recipes, I came up with this one. It would probably taste better with a half cup of heavy cream added but too many people in my family do not eat dairy. Besides, without the cream, it has the advantage of being extremely healthy.

Cut and peel turnips and carrots and put them in a greased roasting pan. I use two parts turnips to one part carrot. The farmer’s market had yellow carrots and they worked great because the puree is yellow rather than orange like sweet potatoes and they are sweeter. Roast them for 20 minutes or until tender. Next dump them into a food processor or better yet, a Vitamixer. Then add salt (to taste), chicken broth (to get it to the thickness you like) and a tablespoon of maple syrup. The maple syrup was important because the baseball size turnip was pretty strong tasting though the little ones were not. A couple of spins around the Vitamixer and the result was creamy and tasty. Now to find more people to eat it.

I called my virtual assistant, Tania who lives a few hours away. “So, do you want to come for Thanksgiving?” I asked.

“What are you serving?” she asked warily.

“Pureed organic turnips with a hint of maple syrup,” I said in my most seductive voice.

“Gee, it looks like we will be awfully busy that day,” she retorted.

“Well, I also got a delicious turkey from the Amish farmers,” I tried again. “After which, I signed up for their e-mail list.”

“You are making that up,” she gasped appalled.

“Am not. The Amish have e-mail now. I wonder what kind of horse powered generator they use to run their computers?” I mused.

“They do not have computers,” she corrected. “They probably hire outsiders like they do for driving and things.”

“Well, they are famously adaptive business people, “ I agreed. “But I still think there might be a poor horse walking around in circles somewhere long into the night so Amish teenagers can be on Facebook.”

“I think you better cut down on your turnip consumption, it is affecting your mind,” she countered.

I would love to cut down as I do not like plain turnips very much but what am I going to do with all of them? They are such an underdog vegetable that I am afraid if I donate them to the Manna Food Bank, they will wish it was carrots or green beans instead. One of the vendors selling them at the farmer’s market said he had no clue what to do with them but I bet the Amish farmers have some ideas. Maybe I will send them an e-mail.

Tuesday, November 16, 2010

Blog #18 What to do to prevent the flu

To read a detailed, technical chronicle of the foils of the flu shot, see my last blog. To summarize, the flu shot does not work but contains harmful toxins and preservatives like aluminum and mercury so thoughtful people avoid it. The pressing question is what really does prevent the flu? I will start with the boring stuff that everyone knows but does not want to do.

• Exercise
• Healthy Diet
• Getting enough sleep

These three basic steps are enormously effective at improving immune function but most people prefer the myth of a magic shot instead. Exercise is hard to squeeze in anytime but in the winter there are so many better weather excuses to avoid it. The truth is you do not have to train for the Boston marathon, just walk 25 minutes 4 or 5 days per week. My solution for this was to purchase some very comfortable ski pants. Now no matter how cold it is, I can walk comfortably with my dogs who never complain about the weather.

A healthier diet does not have to be intimidating either. Added sugar is the major immune suppressor in the diet. If you just cut that way down your immune function will pick up significantly. Eat fruit (fresh or dried) or put some raw honey (which has immune enhancing properties) in your tea to soothe your sweet tooth. This is the hardest step for me.

If you don’t build enough sleep into your schedule, your body will eventually correct that by making you sick so you have to sleep. By biggest problem with this is the &%$#%^ computer and e-mail. If I stay on too long, the e-mails run through my head when I’d rather be sleeping. In my practice I have noticed that turning off the computer is a particularly difficult problem for men.

Now for the more exciting, easier supplement strategies:
• Get your blood vitamin D level up to at least 60.
• Take vitamin C, probiotics and at least 15 mg of zinc daily.
• Keep a strong natural killer cell enhancer on hand in case you feel an illness coming on.

Robust vitamin D levels are highly associated with lower illness rates (including cancer). Blood levels over 30 or 32 ng/ml are considered “normal” but higher levels can protect against illness. Of course, the only way to know for sure if you have a decent vitamin D level is to have your doctor order a blood vitamin D test. Since about 70% of women and children are low, most doctors agree to this request and it is probably worth doing.

Vitamin D-3 (the natural version) is easily available in drops and pills. Several doctors I know recommend taking one large dose (25,000-30,000 IUs) immediately if you start feeling under the weather. For dosage recommendations for children, consult your pediatrician. Note that nutritional interventions to prevent illness do not work once the illness sets in. You must strike early when the immune system first notices a problem.

Consistently taking the immune trio of probiotics, vitamin C and zinc can keep up your defenses during the flu season. Keep probiotics in the refrigerator and find one that has at least 10 billion bugs. Take 500-2000 mg of vitamin C depending on age of the person and level of vulnerability to illness. You cannot overdose on vitamin C because when the body cannot absorb anymore, it causes diarrhea and out it goes. A good multiple vitamin/mineral may already contain the basic zinc most people need but you can take an extra 15 or 20mg daily during periods where you need an extra boost.

Keeping a strong immune enhancer on hand is a must because you know you are going to need it at 11:00 PM on a Tuesday night. Waiting 12 hours to get to the store (or days until it comes by mail) will be too late as the illness will have enough time to take hold. Viruses replicate very quickly and the more cells they have time to infect, the more serious the illness. Natural killer cells are the first line defense against viruses. Several products enhance these fighters and people have individualized responses to them. Some find one product works better for them than another. I will take one of these for a few days (or sometimes just one or two doses) if I feel like I am run down or fighting something.

My three favorite are:

• ProBoost Packets (http://www.proboostmed.com/faq.html)
• 4 Life Transfer Factor – Trifactor formula (http://www.amazon.com/4Life-Transfer-Factor-Classic-capsules/dp/B000OUY84U)
• American BioSciences ImmPower (http://www.vitacost.com/American-BioSciences-Immpower-AHCC).

The price of these products vary greatly but they all work great. Follow the directions on the bottle. This is a blog and should not be used as a substitute for medical advice. If you have questions, contact a knowledgeable medical professional.

Finally, use hand sanitizers frequently. Just kidding. These products have been found in studies to be as useless as the flu shot. You may as well rub your hands in the grass or on your pants. Better to wash your hands with plain old soap and water every once in awhile.

Just to let you know how long you need to wash your hands to significantly get the germ level down, imagine singing through a verse of “All the Single Ladies” or about 30 seconds. That is what it takes and unless you are preparing for surgery, you probably are not doing this.

Not to worry, while germs cause colds and flus, they are less responsible for illness then most people believe: Mainly because they are everywhere so one cannot avoid them. In one study, healthy volunteers were asked to play cards with other volunteers who had colds. (Warning: this is a gross study.) No tissues were provided so after awhile the cards were literally damp with the viral laden nasal discharge from the sick participants. The high virus exposure did not result in significantly more colds among the healthy volunteers.

As Pasteur said at the end of his life, “It is the environment”. It probably sounded better in French but after years of proving germs caused disease, in the end, he realized it was the environment the germs were introduced in to that often counted more than the bugs themselves. So, strengthen your environment and the germs will find somebody weaker to attack.

Monday, November 8, 2010

Blog #17 The Most Hysterical TIme of the Year

Bundled in my overcoat and out walking my dogs, I cannot help but appreciate the crisp air and beautiful foliage. The joggers are out and the left over Halloween pumpkins seem to wink as you pass by or perhaps they are just spoiling and sagging some. Still, fall would be absolutely perfect except for one sour note. Yes, it is time for the annual drug company induced flu hysteria.

“The flu is coming, the flu is coming,” is the battle cry. “Experts advise the best way to prevent the flu is to get the flu shot or flu mist,” shout the television commercials. I ran into flu shot "clinics" at the airport. And then, while looking for an elusive shower cap, at several pharmacies. All utilized cleverly worded signs to entice or frighten the consumer into submitting to unproven technologies. You cannot avoid being affected by the deluge or the very seductive word, “free”. Everyone likes getting stuff for free.

For me, the result is many phone calls and e-mails. The first came from my friend, Lizzy. Lizzy evaluates children for sensory processing issues. She sounded awful on the answering machine. “What should I do?” she wanted to know. She had been testing a child who had come directly to her office after getting a dose of the flu mist. He had been sneezing throughout the session and now, several hours later she was feeling heavy headed and achy.

You may recall from several years ago when experts unequivocally stated the flu mist did not work. Part of the problem was it contains a live virus so it had a tendency to cause the flu. That was the year that Walmart was naively squirting the viral mist up the noses of its shoppers only to find that they would wander over to the deodorant aisle and sneeze. Viral clean-up needed on aisle 7. It did not take them long to figure out they were potentially spreading more flu than they were preventing.

Now Lizzy was worried she was coming down with the flu. It was still early enough for her immune system to fight it off. She upped her vitamin C, probiotics and immediately took a packet of a powerful natural killer cell enhancer called ProBoost. I had introduced her to ProBoost several years ago and she has not been sick since. I told her to take a second packet the next morning and to take one large (25,000 IU) one time dose of vitamin D. When I talked to her a few days later, she was doing fine, disaster averted.

The calls and e-mails, however, were just beginning. Tania, my loyal assistant called soon after. “They are offering the flu shot and flu mist at my son’s school,” she reported. “I was wondering if I should keep him home that day.”

Good question. “If they were sprinkling virus around the Nordstrom Rack, what would you do?” I asked.

“Show up early to avoid the crowds?” she retorted smarty pants that she is.

Very funny,

“Go to TJ Maxx instead?” she continued on a roll. “I never really liked Nordstrom Rack anyway.”

It is a start, I agreed.

What about the flu shot? That does not contain live virus. Putting aside the questions about the mercury content and other potentially dangerous preservatives for the moment, does it work? Apparently not as the number of people getting the flu is not decreasing despite dramatically higher vaccination levels.


The research, what little there is, has never proven the efficacy of the flu shot. In fact, there have never been the basic studies done on the flu shot that are required of other FDA approved medication. Not a single double blind study.

What a review of 15 studies found was that influenza vaccines were ineffective against influenza-like illnesses, influenza and pneumonia. (The Cochrane Database of Systematic Reviews 2006.) It also works equivalent to placebo in children under 2. (The Cochrane Database of Systematic Reviews 2008.) In other words, it does not work.

One study found the flu vaccine may triple the risk for flu-related hospitalization in children with asthma. (May 25, 2009, www.medscape.com/viewarticle/703235). There are a shocking number of negative studies yet the shot is consistently recommended. (For more flu shot info see: www.drtenpenny.com.)

The best explanation for this incomprehensible disconnect was offered in a brilliant article in the Atlantic Magazine (November 2009), “Does the Vaccine Matter?” According to the article, the research often quoted to promote the shot does not prove the vaccine works but uses conclusions from cohort studies. These studies look at death rates associated with various factors. It is often observed that people who get the flu shot die at a much lower rate than those who do not. So, therefore, the flu shot saves lives, right?

Nope. It turns out that people who get the flu shot die much less often than other people summer, winter, spring and fall. In fact, they die less from all causes all the time because they tend to be healthier to begin with. It is called a “healthy user effect” and completely accounts for the lower death rate in flu shot receivers. When Dr. Lisa Jackson, a brave Seattle based researcher and physician studied the association more closely, she found the shot did not reduce death whatsoever.

But the November 2009 Atlantic Magazine article said it better than I can:

“…. in 2004, Jackson and three colleagues set out to determine whether the mortality difference between the vaccinated and the unvaccinated might be caused by a phenomenon known as the “healthy user effect.” They hypothesized that on average, people who get vaccinated are simply healthier than those who don’t, and thus less liable to die over the short term. People who don’t get vaccinated may be bedridden or otherwise too sick to go get a shot. They may also be more likely to succumb to flu or any other illness, because they are generally older and sicker. To test their thesis, Jackson and her colleagues combed through eight years of medical data on more than 72,000 people 65 and older. They looked at who got flu shots and who didn’t. Then they examined which group’s members were more likely to die of any cause when it was not flu season.


Jackson’s findings showed that outside of flu season, the baseline risk of death among people who did not get vaccinated was approximately 60 percent higher than among those who did, lending support to the hypothesis that on average, healthy people chose to get the vaccine, while the “frail elderly” didn’t or couldn’t. In fact, the healthy-user effect explained the entire benefit that other researchers were attributing to flu vaccine, suggesting that the vaccine itself might not reduce mortality at all. Jackson’s papers “are beautiful,” says Lone Simonsen, who is a professor of global health at George Washington University, in Washington, D.C., and an internationally recognized expert in influenza and vaccine epidemiology. “They are classic studies in epidemiology, they are so carefully done.”

The results were also so unexpected that many experts simply refused to believe them. Jackson’s papers were turned down for publication in the top-ranked medical journals. One flu expert who reviewed her studies for the Journal of the American Medical Association wrote, “To accept these results would be to say that the earth is flat!” When the papers were finally published in 2006, in the less prominent International Journal of Epidemiology, they were largely ignored by doctors and public-health officials. “The answer I got,” says Jackson, “was not the right answer.”

The entire article is available online.


So, the flu shot and the flu mist do not work. So what does work? To be continued………

Monday, November 1, 2010

Blog #16 Vitamin M Continued......

“You were soooooo right,” Ellen enthused. Oh goodie, I thought. I love being right. Then it occurred to me that I had no idea to what she was referring.

“About what?” I queried.

“You know,” she continued. “About movement and speech. Remember that story you told me?”

I did. It was currently my favorite story about movement involving a 5-year-old boy on the autism spectrum. I will call him, Kirk. Kirk hopped from one thing to the next with limited attention or engagement. His language consisted of demands and basic observations with little conversation. If you work with or have a child with autism, you may know about the concept of closing circles of communication. Basically, you say something, the child acknowledges your opening and responds with something related to what you said and sends the conversation back to you. That is one circle.

The late Dr. Stanley Greenspan stressed the importance of closing circles of communication and developed many techniques to help improve conversational skills. The child needs to be interested enough in another person to engage and then respond appropriately to unexpected conversational gambits. An autistic conversation is more like a political debate on TV when one question is asked and another is answered. This “conversation” tends to be one-sided. Something like this:

“What did you do at school today?”

“Thomas”

“Oh, you played with Thomas?”

“No, want to play with Thomas.”

“You want to play with Thomas the tank engine. Okay, but did you have music today?

“Eat cookies.”

Etcetera.

Kirk communicated at this level with much prompting and redirection needed to have any level of conversation. The parents and speech therapist were working hard to improve the quality and complexity of the interactions. I explained to the mother that the language centers were right next to the movement centers. Parents so often concentrate directly on speech rather than working on motor skills and/or sensory function. When language is not improving, improving sensory and motor function can create a neurological foundation for better speech. It is the reason children usually walk before they talk and why boys, in particular, use movement to help them think straight.

With this little developmental tidbit in mind, the Kirk’s family headed off to Disney World. It had been a tough year and the parents decided for one day to allow Kirk to do whatever he wanted. What Kirk wanted was to go on the Disney equivalent of the roller coaster “20 times”. So, they let him.

At the end of the day, Kirk was communicating better than he ever had. He was answering questions and initiating more conversation. His parents were so excited but did not know how to sustain the gains.

Since they did not have room for a roller coaster in their living room and they could not move to Disney World, the question was what to do to get Kirk’s level of movement and sensory input way up. We talked about using Wii fit and checking in with their occupational therapist about what equipment could be installed and used at home. This was the story I told Ellen.

Ellen took her son with speech delays to a local amusement park and used the same strategy with similar results. “You should have heard him talk,” she reported. “It was unbelievable”.

Once again, I had a conversation about increasing the levels of vitamin M in a little boy. “Sometimes I think there is not enough movement in the world for him,” his mother cracked.

The difference between these two children and Colin, discussed in the previous vitamin M blog is in the type of movement. For Colin, it was direct heavy exercise while in Kirk and this young boy it was machinery moving them. While the child moving himself is generally preferable, the intense movement of a roller coaster is very stimulating to the nervous system and can also do the trick. The key is finding a way to get lots of movement into everyday life.