Dispelling nutrition myths, ranting, and occasionally, raving


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Is a spoonful of sugar the way to get the vegetables to go down?

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When I saw this article: “Sugar, salt or sweeteners may be key to getting children to eat greens” last week in the Nutrition Resource Centre “News in Brief” email I knew that I had to read more. I mean, were the authors really suggesting that we should add sugar to veggies to get infants and toddlers to eat them? Or was this just a case of a misleading or misinterpreted press release? I found a copy of the full article: Mary Poppins was right: Adding small amounts of sugar or salt reduces the bitterness of vegetables and set about reading.

One thing that struck me right away was that this study was done with adults, no infants or toddlers, or children of any age were involved in the research. Adult participants were provided with puréed vegetables (broccoli, kale, and spinach) with varying concentrations of added sugar. They were asked to rate them on various attributes, and most importantly, they were asked to indicate whether or not they liked or disliked each sample. I was surprised that the conclusion would be drawn that adding sugar to green vegetables is a reasonable means to encourage infants to eat them (I’m saying infants because these were puréed veggies and as such are really only suitable for babies just starting to eat solid foods) based on ratings by adults. After all, adults have very different palates than infants and have very different relationships with food that have been shaped over decades. To me it seems inappropriate to conclude that because adults preferred sugar sweetened veggies that infants will as well. The authors themselves also state that, “It should be noted that infants and toddlers are also not merely small adults”. However, they also use the analogy of adults beginning coffee consumption with added sugar and gradually weaning off the sugar as justification for proposing adding sugar to vegetables when the World Health Organization, among many other bodies, is currently encouraging reduced consumption of added sugars.

The second thing I wondered about was precisely how much sugar was added to each serving of vegetables. The news article, and much of the journal article, references 1% and 2% concentrations but what did that translate to in teaspoons or grams? It sounds pretty innocuous, right? 1% or 2% is hardly anything. Well, in actuality the 1% was equivalent to the addition of 1/2 teaspoon per serving and the 2% was equivalent to 1 teaspoon per serving. Not an insignificant amount when you’re talking about toddlers who are generally only consuming a tablespoon or two of a food in a serving. Interestingly, the researchers asked parents how comfortable they would be offering their babies vegetables with added sugar in amounts of 8 calories, 16 calories, 1/2 teaspoon, or 1 teaspoon. The 8 calories = 1/2 teaspoon = 1% concentration. The 16 calories = 1 teaspoon = 2% concentration. Essentially asking: how can we frame this added sugar to make it more palatable to parents who are trying to feed their children healthy diets?

Despite the general conclusion that adding sugar to vegetables may encourage young children to eat them, even the ratings by adults were not overwhelmingly improved by the added sugar. For broccoli and kale purées both 1% and 2% sugar increased overall liking. For spinach the 2% sugar (but not the 1%) increased overall liking. For broccoli and spinach the sugar increased the ratings of liking from disliked to liked. However, for kale, even at the highest sugar level ratings never rose above the midpoint (i.e. neither like nor dislike). So, these adults did not like any of the green vegetables to begin with (at least not in puréed form) but after adding higher quantities of sugar they liked the spinach, and even with the smaller quantity of added sugar they liked the broccoli. But neither amount of sugar was enough to get them to like the kale. Would babies have different initial reactions to these vegetables? Would the addition of sugar cause them to change these reactions? I don’t know and I don’t think anyone can say based on the results of this study alone.

Just for fun, I took a look at the funding sources for the study after I finished reading it. Can you guess what one of the funding organizations was? If you guess the Sugar Association you’d be correct. I think this explains a lot because honestly I was a bit baffled as to why anyone would be looking into adding sugar to get babies to eat vegetables and why such tenuous conclusions would be drawn and publicized based on the actual findings. But who other than the Sugar Association would think that we need to encourage babies to eat more sugar?

I think a better analogy than the sugar sweetened coffee for this research would be the argument that chocolate milk is a good way to get kids to drink milk or that baking apples into a pie is a good way to encourage fruit consumption. In some ways it’s even worse because infants are at the mercy of their caregivers when it comes to what foods are offered to them and encouraging a preference for only sweet foods at such a young impressionable age could have long lasting implications for their food choices and health throughout their lives.

 

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Grocery store lessons: Baby food pouches

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Sometimes I have loads of things to blog about and other times I struggle to find a topic that I feel like ranting about. This was one of those weeks where nothing noteworthy caught my attention. Thankfully, my friend who runs a day-home suggested I write about baby food pouches which seem to have crept from being food for babies to being food for school-aged children.

If you’re not a parent of young children you may ask (as I did) “what are food pouches”? They’re basically pureed baby food but in a squeezable pouch. Generally they’re more expensive than your traditional jarred baby food and they come in fancy flavours like “wildberry, rhubarb, kale, & quinoa”. Parents like them because there’s no need for a spoon so they’re handy when you’re on the go. Just twist off the top and let your kid squeeze and suck away at it while you’re running errands. But, what’s the best feature of these newfangled baby foods is also the worst feature.

While there’s no disputing the fact that these are handy in a pinch, that’s really how these pouches should be used. Ideally, you’d want to be squeezing these pouches out into a bowl and feeding the to your baby (or letting them feed themselves) with a spoon. When babies are learning how to eat (at about six months of age) there’s this window of opportunity during which they learn things like chewing, appreciation for various textures, and how to put food in their mouths. Gone are the days when purees were the mainstay for babies for month on end. Now parents may use them for a short period, start baby with a variety of textures, or skip the purees altogether. The concern with children receiving all of their food from squeeze pouches is that their mouths may not develop properly and they may also be unaccepting of different textures when they are finally introduced. There’s also a missed opportunity for infants to develop hand-eye coordination when feeding themselves. These pouches really shouldn’t be considered a meal for a toddler or older child.

Something else I’ve wondered about when it comes to these fancy baby food pouches is the gourmet ingredients themselves. Introducing babies to a variety of foods and flavours is important but what about food allergies? When you’re giving your baby new foods, generally you would introduce one new food at a time so that if there’s an allergic reaction it’s easy to pinpoint the source. When you’re giving your baby “yumberries and plum with ancient grains” what are the odds that he or she has had at least two out of three of those ingredients before? I mean heck, I’ve never had yumberries. I’m not even sure what they are. I feel like by marketing these as baby foods that provides parents with a potentially false sense of safety when it comes to giving them to their children.

Speaking of safety, I’ve seen a number of recalls of these baby food pouches in recent years. When I worked in a grocery store, I also came across one that was bulging (a common sign of bacterial growth). I think that it’s a lot easier for these packages to be opened and closed and put back on the shelf without anyone noticing that the seal’s been broken than it is with jarred baby food where there’s usually a plastic wrap around the lid as well as the popped down seal of the jar lid. Not to fearmonger. I just think that it would be easier for a child (or adult) to be curious about a flavour, twist the top, and put it back on the shelf without the fact that it had been opened being obvious.

Back to the issue of price. Many of these retail for around $2 (some a bit less, some more). Which can add up quickly if they’re the primary source of food for your little one. Jarred baby food is generally less than a dollar. Even more affordable though, is to give your baby an unseasoned version of what you’re eating. You can puree it or mince it for younger infants, or provide finger friendly options as they’re ready. There’s a lot more that can be said about infant feeding and starting babies on solid foods. If you have questions, there’s a great resource from Best Start. If you’re in Canada, you can also contact your local public health unit to find out if they offer infant feeding classes.


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Is store bought baby food better than home cooked?

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When I saw this article in the Daily Mail (yeah, I know) last week I knew that I had to read the original research to see what it said. As a dietitian I’m always trying to encourage people to cook their own meals. When I talk to mums about introducing their babies to solid foods I suggest that they see it as an opportunity to enjoy balanced meals as a family. Just what I need is headlines and articles proclaiming that pre-made store bought baby food is healthier than what ever they might be preparing at home.

I was frustrated to be unable to see the list of cookbooks the authors used in this study. The link just takes me to Amazon, and the list of the most popular baby food cookbooks they used was complied in 2013 so any results I might find could be considerably different today. Naturally, I worry about the use of baby food cookbooks as a comparison to ready-meals as they tend to be written by people with limited (or no) nutrition credentials (*cough* Pete Evans *cough*. Cookbooks are also quite unlikely to provide a true picture of what parents are feeding their children.

The obvious conclusion to draw from the study is that home cooked meals are superior (from both a cost and nutritional standpoint) to ready meals (at all ages) provided parents are preparing foods without added salt and sauces. The authors didn’t seem to reach this conclusion though. Perhaps the disingenuous comparison between cookbook recipes and ready meals, and the conclusion that ready meals may be better for babies, had something to do with the funding they received from Interface Food and Drink, an organization aimed at connecting the food and drink industry with researchers.

So, we know that home cooked meals can be healthy if parents don’t waste their money on special baby cookbooks. I think that it’s also important to note that the researchers were comparing quantities based on recipe yields and packages, not what babies are actually eating. Even if babies were eating recipes prepared from these cookbooks, they may not be eating every bite. Babies are much better than us adults at knowing when they’re full. If parents are respecting their babies cues and only feeding them as much as they show a desire to eat then it shouldn’t matter how much a recipe makes, or how much is in a package.

The true message from this study should be that you don’t need to waste your money on baby food cookbooks. Nor do you need to waste your money on packaged baby foods. Most babies will thrive on, and enjoy, a variety of simply prepared “normal” foods.

If you’re looking for more information on starting your baby on solids, I recommend visiting Best Start as well as watching this video from Toronto Public Health. If possible, sign-up for an infant feeding class through your local public health office.

 


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Grocery Store Lessons: Liberte Baby Yoghurt

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Baby yoghurt isn’t a new product. I had thought about blogging about it a while ago and then forgot and then thought that it had been discontinued. Unfortunately, that wasn’t the case. File this one under ridiculous unnecessary products that you never need to buy.

There is no reason that a baby needs yoghurt with added sugar. And that’s what this product is. It’s a series of yoghurts with 6% milk fat. You’re supposed to start them on the plain (with a mere teaspoon of sugar per 75 gram package). Ingredients: whole milk, cream, cane sugar, milk protein concentrate, bacterial cultures, and vitamin D. Then you can progress to the yoghurts at “step 2”; banana or strawberry.

The banana and strawberry both have 7 grams (just under two teaspoons of sugar) per 75 gram serving.

Ingredients in the banana: whole milk, fruit preparation (banana puree [i.e. flavoured sugar], cane sugar, water, tapioca starch, pectin, natural flavour, lemon juice concentrate), cream, cane sugar, milk protein, concentrate, bacterial cultures, and vitamin D.

Ingredients in the strawberry: whole milk, fruit preparation (strawberry pureecane sugar, water, rice starch, natural flavour, carrot juice concentrate, cranberry juice concentrate, lemon juice concentrate), cream, cane sugar, milk protein concentrate, bacterial cultures, vitamin D.

Babies don’t need sweetened yoghurt. Just because many adults need sugary flavoured yoghurts doesn’t mean that babies do. Their tastebuds are much more sensitive than ours and they’re also learning what they like (and dislike). There’s no need for us to impose our preferences and sweet teeth on them. Lots of babies enjoy the tangy taste of plain full-fat yoghurt.

Parents don’t need to shell out the extra cash for smaller servings of plain yoghurt for their babies. Save your cash and get unsweetened plain yoghurt for your baby.


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Baby’s first food

As a dietitian I often field questions from my friends who are starting their babies on solids. The other day I received an email from a friend whose pediatrician suggested that she start her 6-month-old baby on a single-grain iron-fortified baby cereal. She was concerned about a rice cereal she had found and was helpful enough to send me a link to the product details. This Gerber Baby Cereal Rice claims to be “the ideal choice for baby’s first solid food”. One look at the ingredient list told me that this was not the case. My biggest concerns were: 1. the fact that skim milk powder was the second ingredient (the current recommendation for infant feeding is that babies should not be given cow’s milk until at least nine months of age as it can be difficult for them to digest – their digestive systems continue to develop during infancy), 2. Potato maltodextrin? Why does a baby cereal need a sweetener? This is a disturbing addition to me. I’m also not convinced that the additions of the three types of oil are necessary, or beneficial. Ideally, the baby should continue to be breastfed after the introduction of solids and should be obtaining necessary fats from breastmilk.

I also would like to point out a problem with the pediatrician’s advice. Giving baby cereal as a first food is no longer the best practice recommendation. The current recommendation is to start babies off on ANY iron-rich food. Baby cereal is only iron-rich because it’s fortified. Why not start your baby off on something that doesn’t contain added oils, milk, or maltodextrin? You can give your baby meat, poultry, eggs (yes, even the whites!), beans, legumes, tofu…

If you do decide to start with a baby cereal, make sure that you give it a good shake before you prepare it as the iron has a tendency to sink to the bottom of the box. Also, please read the labels. If you’re not sure about a product, do what my friend did and ask a dietitian. Try to choose a product that is a single grain that’s fortified but that doesn’t have loads of unnecessary added ingredients.