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How to Boost Your Child’s Bones for Lifelong Health

Children’s bones keep growing throughout childhood. They grow fastest of all very early in life and when children go through puberty.

The bones keep getting denser until they reach what’s known as “peak bone mass”. This usually happens between the ages of 18 and 25.

boost-your-childs-bone-healthThe denser your child’s bones are at the time of peak bone mass, the greater their reserves of bone to protect against the fragile bone disease osteoporosis later in life.

“The reserve of bone you establish during childhood and the teenage years is with you through early adulthood,” explains Dr Paul Arundel, a consultant in paediatric metabolic bone disease at Sheffield Children’s Hospital. “We all start to lose bone mass later in life. If you are starting from a low baseline you are more likely to develop osteoporosis sooner.”

The good news is that you can protect your child’s bone health with some simple lifestyle measures.

Your Child’s Bone-friendly Diet

Building strong bones in childhood requires a range of vitamins and minerals. A healthy, balanced diet will provide this. That means a diet that includes:

  • fruit and vegetables – at least five portions every day (but no more than one 150ml – *about 5 oz – glass of fruit juice)
  • carbohydrates – such as potatoes, pasta, rice and bread (preferably wholegrain)
  • protein – such as meat, fish, eggs, beans, nuts and seeds
  • dairy products – such as milk, cheese and yoghurts

There are a couple of nutrients that are particularly important for building strong healthy bones.

Calcium for Healthy Bones

Our bodies contain about 1kg (*about 2.2 lbs) of calcium. About 99% of this is found in our bones and teeth – it’s what makes them strong and hard. Most of this calcium is laid down during childhood and the teenage years.

Calcium is particularly vital during puberty when the bones grow quicker than at any other time. Puberty takes place over a number of years, typically sometime between 11 to 15 for girls and 12 to 16 for boys.

The recommended calcium intake for children and young people aged from 11 to 18 is 800-1,000mg compared with 700mg for adults. But research shows that, on average, children and young people in this age group don’t get enough.

“Teens need more calcium because they’re growing,” says Dr Arundel. “People don’t think about bone health in teenagers as much as they do with toddlers, but teenagers are growing a lot more.”

Foods that contain lots of calcium include dairy foods such as milk, cheese and yoghurt, but also tinned sardines (with the bones in), green, leafy vegetables (but not spinach), peas, dried figs, nuts, seeds and anything that’s fortified with calcium, including some soya milks.

Vitamin D for Kids’ Bone Health

Vitamin D is important for bones because it helps our bodies to absorb calcium.

Our main source of vitamin D is sunlight. Vitamin D is made by our skin when it’s exposed to sunlight during the summer months (late March/April to the end of September).

There are only a few foods that are a good source of vitamin D. These include oily fish, eggs and foods that have been fortified with vitamin D, such as fat spreads and some breakfast cereals. Read Food for strong bones.

To ensure they get enough vitamin D, the following groups should take daily vitamin D supplements, to make sure they get enough (*US recommendations are similar – click here):

  • All babies from birth to one year of age (including breastfed babies and formula fed babies who have less than 500ml a day of infant formula)
  • All children aged one to four years old

Everyone over the age of five years is advised to consider taking a daily supplement containing 10 micrograms (mcg) of vitamin D.

But most people aged five years and above will probably get enough vitamin D from sunlight in the summer (late March/early April to the end of September), so you might choose not to take a vitamin D supplement during these months.

It’s important never to let your child’s skin go red or start to burn. Babies under six months should never go in direct sunlight. Find out how to get vitamin D from sunlight safely.

Find out more about who should take vitamin D supplements and how much to take.

If you receive benefits, you may be eligible for free Healthy Start vitamins, which contain vitamin D. Your health visitor can tell you more, or you can visit the Healthy Start website.

Bone-strengthening Exercises for Children

Daily physical activity is important for children’s health and development, including their bone health.

Try not to let your child be sedentary for long periods. You can do this by reducing the amount of time they spend sitting down, for example, watching TV or playing video games.

Children under five who aren’t yet walking should be encouraged to play actively on the floor. Children who can walk on their own should be physically active daily for at least 180 minutes (three hours) spread throughout the day. This should include some bone-strengthening activities, such as climbing and jumping.

Children aged five to 18 need at least 60 minutes (one hour) of physical activity every day, which should include moderate-intensity activity, such as cycling and playground games.

To strengthen muscles and bones, vigorous-intensity activities should be included at least three times a week. This could be swinging on playground equipment, sports such as gymnastics or tennis, or hopping and skipping.

See 10 ways to get active with your kids.

Eating Disorders and Bone Health

Eating disorders affect people of all ages, both male and female. But girls and women are more likely to be affected and anorexia most commonly develops in the teenage years.

The bones are still growing and strengthening at this time and eating disorders like anorexia can affect their development. Low body weight can lower oestrogen levels, which may reduce bone density. Poor nutrition and reduced muscle strength caused by eating disorders can also lower bone density.

If your teenage child has anorexia or another eating disorder, it’s important to seek medical advice about their bone health.

Editor’s Note: *clarification provided for our US readers.





How to Avoid Your Child’s Advertising-Fueled Nag Factor

I’ll admit it—the first brand name my son recognized was Starbucks. This probably says something about the coffee habits in our family. However, it also says something about the advertising and branded world we live in. At the time of this recognition my son was about 2 or 2.5 years old. It just goes to show how powerful branded messages and advertising are for even the youngest members of our society.

After reading this disturbing article that explained that the 0-3 year old age range is now the prime target for advertisers, I started to delve more into the research on advertising to children.

kids advertising and the nag factorWhat I found was not encouraging. It seems clear that advertisers focus a lot of their time and money on ads for food products targeted to kids, most of which are quite unhealthy. A study released by the Kaiser Family Foundation showed that advertising on children’s television (aimed at kids under age 12) had the highest proportion of food ads (50% of all ads) compared to all other genres of TV. What types of foods do these ads promote? Much like you might expect, these food ads targeted toward children primarily focus on candy and snacks (34%), cereal (28%), and fast food (10%).

Unfortunately, this type of advertising works. Studies show that children who watch more ads for food products on television are much more likely to prefer unhealthy foods when offered a choice.

So why is this advertising to children so effective? One factor, of course, is the advertisers are smart—they have harnessed the knowledge of psychology and marketing to be able to market products (especially food) to children in just the right way to make it very appealing to little minds.

Additionally, as we all know, children are relatively impressionable. Young children, in particular, have very little power to resist advertising when they see it. They do not yet have the skills to understand the advertisers’ persuasive tactics.

Lastly, and perhaps most disturbing, advertisers are aware of and have harnessed the power of “the nag factor.” We all know what that means. Kids nag their parents incessantly for products that they’ve seen advertised, usually on TV. One recent study looked at the “nag factor” and found that kids who are more familiar with commercial television characters are more likely to nag their parents for the products associated with those characters.

For me, one of the most problematic aspects of all this advertising to children is that the advertisers are really trying to indoctrinate kids into the idea that life should be all about purchasing and getting material things.

The good news is that parents are not helpless in this battle with advertisers for their children’s minds (and stomachs). Although advertising, particularly related to food items, is very persuasive to children, parents can be quite persuasive too as long as they promote a constant message of healthy food choices.

In a new study just published, several researchers considered the role of parents’ messages in the food choices made by children ages 3-5 just after watching advertising for food products. In one part of the study, children watched a commercial for French fries and were then given the option to choose French fries or a healthier food option for a snack. Parents looked on and one group was told to encourage their children to make the healthier choice, while the other group of parents was told to remain neutral about the food choice. When parents remained neutral, 71% of the children chose the French fries over the healthy option. However, when parents encouraged a healthier choice, the percentage of kids choosing French fries dropped to 55%. While this is not a dramatic drop, it does show that parental influence does have power, even in light of direct advertising for unhealthy products.

I think it’s unlikely that this type of marketing will end or even slow down, but this research offers encouragement that we as parents can influence good choices by our children, as long as we adhere to a clear, consistent message. It is obvious that advertising has a strong impact on children, so limiting children’s exposure to commercials will most likely make your children’s choices better in the long run and perhaps your life a little easier as a parent (e.g., less nagging).

Additionally, as children get older, I could see it being helpful to explain to them how advertisers play their game. If kids can understand why and how advertising is so persuasive, they might be more likely to resist it.

With my older son, I have begun explaining how some things we see on TV or the internet are a “trick.” The people making the product are trying to “trick” us into spending money on something that is either unhealthy or useless (like a junky toy). I have been reminding him of times when he bought a cheap toy and was bored with it after a day or two. These lessons are starting to sink in but it is an ongoing battle with advertising.

Here are some good resources available for helping kids learn media literacy:

 

How to Help Your Underweight Teen Boy Get Healthy

Are you worried about being underweight? Or perhaps your friends or parents have mentioned it.

You may have friends who are taller, heavier and more muscular than you. We all grow and develop at different rates. Lots of boys don’t reach their adult weight until they are over 18.

You can check whether you’re a healthy weight by using our healthy weight calculator. If you are underweight, your GP (*pediatrician), practice nurse or school nurse can give you help and advice.

underweight-teen-boysThere may be an underlying medical cause for your low weight that needs to be checked out. Gut problems like coeliac disease, for example, can make people lose weight.

Read about other medical problems that can cause unexplained weight loss.

Maybe you’re having mental or emotional problems that have affected your eating habits. Depression and anxiety, for example, can both make you lose weight.

Or perhaps you haven’t been eating a healthy, balanced diet.

Whatever the situation, if you’re concerned about your weight or your diet, the best thing to do is tell someone. There’s a lot that can be done to help.

Why Being a Healthy Weight Matters

Being underweight can leave you with no energy and affect your immune system, meaning you could pick up colds and other infections more easily.

If your diet is poor, you may also be missing out on vitamins and minerals you need to grow and develop.

The good news is that, with a little help, you can gradually gain weight until you get to a weight that is healthy for your height and age.

Healthy Diet for Teen Boys

It’s important that you gain weight in a healthy way. Try not to go for chocolate, cakes, fizzy drinks and other foods high in fat or sugar. Eating these types of foods too often is likely to increase your body fat, rather than building strong bones and muscles.

Instead, aim to eat three meals and three snacks a day. You should be having:

  • Plenty of starchy carbohydrates, such as bread, pasta, rice and potatoes (choose wholegrain versions or potatoes with their skins on if you can)
  • At least five portions of a variety of fruit and vegetables a day
  • Some meat, fish, eggs, beans and other non-dairy sources of protein
  • Some milk and dairy food

We all need some fat in our diet, but it’s important to keep an eye on the amount and type of fat we’re eating. Try to cut down on the amount of saturated fat you eat  that’s the fat found in sausages, salami, pies, hard cheese, cream, butter, cakes and biscuits.

Cut down on sugary foods, such as chocolate, sweets, cakes, biscuits and sugary soft drinks.

Strength training can also help to build strong muscles and bones. Find out how to increase your strength and flexibility.

Boost Your Calories

To bump up your energy intake in a healthy way, try these tips:

  • Make time for breakfast. Try porridge made with semi-skimmed (*1% or 2% milk) milk and sprinkle some chopped fruit or raisins on top. Or how about eggs on toast with some grilled tomatoes or mushrooms?
  • Crumpets, bananas or unsalted nuts all make good snacks.
  • A jacket (*baked) potato with baked beans or tuna on top makes a healthy lunch and contains both energy-rich carbohydrates and protein. Adding cheese will provide calcium.
  • Try yoghurts and milky puddings, such as rice pudding.
  • Have a healthy snack before bed. Cereal with semi-skimmed milk is a good choice (choose a cereal that is lower in sugar), or some toast.

Find out how many calories the average teenager needs.

You should also make sure you get plenty of sleep. About 8 to 10 hours a day is ideal for teenagers. Avoid smoking and alcohol.

Teen Boys and Eating Disorders

Sometimes there can be other issues that stop you from eating a healthy diet.

If you feel anxious when you think about food, or you feel you may be using control over food to help you cope with stress, low self-esteem or a difficult time at home or school, then you may have an eating disorder.

People with eating disorders often say they feel that their eating habits help them keep control of their lives. But that’s an illusion: it’s not them who are in control, but the eating disorder.

If you feel you may have an eating disorder, help is available.

Tell someone: ideally your parents, guardians or another adult you trust.

The eating disorders charity b-eat has a Youthline, where you can get advice.

Editor’s Note: *clarification provided for our US readers.





How to Help Your Family Eat Healthy in 2017: Processed Foods

Processed foods aren’t just microwave meals and other ready meals. The term ‘processed food’ applies to any food that has been altered from its natural state in some way, either for safety reasons or convenience. This means you may be eating more processed food than you realise.

Processed foods aren’t necessarily unhealthy, but anything that’s been processed may contain added salt, sugar and fat.

One advantage of cooking food from scratch at home is that you know exactly what is going into it, including the amount of added salt or sugar.

However, even homemade food sometimes uses processed ingredients. Read on to find out how you can eat processed foods as part of a healthy diet.

What Counts as Processed Food?

Most shop-bought foods will have been processed in some way.

Examples of common processed foods include:

  • Breakfast cereals
  • Cheese
  • Tinned vegetables
  • Bread
  • Savoury snacks, such as crisps (*potato chips)
  • Meat products, such as bacon
  • “Convenience foods”, such as microwave meals or ready meals
  • Drinks, such as milk or soft drinks

Food processing techniques include freezing, canning, baking, drying and pasteurising products.

How to eat healthy - processed foodDietitian Sian Porter says: “Not all processed food is a bad choice. Some foods need processing to make them safe, such as milk, which needs to be pasteurised to remove harmful bacteria. Other foods need processing to make them suitable for use, such as pressing seeds to make oil.

“Freezing fruit and veg preserves most vitamins, while tinned produce (choose those without added sugar and salt) can mean convenient storage, cooking and choice to eat all year round, with less waste and cost than fresh.”

What Makes Some Processed Foods Less Healthy?

Ingredients such as salt, sugar and fat are sometimes added to processed foods to make their flavour more appealing and to prolong their shelf life, or in some cases to contribute to the food’s structure, such as salt in bread or sugar in cakes.

This can lead to people eating more than the recommended amounts for these additives, as they may not be aware of how much has been added to the food they are buying and eating. These foods can also be higher in calories due to the high amounts of added sugar or fat in them.

Furthermore, a diet high in red and processed meat (regularly eating more than 90g a day) has also been linked to an increased risk of bowel cancer. Some studies have also shown that eating a large amount of processed meat may be linked to a higher risk of cancer or heart disease.

What is Processed Meat?

Processed meat refers to meat that has been preserved by smoking, curing, salting or adding preservatives. This includes sausages, bacon, ham, salami and pâtés.

The (*UK) Department of Health recommends that if you currently eat more than 90g (cooked weight) of red and processed meat a day, that you cut down to 70g a day. This is equivalent to two or three rashers (*strips) of bacon, or a little over two slices of roast lamb, beef or pork, with each about the size of half a slice of bread.

However, it’s important to remember that the term “processed” applies to a very broad range of foods, many of which can be eaten as part of a healthy, balanced diet.

How Can My Family Eat Processed Foods as Part of a Healthy Diet?

Reading nutrition labels can help you choose between processed products and keep a check on the amount of processed foods you’re eating that are high in fat, salt and added sugars.

Adding tinned tomatoes to your shopping basket, for example, is a great way to boost your 5 a day. They can also be stored for longer and cost less than fresh tomatoes – just check the label to make sure there’s no added salt or sugar.

Most pre-packed foods have a nutrition label on the back or side of the packaging.

These labels include information on protein, carbohydrate and fat. They may provide additional information on saturated fat, sugars, sodium and salt. All nutrition information is provided per 100 grams and sometimes per portion.

How Do I Know if a Processed Food is High in Fat, Saturated Fat, Sugar or Salt?

There are guidelines to tell you if a food is high or low in fat, saturated fat, salt or sugar. These are:

Total Fat

High: more than 17.5g of fat per 100g (*rougly half an ounce per 3oz)
Low: 3g of fat or less per 100g (*about a tenth of an ounce per 3oz)

Saturated Fat

High: more than 5g of saturated fat per 100g  (*100g is about 3.5oz)
Low: 1.5g of saturated fat or less per 100g

Sugars

High: more than 22.5g of total sugars per 100g  (*a little under 3/4 of an ounce per 3 oz)
Low: 5g of total sugars or less per 100g

Salt

High: more than 1.5g of salt per 100g (or 0.6g sodium)
Low: 0.3g of salt or less per 100g (or 0.1g sodium)

For example, if you are trying to cut down on saturated fat, try to limit the amount of foods you eat that have more than 5g of saturated fat per 100g.

If the processed food you want to buy has a nutrition label that uses colour-coding, you will often find a mixture of red, amber and green. So, when you’re choosing between similar products, try to go for more greens and ambers, and fewer reds, if you want to make a healthier choice.

However, even healthier ready meals may be higher in fat and other additives than a homemade equivalent. That’s not to say that homemade foods can’t also be high in calories, fat, salt and sugar, but if you make the meal yourself, you’ll have a much better idea of what’s gone into it. You could even save yourself some money, too.

When Cooking Food at Home…

For tips on how to eat healthily on a budget, read our healthy recipe ideas and check out the Eat4Cheap challenge.

Editor’s Note: *clarification provided for our US readers.





Supporting Friends or Relatives with Eating Disorders

If your friend or relative has an eating problem, they will eventually have to get professional help from a doctor, practice nurse, or a school or college nurse.

support for eating disordersIf a friend or relative has an eating disorder, such as anorexiabulimia or binge eating, you might want to encourage them to speak to someone about it. You could go with them for support if they want you to.

But there are other things you can do. You’re already doing a great job by finding out how to help them  it shows you care.

You may have noticed your friend has changed. They may no longer go out or want to be included in things.

Keep trying to include them, just like before. Even if they don’t join in, they will still like to be asked. It will make them feel valued as a person.

You can also try to build up their self-esteem, perhaps by telling them what a great person they are and how much you appreciate having them as a friend.

Try not to give advice or criticism. Give your time and listen to them. This can be tough when you don’t agree with what they say about themselves and what they eat.

Remember, you don’t have to know all the answers. Just being there is what’s important. This is especially true when it feels like your friend or relative is rejecting your friendship, help and support.

How are eating disorders treated?

Treatment for eating disorders varies around the country. Different types of help may be offered depending on where you live.

Treatment includes dealing with the emotional issues as well as the physical, but this must be done slowly so your friend or relative is able to cope with the changes.

Treatment will involve your friend or relative talking to someone about the emotional difficulties that have led to their eating disorder. It will also explore their physical problems, general health and eating patterns. Help with eating and putting on weight is usually not enough.

The earlier your friend or relative embarks on the treatment programme and the more they engage with it, the better their chances of making a good recovery.

Will they have to go into hospital?

Most people with eating disorders are seen as outpatients. This means they visit the hospital  for example, one day a week. In severe cases, they might need to visit the hospital more often, or be admitted to hospital for more intensive support and treatment (known as inpatient care).

Should I visit them in hospital?

This depends on what your friend wants, how you feel and what the treatment centre allows. Let them know you’re thinking of them and would like to visit them. If this is not possible, you can always write to them or call to let them know you’re still there to support them.

Can people be forced to get help for eating disorders?

If your friend or relative has lost a lot of weight, they may be in danger of starving themselves and developing serious complications. They may not be able to think clearly and may refuse life-saving treatment.

In these circumstances, their doctor may decide to admit them to hospital for specialist treatment. This can only be done after the doctor has consulted colleagues and they agree with the doctor’s decision. This is called being sectioned and it is done under the rules of the Mental Health Act (*in the UK).

Will they be cured when they come home?

Your friend or relative will still need your support. Most people with an eating disorder do recover and learn to use more positive ways of coping.

But recovery from an eating disorder can be very difficult and can take a long time. Part of your friend may want to get better, while the other part might be very scared about giving up the eating disorder. They might think, “I want to get better, but just don’t want to gain weight.”

They will probably have good days and bad days. During times of stress, the eating difficulties may return. Changing the way people with eating disorders think and feel is never easy and it takes time.

The eating disorders charity beat has a dedicated online space for anyone who is supporting someone with an eating disorder.

Editor’s Note: *clarification provided for our US readers.

Resources in the US:

 





OK to Salt a Child’s Food? I Disagree

don't-salt-kids-foodI am a fan of the health and wellness articles in the New York Times (NYT). Their reporting is based on scientific studies and evidence – but the articles are engaging and bring the science down to a more readable level. So, this post is a departure for me, because I disagree with a recent NYT article, by Rachel Rabkin Peachman, on whether it’s ok to salt a child’s food.

The basic argument of the article is that using a little bit of salt on your child’s food isn’t going to add that much sodium – especially compared to how much is hidden in processed foods. And that if adding a bit of salt to healthy but bitter foods, like broccoli, gets kids to eat more of these – then it’s probably worthwhile.

But I strongly disagree.

So What’s the Problem?

First of all, salt intake is MUCH too high in most countries, and this causes serious health issues. In the US, adults and children consume around two to three times more salt than is recommended, most of which is added to foods during processing. The Harvard School of Public Health highlights that these excess salt levels lead to high blood pressure and heart disease – as well as stomach cancer and osteoporosis. Nation-wide salt reduction efforts in the UK, starting in 2003, resulted in a 15% drop in salt consumption and very significant drops in blood pressure, stroke and heart attacks.

And these issues are not just adult concerns. Both the American Heart Association and the American Academy of Pediatrics say that factors leading to high blood pressure and heart disease begin in childhood. Studies have shown that about 15% of kids already have high blood pressure.

Starting in Childhood is Key

Research shows that most food preferences are developed in childhood and are difficult to shift. I’ve seen this first-hand through my own research dissertation for my Masters in Public Health. My project involved qualitative focus group interviews with employees of companies who offer a home delivery service for fresh produce as part of their wellness program. The people I met with struggled to eat the recommended levels of fruit and vegetables – even if they wanted to. Many cited that not growing up eating a large amount and variety of produce set habits that are tough to break and limited their knowledge about healthier cooking and eating.

Ms Peachman’s article states that children who learn to like bitter vegetables with toppings like salt, will like the veggies even after the salt is taken away. Personally, I VERY much doubt that. The study they cited as evidence didn’t use salt, but rather cream cheese – plus another New York times article published in 2011 points out that babies fed higher levels of sodium prefer salty foods when they are older. Again, both the American Heart Association and the American Academy of Pediatrics (AAP) recommend taking the salt shaker off the table – and trying to reduce the sodium kids get through processed food. Kids will learn to prefer less salty food. That’s advice I believe – and how we operate in our house. Now the whole family generally finds that processed and restaurant foods taste too salty.

What to Do Instead?

So, without adding salt, what CAN you do to help kids learn to like certain healthy vegetables that may not be so appealing at first bite? The AAP recommends using other things to alter or boost taste – like herbs, spices and lemon juice.

We do all those in our house. Pepper always gets put on the table, along with Mrs Dash – a salt-free topping. And I use herbs and spices like basil, oregano, rosemary, thyme and cumin. I also brown steamed vegetables, like Brussels sprouts and cauliflower, in a frying pan with a bit of butter or olive oil to add to the taste. Another good option is a little bit of Parmesan cheese sprinkled on veggies – or cooked onions or leeks mixed with veggies like broccoli. See the end of this article for more resources for getting kids to eat veggies.

The point is, there are healthier ways to help kids get used to vegetables – ones that can become lifelong habits without concern.

Tips for Getting Kids to Eat Veggies 

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