Happy meals can be as simple as fruit and nuts

By Wanda A. Adams
Advertiser Food Editor

Dr. Brijit Reis, a pediatrician, has seen patients as young as 2 or 3 with plaque buildup in their arteries. She sees overweight children and children with pre-diabetic indications in her Kailua practice almost daily.

Dr. Brijit Reis and 5-year-old vegetarian Jasmine Westerdahl share a drink of soy milk, frozen strawberries and blueberries in the pediatrician's Kailua office. Reis points out that for very young children, almost all food choices can be made by parents. Deborah Booker • The Honolulu Advertiser

The difference between Reis and many parents is that she has enough information about nutrition to make wise choices while she's power-walking down the grocery store aisles — most recently, a bag of almonds and a bunch of grapes.

She also doesn't allow herself to worry much about peer pressure or her children's junk-food whims.

"Kids will eat what you give them in the car on the way home," she said, practically. "They're hungry and they're a captive audience."

A third difference between Reis and many parents is that she is careful to exercise portion control. She doesn't just hand the bag of almonds over the back seat, but doles out cupfuls or a handful.

Reis, who took over a pediatric practice in Kailua this month and will give a seminar on children's nutrition and wellness tomorrow for Castle Hospital's Wellness & Lifestyle Center, says parents are in an advantageous position to give their children a good nutritional base. And babyhood isn't too early to start.

Even after children are in school, until about middle-school age, parents — by what they serve at home, what meals are sent to school, what snacks are allowed, how much money is doled out and what practices they model — largely determine children's eating patterns. "You'll never have that opportunity, ever again," Reis said.

Five-year-old Jasmine Westerdahl, a Reis patient, is an example of how that can work. Her parents, Dr. John Westerdahl (director of Castle's Wellness & Lifestyle Center) and Doris Westerdahl, are vegans and Jasmine is, too. By and large, she eats a normal kid-type diet: toast and jam for breakfast, peanut-butter and jelly sandwiches for lunch, yogurt or chips for snacks. But the toast is whole-grain, the jam and jelly are pure fruit preserves, the peanut butter is natural and organic, the yogurt is soy-based, and the chips are nothing but grain and a little salt — and baked.

And — big difference — Jasmine doesn't eat candy or drink soda, and she likes — and regularly eats — vegetables. Asked if she eats chocolate, she looks grave and shakes her head. Often when she sees advertisements for unhealthful foods on TV, she brings them to her parents' attention.

Pediatrician Brijit Reis measures Jasmine Westerdahl. Deborah Booker • The Honolulu Advertiser

Doris Westerdahl said a key is involving Jasmine in meal preparation. Jasmine (who, by the way, is in the 50th percentile for weight and the 75th for height) might wash the vegetables for Mommy to chop, then both participate in putting them in the steamer.

Jasmine is also encouraged to help in deciding what she'll take to school for lunch, or what they'll have for dinner. "We go through the refrigerator and talk about it," said Doris Westerdahl.

Jasmine attends Windward Adventist School (Seventh-day Adventists are vegetarians) and she takes lunch. But she does have classmates who aren't vegetarians, so she is exposed to foods that aren't in her diet plan and has learned to answer questions about being a vegan.

Pediatrician Reis approves this practice and says it's important never to get into "food battles" or force new foods on children.

"Just give them a little. Serve it again another time. Don't make it a big deal," Reis suggests.

As for candies, John Westerdahl says that because Jasmine has never eaten them, she has no real craving for foods high in refined sugars. A dried banana is sweet enough for her. Reis, by the way, gives patients stickers instead of lollipops.

Reis said you needn't become a vegetarian or shop only in health-food stores to have a nutritious diet. Fruit, nuts, soy milk, low-fat and low-salt crackers, baked chips, granola bars (but read labels!) and gorp mixtures all are available in standard stores.

"It's not that hard," she said. "It's just making sure you have something on hand so you don't fall back into old habits or what's easy."

Step by step

Where to start in the journey toward better family nutrition? Pediatrician Brijit Reis of Kailua suggests five gentle steps that go a long way toward reducing fats and sugars.

1. Eliminate sodas, sports drinks, fruit drinks. Limit pure fruit juice to 6 ounces a day up to age 10, 12 ounces a day thereafter. Sugary "empty-calorie" drinks are a key contributor to obesity, add unnecessary caffeine, contribute to calcium loss and take the place of more nutritional foods. Drink water instead.

2. Throw out anything with "partially hydrogenated vegetable oil" (high in trans fats) on the label. Trans fats elevate "bad cholesterol" (LDL) and lower "good" cholesterol (HDL). Instead: For cooking and salad dressing, use measured amounts of olive oil and/or expeller pressed canola oil. Switch to low-fat or nonfat baked goods, chips. Bake instead of fry.

3. For children older than 2, switch to one-percent or nonfat dairy milk or calcium-fortified soy milk. Reis says very young children generally are not resistant to such a change; it's parents who think they'll dislike the flavor or texture, or assume children need whole milk.

4. Get children involved in meal preparation. "The more they are involved in making it, the more likely they are to eat it," Reis said.

5. Replace conventional peanut butter with natural or homemade nut butters, and sugar-sweetened jellies and jams with fruit-only preserves. The common peanut butters are loaded with sugars and high in trans fats. Fruit sugars are digested more slowly and may contain more fiber and nutrients.