My take on the new AAP guidelines
The American Academy of Pediatrics (AAP) has released new guidelines for the treatment of childhood and adolescent ob*sity. They are incredibly aggressive and are 180 degrees from where we should be headed on this topic.
The AAP does acknowledge that ob*sity is complicated and multifactorial, and that the studies they looked at to develop these guidelines don't actually meet the standards of quality they set. But they pressed on, regardless. Further, they made the jump that an increase in BMI is bad for health (not clear), and therefore, a decrease in BMI is good for health (even less clear).
What we end up with is the AAP pathologizing larger bodies. Being fat is not actually a disease, but we are teaching kids that their bodies are wrong. None of this is helpful for the kid getting bullied or teased at school for being fat. Now they get to hear it from their doctor, too.
The recommendations the AAP has put out are as follows:
None of this has been shown to be safe or effective. In fact, the authors admit that weight cycling can be expected. Basically for these kids' whole lives, they should be trying to lose weight and will gain and lose over and over. They are trying to normalize something we know to be harmful to physical and mental health.
What can parents do?
1. Opt out - refuse to participate in any of these "treatments"
2. Ask lots of questions about safety, effectiveness, and risks involved in proposed treatments
3. Model normal, healthy eating at home
4. Foster Intuitive Eating in your kids
5. Offer balanced meals and snacks and let your kids decide if and how much to eat
6. Get professional help from a weight-inclusive provider, if needed
My Take on Soy
What is it?
If you’ve never heard of selenium, you’re definitely not alone. This little known nutrient is a mineral that is found in various foods and serves many important functions in the body. The recommended daily allowance (RDA) for adults over age 19 is 55 micrograms (mcg) per day. However, slightly more is needed for pregnant (60 mcg/day) or lactating people (70 mcg/day). Selenium deficiency is rare in North America but can be more common in places such as parts of Europe and Asia where there is less selenium in the soil where food is grown (1).
Where can we find it?
Common food sources of selenium include animal proteins such as beef, chicken, turkey, some types of fish, egg, and cottage cheese. Selenium is also found in plant foods like oatmeal, brown rice, beans, lentils, Brazil nuts, bread, and cereals (2).
Why do we need it?
Selenium supports many important functions for humans. It is a crucial part of selenoproteins and enzymes, which act to protect tissues and DNA from free radical damage. Research is being done to learn more about the protective effects of selenium in relation to cancer prevention (2). Selenoproteins have positive effects for cardiovascular health as well by keeping blood platelets from sticking and helping to reduce inflammation (2). Thyroid health is often associated with selenium due to its higher concentration in this gland and effect on thyroid hormone synthesis. Inadequate selenium is one factor that has been found to contribute to the development of autoimmune thyroid conditions (1). This information may lead one to think that more selenium is better, however it is possible to have too much especially when it comes to minerals.
The tolerable upper intake level (UL) of selenium for all adults is 400 mcg per day (1). Before considering supplementation, it is best to consult your medical provider and/or a Registered Dietitian, who can help to determine how much supplementation, if any, would be appropriate for an individual.
Most people who have heard of selenium may know that Brazil nuts are widely touted as a good source of this mineral. But as with many foods, the amount of selenium varies widely depending on the mineral content and pH of the soil where the nuts are grown. In fact, one Brazil nut may contain as little as 11% or as much as 288% of the RDA for an adult (3). While it is rare for food sources of nutrients to cause adverse effects from toxicity, Brazil nuts could lead to toxicity if regularly consumed in high amounts.
1. Harvard T.H. Chan School of Public Health. The Nutrition Source: Selenium. https://www.hsph.harvard.edu/nutritionsource/selenium/#:~:text=RDA%3A%20The%20Recommended%20Dietary%20Allowance,and%2070%20micrograms%20daily%2C%20respectively. Accessed 5/28/2022.
2. National Institutes of Health Office of Dietary Supplements: Selenium Fact Sheet for Health Professionals. https://ods.od.nih.gov/factsheets/Selenium-HealthProfessional/ Accessed 5/28/2022.
3. E.C. Silva Junior, et al. Natural variation of selenium in Brazil nuts and soils from the Amazon region. Chemosphere. 2017 Dec;188:650-659. https://doi.org/10.1016/j.chemosphere.2017.08.158.
The very unsexy topic of moderation is the reason you're having trouble living a healthy lifestyle.
Wellness Series: Chair Stretches
Try these stretches throughout the day or at the end of your day:
1. Shrug the shoulders
2. Roll the shoulders forward and back
3. Drop ear to shoulder
4. Turn head to one side
5. Turn head to one side and drop the chin
6. Extend leg(s), flex foot, and lean forward with a flat back
7. Round and flatten the back
8. Open arms wide with palms up
9. Interlace fingers behind the back and pull down and away
10. Cross ankle over knee and lean forward with a flat back
Recipe provided by Ashley Combs, Dietetic Intern
Cook time: 45 minutes
Yield: 6 servings
3 medium acorn squash
4 tablespoons extra-virgin olive oil, divided
1 ¼ teaspoon fine sea salt, divided
1 cup quinoa, rinsed and drained
2 cups water
⅓ cup dried cranberries
1 pound ground turkey (or beef, chicken, or omit to make vegetarian)
⅓ cup raw pepitas (hulled pumpkin seeds)
⅓ cup chopped green onion
⅓ cup chopped fresh flat-leaf parsley, plus some for garnish
2 clove garlic, pressed or minced
1 tablespoon lemon juice
¾ cup grated Parmesan cheese (optional)
½ cup crumbled goat cheese or feta (optional)
1) Preheat the oven to 400 degrees Fahrenheit. Grease a large, rimmed baking sheet, or you can line it with parchment paper for easier clean-up.
2) Prepare the squash by taking a sharp knife and cutting each squash in half from the tip to the stem (slicing just next to the stem). Scoop out the seeds and strings inside to throw away or compost.
3) Place the squash halves cut side up on the prepared pan. Drizzle 2 tablespoons olive oil and sprinkle ½ teaspoon of salt over the entire pan of squash. Rub the oil into the cut sides of the squash, then turn them over so the cut sides are down. Bake for about 30 to 45 minutes or until the flesh of the squash has become golden and is easily pierced with a knife. Leave the oven on.
4) Meanwhile, in a medium saucepan, combine the rinsed quinoa and water and bring to a boil over medium-high heat. Once boiling, reduce the heat to a simmer and cook uncovered for about 12 to 18 minutes, or until all the water is absorbed. Remove the pot from the heat and stir in the cranberries. Cover, and let the mixture steam until ready to use.
5) In a large skillet, drizzle a tablespoon of olive oil over medium heat. Then add the ground turkey and break it into small pieces. Cook for about 6 minutes or until no longer pink. Season the cooked turkey with about ½ teaspoon salt and ½ teaspoon pepper and then transfer to a large bowl.
6) In a skillet, toast the pepitas over medium heat, stirring frequently. The pepitas will turn golden and will make little popping noises, which takes about 4 to 5 minutes. Take the skillet off the heat and set aside to let cool.
7) Uncover the quinoa and fluff it with a fork. Pour the quinoa and cranberry mixture into the large bowl with the turkey. Add the toasted pepitas, chopped green onion, parsley, garlic, lemon juice, ¼ teaspoon salt, and 1 tablespoon olive oil. Stir until the ingredients are evenly distributed. Taste and add additional salt if necessary.
8) If adding the Parmesan cheese and goat/feta cheese, let the mixture cool first for a few minutes before adding the cheese mixture. Then gently stir to combine.
9) Turn the cooked squash halves over so the cut sides are facing up. Spoon and evenly distribute the quinoa mixture into each squash cavity. Return the squash to the oven and bake for 15 to 18 minutes, or until the cheesy quinoa is turning golden on top.
10) Garnish the stuffed squash with more chopped parsley and serve warm.
11) To store your stuffed squash, wait until cooled to room temperature and keep refrigerated in a sealed container for 4 days. To keep for longer, place cooled stuffed squash in a freezer bag or container and keep in the freezer for up to 10 months.
Mindfulness Series: Yoga
Benefits of yoga
Tis the season of family gatherings, bountiful feasts, holiday traditions and memories, gift giving, etc. But with all of that tends to come a certain level of stress. That stress combined with other common seasonal occurrences (like increased sugar intake and decreased vitamin D levels) weaken the immune system and leave us susceptible to colds and flu. Stressful situations can also lead to things like emotional eating and/or disordered eating. One of many things we can do during this time of year is to prioritize our stress management and mental health. Here are some ways to help control and alleviate stress over the holidays:
Written by Ashley Combs, Dietetic Intern, Garden to Table Nutrition
Wellness Series: Meditation Part 2
Meditation apps to try:
Habitica - rewards for sticking to new habits (like a video game)
MyStrength app (free for Douglas County residents)
Got It Life for Athletes
Buddhify (has different scenarios)
InsightTimer - guided meditations
Serenity (has different methods of meditation)
Here you will find 10 and 20 minute Qi Gong videos for morning and evening: https://www.youtube.com/c/TylerTrahan/videos
Dr. Smith and Heather are back with a focus on Wellness. This video is the first in a series on mindfulness. Get the basics of meditation, why it might be helpful, who should try it, and how to get started.
You can catch these videos and more on Facebook