Pregnancy Nutrition: The Basics

I was honored to have written a 3-part series on pregnancy nutrition for a great product for expectant moms.  The product is called Ritmo™ which is a sound system belt that transmits songs and stories to your baby.  I wanted to share these articles with Mommy Dietitian readers, and with the posting here, you get a bonus healthy weight gain section.  Feel free to pass them along to anyone you know that is pregnant or even thinking about becoming pregnant.

Pregnancy Nutrition: THE BASICS

Congratulations on your pregnancy! Whether it is your first child or you have been pregnant before, it is thrilling news to find out you are having a baby. As a mother of a 3 year old and a 6 year old, I can attest to the road you are on this very minute. I remember the excitement and joy, but also remember the fear of the unknown. Relax! Any new adventure naturally comes with it some fear. It is very normal. The great news is that your body knows exactly what to do in order to grow this baby. My advice is follow some basic guidelines in nutrition so you can provide the fuel required to start this baby’s life off on the right foot.

Pregnancy is certainly a great motivator to eat smart. Balanced nutrition will yield a healthy body weight and will also help you achieve the vital nutrients you and your baby need during this incredible time of growth. It amazes me to know that the blood volume in our bodies increase 45-50% in pregnancy! This increase is needed for extra blood flow to the uterus, higher metabolic needs of the fetus, and increased perfusion of other organs, especially your kidneys. All of this requires proper nutrition. We will touch on the basics of pregnancy nutrition in this article so you can hit the ground running in the right direction.

Proper Weight Gain. Studies show that gaining the right amount of weight really helps your baby in being born a normal weight. Low weight gains, especially in underweight women, are associated with increased risk of perinatal mortality and low birth weights. High weight gains, particularly in obese women, are associated with increased risk of birth weight , longer labor times, complicated deliveries and birth traumas. The first thing you want to do is figure out what your body mass index (BMI) was before getting pregnant. Once you get that BMI number, look at the table below to establish what the weight gain recommendations are for you. Your obstetrician will weigh you periodically to make sure you are on the right track.

Step 1: Figure Out Your Pre-Pregnancy Body Mass Index (BMI)
http://www.nhlbi.nih.gov/guidelines/obesity/bmi_tbl.pdf

Step 2: Follow Recommendations for Total and Rate of Weight Gain During Pregnancy, by Prepregnancy BMI















5 Key Nutrients during Pregnancy. Nutrition needs increase during pregnancy due to rapid fetal growth, and there are some key nutrients that you should focus on while you are pregnant.

Folic Acid. Folic acid, folate or less known as vitamin B9, is critical in pregnancy nutrition. Folic acid supports reactions required for rapid cell division, carbon transfers and maintenance of red blood cells during the fetal growth process. Normal female needs are 400mcg, but daily pregnancy needs are 600mcg. Due to the critical nature of this nutrient during pregnancy, it is recommended that all pregnant women take 400mcg of a folic acid supplement to ensure adequacy (if taking a prenatal vitamin, the folic acid requirements should be included). However, foods that are high in folic acid include fruits and vegetables (especially leafy greens), whole grains and fortified cereals.

Iron. Due to the increase in blood volume as mentioned above, iron needs increase during pregnancy from 18mg to 27mg for most pregnant women.* As you progress in your pregnancy, you are at higher risk of becoming anemic due to the increased growth of the baby. Your doctor will do hematocrit finger pricks to check iron status. It is good to be mindful of foods that are naturally high in iron – such as beans, lentils, cooked spinach, fish, nuts, dried fruits, beef and other meats. There is an increase in high iron foods such as tofu of which ½ cup provides 13.2mg. Non-animal sources contain a type of iron that requires Vitamin C for absorption. Iron and calcium fight for absorption so as able, separate high iron foods from foods that are high in calcium.

Zinc. Zinc plays a vital role in protein synthesis, cell division, hormone metabolism and immune function. These bodily functions are highly utilized during pregnancy. Therefore, needs go up from 8mg to 11mg per day.* Vegetarians, depending how restrictive, may need to consider supplementation. Foods high in zinc that are recommended for pregnant women are red meat, poultry, eggs, pork, nuts, pumpkin seeds, summer squash, asparagus, chard, collard greens and broccoli.

Calcium & Vitamin D. Although needs do not increase during pregnancy, calcium (1000mg per day) and vitamin D (200-400mg per day, but amounts currently under review) are essential to bone mineralization and metabolism. Unfortunately, many women do not get adequate levels so purposeful intake is advised. Foods high in calcium are dairy foods, spinach, collard greens, soy, rhubarb and fortified cereals. Vitamin D is mostly found in dairy foods, fatty fish such as salmon and tuna; fortified foods, mushrooms and animal fat such as butter. Sunshine is an excellent source of vitamin D, so consider 15-20 minutes of daily sunshine to help achieve minimum levels.

Making a pregnancy meal plan. In general, a typical pattern should include 3 meals and 2-3 snacks each day to keep your body running well. The amounts of each type of food really depend based on your individual calorie and nutrient needs. If you are feeling nauseous, try and focus on foods that have more mild smells, spices and flavors. With my daughter, all I felt was a little nausea in the first trimester. With my son, I was very sensitive to smells and even remember changing my mind about foods mid-meal. Yuck! No worries, just make some adjustments if this happens to you. Plan around your aversions as much as you can. Overall, it is good to think this way for each meal and snack:

Breakfast: Dairy, protein, fruit, grain, healthy fat
Lunch & Dinner: Protein, vegetable, fruit, grains, dairy, healthy fat
Snacks (2-3): Protein, grains, fruit or vegetable, healthy fat

Balanced nutrition in pregnancy allows moms to
enjoy decadent treats. Here I am, pregnant with my son,
Evan, pretty excited about my baby shower cake.

Although the MyPyramid website is dynamic, a great way to get a plan that is perfect for you is to consult with a local Registered Dietitian (RD) that specializes in pregnancy nutrition. This is especially important if you have pre-existing health conditions, are having trouble getting nutrients in due to hormonal illness or have special dietary needs.

With a little proper planning and considering, you and your baby will be off on a healthy, exciting adventure. Be sure to cherish these days, write thoughts and feelings down – and above all, enjoy and appreciate this great miracle that is occurring inside your body right now. Blessings of good health to you and baby!

Linked Resources:
*Complete list of the Dietary Reference Intakes (DRIs) in Pregnancy

MyPyramid Plan for Moms

Expect the Best with Elizabeth Ward, MS, RD

Produce Variety Assurance (PVA)

Does your family have produce variety assurance (PVA)? Don’t worry. It’s a new term that I just randomly coined, but involves an important consideration. We often talk about the importance of produce and even variety within that produce, but are we really living this out in our daily lives? I recently had to ask myself that very question for my own family. Do we regularly consume fruits and vegetables? I am happy to report -yes! Do we alternate the varieties of differing kinds of produce? Hmm. Not always. We adore fresh produce and eat them regularly, but we’re like most people. We are creatures of habit! We still have that tendency to flock to our family favorites. I like to pick up some different stuff here and there, but then I slowly start going back to my habitual varieties. That’s when one of my patient’s mothers told me about a thriving local produce co-op here in the area. I immediately joined because I knew this was our family’s answer to PVA.


I just love the concept of produce-co-ops and community supported agriculture (CSA) groups for so many reasons. They bring local families together in mutual admiration for fresh foods and they promote grassroot efforts to support farmers and agriculture. Today I get to pick up my “share” of produce – whatever that may be- which will dictate our family’s menu over the next 2 weeks. What a great way to keep our experiences with food new, interesting and rich in all kinds of colorful varieties.

Our 1/2 share of  of produce via Your Health Source  food co-op.
This delivery, we opted for a full share of produce, which will be
double content.  We look forward to what we'll get this time!

Your Health Source is a family-run food co-op that coordinates the delivery of USDA certified and if possible, local produce for a variety of areas in Texas, into Oklahoma and Colorado. You can also order fresh grains, meats and other foods - and have access to health communities and recipes through e-mail distribution. I recently caught up with Monica Brown to find more information about Your Health Source. They started the co-op 9 years ago when she moved away from what she calls the “standard American diet”. The increase of fruits and vegetables in her family yielded life-changing health benefits for each family member, including helping one of her son’s behavioral problems and solving her own digestion issues. Aside from the nutritional benefits, Monica admits that one of the best benefits to her family has been the new friendships they have formed. “I know people today that I would have never known if it weren’t for the co-op. I rarely make a friend at the grocery store – but at co-op, I have friends for a lifetime now.” Monica is also appreciative that her children have had the benefit of witnessing so many families striving to make healthy choices. Her and her husband see their co-op as a way to serve families everywhere that yield the highest of health benefits. It is families like the Brown’s that inspire us all to make health investments in our local communities. After all, it is one of the many things First Lady Michelle Obama encourages in the Let’s Move initiative to fight childhood obesity.

If you want to promote PVA in your family, consider joining a produce co-op, community supported agriculture (CSA) group, schedule regular visits at your local farmer’s market or just reach out to a local farmer. What a great way to expose your children and family to the colors of the produce rainbow! If you have anything to share on the subject, I would love to hear from you.

For more information on The Brown Family’s co-op, go to their website below. A special thanks to my friend and dietitian colleague, Robin Plotkin, for giving me the Edible Communities websites below. What a wonderful resource for us all.

Online Resources for Produce Co-ops, CSAs, Organic and Local Foods

Your Health Source Co-Op: http://www.yourhealthsource.org/
Local Harvest: http://www.localharvest.org/
USDA's Farmer's Market search: http://apps.ams.usda.gov/FarmersMarkets/
Pick Texas: http://www.picktexas.com/
Edible DFW (for the Dallas/Fort Worth area): http://www.ediblecommunities.com/dallasfortworth/
Edible Communities (for all areas throughout the U.S.): http://www.editblecommunities.com/
USDA’s Fruits & Veggies More Matters (includes recipes by produce type): http://www.fruitsandveggiesmorematters.org/

Love Me A Blueberr-y!

I have fallen into a late love affair with blueberries.  Yep, even nutrition lovers like me still fall into those ruts of choosing the same "always" foods.  Guilty as charged - I have for the most part, passed over blueberries for no real reason.  Yes, this is a true and almost hard-to-believe confession.  After all, we all know the great health benefits of blueberries, right?  This great fruit is absolutely loaded with antioxidants, is high in fiber and a great source of Vitamin C.  Emerging research even reveals that it has a significant protective effect on cognitive decline.  They also help protect against urinary tract infections and other urinary diseases.  But here I was, dissin' those blueberries.  Until I got some "blues" in my produce coop share.  I thought to myself, "Hmmm....I wonder if the family will eat these?"  You see, my kids and husband absolutely adore their red counterparts - strawberries, and will eat an entire container within 24 hours.  We enjoy other berries as well, but blueberries have been the ignored ones until now.  I just need to remind myself that this is a new food for the family and resistance will be there.  My kids haven't been exposed much to blueberries and that is no fault of their own (uh-hem).  My task is to make blueberries tasty for all and I am ready for that challenge.  Dah-dah-dah-dah!

Blueberry Breakfast Salad
from Lynn's Paradise Cafe
Louisville, Kentucky

As for me, I have been popping blueberries since last Tuesday and they are now my snack buddies.  I really like the fact that they really aren't that sweet (I am a salty vs. sweety kinda person).  They have a wonderful tangy-to-mild taste without the intimidating "explosion" I so feared with these little round balls.  Recently, I jumped on the US Highbush Blueberry Council website and found some great blueberry recipes.  My personal favorite is the Breakfast Blueberry Salad that was submitted by Lynn's Cafe out of Louisville, Kentucky.  I like this served with some low-fat, low sugar regular or Greek yogurt.  Here it is for you to try (I took the salad portion down to serve one, the dressing to serve many salads):

Ingredients
1 1/2 cups mixed, torn salad greens
1/2 cup fresh blueberries
1/2 cup orange sections or canned mandarin oranges, drained
1/4 cup Granola
*Blueberry vinaigrette

*Blueberry Vinaigrette: In a food processor container, combine 1 cup olive oil, 1 cup blueberries, 1 tablespoon Dijon mustard, 2 tablespoons brown sugar, 2 teaspoons minced shallot, 3/4 teaspoon kosher salt, 1/2 teaspoon ground white pepper and 1/2 teaspoon paprika.  Provcess until mixture is smooth.  Chill at least 30 minutes to blend flavors.

Directions: Toss salad greens with 1 1/2 cups of the blueberry vinaigrette.  Arrange orange sections and blueberries on top of the salad.  Sprinkle each salad with granola.  Drizzle dressing on top.  Serve immediately.

Nutrition Information (without dressing): 192 calories, 2 fat, 0g saturated fat, 44g carbs, 7g fiber, 4g protein.  Daily Values: 135% Vitamin A, 110% Vitamin C, 8% Calcium, 10% Iron.

What is your favorite blueberry recipe?  I'd love to know what they are so we can try them here at the Lemond house.  After all, blueberries are in season somewhere throughout the U.S. all the way through the end of the year.  It looks like I have plenty of time to get to know my new, blue friends. 

Think twice before you diss a nutrition powerhouse such as blueberries.  You will be missing out on many health benefits, and just as importantly, your family may be equally missing out by your personal exclusion as well.

3 Keys to True Food Love

Have you ever thought of how the state of your body image impacts the relationship you have with food? It sounds obvious. But in my experience with hundreds of adult weight management clients, I certainly have seen the connection firsthand. I coach people on how to establish healthier food patterns and have observed that their own self-image seems to be a big determinant to their success.  If there are serious issues, of course I refer them out to a counselor that will assist with that compoenent. However, I was reminded of body image the other day in my own life, which was the catalyst of today’s blog post.  How, you ask?

Children can say the darndest of things! The other day, we were running around getting ready to head out to yet another 4th of July celebration when my 6 year-old daughter turned to me and grabbed my belly. She said, “Mommy, you look like you are going to have a baby.” Well, that certainly stopped me in my tracks. I thought to myself, “Did she really just say that to me? Yep, she did!” I would be lying if I said I was completely unaffected. But it’s a good thing that I have a health self-image. And it’s also a good thing that I have a great respect for food and how it nourishes my body. Otherwise, as I have seen so many times with others – the comment can cause a cascade of negative reactions. It would start with the allowance of that one comment to question my body satisfaction. This could then cause me to want to restrict food in order to achieve that body image that does not “look pregnant.” Do you see how this negative cycle can start so easily?

A positive body image not only helps
your relationship with food, but also
your children's.

This situation made me think of all the moms, women and even men out there that allow negative influences to impact their body images. I deal with so many adults in my private practice that are striving so hard to be that perfect body image that they imagine in their minds. This obsession most certainly impacts their relationship with food. You see, I am 5’5” and weight 118 pounds.  The only reason I share this information about myself is to prove a point - which is that even a normal body weight may not eliminate negative comments about your body.  It does not matter what your mind is telling you, there is no body weight that will allow you to achieve “body nirvana.” It starts with the inside and how you see your self-worth altogether. So, invest in your surroundings so they can promote a healthy body image regardless of body size. I came up with my top 3 things I tell my clients when discussing building a positive body image which in turn promotes a healthy relationship with food:

1. Rid Yourself of Negative Influences. No, that doesn’t mean disowning your children for saying negative things about your body! {giggle} It means avoiding magazines, television programs, friends, or places you go that might flood your mind with unrealistic body images or that might over promote aesthetic beauty. You may think that these are positive motivators, but they are not. As many people that I have seen in my practice, I have learned that these influences do not help you in keeping your overall health the highest priority in maintaining a healthy weight. It all becomes about the body weight and body image – and desperation becomes a sad part of this circus ride.

2. Consciously Surround Yourself with Positive Influences. Be around people that are positive and encouraging to you. Seek out reliable resources when it comes to food and nutrition so that you can truly see how food has so much more power than causing weight gain or loss. A local Registered Dietitian can help put you on a balanced plan that can be customized specifically for you. Dietetics school blew me away with the facts of food’s power in our lives. Food has the power to protect, prevent and in some cases, cure. Think of food in this way instead of only as a means of gaining or losing weight. And equally important, step back and realize the person you are regardless of what the scale says, and this will free you up to living a healthy lifestyle for the right motivations.

3. Be a part of something bigger than yourself. You can see the power of this perspective when becoming a parent. I was so much more self-absorbed when I was single. But now that I am a wife and mother, I make decisions not only for my own sake, but also those around me. If I don’t invest in a positive self-image that is grounded in more than aesthetics, it will certainly impact how I teach my children about food. Eating well and taking care of my body gives me the energy and good health I need in order to raise a family. Become part of a group, church or community that makes strives to make the world a better place for all. Being a part of something bigger than yourself really helps a person go deeper – deeper than surface motivations. For me, my faith in God is a huge part of why I do what I do - personally and professionally. It helps keep the focus off of me and instead on others.

You may be wondering what I said to my daughter after she made that comment. I calmly explained to her that it is not nice to say that to someone if they really are not pregnant. [I recalled a similar situation from back when she was 4 years old when she did the same thing to a morbidly obese friend at church. She asked her if she was pregnant. All of us in the group were extremely embarrassed, as you can imagine.] It is important that we have these teaching moments with our children without making it a huge deal. Fortunately, I was able to move on with my day pretty easily. I hope that if something like this happens to you that you can do the same. A positive body image frees oneself to truly appreciate food for what it truly offers.

For more information on how to achieve a positive body image, I recommend http://www.womenshealth.gov/bodyimage/. Consider reading the section on how the attitude of parents about appearance and diet affects their kids’ attitudes. They provide good tips on how to positively influence your child’s body image.

Ditching Dairy? CAUTION!!

Use caution when avoiding entire food groups,
including dairy.  You may be setting yourself up
for nutrition deficiencies that may manifest
in health problems.

I recently attended a Diary Forum in Alexandria, Virginia that was all about lactose intolerance. It amazed me to learn how many people avoid dairy products because they think they are lactose intolerant! Before ditching the dairy, consider my caution for you and/or your family as it can have major nutritional consequences.

When people think of milk and other dairy foods, they think of calcium. But the truth is that milk contains 9 essential nutrients that our bodies need in order to function normally. Of those nine essential nutrients, milk meets at least 20% of your daily value for not only calcium, but vitamin D, riboflavin and phosphorus. That is why the Dairy Guidelines of Americans strongly recommends three servings of low-fat dairy per day in order to meet your minimum nutrition needs. Did you know that dairy foods are most Americans primary food source of vitamin D? Much in thanks to the great work by Dr. Michael Holick, we have been learning more and more about the epidemic of vitamin D insufficiency and deficiency that is having serious health concerns.

The lack of nutrient information regarding dairy really hit home with me the other day. An amazing, well-respected doctor I work closely with in my practice shared with me that when a patient comes to him with lactose intolerance, he simply tells them to avoid milk and start a calcium supplement. I had to remind him that dairy not only provides so many more nutrients than just calcium as mentioned above, it also contains naturally occurring ACE inhibitors similar to the same components given in prescriptive form that help regulate blood pressure. That is why the government-backed blood pressure diet, called the DASH diet (Dietary Approaches to Stop Hypertension), encourages 3 servings of dairy because it has all 3 of the nutrients of the DASH diet that help regulate blood pressure – calcium, potassium and magnesium. Milk also contains melatonin that helps decrease stress and promotes sleep. (Ever drink a warm glass of milk before bedtime? There’s a reason behind that!) And as if that was not enough, over the last several years there has been a slew of research coming out on the impact of dairy foods in weight management.  Hmm...a link between a decrease in dairy foods and obesity?  Many say, yes.

Growing up, our favorite mealtime beverage was milk. I grew up in a combined family of 6 children (think Brady Bunch, and I was "Cindy" -- the youngest) and my mother reports that we went through 5-7 gallons of milk every week! I drank milk with every meal and so did all my siblings. But I remember very well that when I was around 17 or 18 years of age, milk and I started having problems. Within 2-3 hours of drinking milk, I would have bad stomach pain, bloating and eventually gas that was very characteristic of lactose intolerance. Oh, the shame as a teenage female! The very easy thing to do is just eliminate dairy to avoid the very embarrassing consequences. But as I fell in love with nutrition in the 90’s, I learned that this was a move was costing me dearly and as a result, negatively impacted my nutrition status.  Now, I am enjoying dairy again and that has helped me be a positive role model for my young children.  (Check out my son's Yogurt Emergency, which was a previous blog post.  I know many moms can relate!)

So, the question is for you – have you or a loved one ditched dairy for the same reason as I did as a teenager? If so:

1. Get Diagnosed. Don’t self-diagnose like I did because it could be something else other than lactose intolerance. All that rumbles in not lactose intolerance! A proper diagnosis is done via a hydrogen breath test and it is covered under most insurance plans. Keep in mind that lactose intolerance is very different than a milk allergy. Lactose intolerance involves the lack of an enzyme that helps digest the milk carbohydrate, lactose. Milk allergy or milk-protein intolerance, is mostly found in young children, and involves an immune reaction to the milk protein. If you or your child has milk allergy, it is highly recommended that you see a Registered Dietitian for nutrition guidance. In this case, complete elimination of dairy components is necessary due to possible dangerous allergic reactions. The good news is that most children outgrow milk allergy by the time they are 3 years of age. It is rare to that a person continues the allergy into adulthood. If they do, there are actually immunologists that can do milk challenges that will decrease or even eliminate the milk allergy altogether.

2. Work it in. Most people with lactose intolerance can tolerate small amounts of milk at a time and most can eat yogurt and cheese without the negative side effects. At your local grocery store, there are lactose-free milk products of varying brands – Lactaid®, Dairy Ease® and even store brands now. Lactaid® is even coming out with an organic version of lactose-free milk for those that prefer organic varieties. There are even over the counter oral lactase enzyme pills that a person can take that be taken prior to the ingestion of dairy. The National Dairy Council has a great educational resource to help you find ways to get dairy in even when you have lactose intolerance.

3. Seek a Registered Dietitian (RD). Anytime you are thinking of eliminating an entire food group, it is highly recommended that you meet with a Registered Dietitian (RD) in your area to develop a plan for you. You may not realize what key nutrients you are eliminating from your diet that may be compromising your health. As an RD myself, I am very sensitive to the food desires of my patients. If eliminating dairy or other foods are simply a personal preference, we will honor that and can ultimately work within your desires to put an alternate nutrition plan that will meet all your needs.

Get the facts when it comes to nutrition. Even if it's written, it doesn't always make it factual.  And we all come with our own nutrition biases, but ask questions about those biases that may have been handed down from generation to generation. Are they really true? As in lactose intolerance for instance, many African American families avoid milk altogether because they already assume it will be a problem. Lactose intolerance in African Americans is grossly overstated, and teaching your children to avoid dairy can have lasting consequences for yourself and for them. Proper diagnosis and learning ways to get dairy foods in can be the best move for you. What is your nutrition bias? Dairy or otherwise, ask the questions and get accurate answers. You owe it to yourself and you also owe it to your family.

The "Must Knows" of Outdoor Hydration in Children

Children enjoying fresh, ripe fruit is one of the great ways to
help keep them hydrated this summer while outdoors.

It is true.  Our children overheat much easier than adults while outdoors in the summer heat.  I notice this easily with  my 3 year-old son.  His little face gets red quickly when running around in the heat!  The more humid the weather, the more my little guy and your children are at risk for heat-related illnesses such as heat exhaustion and fatal heat stroke.  While we are encouraged to head outdoors throughout the summer, let's do some proper planning so we can avoid any emergency room visits due to overeating bodies.  Some of the non-nutritive things we can do to prevent overheating include wearing light-colored and lightweight clothing (or even wicking-type material that allows more air through the clothing), using water to cool the body via swimming, sprinklers or spray bottles, or periodically going into shaded areas.  Outdoor explorations at the very beginning of the day or even toward the evening times are also a good consideration.  That way, we avoid the heat of the day.

But proper hydration is a vital key in maintaining normal body temperatures while outdoors.  The American Academy of Pediatrics recommends that a child be well-hydrated prior to any prolonged physical activity.  During the activity, the following amounts of water should be consumed every 20 minutes even if the child does not feel thirsty (cold water is generally more palatable):

--> 5 ounces for children > 3 years of age weighing up to 88 pounds
--> 9 ounces for children and adolescents >88 pounds

The most accurate way to rehydrate is to weigh the child before and after physical activity - then replenish accordingly by loss.  For excessive sweating and/or high intensity physical activity greater than >1 hour, the American Academy of Sports Medicine (ACSM) recommends an electrolyte replacement drink such as Gatorade®, POWERADE® or CeraSport® (I happen to like the quality of CeraSport® the best).  These beverages are good for prolonged outdoor activities that do not allow for snack stops using food (see below).  These beverages replenish water, but also essential minerals that are lost through sweat.

Food Sources for Hydration
If your outdoor activity allows for snacking, take advantage of the food sources that can assist with hydration alongside the cold water supply.  Since it is vital for our children to stay hydrated, we want to choose some snacks that they are sure to consume.  Again, for the high sweat factor and prolonged outdoor activities, we need water plus sugar, potassium, magnesium which are the essential nutrients lost in perspiration.  Choose a combination of healthy sweetness and healthy saltiness.  My choices are:

1. Fresh fruit.  Fruit is actually 80-90% made of water and it contains most of the electrolytes needing replishment.  Keep cut-up pieces of ripe fruit ready for your children to grab and enjoy.  Fruit such as watermelon, cantaloupe, oranges, mango and pineapple are great choices that can be eaten separately or even put on skewers to make a nice, tasty kabob.  Or, you can make some frozen yogurt fruit smoothies for them to enjoy.  See my easy peasy recipe that was featured in the Dallas Moms Blog earlier this month.  The yogurt provides more mineral replacement and quality protein.  My daughter loves them!

2. Salted nuts.  Salted nuts of any variety are great snacks to keep outdoors for your children to grab and refuel during and after physical activities.  The sodium on the salted nuts fill the mineral gap that the fruit does not supply.  However, be careful of any children that might be playing outside that might have a nut allergy.  If you have anyone present with a nut allergy, consider using other salty foods such as popcorn or whole grain crackers.

Keep children that have had an illness involving diarrhea or vomiting indoors for at least 24 hours following their illness.  And make a call to your doctor to discuss special hydration considerations for children with medical conditions before heading into the heat - especially for lengths greater than one hour.  All parents would benefit from reviewing the signs and symptoms of all heat-related illnesses before heading outdoors.  The more your family is prepared, the more time you can spend enjoying your time together outside!  Our family is headed out geocaching in the morning with our fresh reminder on proper outdoor hydration to avoid heat-related illnesses.  How about yours?

New Activity + Outside = Family Fun & Energy Balance

Some of my best childhood memories were of my brother and I going on day long outdoor explorations.  We'd pack ourselves sack lunches and just head out with no real plans other than to play and discover.  Many times we'd head to a nearby lake and watch fish, catch garter snakes or even go visit our pet rock.  What is your favorite outdoor memory as a child?

Let's Move, the child obesity initiative started by First Lady Michelle Obama, is promoting Let's Move Outside!.  Let's Move Outside! encourages parents to move outside with their children in order for them to achieve the recommended 60 minutes of active and vigorous activity each day.  Many children are not meeting this minimum recommendation, which is one of the many contributors of the child obesity epidemic.  The Let's Move website provides tons of ideas for families, including links to local activities depending on where the family lives.

One outdoor activity that I learned from a patient of mine last year is geocaching.  It's basically a high-tech treasure hunt that families anywhere in the world can enjoy.  Started by a man named Dave Ulmer in May of 2000, it was originally geared toward only the GPS user community that utilized that very new technology at the time.  Today, there are over 1 million "caches" all over the world that that can be found.  One may be just yards away from where you are sitting at this very moment!  Now mobile devices come with GPS technology, and there are applications that can pull up all the geocaches in your area on one screen.

Remember, simply stated, ENERGY IN (food) - ENERGY OUT (activity) = Weight Maintenance OR Weight Loss OR Weight Gain. It's all about energy balance, which is what dietitians specialize in. Although we talk much about the energy in part, we also need to discuss energy out. How are you balancing your energy?  How are you promoting energy balance in the life of your children?

Summertime is the perfect time of year to try a new family activity to promote good energy balance.  And at the same time, you are helping your build memories that they will eventually look back and remember with great happiness.  Learn about all the great outdoor activities in your area by going to the Let's Move website or, even try some geocaching!  What a way to spend quality time together, improve your health and be a great role model for your children.  For everything you need to know about geocaching including how to get started go to http://www.geocaching.com/.  In our next post, we will discuss proper hydration for children and adults while enjoying those great outdoor activities.  Stay tuned!