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Be Well for Parents - December 2011 Issue

Feature: Kids & Sugar – 5 Tips for Handling Holiday Treats

Feature: Healthier Holiday Treats for Kids – 5 Tips

As parents, we want our kids to get the most from the holidays without overdosing on sweets. Our experts suggest five tips for cutting back on sugar without cutting back on fun – and include recipes for healthier holiday treats.

Parents need not ban sugar completely unless a child has type 2 diabetes, but a little refined sugar goes a long way. Eating refined sugar in moderation avoids three problems, says Cleveland Clinic Children’s Hospital pediatrician Amy Sniderman, MD:

  • Stomachaches. Letting kids indulge in sugar-laden candies, cakes and cookies can upset their stomachs.
  • Weight gain. Kids can put on holiday pounds just like adults.
  • Tooth decay. Kids may start the new year with new cavities — sugar nourishes the bacteria responsible for tooth decay.

Here's how you can take a healthier approach to your child's holiday treats:

1. Be a healthy role model
It’s hard to limit kids’ sugar consumption when you’re piling your own plate with desserts. “Children really like to do what their parents are doing,” says Dr. Sniderman. “It’s always easier to follow a healthy lifestyle when someone does it with you.” Eat in moderation, and your kids will be likely to do the same.

2. Prep kids for parties
Before going to a gathering where a big meal and tempting treats will be served, talk with your kids about how to manage their eating. “School-age children are old enough to understand that something isn’t good for them if a parent takes the time to explain it,” says Dr. Sniderman.

Explain portion control using the American Dietetic Association’s colorful new food plate. Limit kids to two or three pieces of candy at a time. If they bring extra candy home from school, dole it out sparingly – or give it away.

Make sure your kids eat healthy, balanced meals over the holidays so that most of their calories come from nutritious foods. Have them snack on something healthy before a party so they don’t arrive hungry – a recipe for overeating.

3. Encourage kids to choose wisely
When many desserts are available, ask your child to choose the one he or she likes the most. “Kids like to have a choice,” says Dr. Sniderman. Or let your child choose small portions of a few desserts. If your child is full, offer to bring a favorite dessert home to eat later.

4. Focus on fun, not food
Holiday goodies don’t have to be the focus of celebrations. You can make family holidays more meaningful by emphasizing activities that don’t involve eating. Build a snowman, create holiday crafts and play party games. If you’re handy in the kitchen, bake cookies to share with friends and neighbors. “Children learn about sharing and doing a good deed,” says Dr. Sniderman.

5. Make your own treats
Cleveland Clinic registered pediatric dietitian Abby Reinier, RD, LD, suggests the following kid-friendly alternatives to cookies, candies and desserts. (If your child is allergic to peanuts, tree nuts, dairy, wheat or soy, be sure to modify the ingredients. Also check treats at parties for problem ingredients – when in doubt, do without.)

“The treats below fall into the sweet category but are lower in sugar,” says Ms. Reinier. “Plus, they are fun and easy enough for the whole family to make!”

  • Festive trail mix: Combine Kellogg’s Frosted Mini-Wheats® Little Bites cereal with Multi Grain Cheerios® cereal, dried cranberries, raisins and nuts (peanuts, cashews or other nuts). Mix in red and green M&MS® Minis or dark chocolate mini-chips.
  • Reindeer faces: Spread whole wheat Ritz® crackers with natural peanut butter or an alternative nut butter. Add two raisins for the eyes and a dried cranberry or red M&M mini for the nose. Break a tiny pretzel twist in half to make the antlers.
  • Fruit kabobs: Cut a variety of your child’s favorite fresh fruits into bite-sized pieces and place onto skewers. Dip them in low-fat strawberry yogurt for added fun and flavor.
  • Holiday JELL-O Jigglers®: Prepare sugar-free or regular Jello-O (using half the sugar) per package directions. Once set and cold, cut out fun shapes using holiday- or winter-themed cookie cutters.
A note about sugar & hyperactivity

If you think your child becomes more excitable than usual at holiday parties, blame the socializing rather than the sweets. Dr. Sniderman says research has not shown any connection between children’s hyperactivity and sugar intake.

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Coughing, wheezing, shortness of breath, inability to keep up in sports – asthma symptoms can be hard to identify because they vary so much. Talk to your child’s pediatrician about what can bring on an attack, and how to prevent and treat one. Triggers include colds and respiratory infections, seasonal allergies and secondhand smoke. With asthma education and preventive measures, your child won’t have to miss out on sports or outdoor play.

Parents Children's Health Essentials – December 2011 Issue

Feature: Vitamins & Minerals – Do You Know Your ABCs?

Feature: The ABCs of Vitamins and Minerals – What You Need to Know

Vitamin and mineral supplements not only fill the stores shelves…they fill the news. You may be questioning which dietary supplements you really need.

We asked three experts – Cleveland Clinic internist Keith Fuller, MD, registered Wellness Institute dietitian Kristin Kirkpatrick, MS, RD, LD, and women's health specialist Judith Volkar, MD – to comment on six popular supplements:

1. B vitamins

Collectively, the B vitamins – B1, B2, B3, B5, B6, B9 (folic acid) and B12 – can reduce stress and improve mood. Who needs to supplement their B? Three groups of people:

  • Vegans need the B12 found in meat, chicken, fish, dairy and eggs to prevent anemia and ensure healthy nervous system function.
  • People 65 and older may need B12 because it becomes hard to absorb from food as we age.
  • Women who are pregnant or trying to conceive need folic acid to help guard against birth defects.
2. Vitamin C

Vitamin C supplements may shorten the duration and misery of colds but are unlikely to prevent them. “I don’t think people need C on a daily basis, but taking a large dose at the onset of a cold can be helpful,” says Dr. Fuller.

It’s easy to get C from fruits and vegetables. But “think beyond the orange,“ advises Ms. Kirkpatrick. That morning glass of orange juice is full of sugar and carbs; look instead for C from bell peppers, broccoli, papaya and kiwi.

Avoid taking vitamin C with aspirin – both can irritate the stomach. And remember that high doses of C may interfere with cholesterol medication.

3. Calcium

Best known for improving bone health, calcium is easy to find in milk, cheese and yogurt. “We think ‘calcium’ and imagine the cow, but there are plenty of plant-based sources as well, like spinach and collard greens,” notes Ms. Kirkpatrick. Another source is sardines. “They are a nice, lean fish. If you eat the bones, they won’t crunch and you’ll get your calcium,” she says.

Know which type of calcium supplement you’re taking and when to take it. Calcium citrate can be taken at any time. Calcium carbonate must be taken with food. And because the body can absorb only so much calcium at one time, it’s best to take half in the morning and half at night.

4. Vitamin D

This is the supplement most healthcare providers recommend. Important for bone and muscle health, “vitamin D is difficult to find in natural food sources,” explains Dr. Fuller. Fortified dairy products, cereals and breads usually don’t provide enough vitamin D. Sunshine – the other source of D – can be scarce.

Vitamin D, which works with calcium, is important for women as they age to prevent bones from becoming fragile. “Women often take a calcium supplement that has vitamin D in it. We recommend additional D to get their levels up,” says Dr. Volkar. “D3 is better absorbed than D2.”

A Cleveland Clinic study recently found that vitamin D is best absorbed when taken with the largest meal of the day – preferably one containing healthy fats because vitamin D is fat-soluble.

5. Vitamin E

Daily vitamin E supplementation has been touted for preventing cancer and heart disease. However, a large, seven-year national study by Cleveland Clinic experts proved that men who took vitamin E every day actually increased their risk of prostate cancer by 17 percent. The longer the supplement was taken, the higher their risk.

The message: For most men, taking vitamin E supplements may do more harm than good.

Other studies have failed to show that vitamin E supplements protect against heart disease. For heart health, it’s safer to get vitamin E from dietary sources – safflower, sunflower and wheat germ oils; nuts and seeds; olives; and green veggies.

At high doses, vitamin E supplements act like a blood thinner and can increase the risk of bleeding and stroke.

6. Magnesium

Magnesium, the fourth most abundant mineral in the body, can help with muscle cramps, migraines and sleep problems. “People are often deficient in magnesium and don’t realize it,” says Dr. Fuller. Halibut, almonds, soy products and pumpkin seeds are great dietary sources of magnesium. Magnesium is typically found in calcium supplements to enhance absorption.

Benefits may not add up

A growing body of research seems to reinforce the role of dietary supplements as just that: supplements to our diet, taken to correct a deficiency.

“The bottom line is to get most of your vitamins and minerals from dietary sources rather than from a pill,” says Dr. Volkar. “The majority of us don’t need to spend a lot of money on supplements. For overall health, we’re better off exercising instead.”

Ms. Kirkpatrick heartily agrees: “As a dietitian, I believe you can get 99 percent of all your nutrients from food. You’re not just getting one specific nutrient from a pill; you’re getting a variety of nutrients from a whole food.”

A word on multivitamins

What if you aren’t consistently eating a well-balanced diet? “A multivitamin is good for most adults who are not getting all the nutrients that they need every day,” says Dr. Fuller.

Although a recent study found multivitamins to be dangerous for postmenopausal women, “you have to take that study with a grain of salt,” says Dr. Volkar. The study relied on questionnaires rather than on rigorous scientific method.

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Parents Children's Health Essentials – December 2011 Issue

Free Guide: Childhood Leukemia and Lymphoma

Free Guide: Childhood Leukemia and Lymphoma

Today, 80 percent of children and adolescents survive cancer. The cure rates for two of the most common childhood cancers – acute lymphocytic leukemia (ALL) and Hodgkin’s lymphoma – are even higher. Learn how leukemia and lymphoma are diagnosed and treated.

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Recipe: Healthy Lasagna Rolls

Make a hearty batch of lasagna rolls for your family using whole-grain noodles, fat-free ground turkey breast and low-fat mozzarella cheese. Serve with a side dish of steamed vegetables or a tossed salad for a healthy, filling meal.


12 long whole-grain lasagna noodles
6 ounces ground turkey breast (skinless white meat, extra lean)
10 ounces frozen chopped spinach, thawed and drained
1/4 teaspoon red pepper flakes
1 cup low-fat ricotta cheese
2 cups marinara sauce
3/4 cup shredded low-fat mozzarella cheese

  1. Bring a large pot of water to a boil. Add lasagna noodles and follow cooking instructions on package. Drain water and let noodles cool. Once cool enough to touch, place each noodle flat and cut in half crosswise.
  2. While the pasta cooks, brown the ground turkey in a large nonstick sauté pan over medium heat until cooked thoroughly. Drain any liquid, then add spinach and red pepper flakes to the cooked ground turkey. Heat until the spinach is warmed.
  3. Remove turkey and spinach mixture from heat and let cool slightly. Place in a mixing bowl, add the ricotta cheese, and mix thoroughly.
  4. Preheat oven to 400 degrees. Spread ½ cup of marinara sauce on the bottom of a 13x9″ baking dish. Add 1 tablespoon of mixture onto each lasagna noodle at one end, then roll into a tight package. Place each roll into the baking dish.
  5. Top the lasagna rolls with the remaining 1-½ cups marinara sauce; sprinkle with the mozzarella cheese.
  6. Cover with foil and bake 15 minutes. Remove foil and bake for another 10 minutes, until the cheese and sauce are bubbling.

Makes 8 servings


6 servings (4 roll-ups per serving)
Calories: 320
Total carbohydrate: 44 g
Protein: 24 g
Total fat: 8 g
Saturated fat: 3 g
Cholesterol: 34 mg
Sodium: 604 mg
Potassium: 406 mg
Dietary fiber: 8 g
Sugar: 6 g

Recipe from our Children's Hospital Pediatric Nutrition Support Team

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Parents Children's Health Essentials – December 2011 Issue

Let's Move It! Free Mobile App

Let Cleveland Clinic and your mobile phone keep you motivated. More than just a pedometer, our free mobile app offers walking challenges, a calorie tracker and videos to encourage and inspire.