Practically Edible: Food Tips for Children and Pregnant
and Nursing Mothers (March 2005)
Sweeping changes in preventive medicine, agriculture, food products, pollution and mixed cultural cuisines have enhanced food options but made it more difficult to discern how best to meet children’s physiologic needs. The following are some answers to parents’ frequently expressed concerns.
Q. Isn’t a lot of fish good for children?
A. Fish is good for children, but its merits must be balanced with risk of toxic exposure. Fish
provide vitamin D, protein and beneficial fats. Omega-3 fatty acids promote brain develop-ment in infants and children as well as prevent heart disease. However, fish may also contain pollutants such as polychlorinated biphenyls (PCBs), dioxins, mercury and flame retardants. Fatty fish and large predatory fish contain the highest levels of such environmental toxins. Fetal and infant exposure occurs indirectly through the placenta or through maternal breast milk. During early life, repeated and overexposure to mercury and PCBs may lower IQ, impair learning skills or increase behavior disorders.
The Smart Fish Guide (Institute for Agriculture and Trade Policy—www.iatp.org/foodandhealth/) recommends:
For further advice regarding fish consumption, see:
Q. What about canned tuna?
A. Trimming fat alone does not remove the mercury found in the flesh of fish. The Smart Fish Guide says it best, "Canned tuna is a popular, inexpensive and nutrient-rich food for both women and children. However, it’s important to limit consumption to protect fetuses and children.
Women of childbearing age can safely eat:
Children can safely eat a ½ can of chunk light tuna per week."
Q. More advice for pregnant or nursing women or women considering motherhood?
A. Avoid shark, swordfish, king mackerel or tilefish. Eat no more than 12 oz. of fish per week. Vary the types of fish consumed.
Q. My child struggles with intermittent constipation and refuses to take Milk of Magnesia, Benefiber or Miralax. Isn’t there anything else besides medicines? (...and by the way, he/she won’t eat fruits or vegetables either)
A. A child’s daily fiber needs in grams can be estimated by adding 5 to the age in years. An adult requires 20-30g per day. The many forms of fiber are broadly categorized as water soluble or insoluble. When choosing pasta, rice, cereal or bread, check labels for the highest fiber content/serving, especially the insoluble form. For instance, the fiber content of spaghetti or macaroni can be more than doubled by simply using whole wheat pasta instead. For children who don’t eat raw produce, blend vegetables into soups, gravies and sauces (including those used for pizza, pot pies or stir fry), and blend fruits into smoothies, yogurt and ice cream. For children who prefer crackers and chips, use high-fiber crackers with high-fiber dips such as bean dip or guacamole.
Breakfast cereals, salads, yogurt, baked goods and casseroles can be enhanced with sprinkled flaxseed, wheat bran and wheat germ. Flaxseed contains 3.3g fiber per tablespoon. Use freshly ground flaxseed to increase availability of other nutrients such as omega-3 fatty acids.
Wheat bran, including the outer kernel shell, contains 12g fiber per ounce (in addition to 40% RDA for niacin and magnesium, 20-40% RDA for iron, 60 calories, 5 gm of protein, but only 1 gram of fat). Wheat germ contains less fiber (3 g), more fat (4 g, mostly polyunsaturated), more calories (100 cal), 30% RDA for thiamin, Vitamin E and zinc; 20% folic acid and 10% iron and riboflavin. So, a child who requires more calories as well as a stool softener might benefit with more wheat germ and an overweight child, or one with iron deficiency, may benefit from wheat bran. Optimally, use a variety of fiber sources and distribute intake throughout the day (this strategy also avoids gas, another frequent complaint). Encourage fluid intake (popsicles, jello and soup count).
Q. What do parents need to know about organic produce?
A. California parents can choose from a wide selection of produce grown locally and abroad. Read labels carefully. “100% organic” does mean 100% organic, whereas “organic” means 95% organic by weight. Products containing at least 70% organic ingredients by weight are labeled, “made with organic ingredients.” Produce from other countries may not be as stringently regulated as in the United States.
Logically, pesticide intake should be reduced by eating more organic than pesticide-treated produce. This concept has been suggested but not yet proven by Curl et al. (Environmental Health Perspectives March 2003;111(3):377-382). Exclusive intake of organic produce does not completely avoid pesticide exposure. Persistent organic pollutants or POP (like the pesticides DDT and dieldrin) may remain in the environment for many years after discontinuation of use (Schafer et al. J Epidemiol Community Health 2002;56:813-817). Secondly, POPs, ingested in dietary plants and animals, concentrate in human fat and may even be present in human blood or breast milk. Determination of the biologic consequences of these exposures requires study of hundreds of compounds, alone and in combination, in context of other foods consumed, food preparation, stage of human development when consumed, etc. The same scrutiny may be important to understanding the consequences of some “natural” pesticides and fertilizers.
To reduce intake of pesticides or other contaminants, watch for sales at Whole Foods, Trader Joe’s, or large supermarkets and take advantage of farmers markets. Mix available organic produce with a variety of conventionally grown produce. Reduce potential toxic residues in conventional produce by trimming the tops and outer leaves of leafy vegetables, and washing and peeling wax coatings. Local, conventionally grown produce in season contains less anti-spoilage chemicals because prolonged storage and long-distance shipping are avoided. Organic produce must be thoroughly washed as well, in addition to trimming punctured or bruised surfaces/skins. Both measures remove potential microbial contaminants.
Studies to date show organic and non-organic produce to be nutritionally similar, which should be reassuring for parents who cannot afford or access organic produce. Products made with organic ingredients are not necessarily healthier especially if the product still contains high sugar, saturated fat and calories. Per the University of California, Berkeley Wellness Letter 19 (5):2-3, Feb. 2003, "organic potato chips are still potato ships, and organic butter is still 100% fat." Check labels on microwave popcorn for saturated fat content.
Bottom line, for organic or conventionally grown produce:
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