Here are a few ways to help your children reduce their soft-drink consumption

1. Education:- Children should be taught about the negative affects the soft drinks have. This should be explained in easy ways that they can understand depending on their age. Taste will probably predominate and children will still want to drink what tastes good therefore it is very important for them to know that there are other alternatives that taste good too.
2. Limit availability:- As parents /guardians you are in full control of what food/drinks are available at home. If you do not buy soft drinks, children will not have them at home and therefore will not drink them.
3. Lead by example: Make it common practice as a family to drink water instead. Children tend to follow by example. If they see you drinking water, they are more likely to drink it themselves.
4. Cut down slowly: If your child is used to drinking soft drinks do not stop them all at once. Taste buds need time to get accustomed to different tastes and if your child is used to caffeine and sugar boost from soft drinks stopping them all at once can trigger irritability.

Ways of reducing intake slowly include :–

• Decrease the quantity per serving e.g. half a glass instead of a full glass
• Limit the amount of times they can drink it during a day e.g. limit soft drinks only during certain meals.
• Dilute with water

Work on these reductions slowly until eventually all soft drinks is replaced with water.

5. Offer good tasting alternatives: When you are decreasing soft drink intake from your child offer good tasting alternatives such as fruit infused Be careful when buying commercially available fruit flavored water some of them are loaded with sugar while others have sweeteners added.

Diet soft drinks are not a healthier option. Not only is the ‘habit’ of drinking sweet drinks maintained, studies have also shown that drinking diet soft drinks can still result in weight gain due to craving more sweet foods and drinks – this can add up to excess calories. The long-term effects of children drinking artificially-sweetened drinks are unknown².

6. Special Occasion treat: It is very difficult to control what food and drinks are offered at other people’s places. If for example, soft drinks are offered at a friend’s place do not worry. Just make sure these are on very special and limited occasions.

AUTHOR :        Melania Spiteri  B.Pharm (Hons), pg dip nutr & diet, M.Ent.

Melania is a state registered pharmacist and nutritionist

References

1. Harvard T. H. Chan School of Public Health. The Nutrition Source – Soft-drinks and Disease. (Accessed on August 2nd 2017) https://www.hsph.harvard.edu/nutritionsource/healthy-drinks/soft-drinks-and-disease/

2. Harvard T. H. Chan School of Public Health. The Nutrition Source – Artificial Sweeteners. (Accessed on August 2nd 2017) https://www.hsph.harvard.edu/nutritionsource/healthy-drinks/artificial-sweeteners

The obesity problem is often simply explained as being a matter of calories in versus calories out – we eat too much food and burn off a little energy. This may sound really simple, however as human beings we are complex and if tackling obesity was a simple mathematical equation it would probably not be much of a problem. Many factors in a child’s life play an important role and can lead to childhood obesity. Such factors include genetic, environmental and social factors amongst others and as parents it is your duty to adopt various strategies to prevent your child from having excess weight. Unfortunately we are living in an ‘obesogenic environment’ (an environment that promotes weight gain) which does not help us.  Children and adults alike are constantly being exposed to foods that have a tendency of making us gain weight and being tempted by technology and screen time which reduces physical activity time. The occasional birthday cake or screen game are nothing to worry about however when this becomes the norm then yes it becomes a problem!

Obese children tend to become obese adults. Childhood is therefore the best time to stop obesity and turn to lifelong healthy habits. No drastic or severe measures are required but rather small and consistent measures that require progress. Start today by offering a healthy snack instead of sweets or go for a short walk instead of watching TV. There is no magic bullet to stop obesity but it is up to one’s own individual motivation to adopt a healthy lifestyle and not fall into the trap of promotional propaganda and special offers. Choose fresh and local produce and limit processed foods to the barest minimum.

AUTHOR :        Melania Spiteri  B.Pharm (Hons), pg dip nutr & diet, M.Ent.

Melania is a state registered pharmacist and nutritionist.

1. Global status report on noncommunicable diseases 2010. Geneva, World Health Organization, 2011. Available at: http://www.who.int/nmh/publications/ncd_report2010/en/ [accessed March 2018].
2. Weighing the Costs of Obesity in Malta. PwC Report. March 2017
3.  Grech, V., Aquilina, S., Camilleri, E., Camilleri, K., Busuttil, M. L., Farrugia Sant’Angelo, V. & Calleja, N. (2016) The Malta Childhood National Body Mass Index Study – a population study. Journal of Pediatric Gastroenterology and Nutrition. doi: 10.1097/ MPG.0000000000001430.

These statements might be easily dismissed as excuses and one can argue that we have our priorities mixed up. However these statements might also stem from the fact that there is a misconception of what exercise really is. One might imagine exercise as some chore that requires firm preparation, some fancy subscription or complex exercise equipment. However this is far from the truth.

We need to keep in mind that exercise especially in children, requires movement and it has to be FUN. It is especially important to ingrain from an early age that exercise should not be seen as a chore and that its aim is to lead to a healthy lifestyle. One should be careful in how to mention specific exercise aims such as losing weight as these might lead to body image problems or a distorted idea of what exercise really is.

Exercise can start early on in children with the simplest of tools, for example one can encourage their children to dance to music and encourage more active play. It is important to be knowledgeable in regards what activities are carried out at school or playschool in order to make sure that there is sufficient movement and play during the day. Going to the swings is also a great way for children to get to exercise, learning new motor skills as well as starting to interact in a playful manner with other children. One can also be creative and integrate some simple yet active household chores as exercise. During their early years it is important to join our children in their active time. This helps foster a sense of physical activity time for the whole family such as going out for countryside walks or to the beach when the weather is warmer – again the focus should be having fun whilst also staying healthy.

As our children grow older and start grasping more difficult motor skills we might consider more challenging activities. A sport can provide such a challenge. Sometimes parents are daunted and discouraged by the prospect of choosing a sport for their children. And the process may indeed be a hard one. One can keep in mind some simple advice to help them along in this process. We should not try to form the next Messi or Michael Jordan early in the child’s development. It is more important early on to provide a wide set of sport FUNdamental’s. These include coordination and movement abilities that can be used in a wide range of sports. This can be achieved by exposing the young child to a number of different sports. Varying between team and individual sports also helps the child develop valuable skills such as the ability to work in a team as well as work independently. Varying between sports also helps prevent certain overuse injuries with might occur at a young age. It is also very important to avoid falling into the pitfall of enrolling the child into the sport that we like or into our favourite sports team. We should provide sufficient independence and allow them to choose the sport of their liking. Whenever possible, attend their events to cheer them on. Perhaps most importantly, provide positive reinforcement by acknowledging their efforts, rather than focusing on what they do wrong.

As a final note it is a moot point that sport or physical activity should not be used as a bargaining chip or seen as a reward, but rather it should be an integral part of our lives. We might otherwise risk portraying the wrong message that physical activity is secondary to other ‘more important’ activities that we might have during the day. Yes we only have 24 hours in a day but we should not let that fact compromise our health.

Johann Zarb

Physiotherapist & Nutritionist

B.Sc.(Hons) Physiotherapy,Pg.Dip Nutrition & Dietetics., SRP

Once a fruit is blended or juiced, the structure of the fruit changes and so do its total health benefits. Below is a short list explaining some differences between drinking a fruit juice and eating fresh fruit.

• Lost nutrients: When you eat a whole fruit you are consuming the juice, pulp and sometimes the skin. The edible skin of the fruit is high in phytonutrients such as carotenoids and flavonoids while the pulp is high in fiber. During the juicing process these nutrients and their benefits are often lost resulting in a lower nutritious value.
• Less satisfying: Once the fruit has been juiced, the structure is changed. Chewing is no longer required and therefore drinking juice is not as satisfying as eating a fruit often leaving you hungry and more likely to snack afterwards. The fiber content in the whole fruit also helps you feel full.
• Spike in blood sugar level: The juicing process results in a more concentrated source of natural sugars which is absorbed quicker and more easily when compared to that in a whole fruit containing fiber. This concentrated source of sugar results in a rapid increase in blood glucose similar to the effect of drinking a soft drink. Furthermore, some commercially available juices have added sugar and/or sweeteners.
• Higher in sugar content: If you squeeze a single orange, the amount of juice made is so small that you would need 2-4 oranges to fill one glass of juice. Therefore one serving (1 glass) of orange juice would be higher in calories and sugar than 1 serving of fresh fruit (1 medium -sized of orange).
• Impact on tooth decay: Drinking acidic fruit juices such as orange, grapefruit and pineapple can also increase the risk of tooth decay.

To answer the above question, eating fresh fruit and drinking a juice is therefore not the same. It is definitely better to eat fresh/frozen fruit rather than drink it. However, should you or your child not like eating fruit, drinking fruit juice instead of soft drinks is still a better option.  Fruit juice contains vitamins and minerals while soft drinks contain just ‘empty calories’. Below are some recommendations to follow.

For a one minute video clip showing the difference between fruit and fruit juice click here.

• 100% fruit juice (with no added sugar) is OK to have occasionally – not more than 1 glass of juice a day. Ideally this should be diluted with water and offered only at mealtimes
• Making a smoothie rather than a juice would be a better option. The fruits in a smoothie are blended and not juiced using the whole fruit. This means that they have added fiber from the skin and pulp.  The fiber in a smoothie will keep you fuller for longer and allows for a slower spike in blood glucose when compared to that of a juice. You can also add some vegetables to the smoothie to increase the fiber content even further.  Be careful some smoothies may contain high levels of fats and sugars depending on the ingredients used.

AUTHOR :    Melania Spiteri  B.Pharm (Hons), pg dip nutr & diet, M.Ent.

Melania is a state registered pharmacist and nutritionist.

Healthy snacks on the other hand play an important part in helping your child stay energized in between meals while offering an opportunity for  him/her to reach the recommended daily nutrient requirements and help the child develop healthy eating habits.  With a little creativity, healthy snacks can offer vital nutrients in your child’s daily meal plan becoming essential for their healthy development.

EXAMPLES OF HEALTHY SNACKS

• Vegetable sticks (e.g. carrots, peppers, cumbers) with hummus
• Unsweetened yogurt topped with fruit
• Fruit mix (e.g. bananas, blueberries, peaches, strawberries)
• Whole grain crackers with cut up vegetables
• Homemade fruit muffins made with oats or whole grains
• Homemade trail mix ( A mixture of nuts, cereal, dried fruit, and/or seeds)
• Fruit smoothies made with yogurt or milk, (e.g. Mix in a blender milk (1⁄2 cup skimmed milk), fruit (1⁄2 cup strawberries) and 4 tablespoons Greek yogurt.

TIPS ON HOW TO BE PREPARED FOR HEALTHY SNACKS

1. HAVE HEALTHY SNACKS AVAILABLE: As a parent/ guardian you are in charge of what food to buy for your household. If your child is hungry he/she will eat whatever is available in the fridge or cupboard. Do not waste your money on pre-packed junk food. These are very tempting for children (plus adults) and will definitely be the child’s first choice if available.
2. PREPARE FOR SNACK TIME: It is not only important to stack up your fridge or cupboard with healthy options, it is best if you have the snacks ready. For example cut vegetables such as carrots, peppers and store them in air tight containers in the fridge fridge. If preparing healthy muffins prepare some extra to freeze
3. SCHEDULE SNACK TIME: A common problem is that if snacks are given very close to mealtimes, the child might fill up on the snack and is then not hungry for lunch or dinner. It is best to schedule snack time two to three hours away from lunch or dinner.
4. BE A ROLE MODEL: Choose healthy snacks for yourself. If your child sees you snacking on fruit, they will be more likely to copy you. Click  here to watch a one minute video of how children copy their parents.  Do not blame them for wanting biscuits, chocolate and crisps if that is what they see you eat!

Healthy snacks are always highly recommended however the occasional treat is also welcome. Everyone would need an indulgence once in a while especially children. Do not ban treats completely since this will make the children crave for them more and by making treats available on occasional basis in limited quantities, the children will be more likely to eat healthy snacks on a daily basis.

The boys also received a souvenir bookmark, draw-string bag and a healthy oat and banana muffin instead of a hot dog or chocolate pancake as in previous years. The school staff, together with parents, are adopting healthier food options for school fundraising days and activities as they strive to bring about a culture change in the school environment.  They are modelling healthy habits with the aim of educating on the importance of a healthy lifestyle. Water consumption during the school day is also encouraged by the staff.

That sure was a Happy St Benild’s Day with a difference!

St. Benild’s School together with Stella Maris College Junior School is participating in our project entitled “Targeting Obesity as a National Disability through a Community Pharmacist Driven Approach”.

Click here for recipe.

“Eating healthy is impossible.” We have all thought this at some point in our life. We have all said it. And probably many of us believe it to the extent that we won’t even try. Such statements and beliefs are even more common when it comes to offering healthy food to children. It is very common to hear parents, grandparents and even relatives remark on how difficult it is to feed fruit and vegetables to children. It is easy to please children and always offer the foods they prefer, however, do you know that the habits your kids are forming now will affect their health later in life?

Thomas McInerny, MD FAAP,  past president of the American Academy of Pediatrics (AAP) stated “Not only is it extremely important for kids to get all the vitamins, nutrients and physical activity they need to stay healthy, but habits formed early in life — both good and bad — can last a lifetime”.  Bad eating habits can have unhealthy consequences, such as being overweight or obese which currently affects 40% of school-aged children in Malta as has been shown in a recent study led by Prof V Grech¹.  Children who are obese are more likely to become obese adults, increasing the risk for certain health problems such as  type 2 diabetes, heart disease and cancer.

 Your child can learn healthy habits early in life offering lifetime benefits. It starts at home with you. Children see, hear and try to copy everything you do. They are constantly  learning by watching you. For the coming year try not to focus on drastic changes but rather be a positive role model and enforce the message that good health is important by actively trying to live a healthy lifestyle implementing small sustainable changes one by one.

The health promotion and disease prevention directorate recommends 6 ways to a healthy lifestyle to help your kids establish healthy habits. Make these part of your family’s daily routine:

1. Eat more fruit and vegetables:  Eat plenty of fruits, vegetables and whole grains in reasonable portions. This is even possible with ‘picky eaters’.

2. Eat fewer snacks and select healthier options: Eat breakfast, lunch and dinner with two snacks in between. Opt for fruit/vegetable based snacks rather than sugar and fat loaded snacks such as crisps or biscuits.

3. Turn off TV and computer and get active: Limit the amount of time your child spends in front of a screen to no more than 1-2 hours daily. These habits can increase the risk for obesity.

4. Chose water as a drink: Encourage drinking water and skip the soft drinks- these are full of sugar and offer no nutritional value.

5. Get active each day: Encourage daily physical activity and make it fun. Try different activities until your child finds something they enjoy (e.g. football, karate, swimming, gymnastics, dance, etc.). During the weekends get moving as a family by going for walks, biking or playing together.

6. Have adequate rest and sleep: Quality sleep will help your child stay healthy. You can help your child develop good sleep habits by creating a regular sleep routine, including a regular bedtime. Keep the TV out of your child’s bedroom and do not allow watching TV close to bedtime. Primary school aged children need an average of 8-9 hours sleep per day.

As the New Year begins, work on creating healthy habits for your family that will last a lifetime. Remember small but constant changes are more sustainable than drastic changes that will only last a short while! Children follow their parents thus you are their role model. Take Care of Your Health and Guide responsibly!

References

1. Grech V, Aquilina S, Camilleri E, Spiteri K, Busuttil M, Sant’Angelo V F,  Calleja N. The Malta Childhood National Body Mass Index Study: A population study. Journal of Pediatric Gastroenterology and Nutrition. 65(3):327-331, September 2017.

Recommended Reading

Healthy New Year’s Resolutions Ideas for Kids

Grade 2 St Benild School, Sliema set off on a healthy Christmas party. The aim of the event was to show students that with a little effort we can keep healthy even during the festive season.

The teaching team planned and organised the event. The teacher bought all the consumables a day prior to the event so as to set the children thinking about the mission. On the day of the party, the boys were eager to put on the chef’s attire and prepare their own food.

A class of twenty-five boys was divided into five groups, where each group prepared at least three healthy festive dishes – a vegetable dish, a fruit dish and a Santa dessert. The Teacher and Learning Support Assistants in the class helped with the peeling and chopping of the food items, while the boys enjoyed mixing and displaying their own party food. The boys exposed their taste buds to different fruits like berries, kiwi, banana, and grapes, and to different vegetables like coloured peppers, olives and cherry tomatoes. A variety of white and brown bread, pita bread and water biscuits was displayed with cheese, ham and pesto dips. The boys were encouraged to try water infused with strawberries and fresh oranges, whereas the less daring pupils drank plain water.
All the boys enjoyed themselves while eating the party snacks they created themselves. The Santa dessert was the highlight of the event. The healthy Christmas party was a complete success. The boys had lots of fun both preparing and eating healthy food. Engaging the little ones actively encouraged them to try new food items whilst and experiencing an array of unfamiliar tastes.
Well done to the teaching team who came up with this brilliant idea and the pupils for collaborating to the full. Keep it up….until the next celebration!

Why is Breakfast important?

Breakfast is the first meal of the morning which literally means “breaking the fast”. It is a great way to help refuel your body after the night and give you and your child the energy you need to get things done. Imagine you are a car. After a night’s sleep, your fuel tank is empty and in need of a refill. A car without fuel will not perform well and so does our body. Children who do not eat a nutritious breakfast have lower energy, become tired at school and have shorter attention spans. Various studies have shown that school- aged children who take a nutritious breakfast perform better at school and are able to concentrate more.
A well balanced breakfast helps your child feel full for longer periods and suffer less from hunger pangs. Children who do not eat a good breakfast are more likely to eat junk food during the day and snack on foods which are high in sugar and fat offering low nutritional value. This would not only have an impact on their general health status but even their weight.
A wholesome breakfast is also good way to ensure your child gets the necessary vitamins and minerals from healthy foods such as diary, wholegrains and fruit.
These are just a few reasons why breakfast is an important meal for your child but be careful not all breakfasts are the same!

What kind of breakfast?

It is not only important that your child has breakfast everyday but what your child eats is even more important. Opening a packet of biscuits or a sugar loaded cereal pack is a quick and easy option but be very careful these are very  high in calories, sugar, and fat and do not contain the required nutrients that your child really needs.  Just like with any other meal try choosing nutritious foods that contain some carbohydrates, proteins and high amounts of fiber, while being low in added sugar and fat.

Here are some ideas for a quick healthy breakfast:

• whole-grain cereal with semi-skimmed/skimmed milk  and ½ banana
• whole-wheat pita stuffed with sliced hard-cooked eggs
• whole-grain cereal topped with low-fat yogurt, nuts or fruit sprinkled with cinnamon or allspice.
• whole-grain toast topped with fresh fruit (banana or apple wedges)and some nuts plus a glass of low-fat milk to drink
• vegetable omelet with whole-grain toast
• bran muffin and berries

Tips to make it happen

While reading this you might probably be thinking… ‘in the morning I barely have time to finish and get my children ready on time let alone prepare breakfast for them and make sure they eat it!’
Here are some suggestions to help you make it happen and ensure that even when you are in a rush your child manages to get a good breakfast.

1. Keep convenient food readily available e.g. fruit, cheese, wholegrain sliced bread, small packs of healthy whole grain cereal. It takes no more than one minute to put a sliced cheese between two slices of whole grain bread or grab a plain yogurt and pre-cut fruit from the fridge. (Be careful fruit flavored yogurt can have a lot of added sugar)
2. Try preparing for breakfast the day before.  Boiled eggs are an example of a perfect breakfast food which can be prepared the night before – to save time, you can even prepare a whole batch on a Sunday for the whole week. You can also for example cut fruit and place it in an air tight container in the fridge to find it ready in the morning. Let your child help you in this preparation.
3. Allow your child to eat breakfast on the way to school if your child had no time to have it at home.

Don’t forget how important being a role model and setting a good example is. Allow your children to see you have breakfast everyday. This way you will be showing them that it is important to start the day with a healthy morning meal. So why not try sleeping a little bit earlier and waking up ten minutes before to try and make time for breakfast together!

Below is a list of some tips to work on:-

1. Serve fruit and/or vegetables at every meal and snack. Your child will probably not eat it the first, second or third time – do not be discouraged. Keep offering very small pea size quantities of that vegetable or fruit until your child actually tastes it. Always give this before giving your child his/her favorite food. It takes time for a child to accept a different texture, taste and decide they actually like this new food. I WOULD INCLUDE THAT STUDIES SHOW IT TAKES 8-13 TIMES BEFORE A CHILD COULD ACTUALLY TASTE A NEW FOOD

2. Don’t be afraid to say no to chocolate, sweets, crisps, sugary drinks etc. especially if your child already had some that day. Your child will probably break down into a tantrum, start crying, yelling and loads more. Be strong and affirmative in your decision!

3. Be careful about portion sizes and allow your child to stop eating when they are full (even if you think they did not eat enough). Giving to much food and insisting that your child finishes all the food given even if they are no longer hungry can lead to unhealthy overeating habits.

4. Encourage children to participate in food preparation and shopping. This will give you the opportunity to teach your child about nutrition and will give your child a sense of accomplishment. Also, children are more willing to try a new food if they helped in preparing it themselves.

5. Do not use food to punish or reward your child. It is not uncommon to hear phrases like “if you finish your vegetables I will give you a dessert”. This send the wrong message to a child that desserts are actually better than vegetables.

6. Plan snacks. Constant snacking may lead to overeating and reduce your child’s appetite at meal times. Try to plan specific snacking time and avoid giving snacks very close to meal times.   Make sure to have healthy snacks available! See our next blog for some healthy snack ideas.

7. If your child skips a meal, do not let them “make up for it” with some sweets or crackers. Offer a healthy snack instead for example some fruit or vegetable sticks with cream cheese, and make sure that they eat enough at their next full meal.

8. Be a role model. From a young age children want to copy what adults do. Eat the way you want your child to eat. If you never drink water or eat vegetables you cannot really expect your child to do so!

Do not try to attempt making all these changes at once. it will not work. Change takes time, try to aim at small changes which are constant over time, reinforce these changes and build on them.