When your child started school earlier this month, your family may have considered whether to buy the school lunch or provide food from home. Or did you automatically opt for one without giving much consideration to the other?

He Said

My first job as a dietitian was a research position that entailed traveling the country to collect and process data about the food served in elementary school cafeterias.

In one Chicago suburb, it was considered “uncool” to eat vegetables. Because students were more likely to use vegetables as ammunition for a food fight rather than for consumption, cafeteria supervisors intercepted students coming out of the lunch line and removed the vegetables from their trays before they sat down. I remember looking into a trash can and seeing thousands of peas that were served but never had a chance to be eaten.

In contrast, I visited a Tennessee hill town where they were dealing with the problem of students taking too many vegetables from the self-serve salad bar. I watched cashiers ring up students with one hand and pick off vegetables from their trays with the other hand in order to keep portion sizes in line with system guidelines.

One school I visited here in Massachusetts served soft pretzels as a main course. The school system dietitian explained to me that she wanted to make the lunches in her system healthier, but she was encountering harsh resistance from both parents and principals who cared more about the children eating – period – than they did about providing a healthier option that they feared the kids would reject.

Everywhere I went, I saw students discard or trade away food that their parents had provided from home. Just because you or the cafeteria staff gives your child something to eat does not guarantee that it will make it into his or her mouth, and a school lunch is not inherently more or less healthy than what is brought from home.

As you and your child decide what’s for lunch, consider not just your child’s preferences and health, but also the realities of the cafeteria dynamic. In order to get a glimpse of the latter, think about planning a visit to eat lunch with your child in the cafeteria. I saw parents eating with their children in every single school system that I visited.

She Said

Planning ahead is a great strategy for figuring out school lunch. First, I think it’s a good idea to suss out what your child’s school is serving. Most public and private schools have websites nowadays, so looking up the weekly/monthly cafeteria menu shouldn’t be too difficult. If, however, no website exists, talk to the school and they can give you a hard copy of the menu.

If you and your child look at the menu and nothing looks appealing, the next step would be talking with your child about what he or she would like to bring for lunch. Letting your child help in planning and/or putting together lunch will greatly increase the odds that he or she will eat said lunch! Having your child accompany you to the grocery store to pick out lunch foods would be a smart idea as well.

Finally, a lot of my clients feel stuck around what to bring, feeling like sandwiches are the only option. Not true! One can piece together a totally healthy lunch without needing it to be “standard.” For example, hummus and pita, baby carrots, fruit, and milk can make a delicious piecemeal lunch. Another idea could be crackers and cheese, with cut-up peppers, fruit, and a beverage. Bringing leftovers from last night’s dinner, such as a pasta dish, would also work really well.

The bottom line: If your child can be involved in one or all steps in the school lunch process, success will be sure to follow.

The definition of “proper hydration” not only varies from person to person, but also depends on the circumstances. Given the abundance of fluid choices on the market, we certainly understand why people question what is best and how much to have.

He Said

As the duration of our exercise session increases, especially if we are working out in the heat, the more likely we are to benefit from more than just plain water. In addition to replenishing fluid, we need to replace the electrolytes lost in sweat and the carbohydrates we metabolize for energy. Juice usually does not cut it, as the sodium concentration is too low and the abundance of fructose can cause gastrointestinal distress. For many athletes, sports drinks are the answer.

Commercial products, such as Gatorade and PowerAde, are popular options as is coconut water. Most of these offer a balanced blend of sugars, which increases gastrointestinal tolerance and absorption rate. One drawback to coconut water, however, is low sodium content. Many athletes, especially those whose sweat leaves white salt marks on their clothing, may benefit by adding extra salt to their coconut water.

We can typically control what we drink during training and sports where we can keep our beverage of choice on the sidelines, but the same is not always true during endurance events. Fuel belts and fluid backpacks can help, but their weight and bulk can hinder performance. Sometimes we are at the mercy of whatever the race director gives us. In this case, find out in advance (Check the race’s website and/or contact the race director.) what will be provided and practice with it in your training. If you perform well with it, great; if not, use the time to formulate a Plan B. For example, station along the route friends who can hand you your beverage of choice as you pass by.

Remember that perhaps no area of nutrition is more individualized than sports nutrition, so experiment during your training to figure out what has you performing your best. To the fullest extent possible, avoid drinking anything during competition that you have not tolerated during practice.

She Said

Why do we need water? Well, the wet stuff is for more than just quenching your thirst; every system in the human body depends on it (and your body is made up of 60-75% water). You need water to regulate your body temperature, lubricate your joints, flush toxins from your body, protect body organs and tissues, and carry nutrients and oxygen to cells. So, clearly, we need water to live!

I’m sure many of you have heard the advice “drink eight 8-ounce glasses of water each day,” and while that figure is not too off-target, it’s not a hard and fast rule. The Institute of Medicine determined that an adequate fluid intake for women is about 2.2 liters (approximately 9 cups) of total beverages a day; for men, it’s about 3 liters, or 13 cups. To reach these amounts, you can include the water that naturally occurs in many fruits and vegetables, soups, and beverages other than water, as all fluids count toward this daily total.

Of course, the above figures are averages, not exact numbers. Adequate hydration varies from person to person. Some people simply need more fluids, while others need less. To assess hydration status, I often tell my patients to look at their urine, as it can be an excellent indicator of dehydration. If your urine is very light yellow, almost clear, you are adequately hydrated. Dark yellow? Then you most likely need to up your fluids. In the end, pay attention to your body’s thirst cues – your body has more wisdom than you think.

Whether we are standing in the frozen foods aisle peering through frosty glass doors or holding up the line at the local ice cream shop, the choice many of us struggle to make is the same: do we opt for the frozen yogurt, or do we go for the ice cream?

He Said

Back about a decade ago, I went through a phase where I was modifying cookie recipes in all sorts of ways in an effort to make them healthier: nuts and dried fruit instead of chocolate chips, oil instead of butter, whole wheat instead of white flour, reduced sugar, etc. These changes sounded good in theory, but who was I kidding; these “cookies” were only cookies by name and bore a stronger resemblance to pancakes.

They never quite hit the spot. Either I ate the healthier cookies by the batch in an effort to quell my cookie craving, or I chased them with traditional baked goods anyway.

What does any of that have to do with the ice cream vs. frozen yogurt debate? Just like with my cookie experience, we want to be careful not to get so caught up in nutrition that we neglect pleasure, for if we do, the irony is that we often end up losing out on both.

Frozen yogurt does have some nutrient benefits compared to ice cream (See “She Said” section below.) However, if frozen yogurt is going to leave you still craving ice cream, and you are going to overeat in an effort to satisfy that desire, then perhaps it is better to just have a small amount of ice cream when the craving sets in, enjoy it, and get on with your day.

She Said

So many of my clients have a love/hate relationship with ice cream. Most of them would admit that they adore real, full-fat ice cream, but they often deny themselves this treat for fear that it will make them fat. Instead, they end up eating at one of the myriad frozen yogurt stores (with new ones popping up seemingly every week) to get their cool, creamy fix.

I don’t have a problem with frozen yogurt per se. It has a lot of things going for it, including being lower in saturated fat and a good source of protein and calcium as well as providing probiotics. But ice cream also has nutrition benefits: it is a good source of calcium, vitamin D, vitamin A, and some of the B vitamins that help with energy release. In addition, given its richness, it takes a smaller amount of ice cream (compared to frozen yogurt) to be satisfying. And let’s face it, when you are really craving ice cream, a fro-yo just doesn’t cut it!

I’m not suggesting that anyone go out there and begin a Ben & Jerry’s binge, but totally denying yourself one of summer’s most quintessential treats will just lead to feelings of deprivation and eventually overeating of less satisfying foods. So go ahead and order that real ice cream – just be sure to savor and enjoy it!

We often field questions from patients regarding which is better, organic or conventional produce, especially this time of year when people are visiting farmers’ markets and pick-your-own farms, growing their own gardens, and generally enjoying the abundance of different fruits and vegetables that are in season.

He Said

Would you rather pay less for your produce now and risk discovering later that conventional food is actually harmful, or pay more now for organic and risk finding out later that conventional would have been totally safe all along?

In other words, whether you choose to buy conventional or organic, you are taking a gamble either way. The decision is personal and based on your own concerns and priorities.

The middle ground between the poles is also a perfectly valid option. For those looking to pick their spots, the Environmental Working Group is a helpful resource. They publish a guide to help shoppers determine which fruits and vegetables they consider most important to buy organic based on pesticide contamination.

When it comes to organic vs. conventional produce, there really is no one right answer for everybody. As long as you are eating fruits and vegetables, you are making the right choice.

She Said

While in general I try to buy mostly organic fruits and vegetables, I am not obsessive about it. Yes, there are good reasons to buy organic (no pesticides, chemicals, hormones or genetically modified organisms (GMOs)), but there are a lot of myths out there about why organic foods are superior to conventional foods.

Although many people believe that organic produce is more nutritious than conventional, numerous studies have shown that there often is no difference in nutrient content between the two. What really seems to matter is how long the produce sits on the shelf, as more nutrients are lost when produce sits out for longer periods of time.

While it is true that organic produce is grown without pesticides or chemicals, it is not necessarily better for the environment than conventional produce, as conventional farming is more productive and efficient than organic farming. According to the Hudson Institute’s Center for Global Food Issues, if we were to switch all conventional farming to organic, we would need to cut down 10 million square miles of forest.

Finally, just because organic produce is chemical free does not mean you don’t have to be careful about washing it. It is still susceptible to bacteria.

So, while I don’t think there is anything wrong with choosing organic more often (It’s good to reduce our exposure to chemicals and pesticides.), it is important to know that organic is not inherently better than conventional.

Over the last several months, we have been learning more about the Health at Every Size® (HAES®) movement. The HAES® approach to health emphasizes eating intuitively and being physically active for pleasure rather than focusing on weight loss and dieting.

Clearly, the HAES® approach flies in the face of almost everything our society believes about health (i.e., that thin people are innately healthier than heavier people, and that losing weight is the be-all and end-all to being a healthier, happier person). Given the years and years of messages we have received about how dangerous it is to be overweight, the HAES® approach is a pretty revolutionary and scary premise.

He Said

The HAES® approach is most typically brought up in the context of overweight individuals, but health – or lack thereof – at leaner sizes also falls under the topic’s umbrella. In other words, just because someone is thin does not mean he or she is healthy.

Recently, a new patient was talking with me about the pressure she feels to be skinny in her community where so many of the women she sees around town are thin. While some of the women my patient envies no doubt are blessed with a foundation of helpful genetics on top of which they have built healthy lifestyles, some of them keep their figures through unhealthy means: excessive exercise, disordered eating, laxative abuse, anorexia, purging, etc.

The truth is that so many of us are dealing with health conditions invisible to others, such as diabetes, hypertension, depression, arthritis, Celiac disease, eating disorders, HIV, and high cholesterol, just to name a few, that we can judge neither one’s health nor lifestyle based on his or her size alone with any degree of accuracy.

She Said

I find a number of things about the HAES® approach interesting. The aspect I like the most is that it stresses that health is much more than just how much you weigh.

In a previous blog, I discussed the limitations of the BMI, as it does not give us enough information about an individual to determine his or her overall health. the HAES® approach says that health is about eating according to your body’s hunger, fullness, and appetite cues; exercising for pleasure (as opposed to doing so just to burn calories); and recognizing that health comes in all shapes and sizes.

These ideas are things that I try to stress in my sessions with clients – that if you are only focused on calories in vs. calories out, weight, and exercise solely for the purpose of weight loss, you are missing the bigger picture.