Wednesday, May 8, 2013

Science, Schmience, and SIDS

I analyze research articles for the EAL, lecture on evidence analysis, and generally love the regimented science process.  But I am in a profession (nutrition.public health) where we still know very little about so much. As a parent, there is also so little we know about how to prevent SIDS and Food allergies despite research. Nothing makes sense. Put babies on their backs, put babies on their stomachs, feed your child solid food at 6 months, no, make that 4 months. Use sunscreen, but make it the non-nano kind, and oh yeah also get some "safe" sun time without sunscreen.  Plastics are safe but not when heated, except certain types of plastics, those are safe.  No wonder parents are confused!

I have been thinking about both issues a lot lately, mostly because I have a 2 month old and I am "maternity leave."  I spend some of her nap time helping to develop evidence-based guidelines for The Academy of Nutrition and Dietetics's Evidence Library.  That word, EVIDENCE. A strong word but unfortunately the more articles I review, the more disenchanted I become with the quality of the research and the press that promotes it. Research articles that are neutral or even poor quality get published in very reputable science journals and are followed by snazzy headlines in papers around the world. In the years between 1978-1985 there were 5,000 peer-reviewed journal articles. In the years between 1994- 2001 there were 25,000 peer-reviewed articles!!! What doctor or professional organization can keep up with that? Or worse, conducting a very high quality study cannot be done due to ethical concerns for the human subjects involved. Or it's not funded due to political reasons.

Before the medical world was fixated on evidence-based guidelines, we used common science sense about what was biologically plausible. Of course, it's great of rigorous scientific studies back us up but sometimes that takes years.

For example, I took one of my older children to the doctor and as part of a blood workup, I requested that we check his Vitamin D level. It came back in the normal range. It was just at the end of winter. What happened after that was very strange:

Doctor: "Wow, I have never seen a child with a vitamin D level in the normal range, they are all deficient."

[By the way, I live in very sunny Israel]

Me: "Well, I supplement my children with vitamin D in the winter."

Doctor: "Why do you do that? The guidelines only recommend it until one year."

Me: "Because in my holistic nutrition training (through the Institute for Integrative Medicine), we look at a lot of research that points to the fact, that for whatever unknown reason, we are deficient in Vitamin D, especially in the winter."

Doctor: "Well I cannot recommend that you do that because we don't have guidelines that recommend that you do that just yet."

Meanwhile....we have doctors telling patients not to worry about their child's broken bones from a simple fall or legs getting caught behind their parent's bodies on slides in parks. "It's normal, we see them all the time," can often be heard after a concerned parent questions why the child broke a bone so easily. This article is a perfect example!

Another example, we have pretty good evidence that when you put babies to sleep on their back, Sudden Infant Death Syndrome (SIDS) is reduced.  So public health professionals started campaigns to promote "Back to Sleep."  We don't exactly know why this works, there are many theories. One if that babies breathe in toxic air when they are on their bellies, either from re-breathing their own air or from toxins in indoor air. I, and others, think it's perhaps toxins from all the new furniture and mattresses in their rooms. Indoor air quality is always worse that outdoor air quality. This theory is bolstered by the fact that research shows that fans in a baby's room can further reduce SIDS. But this hasn't made it into the "Guidelines" yet so no moms know about it unless they read research articles or followed the small flurry of articles, such as this one.

And don't even get me started about food allergies and starting solid food recommendations, we have "Guidelines" that were based on professional opinions, and now the American Academy of Pediatrics clearly states that they don't know when exactly or what to feed babies.  More on that another time.

So what to do when we don't have supporting guidelines?

In the meantime, use the "precautionary principle," gets your kids vitamin D levels checked once a year, earlier if you see any signs of deficiency (bow legged, teeth coming in uneven, other bone deformities, delayed motor development, muscle weakness, aches and pains, and fractures. And put a fan in a room where a baby is sleeping. And in a future post, I'll hopefully get to baby-feeding "guidelines".

A good example of the precautionary principle in use regarding plastic safety can be found here: NPR's "Is Better Safe than Sorry Reason Enough for Law?"

In good health, Debra



Monday, February 18, 2013

Healthy Food that Comes in a Package!

My friend Alexandra from NYC gave an awesome kids class last year for Purim (a Jewish holiday that among other things, entails giving fun food presents to friends called Mishloach Manot). I cannot share her secret recipe for Hamantashen (triangle-shaped cookies) but if you are lucky to taste one they will not disappoint! And they even have omega-3's from chia seeds!

Ale once told me in a very animated fashion, that while she prepares healthy snacks for her kids, her daughter loves snacks that "pop" open from a bag...like all the other kids.

So I have put together some foods that go "POP." Perfect for your Mishloach Manot Purim treats and year round.

Click on the picture for Amazon link, two-day shipping will get to you in time for Purim :)

(Please note that all of these products are kosher as of this posting but please check for yourself to be sure)


Monday, February 4, 2013

A few product reviews

Just before we left for our move to Israel, we were sent some great goodies that I wanted to share with you.

Tommee Tippee held a blogger's event in Manhattan last year. At the event I was able to check out all sorts of new products, here are my top 3 picks:

Sectional Plates (read here for more information on sectional plates).
These plates let you put the veggies up front and center, with protein and other foods on the side. Just the way I like my sectional plates!


Back to Nature bottles 
These are great for nursing babies who also take bottles and also a good option to try if your baby if refusing a bottle.  

Amazingly clear video monitor (I don't use the sensor but the video works great). Another plus: it works on 110/220 voltage:
I also checked out their breast pump, which was not on the market yet but it looked like it had some innovative features.  But cannot recommend it just yet...

I also did some endorsement work for Baby Brezza's nutrition pamphlets.  I like their product but if you don't have much disposable income, you can make do with a steamer and a masher. But I loved the convenience of having it cook for me if I didn't already have something the baby could eat from the family table.  And I love that this product is also 110/220 voltage!  Cant wait to break it out for baby #3. 
Liz Cook from the UK company Green Leafy was kind enough to send me two lovely hanging charts that I have in my office. I have the yoga one, which my kids love, and the vegetarian nutrition one, which is very well done a great reminder of all the great foods to eat for a varied diet.


And one of my new favorite books for parents interested in helping their children eat more foods is a book by Karen Le Billon: French Kids Eat Everything
I love all 10 of her rules and I have heard her speak and think she is wonderful.
I am happy she spent time in France but came back to NYC to teach us all their secrets! Plus, there are some great recipes in the back.