Squeezing the Truth Out of Juicing

The American Academy of Pediatrics recently released a new policy statement regarding juice consumption, stating juice should not be introduced to infants before 1 year unless clinically indicated and should be limited for toddlers, children, and teens.

In the 2015-2020 Dietary Guidelines, the federal government allows juice to count as a serving of fruit yet urges Americans to consume primarily whole fruits for the benefits Juice, Juice Bar, Juicing
dietary fiber provides. Meanwhile, Instagram feeds are chock-full of “green juice” posts and business continues to boom at juice bars, leaving many people perplexed about whether or not juice fits into a healthy adult’s diet. It’s time to squeeze the truth out of the longstanding juicing trend.

Juice is simply the liquid extracted from fruits and vegetables, leaving the fibrous material behind. Fruits and vegetables are primarily sources of carbohydrates, containing natural sugars that provide their trademark sweetness. Carbohydrates tend to digest quickly in comparison to other macronutrients, but the presence of fiber as in whole fruit helps slow the absorption of sugar into the bloodstream leading to greater satiety and less of a spike in blood sugar levels.

Juice is often promoted as a health food, a substance to cleanse or detoxify the body, or a means to lose weight. To set the record straight: juice is not needed for health, nor does it cleanse the body. The body has vital organs responsible for detoxification, and no one food causes weight gain or loss.

Though labels on bottles of juice boast containing the juice of 2 apples, 2 cucumbers, a cup each of spinach and kale, blueberries, and strawberries, most people could not imagine sitting down to eat all of this produce in one sitting! Downing a glass of juice is not the same as eating several servings of fruit just as sipping chicken broth is not the same as eating a chicken breast.

Still, juice can be a valuable source of vitamins and minerals on days it’s difficult to consume adequate fruits and veggies. Since most of the fiber is left behind during processing, juice is ideal for those with medical conditions warranting a low fiber diet. Similarly, individuals who struggle to take in adequate energy or have high calorie needs may incorporate juice for additional nourishment without filling up on fiber. For these individuals, the inclusion of juice boosts variety and consumption of important nutrients their bodies need.

Medical conditions and energy needs aside, let’s not forget this most basic truth about juice: Sometimes a cold, sweet glass of juice is just plain delicious and refreshing, and it’s perfectly normal to select foods (and beverages) purely for enjoyment from time to time.

Still deciding whether to juice or not to juice? Keep these strategies in mind:

  • Use your God-given juicers (aka teeth) most of the time. With consumption of more whole fruits and vegetables comes greater satiety, more fiber, and a slower pace.
  • To minimize peaks and valleys in blood sugar and appetite, incorporate appropriately sized portions of juice (typically ~1/2 – 1 cup) as part of a meal or snack rather than sipping it throughout the day or drinking it alone.
  • Add juice into smoothies with Greek yogurt or whey protein for a satisfying, balanced snack or consider blending your fruit rather than juicing it for a higher fiber beverage.

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Food Allergy Awareness | My Child’s Allergic Reaction

Beach Allergic Reaction

Each year, my family takes a trip down to 30A in Florida. For as long as I can remember, we’ve picked up donuts from The Donut Hole to enjoy one morning of our vacation. Knowing my 3-year-old son’s allergies to eggs, peanuts, and tree nuts, my thoughtful brother and sister-in-law made a special trip to a bakery that sells vegan muffins (so egg-free) and other baked goods. They did their homework, asking the owner of the bakery about specific items and whether or not they contained my son’s allergens. They were directed toward several different nut-free, vegan options (or so they were told).

Excited to have found a special treat for my little guy to enjoy as we ate our donuts, we sat down for breakfast together. My son dove into his vanilla muffin along with the rest of his breakfast. Later, he got up from the table not acting like himself. When I asked him what was wrong, he quietly replied, “I don’t know.” We had just discussed the fact that it was our last day at the beach, so I assumed he was sad about that and didn’t push him to talk much more.

We proceeded to change into our swimsuits, lather up with sunscreen, and walk down to the beach. I was carrying my sleeping 6 month old, but when mom finally arrived with my 3-year-old, she commented that he was “moving at a glacial pace.”

He played in the sand for a little while with my dad and brother. A little later, he asked for a snack but didn’t really eat much. I knew something was up when he asked to sit in my lap. This kid had been sprinting up and down the beach all week! Something wasn’t right. He continued to become more and more clingy. At one point, he was sitting under the umbrella covered in a beach towel telling me he had a “feber” (AKA fever). He began asking me for medicine.

At this point, I also thought he might have gotten a little cool in the shade or that maybe he needed to go potty, so I began walking with him back up to our house. He didn’t want to walk, so I ended up carrying him the rest of the way. As we were walking, he began to scratch. By the time we’d gotten to the house, he was itching all over and clawing his neck, legs…really, his entire body.

Finally out of the sun, I was able to see his skin more clearly. It looked like he had a terrible, blistery sunburn. He sat on the tile floor and scratched while I called the bakery to re-check the ingredients of his muffin. Again, I spoke to the owner and was told the muffin did not contain eggs or nuts; however, this time he offered to have someone else check and call me back. I continued to observe my son while I called my mom to come up from the beach because I suspected an allergic reaction. My husband wasn’t able to come on this trip, so I called to let him know as well.

When the bakery called me back, I answered and began asking more questions about the specific egg-free, nut-free flavors the bakery offered. The woman who returned my call listed several options, but vanilla wasn’t one of them. When I asked about the vanilla, I was finally told, “Oh no. The vanilla muffin isn’t vegan. It contains eggs.” My heart dropped as I quickly hung up and went to get the Epipen. As soon as my parents walked into the house, we administered the Epipen amidst lots of screams and tears from my little guy.

Those moments and the ones that followed were so scary and heartbreaking. My son, already not feeling well, knew he was going to have to get a shot and was basically hysterical. As a mother, I was scared to death not knowing how quickly his reaction was going to progress. Many people don’t realize that allergic reactions can worsen over the course of several hours and that antihistamines (which my son takes every morning) can mask certain aspects of allergic reactions.

I was devastated, knowing he trusts me to never give him foods that would hurt him or make him sick.

We rushed, flashers on, to the nearest hospital. Though his heart was racing, my little guy was having a hard time staying awake. We watched videos and encouraged him to keep talking to us on our 15-minute drive to the hospital.

Fortunately, the emergency room staff was wonderful, and we were in a room within 5 minutes of our arrival. They administered a hefty dose of strong steroids and Benadryl and set him up on a heart monitor for the next several hours to watch for any rebound reactions as the Epipen wore off. Fortunately, his breathing was not compromised and his airways stayed open. We had lots of people praying for us by that point, too. I’m not sure what would’ve happened without his Epipen or morning dose of hydroxyzine. I am so thankful that I was with him and that my family, doctors, PA, and nurses knew how to care for him as well.

The bakery owner was very apologetic, tearfully offering to pay for all of my son’s medical expenses; however, this was a life-threatening emergency that could’ve had a completely different outcome due to this oversight and not taking our inquiry related to my child’s food allergies seriously enough. And this from the owner of the bakery! I was baffled, and it honestly makes me exponentially more wary of taking my son out to eat.

I recognize the extra effort that goes into researching the items that are served at bakeries and restaurants when patrons report an allergy and ask about ingredients. It’s additional time and work in a fast-paced industry. At the same time, I believe people not only need more training and awareness of the seriousness of food allergies, but our society, especially those who work in foodservice establishments, also need a little more empathy.

Though he has such a sweet attitude about it, it brings tears to my eyes to think that my son can’t just eat a regular piece of cake at a birthday party or enjoy our tradition of donuts at The Donut Hole. I hate that he can’t order whatever sounds good from a restaurant menu. It’s nerve-wrecking to know he has to rely on other people to tell him which foods are safe and which ones are not at this point in his life. It requires quite a bit of trust on his part, and it requires a ton of our trust in food service establishments.

I share our story in hopes that those who work in food service will see my son and others who have food allergies as real people who want to be normal, who want to belong, who don’t want to have to live in a bubble and eat at home all the time. I share it for friends and family members of those with food allergies to have a greater awareness of what allergic reactions might look like and how to react, knowing that my son’s reaction could’ve been much worse and progressed much faster. I share it so that others will understand the reasons why parents worry so much about foods served at school, parties, and other events.

There is no shame in asking lots of questions and reminding and re-reminding others about a loved one’s food allergies, and I’ll continue to model these behaviors (carrying the Epipen, asking questions, etc.) and to teach my little one how to take his allergies seriously, too.

Our story has a happy ending that includes memories of Veggie Tales videos and Minions stickers at the hospital, and I’m pretty sure my son is no longer worried he has a hole in his leg from the Epipen (yes, he asked). My prayer is that our story somehow prevents more stories of allergic reactions and gives additional insight about how to react with respect.


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Food Allergies: The Numbers and How You Can React with Respect!

Food_Allergy_Awareness_Week

My knowledge of food allergies and the importance of being sensitive to those with food allergies has increased exponentially since my husband was diagnosed with a shellfish allergy and my son was diagnosed with allergies to eggs, peanuts, and tree nuts years ago. We unfortunately learned about some of their allergies the hard way, whereas others were diagnosed in a doctor’s office. As a Registered Dietitian, I had received training and counseled those with food allergies prior to these diagnoses, but there’s nothing that deepened my awareness, understanding, and compassion more than personally experiencing food allergies in my family.

This week is Food Allergy Awareness Week, and this year’s theme is “React with Respect.” The goal of Food Allergy Awareness Week is to help inform the public about the serious consequences of food allergy reactions, as well as how to identify symptoms and respond in case of an emergency. If you are a parent, child, friend, co-worker, school teacher or administrator, employer, friend, roommate, or caregiver, you need to know about food allergies and how to react with respect.

So let’s talk about the numbers when it comes to food allergies and how, in light of those numbers, you can react with respect and sensitivity to individuals with food allergies…

Food allergies affect up to 15 million Americans.

Food allergies affect up to 15 million Americans.

Food allergies affect 6 million children.

That includes nearly 6 million children.

React with Respect

Learn how to recognize the symptoms of allergic reactions and how to respond in case of emergency.

A reaction to food can range from a mild response (such as an itchy mouth) to anaphylaxis, a severe and potentially deadly reaction. Every 3 minutes, a food allergy reaction sends someone to the emergency room in the U.S.

A reaction to food can range from a mild response (such as an itchy mouth) to anaphylaxis, a severe and potentially deadly reaction. Every 3 minutes, a food allergy reaction sends someone to the emergency room in the U.S.

Here’s a personal story…

When my little boy was diagnosed with his food allergies, he was only 8 months old. I was eating a graham cracker with peanut butter at the kitchen table when he started getting fussy. Without hesitation, I picked him up and put him in my lap to soothe him and continued to finish my snack. Soon after, it was time for his nap. My husband took him upstairs and began rocking him to sleep, but our little guy was crying and fussy. His lips began to swell, and he broke out in hives. Recognizing this was likely an allergic reaction (and admittedly totally unprepared), we immediately took him to the emergency room for treatment and to an allergist soon after for testing where he was diagnosed with his other allergies. We were only one of those emergency room visits, and we were so fortunate that our son recovered has been healthy ever since.

React with Respect

Refrain from eating your friend’s/coworker’s/classmate’s allergen when you are around them.

8 foods account for 90% of all reactions: milk, eggs, peanuts, tree nuts, soy, wheat, fish and shellfish. Even trace amounts of a food allergen can cause a reaction.

8 foods account for 90% of all reactions: milk, eggs, peanuts, tree nuts, soy, wheat, fish and shellfish. Even trace amounts of a food allergen can cause a reaction.

React with Respect

When planning celebrations, meetings, outings, etc. that involve food, be sure to ask about food allergies to ensure each person will be able to eat safely.

According to a study released in 2013 by the Centers for Disease Control and Prevention, food allergies among children increased approximately 50% between 1997 and 2011.

According to a study released in 2013 by the Centers for Disease Control and Prevention, food allergies among children increased approximately 50% between 1997 and 2011.

React with Respect

Understand that food allergies are not a choice and that individuals and families who are affected must take special precaution to protect themselves and their loved ones. Be patient and flexible as those affected by allergies must ask lots of questions and be careful about eating out.

1 in 13 children has a food allergy. That’s 2 in every classroom! Prevalence is increasing, so more kids have allergies than in the past.

1 in 13 children has a food allergy. That’s 2 in every classroom! Prevalence is increasing, so more kids have allergies than in the past.

React with Respect

Support other parents by asking about food allergies before sending food to the classroom, and respect school rules regarding food allergies.

Memphis Nutrition Group is excited to have partnered with the Food Allergy Alliance of the Mid-South (FAAM), an organization that promotes food allergy awareness year ’round! My partner and fellow Registered Dietitian Brigid Kay and I now serve as Nutrition Advisors to this fabulous organization, and we’d love for you to join the FAAM!

Here’s a little more information…

FAAM’s goal is to make resources available to our food allergy community that focus on:

  • the immediate support needs of the newly diagnosed
  • ongoing support and education for food allergy families
  • community education and training
  • advocacy on local and national levels

FAAM plans on reaching these goals by:

  • hosting community support meetings for food allergy families
  • connecting newly diagnosed families with resources
  • working with local resources to host special events
  • creating and maintaining relationships with local board certified allergists, health professionals, schools and community organizations
  • maintaining FAAM’s relationship with community members through this website, our email list, and social media
  • joining forces on local, state and national levels to advocate for those affected by food allergies

Are you interested in joining FAAM? Head over to FAAM’s website, simply share a little about yourself, and you’ll receive regular emails about meetings and events, newsletters. FAAM will also notify you about volunteer and advocacy opportunities as they become available.


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Teal Pumpkin Project: A Safe and Fun Halloween for Everyone

Halloween Blog Post on The Teal Pumpkin Project by Blair Mize, RD

Growing up, none of my family members or friends had food allergies that I can remember. My memories of trick-or-treating are filled with excitement, fun costumes, and excessive amounts of candy. Honestly, thoughts of food allergies rarely crossed my mind as a child. Over the years, food allergies have been on the rise. Today, 1 in 13 children has a food allergy.

When Halloween is too scary…

In the past, numerous parents have reported having to “cancel” Halloween for their children with food allergies. For some, Halloween equaled a life or death situation. Seriously. If families still chose to celebrate Halloween, parents were nervous wrecks as they watched their children like hawks to ensure their hands didn’t end up on the wrong treat.

Until 2014, food allergies and Halloween did not mix. 

Last year, the Food Allergy Research & Education (FARE) organization launched a national campaign called The Teal Pumpkin Project™ to raise awareness of food allergies and promote inclusion of all trick-or-treaters throughout the Halloween season. In the first year of this campaign, individuals in 50 states and 7 countries took the pledge to support the Teal Pumpkin Project. FARE predicts the campaign will grow to include over 100,000 households in 2015.

Our household took the pledge.

Our household couldn’t NOT take the pledge! If you have fun memories of Halloween like I did, wouldn’t you hate to see a child miss out on the experience of dressing up or be excluded from trick-or-treating? If you are the family member or friend of a little one, can you imagine not walking the neighborhood with them or having them stop by your house as they trick-or-treat? I know our family, friends, and neighbors loved seeing my brother and me all dressed up in our Halloween costumes…

My Childhood Halloween Memories  Halloween Memories  Halloween Memories from childhood

As the mother of a little boy with severe allergies to peanuts, almonds, and eggs, I am beyond grateful for the widespread adoption of The Teal Pumpkin Project in such a short period of time. I now understand from a personal AND professional standpoint the concerns and considerations of individuals and families with food allergies.

Perhaps you are fortunate enough to be allergy-free in your home…

Use the Teal Pumpkin Project as an opportunity to educate your children and teach them to be sensitive, understanding, and empathetic toward those who have allergies. Help them understand the importance of taking allergies seriously.

How does my family participate in the Teal Pumpkin Project?

1. Go online and pledge to participate in FARE’s Teal Pumpkin Project™!

Shopping for Pumpkins at Sprouts on a Rainy Day

Rainy days mean pumpkin shopping at Sprouts…in his “Hallow-weiner dog” shirt!

2. Grab a pumpkin, teal-colored paint, and a paintbrush. 

Get the whole family involved in the Teal Pumpkin Project. Paint pumpkins together!

Get the whole family involved! While you’re painting your pumpkins, talk about why being respectful and inclusive of children with food allergies is so important.

3. Place your pumpkin outside your front door to signify your participation in the Teal Pumpkin Project.

 

4. Print a free downloadable sign to hang in your window stating “Non-food treats available here.”

Free Downloadable Teal Pumpkin Project Sign

The Teal Pumpkin Project is all about inclusion, so your household may decide to print the free downloadable sign that states “We have candy and non-food treats” (in separate buckets, of course).

5. Go shopping for your non-food treats.

Non-Food Halloween Treats for The Teal Pumpkin Project

We found ours at Target…they had a great selection! Concerned non-food Halloween treats may get too expensive? Consider this: a large bag of assorted candy costs $9.00-$19.00! The most expensive non-food treat I purchased (the 12 puzzle value pack) was $10.00…everything else was $1.00-$3.00.

Here are more examples of non-food treats: finger puppets, stencils, spider rings, playing cards, whistles, vampire fangs, notepads, crazy straws, comic books, kazoos, pinwheels…what am I missing?

6. Finally, don’t forget to SHARE information about and encourage friends to get involved in The Teal Pumpkin Project by using #tealpumpkinproject on social media.

Have a safe and Happy Halloween!


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Practicing Weight Neutrality in a Weight-Biased Healthcare System

PracticingWeightNeutrality

In recent years, our society has become more open and understanding regarding peoples’ differences, but it seems weight is one area in which our culture has miserably failed to become more accepting. When it comes to size and weight, people continue to be judged against unrealistic and arbitrary ideals. Where is weight neutrality in this picture?

Too often, larger people are criticized, shamed, and misunderstood because of their weight. Furthermore, the perception of many healthcare providers remains that “if people would just lose weight, they could be healthy.”

Where’s the weight neutrality?

How ridiculous it is to think we can begin our lives with entirely different sets of genetics and end up looking the same or staying healthy at unnatural weights for our bodies!

Non-diet dietitians are already like fish swimming upstream in a river of 61-billion dollars-worth of diets, and the current becomes even stronger when practicing weight neutrality, especially when serving as the only weight neutral provider on an interdisciplinary team.

For several months, I worked with a woman (we’ll call her Beth) whose goal was to manage her diabetes, blood pressure, and cholesterol. She wanted to be healthy and to live longer, and she initially assumed the way to do so was through dieting. Our first sessions were spent reviewing and discussing research about diets versus intuitive eating, and Beth emphatically vowed, “I’m definitely not going back to dieting EVER!!!” stating she loved the newfound freedom she had with eating.

Eating intuitively, moving mindfully

In the meantime, through learning to eat intuitively and incorporate movement mindfully, Beth managed to cut her triglycerides in half and bring her cholesterol down to a normal range. She gained incredible insight into her relationship with food and recognized how satisfied she felt when she ate healthy AND tasty foods.

Giving up the scale

But there was one major challenge she continued to face: giving up the scale. After much discussion, Beth recognized how the scale was blinding her to the progress she was making toward health. She reluctantly agreed to put the scale in the attic for a while and contact me if she felt the urge to weigh herself.

Changing the view of progress

Beth acknowledged her need to change her view of progress. She began to accept the possibility (which was becoming a reality) of being healthy in a larger body and to recognize that her size did not change her worth and value in life.

She moved away from… She moved toward…
·  Focusing on a number on the scale that she could not directly control ·  Focusing on behaviors that lead to health
·  Focusing on weight first and foremost ·  Concentrating on actions she could control
·  Asking: “How many pounds did I lose?” ·  Noticing her increased trust in herself with food
·  Questioning: “How do I look?” ·  Questioning: “How do I feel?”
·  Priding herself on having good willpower or self-control ·  Priding herself on recognizing inner body cues

(Adapted from Intuitive EatingEvelyn Tribole & Elyse Resch, 2003/2012)

At her next check-up with her primary care physician, the first topic addressed related to weight loss. The physician praised Beth, exclaiming, ”You’ve lost 9 pounds!” Immediately, her mind wandered back to the number she originally had in mind that might make her “healthy” again.

Already feeling ashamed and discouraged, Beth hesitantly told her doctor, “I’ve been feeling exhausted lately.” Her physician responded by stating, “You’re still carrying around lots of extra weight. Imagine carrying around your 10-year-old son all day. You’d feel exhausted, wouldn’t you? That extra weight is keeping you tired!”

Validate the patient’s concerns

In one conversation, Beth’s physician not only fueled her recent fantasy of weight loss as a magic bullet to solve her health problems, she also failed to validate her patient’s concerns. Rather than taking inventory of the lifestyle, psychological, or medical conditions that could be causing her fatigue and offering a plan of care to reach the root of the problem, she gave the simplistic answer: “Lose weight.”

Make evidence-based recommendations

According to the research, 97 percent of diets fail, and most people regain their lost weight in 1-5 years (Puhl, 2008). Combine dieting and weight cycling, and you have a recipe for a physical and emotional health disaster.

Leslie Schilling, MA, RDN, CSSD, LDN puts it this way: “If you were prescribed a drug with such a high failure rate, would you fill the prescription?”

People trust their providers to administer quality, evidence-based care; however, when they receive different messages from different providers, how do they know whom to trust?

It’s time all health professionals learn that the number on the scale does not define a person’s health, worth, or value. Our patients are human beings, not human bodies, and they deserve evidence-based guidance, rather than judgment, shame, or “easy answers.”

Equip people to advocate for themselves

Perhaps as you read about Beth’s experience, you felt anger, sadness, and frustration bubbling up. It is my hope that the feelings you experience throughout Weight Stigma Awareness Week will be used as fuel to begin to educate other providers and equip those with whom you come in contact to advocate for themselves.

Ignoring weight bias does not increase awareness or lead to change, but here are some practices that can:

  • Derail “fat talk” or weight-biased conversations and deflect them using research to support your case.
  • Engage in body activism and encourage body acceptance.
  • Focus on functionality versus appearance in your practice.
  • Listen to your patients and seek to validate their concerns.

And remember to start with yourself. Examine yourself, looking for weight bias in your own life. Though the previous case study only addressed weight bias from a physician, I think we’ve all been taught or heard ideas that perpetuate weight stigma in our training. I know I have.

Practice weight neutrality

As providers, let’s stop believing that differences in weight and size define a patient’s health or worthiness of quality care. Let’s practice weight neutrality. Continue to remove weight stigma and bias in the provider community by changing the view of progress, validating the patient’s concerns, making evidence-based recommendations, and equipping professionals with knowledge and people to advocate for themselves.


It was an honor to contribute this post to Binge Eating Disorder Association’s Weight Stigma Awareness Week 2015. See the original blog post here.

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