Written by: Lloyd N. Werk, MD, MPH
Parents often struggle when guiding their child to eat healthy nutritious meals and establishing healthy eating habits for children at an early age with balanced meals is important. Recently, the U.S. Department of Agriculture (USDA) replaced their “food pyramid” model with MyPlate to make it easier to figure out how to feed kids nutritious, balanced meals at home and on-the-go. MyPlate helps to simplify meal planning by illustrating ideal servings of the fruits, vegetables, grains, proteins, and dairy food groups on a colorful divided plate.

MyPlate helps parents train their children to devote half their plate to fruits and vegetables. Grains and lean protein each take up a quarter of the plate. A side helping of dairy shows kids will also need a serving of low-fat milk or another dairy product to complete their meal.

MyPlate offers simple messages that are easy to incorporate in your family’s daily diet:

• Fill half your child’s plate with vegetables and fruits
• Make at least half the grains you serve whole grains, like oatmeal and brown rice
• Serve fat-free or low-fat (1%) milk and water rather than sugary drinks
• When buying pre-packaged foods, choose ones low in sodium
• Avoid serving oversized portions. Consider smaller plates for younger aged children.

One of the most important features of MyPlate is its emphasis on fruits and vegetables. Vegetables are one of the largest portions on the plate because they provide many of the vitamins and minerals kids need for good health, plus vegetables are naturally low in fat and calories and contain fiber. For parents with picky eaters, adding more vegetables to their child’s plate may seem difficult at first; however, a few simple preparation tips can help your family enjoy fruits and vegetables this summer.

Ten Tips to Liven Up Meals with Fruits and Vegetables

1. Be Ahead of the Game – Cut up peppers, carrots, or broccoli in advance and refrigerate. Also, keep some packaged vegetables in the freezer as they are just as nutritious as fresh vegetables.
2. Seeing is Enjoying – Keep a bowl of whole fruit out as a visible reminder.
3. Brighten Up Your Salad – Add black beans, sliced peppers, chopped red cabbage and other colorful vegetables for color and taste.
4. Fruit at Breakfast – Top cereal or oatmeal with sliced bananas, peaches, grapes, or strawberries. Also, try mixing fruit in fat-free or low-fat yogurt.
5. Fire Up the Grill –Grilling brings out great flavor in vegetables. Try grilling mushrooms, carrots, peppers or potatoes on a kabob skewer – kids will enjoy a fun, new way to eat their vegetables. Grilling fruit can be a tasty new experience too!
6. Expand the Flavor of Casseroles – Peas, pinto beans, squash, tomatoes and sautéed onions add color to this convenient, weekday meal.
7. Pair with Pasta – Planning something Italian? Slip some peppers, spinach, red beans, onions or cherry tomatoes into your traditional tomato sauce. Vegetables provide texture and satisfying low-calorie bulk.
8. Get Creative with Sandwiches – Vegetables make a great addition to your favorite sandwiches and wraps. Substitute mayonnaise with creamy avocado or try sliced tomatoes and romaine lettuce for extra flavor.
9. Savor Stir-Fry – Try a new cooking method! Stir-frying vegetables like broccoli, carrots, sugar snap peas, mushrooms, or green beans are a quick and tasty addition to any meal.
10. When Eating Out – ask for an extra side of vegetables, side salad, or whole fruit.

It may take several attempts to acquire a taste for some vegetables. Encourage your child to try just two or three bites of a vegetable and then offer it again at another meal. Try including fruits and vegetables in each meal and for a snack.

While MyPlate is a guide for healthy eating, it’s not a one-size-fits-all solution. Portion size will vary by age, and depending on a child’s needs, some food groups will be increased and others decreased. Talk to your health care provider to find out what’s best for your kids.

For more information about developing healthy eating habits for your children, please visit www.KidsHealth.org.

Lloyd N. Werk, M.D., M.P.H., F.A.A.P. is the Division Chief of Consultative Pediatrics at Nemours Children’s Clinic and provides services to diagnose and treat children of all ages with obesity issues in the Nemours Healthy Choices Clinic.

Kids are more at risk for injury than adults for a variety of reasons. They are less coordinated, have a slower reaction time, their bones and muscles are still growing, and they are more likely to take risks. Overuse is another big problem. When kids play sports all year long, with little or no rest in between seasons, this causes more strain on their growing bodies. Less recovery time leads to a variety of injuries of varying severity.

With proper preparation by kids, coaches, and parents, a large number of sports-related injuries can be avoided. Here are some of the most common types of injuries and ways to prevent them.

Heatstroke and dehydration are big risks to kids involved in sports during the summer and early
fall months. Working out in heavy gear, running long distances, or having long practices require frequent breaks and the drinking of fluids. For most practices under an hour, water is the drink of choice. In the heat, and for practices that last more than one hour, sports drinks should be offered as well. Drinking fluids before, during, and after playing sports will help to keep kids hydrated. Also, on very hot and humid days, practices should be held either early morning or early evening to avoid the hottest parts of the day.

Acute injuries happen suddenly and are usually associated with some form of trauma. They can range in severity from scrapes, bruises, sprains and strains to broken bones, torn ligaments, eye injuries, and brain injuries. Acute injuries often occur due to a lack of proper equipment or improper use of equipment. For example, helmets should always be worn in sports like football, lacrosse, baseball and softball. They should be in good shape and fit well. Protective eyewear can prevent injuries in basketball or racquet sports. Knee and elbow pads can prevent joint injury due to falls that happen often among children.

Overuse injuries occur from repetitive motion that puts too much stress on the bones and muscles. These types of injuries are especially problematic for kids because they can affect bone growth. Common overuse injuries include damage to the knees, elbows, shoulders, shins, ankles, back, and hips, and can be diagnosed as tendonitis, stress fractures, or even growth plate issues depending on the severity of the injury.

A focus on prevention, sometimes referred to as “prehab,” can help prevent injuries. Proper warm-up, stretching, strength training, good mechanics, as well as knowing how and when to rest are all vital to overuse injury prevention.

Reinjuries take place when an athlete returns to the sport before an injury has time to heal. This
can lead to further, or permanent, damage. For example, one concussion, an injury to the brain, can be dangerous. But if a child, or adult for that matter, returns to play before being medically cleared by a doctor and has another concussion, the result can be permanent brain damage or even death.

Other things to consider:

• Pre-Screening All kids should have a physical before beginning any sport. Pre-screenings can clear kids to play and can identify any condition that could put a child at risk for injury.
• No playing through pain Kids may think they’re helping the team, but they are only hurting themselves. If a child complains of a chronic ache or pain, see a doctor right away. Additionally, if your child suffers any type of head injury, look for signs of a concussion—headache, confusion, dizziness, forgetfulness, nausea, or change in
  behavior—and seek medical attention immediately.
• Returning to play means taking proper precautions to ensure reinjury does not occur. Depending on the injury this could mean taping the affected area, new protective gear, wearing a brace, or involve a formal physical therapy/rehab plan.
• Know the rules and encourage safe play. Get to know your child’s coaches to see what their philosophy is on safety and injury prevention. Make sure your child’s coaches include proper warm-up and cool down exercises with every practice.
• Don’t push Sports should be fun and teach kids life lessons about teamwork, problem solving, and good sportsmanship. Pushing your child to excel and win-at-all-costs can cause emotional stress, overuse injuries, and burnout.

For more tips and detailed information about getting back in the game, visit KidsHealth.org.

Kevin Neal is an orthopedic surgeon in the Department of Orthopedics at Nemours.

These days it seems everyone is trying to get rid of fat, especially with swimsuit season approaching. But did you know that our bodies actually contain a good kind of fat that can help you lose weight?

Biochemist Sheila Collins, the latest addition to the faculty at the Sanford-Burnham Medical Research Institute at Lake Nona, is conducting research to better understand “good fat” and to figure out how to put it to work.

“There are actually two kinds of fat: white fat cells, which are the ones that come to mind when we think about fat, and brown fat cells, a kind of fat that acts sort of like a furnace,” generating heat and burning calories, Collins said.

A major goal for Collins and other scientists is to find safe ways to “switch on” brown fat, allowing people to lose weight by burning more calories.

“Dr. Collins is one of the few people worldwide who are unraveling the basis for how the so-called ‘good fat,’ or brown fat, is capable of burning excess calories,” said Dr. Daniel Kelly, director of Sanford-Burnham at the emerging “medical city” in southeast Orlando. “She brings this exciting project to the Sanford-Burnham site in Orlando with the long-term goal of developing new therapies for the treatment of obesity and its complications.”

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The department will begin to receive doses of the swine flu vaccine to administer to the general public by December and will then hold the vaccination clinic, where eligible residents will be able to receive a free dose of the shot, department spokeswoman Camille Bissainthe said.

To date, most supplies of the vaccine have been shipped directly to local clinics, pediatricians, obstetricians and other healthcare providers who have been administering the vaccine to medical priority groups.

One of the reasons for that, Bissainthe said, is because providers are able to get the vaccine to priority patients quickly. The public sector is still receiving limited quantities of the vaccine as well, she said.

“It’s trickling in,” Bissainthe said. “As the weeks go by, we should start getting an increase in the amount of vaccines.”

On Oct. 23, President Barack Obama declared the swine flu outbreak a national emergency. According to the Centers for Disease Control, since last week 503,200 doses of the vaccine have been shipped to Florida.

The CDC is recommending the vaccine for priority groups, who can verify with their health providers and receive the shot before it’s given out by the public sector.

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You’re planning to move, and you’re sure you’ve thought of everything: a good school system, affordable property taxes, a manageable commute. But what about your health? It turns out that where you live may have an impact on your risk of obesity and diabetes.

A study published this month in Archives of Internal Medicine found that living in a healthy neighborhood—defined as one that encourages you to ditch the car keys, get moving, and eat more healthfully—may lower the risk of developing type 2 diabetes by 38 percent. Previous research has found that living somewhere with these qualities may lower the risk of obesity. “Some neighborhoods encourage people to make healthful choices by providing the amenities and opportunities for those choices,” says Jennifer Black, lead author of a review about neighborhoods and obesity published last year in Nutrition Reviews. Other neighborhoods have barriers to physical activity and to making healthful dietary choices, such as high crime rates or no (or limited) access to shopping or services within walking distance, she says. So find a place where you “feel safe to live, move, walk, work, shop, and eat,” as well as participate in community activities that meet your social needs, Black says. Here are some specific things to look for to make your next neighborhood a healthy one:

Walkability of the neighborhood, including sidewalks. Some new neighborhoods that encourage physical activity are built so that residents can walk to obtain nearly all of the services they need—dry cleaning, restaurants, hair salons, barber shops, gyms, and more. But it’s harder to re-engineer an existing neighborhood to include these services, so this kind of place may be tough to find, says Steven Smith, executive director of the Translational Research Institute at the Florida Hospital and Burnham Institute for Medical Research at Lake Nona in Orlando. Even if you have to get in the car for your errands, though, look out for sidewalks so you can at least move within your neighborhood.

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Although the director of the new Florida Hospital-Burnham Clinical Research Institute has gained a national reputation for his groundbreaking obesity and diabetes research, only in recent years has his field of study become recognized as a legitimate scientific discipline — and one of the top health concerns in the nation and around the world.

“It’s like AIDS was in the ’90s. Everybody is talking about obesity and its related health issues,” said Smith, 48.

And for good reason.

Not only has obesity been linked to Type 2 diabetes, but also everything from increased prevalence of cancer to cardiovascular disease.

“The American Heart Association and other medical groups were seeing deaths from cardiovascular disease in the last 25 years going down, then saw that those affected by obesity and the diabetic epidemic have higher numbers of heart problems,” said Smith. “The American Cancer Society saw that obesity increased risk of cancer. They’re started doing the math, and they got on the bandwagon.”

Read the Rest: The doctor is in: ‘Everybody is talking about obesity’