When I worked as a dietitian in a health clinic, I noticed the subtle shift that occurred in the doctor’s office this time of year. Children are going back to school, and parents are frantically trying to catch up on immunizations, schedule wellness checks and obtain sports physicals. As health professionals we know the important role we play in sending a child to school that is healthy and ready to thrive in the educational environment. Although these visits are often limited in time, incorporating nutrition education is essential. Evidence suggests that children who obtain proper nutrition are more likely to succeed in school, have fewer sick days, have greater focus and even perform better on tests. However, parents often need the guidance of a health professional to realize the importance of healthy eating for their children and to make these changes as realistic as possible. When I was counseling clients, I found that many parents were overwhelmed by what they hear is “good” and “bad” for their children. With so many contradictory nutrition messages, it is not surprising that some just throw up their hands and give up. It is our job to be the voice of reason and empower parents to establish healthy habits for their kids. Don't let this be a daunting process...it can be as simple as 1,2,3!

#1 Highlight the importance of breakfast. Breakfast is the most important meal of the day; when children eat a balanced breakfast they not only feel better, they learn better too. If children don’t get breakfast at home, encourage parents to use the school’s breakfast program if available. Schools meals are often an inexpensive and nutritionally balanced option.

#2 Promote family dinners at home. Meals eaten at home tend to be healthier and family meals are shown to help children develop better socially, mentally and physically. Encourage parents to set a meal time when all or most members of the family can eat together and try to eliminate distractions such as turning off the television. Even setting a goal for a few times a week is a great start!

#3 Reinforce the importance of being a good role model. Kids learn food behaviors by watching those around them. Parents should be eating breakfast with their children and if possible packing healthy lunches to take to work. If parents eat a variety of healthy foods, children are likely to as well.

As always, we are here to provide you with effective nutrition education materials which align with current nutrition recommendations, promote behavior change and are relevant to the needs of your clients. Our colorful booklet, ‘Making Meals Matter for Your School-Age Child-A Guide for Busy Parents’, is an excellent tool you can give to parents during their routine check ups. For parents that want additional information, we also provide downloadable tip sheets on topics that range from the importance of breakfast to healthy snacks for home and school. So before signing off on that back-to-school check-up, consider taking a few moments to equip parents with the tools needed to help their children establish healthy eating behaviors, both for school and at home.

Ashley Rosales, R.D.

Project Manager

Some schools are removing flavored milk from their cafeterias due to pressure from a few vocal parents or school officials. The logic seems simple--remove flavored milk because it contains sugar. In hopes to combat childhood obesity and make the menu healthier, however, some decision-makers may lack the knowledge of the likely nutritional impact of this change.

The Milk Processors Education Program (Milk PEP) conducted a nationwide study to determine the impact of dropping flavored milk from school cafeterias. The study included 58 school districts, four within California. The participating schools had independently decided to stop serving flavored milk. This short YouTube video, Chocolate Milk is Tasty Nutrition sums up the study.

The study found that total milk consumption dropped an average of 35% when flavored milk was eliminated. Consumption dropped because fewer students were selecting milk, and more milk was discarded. The schools and milk suppliers saw a 23% drop in the amount of milk sold. What they couldn’t see prior to participating in the study was that more milk was thrown away when milk choices were limited.

It is assumed that the removal of flavored milk will cause an initial decline in milk consumption, followed by a fairly quick rise in white milk consumption once the students adapt. The data does not support this assumption. After two years, schools did not see an increase in milk consumption.

Flavored milk contains about two teaspoons of added sugar, however, it also contains calcium, protein, magnesium, potassium, phosphorus, riboflavin, niacin, vitamins B12, A and K. Many milk processors are stepping up to reformulate chocolate milk to lower the sugar without compromising palatability or increasing cost to schools.

For those critics that believe children can get enough nutrients from sources other than milk, one must consider what these added foods contribute to the diet. To replace ALL the nutrients from one serving of flavored milk (not just the calcium), schools would need to add a bundle of foods like this over the course of a week:

• Two ounces of cheddar cheese
• One medium egg
• One cup of orange juice with added Vitamin D and calcium
• One half of a cantaloupe

This bundle of food contributes significantly more calories and cost to the menu than a serving of flavored milk. 

Our blog earlier this year, Serving Flavored Milk in Schools, listed some resources we provide to help sort through these issues. For more supporting resources, check out milkdelivers.org.

Some have demonized flavored milk as a cause of obesity, yet little evidence exists to support this. In fact, as obesity rates have risen, milk consumption has fallen. The amount of sugar per serving is small compared to the nutrients it provides. Children, who naturally have a sweet palate, must get the nutrients they need to thrive. Schools should serve as role models to show students good choices and must be realistic about offering foods that are both nutritious and appealing to kids.

Tracy Witmer, R.D.

Territory Manager

On June 17, I had the special privilege of being involved in an event sponsored by the California Milk Advisory Board. The event brought together local and national bloggers and journalists to experience a day in the life of a modern day dairy farm. The purpose of the event was to educate and enlighten these members of the media about dairies, animal care, sustainability and nutrition.

I met the group at the Clauss Family Dairy, where we observed the cows being milked on the milking carousel. This automated process seemed to be a win-win for both the dairy and the cows. It is highly efficient and clearly the cows enjoyed being milked while riding the carousel. One of the bloggers said it looked like a "Disneyland ride for a cow".

After we toured the dairy, we met on the lawn at the Clauss family home for round table discussions. The participants had a chance to spend 20 minutes with each of the following experts: 

• Dr. Frank Mitloehner, Agricultural Air Quality Expert, University of California, Davis to discuss dairy’s shrinking carbon footprint
• Dr. Michael Payne, Doctor of Veterinary Medicine, University of California, Davis to discuss the National Dairy FARM Program: Farmers Assuring Responsible Management in California
• I was at the third table and shared the nutritional properties of dairy foods including recent nutrition research on protein, calcium and vitamin D.

During the discussion, I shared nutrition basics about the nutrients in milk and dietary recommendations. I was able to dispel certain myths about dairy foods, specifically that milk does not cause early puberty, fat-free milk does not have sugar added to it (this was the first time I have ever heard this idea). We discussed evidence-based strategies for coping with lactose intolerance and consuming milk and dairy foods without discomfort. One of the journalists approached me later and said she never realized how much calcium children need every day.

Following the round table discussions, we had an unforgettable and incredibly delicious lunch prepared by Chef Ryan Scott, each course including dairy products. The menu included the following dishes:

•  Cucumber Gazpacho (yogurt)
• Little Gem Salad (crème fraiche dressing; Cheddar cheese brioche)
• Milk Braised Pork Shoulder on a bed of Spring Vegetables
• Buttermilk Panna Cotta with Balsamic-Black Pepper glazed Cherries and Pinenut Shortbread Cookies
• Real California ice cream 

Following the event, bloggers went home and did what they do best, wrote blog posts about their experiences and what they learned. Here are just a few examples of perspectives others had about the event:

•  Happy Cows = Happy Moms
• Let's Talk Milk & Cheese
• Travel to a Modern Dairy Farm

Over the many years I have worked for the Dairy Council of California, I have had many interesting learning opportunities and this ranks among the best. I observed first-hand a family-run, large dairy operation that responsibly produces milk and is proud to share their dairy farming practices with the public.

Maureen Bligh, MA, RD

Project Manager

The San Jose Peninsula District Dietetic Association book club meets every few months to discuss popular books relevant to food and nutrition professionals. All members of the book club are registered dietitians and are required to fulfill 75 hours of continuing education every five years. Much of this continuing education involves staying abreast of the latest in nutrition research. However, it is also important to stay current by reading what consumers are reading in the popular press. Our club selected In Defense of Food by Michael Pollan for July. We met over dinner to discuss the book.

The club members enjoyed reading this thought-provoking book and strongly agree with many of the key messages. Pollan’s thesis, while simplistic, encourages consumers to prepare and eat more meals using whole foods (foods from each of the food groups that are minimally processed). He advocates eating foods based on cultural traditions and steering clear of highly processed foods that have recently emerged on the food industry landscape. He promotes consumption of real, well grown, unprocessed foods. Finally, he advances the importance of eating more communal meals with family and friends.

Pollan challenges readers to eat whole food and avoid the prevailing nutrient-by-nutrient approach—what he calls “nutritionism”. Several club members felt Pollan was overly critical of the nutrition profession. Many felt these criticisms were unfair—that more dietitians are aligned with his philosophy than he inferred.

Our readers felt that In Defense of Food would be a difficult read for most of our clients and his recommendations hard to implement. Cooking most meals from scratch requires more time than many people can devote to meal prep. Rather than the “all or nothing” model presented by Pollan, the registered dietitians in our San Jose book club prefer a reality-based approach to meet clients where they currently are and help them eat more nutrient-rich foods to have an improved rather than perfect diet. How can we help clients strike a balance between the conveniences offered by the food industry and the nutrients available in whole food? This is our challenge as nutrition professionals.

Maureen Bligh, MA, RD

Project Manager

Family meals often are associated with overall improved nutrient intake, healthier body weight and better psychosocial health -- meaning children who eat more meals at home with their parents are more likely to be healthy in mind, body and spirit. Helping parents establish positive eating behaviors in the home, including family meals, is of key importance in achieving overall health for families, and health professionals can play a critical role in this process. Is it enough to just promote family meals in your nutrition education routine? According to a recent study published in the July edition of the Journal of the American Dietetic Association, helping parents enhance specific parenting skills in addition to promotion of family meals may be the recipe for success!

This recent study (JADA, July 2010) followed four different parenting styles to see which had the most potential to influence positive lifestyle factors such as eating behaviors, self-regulation of physical activity and ultimately the risk for overweight. The four parenting styles observed were divided into two dimensions: the degree in which the parents respond to their children and the degree in which parents make demands of their children. An ‘authoritative’ parenting style, which is characterized by a high level of responsiveness as well as a high level of "demandingness", was associated with the greatest frequency of family meals for adolescent children. An authoritative parent is likely to be “empathetic and respectful of a child’s opinions, but maintains clear boundaries and expectations.” On the contrary, a second type of parenting style, ‘authoritarian’, shown through high "demandingness" and low responsiveness, had almost a five-fold increase in odds of being overweight. This parenting style is characterized by “low warmth and strict discipline.” In an effort to combat the childhood obesity crisis it is interesting to consider effective parenting styles as a part of the possible solution.

The results shared in this study lead to many other questions and possibilities for future research, such as what types of specific behaviors do authoritative parents use during mealtimes? Do parents with an authoritative parenting style more often serve balanced meals that include all of the food groups? More research is needed to look more closely at the positive home life behaviors of authoritative parents.

The good news is that we as health professionals can have a greater impact by not only encouraging frequent family meals but also reinforcing aspects of authoritative parenting styles. Our program booklets for parents, Making Meals Matter for Your Young Child and Making Meals Matter for Your School Age Child are both great resources available to health professionals looking for ways to help parents model health behaviors at home and share in nutritious family meals.

Ashley Rosales, R.D.

Project Manager

The Society for Nutrition Education has been hosting an annual conference for over 40 years. The theme of the conference this year is Child Nutrition: Action Today for a Healthy Tomorrow. This is a great opportunity for California nutrition educators since the conference this year is right in our backyard at the beautiful Reno-Tahoe area Peppermill Resort. This conference for nutrition program planners and evaluators, teachers, dietitians and dietetic technicians, researchers, county extension agents, policy makers, chefs, scientists, and more, offers access to the latest developments in food, nutrition, and education. Participants will come away with new research, creative ideas, and practical techniques applicable in many settings. Enjoy the relaxed atmosphere of the SNE annual conference while earning continuing education credits, networking, and advancing your knowledge and skills.

This year, our own Trina Robertson, M.S. R.D. will be presenting at the conference. Her topic is "Activity & Eating”: An Interactive Adult Nutrition Education Program. She will present findings about our adult nutrition program, Activity & Eating. The evaluation results with adults in two unique populations will be highlighted- school employees participating in a worksite wellness initiative and adults learning English as a second language in a community college. In addition to identifying how the program improves adult nutrition and physical activity behaviors, the results of the project assisted in developing priorities on how the Activity & Eating booklet could be improved. Attendees will be the first to see the revised program and how it includes behavior change theories and health literacy concepts. This is a great example of how evaluation can direct program improvement. If you plan on attending, we invite you to come to Trina's session on Tuesday, July 27 from 12:30 - 1:30 pm in the Tuscan 11-12 at the Peppermill Resort. If you hadn't planned on attending, we strongly encourage you to register! Held July 24 - 27, 2010 in Reno/Tahoe, SNE's Conference is the only event geared specifically towards nutrition educators.

Maureen Bligh, M.A.. R.D.

Project Manager

What does it mean to live a healthy life? It seems few have found the right balance between healthy and guilt-free living. There are things you can control that really do affect the quality and length of life (don't smoke and wear a seatbelt). And there are things that are completely out of our control (age, gender and family history). Then there is a large volume of space between these two extremes with many, many lifestyle choices that cause the health-conscious among us a great deal of angst.

There is a myth that perfect health can be achieved if you follow all of the "health rules". Unfortunately, the number of health rules seems to be increasing exponentially; eat locally grown foods, compost, avoid foods with more than 4 ingredients on the food label, exercise 60 minutes per day but be sure to include stretching and strengthening to your routine. Avoid sodium. Drink a glass of wine daily to avoid heart disease and avoid the temptation to drink two glasses to avoid breast cancer. Be watchful of food packaging since it may be leaching harmful chemicals into your food and your house may be toxic as well. Get out in the sun to get some vitamin D, but slather with sun screen after 15 minutes to avoid skin cancer. Navigating all of these choices can either make us compulsive and neurotic or throw our hands up into the air and ignore all health advice completely.

The reality is we don't have total control over our health. A book published last year by two doctors from Tufts University provides some sound advice regarding this topic. Live a Little, by Dr. Susan M. Love, M.D. and Alice D. Domar, Ph.D. provides some guidance to women for living a healthy enough life to be pretty healthy. Their research found that healthy habits tend to form a U-shaped curve, with serious neglect on one end of the curve and obsession on the other. The book describes the range of activities that fall into the "pretty healthy" zone between the extremes for sleep, stress, health screenings, exercise, nutrition and healthy relationships. Within the pretty healthy zone there are a wide variety of health behaviors. This book provides helpful guidelines on where to draw the line to achieve pretty healthy habits in these six areas.

So the trick is to realize that no one has total control over their health; then to exercise, eat wisely and manage stress anyway. The nutrition chapter in the book is titled, Eating Well: Beyond Blueberries, which attempts to strike a balance between health and food enjoyment. As a registered dietitian, I have always believed in a similar philosophy that balances health and quality of life. Dairy Council of California programs are also designed to consider all the factors that drive food choices; taste, convenience, health, culture, etc. The challenge is to eat wisely most of the time, while including some indulgent choices some of the time. And when you eat an indulgent food, enjoy it, since food is truly one of life's best pleasures. A healthy life can and should be simple and enjoyable. This book is a recommended resource for consumers to help them achieve this goal and for health professionals to become better health coaches for their clients.

Maureen Bligh, MA, RD

Project Manager

Do you or your clients have a concern about the environment as it relates to the food supply? Or have you been thinking about this issue but have yet to learn much about it? Dairy Council of California has developed a new resource for health professionals that takes an in-depth look at this issue. The course is unique since it not only educates the participant on the many issues impacting a sustainable food supply, it also offers specific suggestions for how to address this issue with clients. This 4-credit hour online course titled Sustainability, Nutrition and Health is now available online. The course has two components: a 30-minute audio PowerPoint and a PDF handout containing background articles that are intended to broaden and augment the PowerPoint. The course is authored by Marianne Smith Edge, MS, RD, LD, a former president of the American Dietetic Association and a nationally recognized expert in this area. Access to the course is free. If you would like to take the posttest for CEU credits, this test is available at a very reasonable price from Nutrition Dimension.

 Sustainability is an emerging concept and is a process that encompasses social, ecological and economic dimensions. The course focuses on consumers making decisions that are good for the family, good for the environment and good for individual health. The course talks about the meaning of organic food within the sustainability umbrella as well as the issue of feeding our ever-growing population.

The course is unique as it offers the practicing health professional concrete suggestions to use with clients. Health professionals can discuss with clients their choices regarding: 

• The choice of food purchased
• Food packaging
• Home food preparation and storage
• Serving size and waste

Ultimately how to overlay sustainability with the other food and nutrition priorities of individuals and families is a personal choice. It is important, however, to remind clients to consider their health and personal preferences when making these decisions and to include foods from all of the food groups, since each food group provides essential nutrients.

Maureen Bligh, MA, RD

Project Manager

The nutrition advice to "avoid processed foods" is commonly being tossed out by well-meaning individuals. This advice leads one to ponder two questions, "What is a processed food?" and, "What does it mean to my health if I avoid them?" Whole wheat bread, string cheese and frozen broccoli are all processed foods. Should these be avoided? Is it possible to have unintended health consequences by avoiding all foods that have been processed by the food industry?

Processed foods are defined as 'value-added products- raw commodities transformed through the use of materials, labor and technology.’ If a product requires any degree of processing, it is considered a processed food, whether it is something minor like freezing vegetables or more complex, such as producing snack foods. Many processed foods serve important functions for health, such as fortification of a food to enhance its nutritional profile or pasteurization to make a product safe from potentially harmful microorganisms. In fact, processing foods has eradicated certain vitamin and mineral deficiencies and also led to preventing very serious food borne illnesses. On the other hand, there are also processed foods that have low nutritional value due to processing. As a result, it is essential to teach consumers how to navigate through the continuum of processed foods and select more choices that are nutrient dense and fewer that are low in nutrients and high in fat, sugar and salt. Nutrition professionals are uniquely able to help consumers make food choices to meet their health goals and align with their personal values. And of course consumers won't eat anything that does not meet their criteria for acceptable taste.

To learn about more suggestions for educating clients about processed foods, please view our recent Health Connections Newsletter titled, "Processed Food": A Continuum of Choices. You can also subscribe to receive this quarterly newsletter for free!

Ashley Rosales, R.D.

Project Manager

Last month, Oakland Raiders running back, Darren McFadden, joined the students at Grant Elementary for lunch to help celebrate the West Contra Costa Unified School District’s seventeenth annual Nutrition, Health and Fitness Festival.

Darren McFadden supports Fuel Up to Play 60, a national initiative encouraging kids to get involved in promoting healthy eating and physical activity in their schools.

I was honored to interview Darren in front of a crowd of excited students and staff. Darren spoke about the importance of “fueling up” with critical nutrient-rich foods and “playing for 60 minutes” every day. Students were thrilled to have the opportunity to ask their own questions to the Raiders star. The big surprise came when Darren began throwing a few passes to one of the students. Students cheered loudly with every pass. Darren ended his presentation by having the students join him in doing a few stretching exercises.

Dairy Council of California was pleased to participate in this special event recognizing Principal, Dr. Susan Berrington, the teachers , staff and students of Grant Elementary for their support to the West Contra Costa Unified school meals program.

Here is a link to a video of the event: Fuel Up to Play 60 Grant Elementary School. The segment begins at the 3:00 minute mark. 

Valerie Fung-A-Ling

Territory Manager