Supplements for ADHD: Do Vitamins, Herbs, and Fatty Acids Work?

Parents often ask if they can treat their child’s ADHD without prescription medication. There are many alternative treatments in addition to prescription medications – some of which are more effective than others.  I will cover ADHD treatment with supplements today.

Supplements for ADHD – general

If you’re giving your kids supplements for any reason, be sure to tell their physician and pharmacist to avoid any known complications or interactions with other treatments.

Supplement use in general is gaining popularity. All you have to do is visit a pharmacy or specialty store and you will see various products marketed to treat ADHD.

There are some studies that show people with ADHD have low levels of certain vitamins and minerals. More studies are being done to determine if supplementing helps symptoms. There is growing evidence for vitamin supplementation, but there are no standard recommendations yet.

Should you use high dose vitamins?

Clinical trials using various combinations of high dose vitamins such as vitamin C, pantothenic acid, and pyridoxine show no effect on ADHD.

I don’t recommend high dose vitamin supplements unless a specific deficiency is identified. I don’t routinely screen for deficiencies at this time because there are no standard recommendations for this. We still have a long way to go before we know enough to make recommendations.

For children without a known vitamin deficiency, a standard pediatric multivitamin can be used, but effectiveness is not proven. I have no problems with anyone taking a multivitamin daily. However, I cannot recommend any specific brand since none of them are regulated by the FDA and there are many reports that show the label often misrepresents levels of what is really in the bottle. There have been instances of higher or lower than listed amounts of ingredients as well as unlisted ingredients in supplements.

My advice is to buy a brand that allows independent lab testing of their products if you choose to buy any vitamin or supplement.

Vitamins & minerals

The following is adapted from the University of Maryland Medical Center with the help of ADDitude Magazine and Natural Medicines Comprehensive Database.

Magnesium

Symptoms of magnesium deficiency include irritability, decreased attention span, and mental confusion.

Some experts believe that children with ADHD may be showing the effects of mild magnesium deficiency. In one preliminary study of 75 magnesium-deficient children with ADHD, those who received magnesium supplements showed an improvement in behavior compared to those who did not receive the supplements.

Too much magnesium can be dangerous and magnesium can interfere with certain medications, including antibiotics and blood pressure medications.

Talk to your doctor before supplementing with magnesium.

Vitamin B6

Adequate levels of vitamin B6 are needed for the body to make and use brain chemicals called neurotransmitters. These include serotonin, dopamine, and norepinephrine, the chemicals affected in children with ADHD.

One preliminary study found that B6 pyridoxine was slightly more effective than Ritalin in improving behavior among hyperactive children – but other studies failed to show a benefit. The study that did show benefit used a high dose of B6, which could cause nerve damage, so more studies need to be done to confirm that it helps.

If B6 is found to help, we need to learn how to monitor levels and dose the vitamin before this can be used safely.

Because high doses can be dangerous, do not give your child B6 without your doctor’s supervision.

Vitamin C

Vitamin C can help modulate the dopamine levels in the brain. Dopamine is a neurotransmitter that helps control the reward and pleasure centers in the brain.

Vitamin C can affect the way your body absorbs medications (especially stimulants for ADHD) so it is suggested to avoid vitamin C supplements and citrus fruits that are high in vitamin C within the hour of taking medicines.

Preliminary evidence suggests that a low dose of vitamin C in combination with flaxseed oil twice per day might improve some measures of attention, impulsivity, restlessness, and self-control in some children with ADHD. More evidence is needed before this combination can be recommended.

Vitamin D

Vitamin D is the one vitamin that is recommended to take as a supplement by many experts.

As we have gotten smarter about sun exposure, our vitamin D levels have decreased. Vitamin D deficiency has been linked to many problems, including ADHD.

Zinc

Zinc regulates the activity of brain chemicals, fatty acids, and melatonin. All of these are related to behavior.

Several studies show that zinc may help improve behavior.

Higher doses of zinc can be dangerous, so talk to your doctor before giving zinc to a child or taking it yourself.

Iron

Iron deficiencies commonly occur in children due to inadequate dietary sources since kids are so picky. Other causes include blood loss or excessive milk intake.

Iron is needed for the synthesis of dopamine, norepinephrine, and serotonin- all neurotransmitters in the brain.

Low iron has been linked to learning and behavior problems.

Too much iron can be dangerous, so talk with your doctor if you want to start high dose supplements. (Regular multivitamins with iron should not cause overdose if used according to package directions.)

If you’re using high doses of iron, it is important to follow labs to be sure the iron dose is not too high.

Essential fatty acids

Fatty acids, such as those found in fish, fish oil, flax seed (omega-3 fatty acids) and evening primrose oil (omega-6 fatty acids) are “good fats” that play a key role in normal brain function.

In a large review, Omega-3/6 supplementation made no difference in ADHD symptoms, but there are other benefits to this supplement and it carries little risk.

If you want to try fish oil to see if it reduces ADHD symptoms, talk to your doctor about the best dose. Some experts recommend that young school aged kids take 1,000-1,500 mg a day, and kids over 8 years get 2,000-2,500 mg daily.

For ADHD symptom control it is often recommended to get twice the amount of EPA to DHA.

L-carnitine

L-carnitine is formed from an amino acid and helps cells in the body produce energy.

One study found that 54% of a group of boys with ADHD showed improvement in behavior when taking L-carnitine. More research is needed to confirm any benefit.

Because L-carnitine has not been studied for safety in children, talk to your doctor before giving a child L-carnitine.

L-carnitine may make symptoms of hypothyroid worse and may increase the risk of seizures in people who have had seizures before. It can also interact with some medications. L-carnitine should not be given until you talk to your child’s doctor.

 

Proteins

Proteins are great for maintaining a healthy blood sugar and for keeping the brain focused.

They are best eaten as foods: lean meats, eggs, dairy, nuts and seeds, legumes, and fish are high protein foods. Most people in our country eat more protein than is needed.

If your child does not eat these foods in good quantity, there are supplements available. Talk with your doctor to see if they are appropriate for your child. Many of the supplements are high in sugar and other additives. Some have too much protein for children to safely eat on a regular basis.

Herbs

There are some studies supporting nutritional supplements or herbal medicines for ADHD, but many reported treatments have not been found effective.

Pinus marinus (French maritime pine bark), and a Chinese herbal formula (Ningdong) showed some support.

Current data suggest that Ginkgo biloba (ginkgo) and Hypercium perforatum (St. John’s wort) are ineffective in treating ADHD.

Summary

In general I think we all should eat a healthy diet that is made up primarily of fruits, vegetables, lean proteins, and complex carbohydrates.

If children are on a restricted diet due to allergy or sensitivities to foods or additives (or extreme pickiness), discuss their diet with your doctor. Consider working with a nutritionist to be sure your child is getting all the nutrition needed for proper growth.

If supplements are being considered, they should be discussed with your doctor. Talking about risks and benefits can help decide which are right for your child.


Looking for more?

Many parents benefit from support groups to learn from others who have gone through or are currently going through similar situations, fears, failures, and successes. Find one in your area that might help you go through the process with others who share your concerns. If you know of a support group that deserves mention, please share!

ADHD

CHADD is the nationwide support group that offers a lot online and has many local chapters, such as ADHDKC. I am a volunteer board member of ADHDKC and have been impressed with the impact they have made in our community in the short time they have existed (established in 2012). I encourage parents to attend their free informational meetings. The speakers have all been fantastic and there are many more great topics coming up!

Anxiety

Many parents are surprised to learn how much anxiety can affect behavior and learning. To look for local support groups, check out the tool on Psychology Today.

Autism

The Autism Society has an extensive list of resources.

Dyslexia 

Dyslexia Help is designed to help dyslexics, parents, and professionals find the resources they need, from scholarly articles and reviewed books to online forums and support groups.

Learning Disabilities 

Learning Disabilities Association of America offers support groups as well as information to help understand learning disabilities, negotiating the special education process, and helping your child and yourself.

Tourette’s Syndrome and Tic Disorders 

Tourette’s Syndrome Association is a great resource for people with tic disorders.

General Support Group List 

For a list of many support groups in Kansas: Support Groups in Kansas .

School information

Choosing schools for kids with ADHD and learning differences isn’t always possible, but look to the linked articles on ways to decide what might work best for your child. When choosing colleges, look specifically for programs they offer for students who learn differently and plan ahead to get your teen ready for this challenge.

Midwest ADHD Conference – April 2018

Check out the Midwest ADHD Conference coming to the KC area in April, 2018. I’m involved in the planning stages and it will be a FANTASTIC conference for parents, adults with ADHD, and educators/teachers.

Midwest ADHD Conference
The Midwest ADHD Conference will be held in April 2018, in Overland Park, Kansas.


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Weight is Weighing on My Mind

Reports of increasing obesity levels have been circulating for years on the news. I see kids in my office regularly who are in the overweight or obese category and we all struggle how to treat this growing problem. Excess weight in childhood is linked to many health issues such as high cholesterol, diabetes, metabolic syndrome, and it can trigger earlier puberty – leading to overall shorter adult height. Not to mention the psychological and social implications of bullying, depression, eating disorders, and more.

Why is weight so much more of a problem now than it was years ago?
unhealthy foods
Childhood obesity is a growing problem. Kids need to eat healthy and move daily.

I think it’s a combination of what they’re eating and what they’re doing. Today’s kids are shut up in the house after school watching one of many tv channels or playing video games. Even those who are shuttled to activities get overall less exercise because it is structured differently than free play. They ride in the car to practice or class, then sit and wait for things to start. They might sit or stand while others are getting instruction.

Simply put: They eat a lot of processed and junk food and they don’t get to do active things at their own pace with their own creativity for as long as they want.

What to do???

On one hand kids need to learn to make healthy choices to maintain a healthy body weight for height, but on the other hand you don’t want to focus so much on weight that they develop eating disorders. I think this is possible if we focus on the word “healthy” – not “weight”.

Starting at school age I ask kids at well visits if they think they are too heavy, too skinny, too short, or too tall. If they have a concern, I follow up with something along the line of, “How would you change that?” I’m often surprised by the answers, but I can use this very important information to guide how I approach their weight, height, and BMI. We talk about where they are on the graph, and healthy ways to either stay in a good place or how to get to a better BMI. I focus on 3 things we all need to be healthy (not healthy weight, but healthy):

  1. Healthy eating (eat a plant and protein each meal and snack)
  2. Exercise (with proper safety equipment but that’s another topic!)
  3. Sleep (again, another topic entirely!)
Food is a part of our daily needs, but much more than that.

It’s a huge part of our lifestyle. We have special meals for celebrations but on a day to day basis it tends to be more repetitive. We all get into ruts of what our kids will eat, so that is what we prepare. The typical kid likes pizza, nuggets, fries, PB&J, burgers, mac and cheese, and a few other select meals. If we’re lucky our kids like one or two vegetables and some fruits. We might even be able to sneak a whole grain bread in the mix. If our family is busy we eat on the run– often prepared foods that are low in nutrition, high in fat and added sugars, and things our kids think taste good (ie things we won’t hear whining about). We want our kids to be happy and we don’t want to hear they are hungry 30 minutes after the meal is over because they didn’t like what was served and chose not to eat, so we tend to cave in and give them what they want.

We as parents need to learn to stop trying to make our kids happy for the moment, but healthy for a lifetime.

There’s often a discrepancy between the child’s BMI (body mass index) and the parent’s perception of healthy. The perception of calorie needs and actual calorie needs can be very mismatched. I have seen a number of parents who worry that their toddler or child won’t eat, so they encourage unhealthy eating unintentionally in a variety of ways:

  • turn on the tv and feed the child while the child is distracted
  • reward eating with dessert
  • refuse to let the child leave the table until the plate is empty
  • allow excessive milk “since at least it’s healthy”
  • allow snacking throughout the day
  • legitimize that a “healthy” snack of goldfish is better than cookies
Any of these are problematic on several levels.  Kids don’t learn to respond to their own hunger cues if they are forced to eat.  
If offered a choice between a favorite low-nutrition/high fat food and a healthy meal that includes a vegetable, lean protein, whole grain, and low fat milk, which do you think any self-respecting kid would choose?
If they’re only offered the healthy meal or no food at all, most kids will eventually eat because they’re hungry.
No kid will starve to death after 1-2 days of not eating.  
They can, however, over time slowly kill themselves with unhealthy habits.  

So what does your child need to eat?

Think of the calories used in your child’s life and how many they really need.  Calorie needs are based on age, weight, activity level, growing patterns, and more.
It’s too hard to count calories for most of us though.
If kids fill up on healthy options, they won’t be hungry for the junk.
Offer a plant and a protein for each meal and snack. Plants are fruits and vegetables. Proteins are in meats, nuts, eggs and dairy.
Don’t think that your child needs to eat outside of regular meal and snack times.
One of my personal pet peeves is the practice of giving treats during and after athletic games. It’s not uncommon for kids to get a treat at half time and after every game. Most teams have a schedule of which parent will bring treats for after the game.
Do parents realize how damaging this can be?  
  • A 50 pound child playing 15 minutes of basketball burns 39 calories.  Think about how many minutes your child actually plays in a game. Most do not play a full hour, which would burn 158 calories in that 50 pound child.
  • A 50 pound child burns 23 calories playing 15 minutes of t-ball, softball, or baseball.  They burn 90 calories in an hour.
  • A non-competitive 50 pound soccer player burns 34 calories in 15 min/135 per hour. A competitive player burns 51 calories in 15 min/ 203 in an hour.
  • Find your own child’s calories burned (must be at least 50 pounds) at CalorieLab.
Now consider those famous treats at games.  Many teams have a half time snack AND an after game treat.  Calories found on brand company websites or NutritionData:
  • Typical flavored drinks or juice range 50-90 calories per 6 ounce serving.
  • Potato chips (1 ounce) 158 calories (A common bag size is 2 oz… which is 316 calories and has 1/3 of the child’s DAILY recommended fat intake!)
  • Fruit roll up (28g) 104 calories
  • 1 medium chocolate chip cookie: 48 calories
  • Orange slices (1 cup): 85 calories
  • Grapes (1 cup): 62 calories
  • Apple slices (1 cup): 65 calories

So…Let’s say the kids get orange slices (a lot of calories but also good vitamin C, low in fat, and high in fiber) at half time, then a fruit drink and cookie after the game. That totals about 200 calories. The typical 50 pound soccer player burned 135 calories in a one hour game. They took in more calories than they used. They did get some nutrition out of the orange, but they also ate the cookie and fruit drink. The cookie has fewer calories than other options but no nutritional value and a lot of added sugars. The kids end up taking in many more calories than they consumed during play.

 

What’s wrong with WATER? That’s what we should give kids to drink at games.

They should eat real food after the game if only they’re hungry.  Snacks are likely to decrease appetite for the next meal, so if they’re hungry give a mini-meal, not a sugar-filled, empty calorie treat every game.

There are many resources on the web to learn about healthy foods for both kids and parents. Rethink the way you look at how your family eats.

Simple suggestions:

 

      • Offer a fruit and vegetable with a protein at every meal and snack. Fill the plate with various colors! (As I tell the kids: eat a plant and a protein every time you eat ~ meals and snacks!)
      • Picky kids? Hide the vegetable in sauces, offer dips of yogurt or cheese, let kids eat in fun new ways – like with a toothpick. Don’t forget to lead by example and eat your veggies!
junk food
Smiling boy eyeing a burger and candy
  • Buy whole grains.
  • Choose lean proteins.
  • Don’t skip meals.
  • Make time for sleep.
  • Get at least 60 minutes of exercise a day!
  • Eat together as a family as often as possible.
  • Turn off the tv during meals. Don’t use distracted eating!
  • Encourage the “taste a bite without a fight” rule for kids over 3 years. But don’t force more than one bite.
  • Don’t buy foods and drinks with a lot of empty calories. Save them for special treats. If they aren’t in the home, they can’t be eaten!
  • Drink water instead of juice, flavored drinks, or sodas.
  • Limit portions on the plate to fist sized. Keep the serving platters off the table.
  • Eat small healthy snacks between meals. Think of fruit, vegetable slices, cheese, and nuts for snacks.

 

Which Supplements Help Prevent and Treat Infections?

I don’t know anyone who wants to get sick, so most of us try our best to avoid illnesses. We do this by washing our hands and encouraging our kids to cover their coughs. We avoid sick people as much as possible (though we don’t always stay home when we should). We should routinely get enough sleep (most Americans fail in this regard) and eat more fruits and vegetables (again, most of us fail to get the minimum recommended amounts of plants in our diets).

All of these measures can help, but can we get more help from nutritional supplements or other natural remedies? What will boost our immune system?

I’m often asked if vitamin C, zinc, or essential oils will help various ailments or boost our immune system. I know that many people try natural products that are promoted to boost or support the immune system. They’re hopeful that stimulating immune system activity will help the body fight off a virus. But research doesn’t show that our immune system works that way. A virus can cause illness even in healthy people. If you want to read an in-depth summary of how our immune system works, the Skeptical Raptor has done a nice job discussing the complexities and why it’s not as easy as eating healthy and taking supplements. Not to mention the fact that we don’t necessarily want an overactive immune system, which is associated with allergies and autoimmune diseases.

One thing we need to remember first and foremost in the discussion of supplements is that this is an under-regulated industry. The FDA is not authorized to review dietary supplement products for safety and effectiveness before they are marketed. For this reason I hesitate to recommend supplements at all. Even though I do recommend Vitamin D supplements because studies support the need for additional Vitamin D in most people, I cannot endorse one particular product. Over the years many supplements, homeopathic products and herbs have been reported to have significant variances in amounts of product and unnamed contaminants, including lead and other hazards.

Summaries of supplement and other “natural treatment” effectiveness:

  • Probiotics may actually help prevent the number of infections. There are many, many types of probiotics, so further studies are needed on how to choose the best strain.
  • Zinc has been shown to help prevent upper respiratory tract infections in children and teens and to decrease the duration of the common cold symptoms. It is best given as a lozenge to help with absorption. Intranasal zinc has been linked to a permanent loss of smell and should not be used. High doses can cause significant side effects, so talk to your doctor and pharmacist before supplementing.
  • Nasal saline rinses show benefit in treating symptoms of upper respiratory tract infections. Learn how to do these correctly before trying it though. I often recommend Nasopure products as an unpaid endorsement. They’re a local company with a very helpful website. Use their library to learn how to properly use nasal rinses in kids as young as 2 years of age.
  • Honey may reduce the frequency of cough and improve the quality of sleep for children with the common cold. Honey should never be used in children younger than 1 year of age because of the risk of botulism.
  • Echinacea has consistently been shown to be ineffective in many studies. I know that many people have heard of its benefits, so if you aren’t convinced that you shouldn’t waste money on it, see the NCCIH’s Echinacea page.
  • Garlic shows overall low evidence of benefit.
  • Vitamin C can shorten the duration of illness mildly with daily supplementation.
  • Chinese herbal medicines do not have high quality studies so effectiveness is unknown.
  • Geranium extract (Pelargonium sidoides) has insufficient evidence of benefit for cold and cough symptoms.
  • Turmeric‘s supposed anti-inflammatory properties have not been shown to be effective by research.
  • Essential oils have the potential for beneficial effects – but they also have the potential for adverse reactions. Although they are touted as a cure for many ailments, published studies regarding the uses of aromatherapy have generally focused on its psychological effects on stress and anxiety or its use as a topical treatment for skin conditions. Both Young Living and dōTERRA have received warning letters from the FDA about improper marketing and unsubstantiated claims for uses of their oils. While many people think essential oils are safe, they can lead to significant problems. Some people suffer from allergic reactions to oils. They can increase sensitivity to the sun when applied topically. Tea tree oil and lavender have estrogen-like effects and caution should be used with these. Some of these substances can even lead to seizures, liver damage, and death if used improperly. Ingestion of the oils is a growing concern – as more households have them, more children are ingesting them.
Alice Callahan’s “Immune-Boosting” Supplements Won’t Protect You from Back-to-School Germs is a great review of many of the supplements touted to prevent or treat illnesses. Her background in nutrition provides a solid base for reviewing claims that many of us don’t understand completely.
Generally supplements are not recommended, but if you choose to use them, use them cautiously.
  • Supplements contain a wide variety of ingredients – including vitamins, minerals, amino acids, and herbs. Research has confirmed health benefits of some dietary supplements but not others. The woo can be strong in this area, so be cautious where you get your information.
  • Supplements have been known to include unlisted ingredients and to have inconsistent levels of product. When they are recalled, there is no mechanism in place to identify and notify people who have purchased affected products.
  • Find a reliable source to evaluate effectiveness and risks. Some reports have shown that people who take supplements have higher risks of cancer, liver damage, birth defects, bleeding, and other health problems. When looking for information, use noncommercial sites (National Institutes of HealthFood and Drug AdministrationUS Department of AgricultureNational Center for Complementary Health) rather than depending on information from sellers.
  • Natural does not mean safe. I’ve always said that I wouldn’t give my picky eater marijuana to stimulate his appetite and encourage him to eat. Not even if it was organic. That usually gets the point across. You need to know the risks of a product, even if it’s natural.
  • If supplements will be taken, talk to your doctor and pharmacist about drug interactions. Sometimes it’s difficult to know the risks because not all ingredients are included on the label and not all ingredients have been well studied, especially in combination with other supplements and medications.
  • Most dietary supplements have not been tested in pregnant women, nursing mothers, or children. Remember just because something’s natural doesn’t mean it’s safe. Arsenic is natural but I wouldn’t advise taking it in high doses.
  • If something sounds too good to be true, it probably is. There are no miracle cures. Avoid being manipulated by advertising. It’s easy to fall prey because we all want to feel better quickly and parents want their kids to be healthy. But if it claims to be 100% effective or to have no side effects, it’s probably false advertising. Personal accounts of something working are as likely to be based on bias or coincidence as to be from real benefit. Rely on large clinical studies that have been reproduced by other researchers.
  • Dr. Chad Hayes has a very long, but wonderful post on how many of the integrative medicines are not simply not beneficial but potentially dangerous – Citations Needed: The curious “science” of integrative medicineMy experience at “Get Your Life Back NOW!”
This post isn’t about antibiotics, but they don’t work against viral illnesses any better than supplements. They don’t prevent the development of ear infections or pneumonia, so even if your child seems to always develop these complications, your doctor should not prescribe them preventatively. Don’t use antibiotics for routine upper respiratory infections, stomach bugs, and other viral illnesses.

Do you know what really boosts your immune system?

Lead by Example

We’ve all heard the saying: kids will do what they’re shown, not as they’re told.

It’s so true. Think about all the times your kids are watching you. They are learning from you.

What can you do to help them have healthy habits?
  • Eat your vegetables.
  • Get daily exercise.
  • Wear your seatbelt.
  • Stop at stop signs.
  • Don’t use your phone while driving.
  • Wear a life vest near a lake or river.
  • Maintain your composure during times of stress.
  • No phones at the dinner table.
  • Don’t tell lies- even little ones.
  • Get enough sleep.
  • Be kind to others.
  • Call home- your parents and siblings would love to hear from you.
  • Don’t permit violence in your presence.
  • Give your time and talents to others.
  • Take care of your things.
  • Limit screen time.
  • Brush your teeth at least twice a day and floss daily.
  • Wear a helmet when on a bike.
  • Don’t mow the lawn without proper shoes.
  • Make time for family.

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helmets, exercise
Exercising together safely as a family sets great lifelong habits!

New Juice Guidelines!

The American Academy of Pediatrics is releasing new guidelines for introducing and giving fruit juice today.

Juice that comes from fruit is not the same thing as eating fruit. It’s missing the fiber and even the feeling of fullness that comes from eating foods rather than drinking. Too many kids drink excessive juice, which fills them with empty calories and can contribute to obesity and tooth decay.

How much juice should kids have?

  • Juice is not recommended at all under 1 year of age in the new guidelines.
  • Toddlers from 1-3 years can have up to 4 ounces of 100% juice a day.
  • Children ages 4-6 years can have 4-6 ounces (half to three-quarters of a cup).
  • Children ages 7-18 years can have up to 8 ounces (1 cup) of 100% fruit juice as part of the recommended 2 to 2 ½ cups of fruit servings per day.

General tips and tricks:

  • Offer only 100% juice if you’re giving juice at all. Fruit flavored drinks are not the same thing as juice.
  • Water is always healthy! If your kids want it flavored, cut up fruit and put it in the water. There are many recipes online to get ideas, but kids don’t need anything fancy – just put cut up pieces of their favorite fruit with water in a glass container. Put the container in the refrigerator for 2-4 hours and then pour the infused water into their cup without the fruit (which could pose a choking risk). The infused water will stay fresh in the refrigerator for up to 2 days.
  • Some kids like to start the day with a frozen water bottle. Simply put a 1/2 to 3/4 full water bottle in the freezer overnight – don’t fill it too much because ice expands! Add a bit of water in the morning to help it start melting so it’s drinkable when they want a sip. Adjust the amount of water to freeze as needed depending on how insulated your water bottle is.
  • If your kids demand more than the recommended amount of juice for their age per day, water it down. By mixing water (or sparkling water for a bit of zip) with juice, you decrease the amount of sugar in every serving. You can give 1/2 the recommended daily maximum amount of juice with water twice and still stay within the daily limit.
  • Never let kids drink juice out of a bottle.
  • Never put kids to bed with juice. They should brush teeth before bed and be allowed only water until morning.
  • Offer only pasteurized juice. Unpasteurized juice can cause severe illness.
  • Give kids real fruits and/or vegetables with every meal and snack.
  • Make smoothies! Putting fruits and vegetables in a blender to make a smoothie is a great way to give the full fruit or vegetable instead of juice. Consider adding plain yogurt**, chia, flax, oats, nuts, and other healthy additions to increase the nutritional components of the smoothie! **Flavored yogurts often have added sugars. Look for just milk and cultures in your yogurt.
  • Most juice boxes have more than a day’s supply of juice. Don’t use juice boxes. Offer juice in cups so you can limit to the age appropriate amount.
  • Organic juice is not healthier than other juice. Many parents presume it has less sugar or more nutrients, but it doesn’t.
  • Vegetable juices may have less sugar and fewer calories than in the fruit juice, but are often mixed with fruit juices so you must read ingredients. They also lack the fiber of the actual vegetable, so eating the vegetable (or pureeing veggies into a smoothie) is healthier.
  • Beware of labels that look like juice but aren’t 100% juice. The label might say “juice cocktail,” “juice-flavored beverage” or “juice drink.” Most of these have only small amounts of real juice. Their main ingredients are usually water, small amounts of juice, and some type of sweetener, such as high-fructose corn syrup. Nutritionally, these drinks are similar to most soft drinks: rich in sugar and calories, but low in nutrients. Avoid them.
  • Sports drinks are not healthy substitutes for water. They are sugar-sweetened beverages that contain sodium and other electrolytes. Unless one is doing high intensity exercise for over an hour (such as running a marathon, not playing in a baseball tournament), water and a regular healthy diet provide all the calories and electrolytes we need.
  • Water’s the best drink for our bodies. Buy fun reusable water bottles and challenge your kids to empty them throughout the day. The old rule of “8 cups a day” is outdated, but we should get enough water (from the water content in foods + drinks) to keep our urine pale. We need more water when it’s hot, when we exercise, when we’re sick and when the air’s really dry. Once we feel thirsty we’re already mildly dehydrated, so drink water to prevent dehydration.
juice guidelines
The AAP’s 2017 Juice Guidelines

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Nutrition for the Picky Eater

I am frequently asked about how to get kids to eat. In general, there are a few quick “rules”:
  • Don’t offer junk. Don’t make it easily available at home… most kids can’t drive to the store!
  • Hungry kids will eat what’s offered. Let them get hungry between meals. No grazing.
  • Not every food group will be eaten at every meal, so use the day to space foods to incorporate a range of nutrition over time. Think of snacks as mini-meals.
  • Keep meal time fun.
  • Offer a “plant and protein” every meal and snack to get kids to the 5 a day of fruits and veggies and to give a protein for “staying power”. This also fills kids up with the good things so they aren’t hungry for junk.
  • Enforce “Taste a bite without a fight” after 3 years of age.
  • It’s okay to be tricky and fun: add pureed vegetables to things, use yogurt or humus dips, put food on a stick, arrange food into fun shapes, be creative.
  • Juice is not a food.

This is my first attempt at adding video to my blog. I apologize for the tilted view… it looked straight on my camera! YouTube limits the length to 10 minutes, and I ended up at 11 minutes, so it is broken into two shorter segments.

Part 1:

Part 2:
Resources mentioned at the end:

My Pinterest page has several boards with recipes and nutritional information, in addition to other kid-friendly ideas! (Warning: if you don’t use Pinterest, it can be addictive. Tons of great project ideas and recipes, educational sites, and other time wasters…)

Kids Eat Right: The Academy of Nutrition and Dietetics’ page on scientifically based health and nutrition information you can trust to help your child grow healthy.