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Nutrition and Breastfeeding Articles

‘It is hard to know what to believe with so much conflicting nutrition
information. ​I provide you with the latest evidence-based facts.’

Categories

Lunch Boxes in 2024: your child’s toolkit for play, learning and growth

The lunch box provides up to 40% of a child’s daily intake and fuels growth, development & learning. A well-packed lunch can maximise a child’s concentration and learning ability by sustaining energy levels, promoting gut health, stabilising mood, encouraging healthy growth, and building healthy habits to take into their adult years.

 

How to pack a balanced lunch box:

 

  • Aim to cover the 5 food groups to ensure that your child is receiving all the nutrients they need.
  • For example: fruit, chopped vegetables, small tub of yoghurt or full cream milk, wholegrain sandwich with cheese or meat and salad.
  • Include a protein, such as egg, tofu, tuna, lean meat, baked beans, seeds, nuts (if permitted), dairy.
  • Add a slow-release carbohydrates (wholegrain bread, crackers such as Corn Thins, Vita Wheats, brown rice crackers, dairy foods, fruit, popcorn, pasta spirals). This will help with satiety and ensure a child does not come home starving in the afternoon.
  • Present the same foods in different ways: e.g. cucumber slices, sticks, whole baby cucumbers.
  • Treat foods should only appear sometimes, once every week or two. Consider where your child may be receiving other treats, do they need them in their lunch box too? (This includes baked goods, muesli bars, fruit straps, pretzels, juice, chips, etc.)
  • Involve the children in preparation. You may ask what they would like within reason e.g. strawberries or grapes, popcorn or cheese and crackers. Make a list of foods to try together.
  • Continue to send new foods, even if they come home at first. If they are not offered, your child will never try them. When foods are presented frequently, they become a normal part of the daily diet.
  • If lunch comes home uneaten, offer it as an after-school snack, before offering an alternative.
  • If your child only likes Vegemite sandwiches, that’s totally fine. Try to switch to wholegrain bread, add fruit, veg & dairy or another protein to their lunch boxes for balance.
  • Pack lunch in an insulated container with some ice-bricks.
  • Try freezing yoghurt squeezy packs for a great snack that also keeps lunch cool.

 

Remember that even small changes are positive, so try simple swaps such as:

  • Swap a processed snack such as a fruit strap for a piece of fruit.
  • If vegetables are no longer sent, start by sending one or two pieces each day. Acceptance takes time and with persistence the food will be tasted & even eaten.
  • Swap a less nutritious snack for something better e.g. chips for popcorn, or banana bread for a regular sized piece of raisin bread with cream cheese.
  • This can be a tricky area to navigate for families, please come and see me for advice to help your kids achieve their best growth and learning potential through nutrition.

Include enough calcium for bone health:

Calcium is integral for strong bones and women between the ages of 19 and 50 need 2.5 serves of calcium-rich foods per day, to reduce risk of osteoporosis or weakened bones. Women over 50 need an additional serve, due to the drop in oestrogen reduces the amount of calcium in the bones.

One serve of calcium is equal to 250mls of dairy or a plant-based milk with at least 100mg/100mls of added calcium, 2 pieces of cheese or 200g of yoghurt. Other sources of calcium include almonds, sesame seeds, tofu, green leafy vegetables, and fish such as sardines or salmon, though large quantities of these foods are needed to meet calcium needs. For example, 100g or 5 tablespoons of almonds is equivalent to the amount of calcium in a glass of milk. Some women may benefit from a calcium supplement, but it is best to seek medical advice.

Top tips:

  • Include calcium-rich foods 3 times per day to meet your needs
  • check your plant-based milk to ensure it is fortified with calcium
  • Consider adding unsweetened Greek yoghurt with berries as a mid-afternoon snack
  • Try sardines on toast for lunch.

Iron-rich foods & protein:

Iron carries oxygen around the body, so deficiency can lead to symptoms such as tiredness, headaches, and dizziness. A serve is equal to a palm-sized amount of an animal-based iron-rich source, like red meat, fish, chicken, pork, and eggs, or 2 palms of a plant-based iron sources include legumes, nuts, seeds, tofu, green leafy vegetables & wholegrains, such as oats and brown rice. Include these foods a few times a day will deliver your needs. Pair plant-based iron with Vitamin C, such as nuts and berries or tofu with broccoli and capsicum, to assist absorption. Women who are pregnant, vegan, vegetarian or experiencing heavy periods are at greater risk of deficiency and should seek the advice of their GP.

An example is: rolled oats with low fat milk, chia seeds & berries for breakfast, a wholegrain sandwich with lean chicken, cheese and salad for lunch & a lentil curry with brown rice for dinner.

These same foods are rich in protein, which helps to build and sustain muscle mass as we age. It also helps with feelings of fullness and appetite regulation.

Add colour:

As we age, our energy budget reduces, this is dependent on many factors such as activity levels and the amount of muscle. It’s important to eat nutritively, which means make your food count and work for you.

Aim to include half a plate of vegetables at lunch and dinner.

Simple tips to boost vegetable intake are:

  • Add a couple of handfuls of spinach and some cherry tomatoes to morning eggs on toast
  • Include a snack of chopped vegetable sticks with hummus
  • Make a big tray of colourful roast veg, such as beetroot, pumpkin, sweet potato, zucchini and brussels sprouts to use in your lunches over the week, by adding protein.

There is a lot of confusing information about nutrition. Coming back to basics can help you to make healthful decisions. See how you go with these practical tips, 1-2 small changes make a big difference, and be in touch if I can help further.

Summary of top nutrition tips:

Calcium

  • Include calcium-rich foods 3 times per day
  • check your plant-based milk to ensure it is fortified with calcium (at least 100mg/100mls)
  • Try unsweetened Greek yoghurt with berries as a mid-afternoon snack
  • Sardines on toast with spinach and dill.

Iron & protein:

  • Include a palm-sized amount of red meat, fish, chicken, pork, and eggs, or 2 palms of legumes, nuts, seeds, tofu, green leafy vegetables & wholegrains, such as oats and brown rice 3 times per day.
  • Pair plant-based iron with Vitamin C, such as nuts and berries or tofu with broccoli and capsicum, to assist absorption.
  • An example is: rolled oats with low fat milk, chia seeds & berries for breakfast, a wholegrain sandwich with lean chicken, cheese and salad for lunch & a lentil curry with brown rice for dinner.

Add colour:

  • Add handfuls of spinach and some cherry tomatoes to morning eggs on toast
  • Include a snack of chopped vegetable sticks with hummus
  • Make a big tray of colourful roast veg, such as beetroot, pumpkin, sweet potato, zucchini and brussels sprouts to use in your lunches over the week, simply add some protein.


Bite-sized nutrition: simple food swap
Breakfast cereals – how do you choose?

Data collection by Victoria Hobbs, Deakin University

Disclaimer – I receive no remuneration from reviewing these brands; this is an unbiased, professional opinion based on a selection, and is not a definitive list.

How many times have you stood in the breakfast cereal aisle overwhelmed by the sheer number of options? So many people say they are confused about what to eat. I am often seen juggling multiple boxes of cereal, analysing the nutrition information in order to give the best advice to my clients, and make sense of it myself. Cereals can provide valuable nutrients such as fibre, vitamins and carbohydrates; though many contain little nutrition and an undesirable amount of sugar and salt. The complex interplay of the ingredients in your cereal could either fuel your performance, or leave you feeling hungry and fatigued early in the day.

Today, I have ranked a range of popular fruit and nut cereals according to their nutritional profiles (fibre, sugar, whole grain content and sodium), to remove the guess work and make healthier = easier. Where does your daily cereal fit into the list and is it time to make a switch?

Best choices

As a general guide, choose cereals that are:

  • Greater than 50% wholegrains – specified on the ingredients list
  • Greater than 10g fibre/100g
  • Less than 400mg sodium/100g
  • 15g sugar/100g – slightly higher is OK if dried fruit included. Note that dried fruit and fruit may contribute to overall sugar content, this is different to refined sugar.
  • Choose untoasted over toasted muesli varieties

Avoid cereals that list sugar, or a variant within the first 3 ingredients (e.g. glucose, dextrose, honey, golden syrup, coconut sugar, barley malt, rice syrup, etc.). Beware health claims – if it sounds too good to be true, it generally is.

So with all of this in mind, the best choices include:

  1. Be Natural Cashew, Almond, Hazelnut & Coconut: the winner with high fibre, 17.1g, low sugar: 12g, and low sodium: 195mg. Top 3 ingredients: wholegrain cereals, nuts, rice – all valuable sources of nutrition.
  2. Be Natural Pink Lady Apple & Flame Raisin: Dried fruit raise the sugar content, but still a good choice – low salt 210mg, high fibre 14.1g, high whole grains, sugars moderate 17.1g –(wholegrain cereals, rice, fruit).
  3. Morning Sun Natural Style Peach & Pecan Muesli: Great muesli choice, high fibre 11.1g, low salt 18mg and sugar 14.4g from dried fruit is considered low-moderate (Wholegrain oats, dried fruit, wheat bran)
  4. Morning Sun Natural Style Apricot & Almond Muesli: Similar to above. Fibre 10.3g, sugars 15.1g, sodium 19mg (wholegrain rolled oats, dried fruits, wheat bran)
  5. Lowan Fruit & Nut Natural Muesli: competes with Morning Sun, a great choice. High fibre 9.7g, moderate sugars 15.5g (from dried fruit), sodium 36mg (Wholegrain oats, dried fruits, wheat bran straws)
  6. Uncle Toby’s Natural Style Swiss Blend Muesli: untoasted, high fibre 10.2g, low salt 14mg, sugar 16.3g – from dried fruit and fruit pieces as 2nd, 3rd ingredients (Rolled Oats (72%), Dried Fruits (16%) [Sultanas (8%))

The next list shows moderate choices – less fibre and/or more sugar. Choose sometimes

  1. Uncle Toby’s O&G Bircher Muesli Cranberry, Almond & Quinoa:moderate fibre 8.1g, low sugar 11.4g, low sodium 11mg, untoasted (Rolled oats, dried fruit, almonds). Add some bran to boost fibre content
  2. Carman’s Natural Bircher Museli: Lower fibre 7.9g, moderate sugar 16g, though than other options. Low sodium 7mg. Top 3 ingredients look good (Wholegrain oats, fruit, nuts). Add bran, LSA, fruit to boost fibre content.
  3. Kellogg’s Special K Fruit & Nut: Moderate fibre 8.1g, high sugar 19.6g, moderate sodium 310mg (Rice, wholegrains, fruit). Better choices above
  4. Uncle Toby’s Plus Fibre Apple and Sultanas: It’s a trade-off, with high fibre 17.9g, but higher sugar content 23.3g, (wholegrain cereals, dried fruit – contributing to high sugar content, wheat bran), low sodium. Either mix this with wholegrain/bran flakes, or choose a different option and add a small amount of your own dried fruit to keep sugars down.
  5. Table of Plenty Macadamia, Cranberry & Coconut Muesli:despite high fibre 10.4g, low sodium 15mg, moderate sugar 17.3g, derived from dried fruit and golden syrup as 2nd, 3rdingredients – not a satisfying choice.
  6. Carman’s Classic Fruit & Nut Muesli: toasted muesli, moderate fibre 8.7g, moderate sugars 15g (despite first ingredient wholegrain oats, with golden syrup in the top 3, this is higher in refined sugars. Choose an untoasted muesli with more nuts and less added sugar.

Lastly, many of these may sound healthy, but are not the best choices for breakfast…high sugar, low fibre, low nutrient contribution and not the best way to start the day.

  1. All Bran Honey Almond: Sounds healthier than it is with All Bran in the title. High fibre 16.1g, but also very high sugar content 23.9g (Wholegrain wheat, wheat bran, sugar), moderate salt 315mg.
  2. Uncle Toby’s Oat Crisp Honey & Macadamia Cereal: Toasted, high sugar 22g – 2nd ingredient Wholegrain cereals, sugar, macadamias), fibre moderate 8g.
  3. Kellogg’s Just Right Cereal: Not really just right, with high sugar 28.7g, note ingredients (Wholegrain cereals, sultanas, sugar), low salt 30mg, high fibre 10.2g. Better choices above
  4. Arnold’s Farm Toasted muesli clusters: Sugar high 19.5g – added as second ingredient (Wholegrain Rolled Oats, Glucose, Oat Bran), steer clear, fibre 8.2g, low sodium 30mg.

For individual advice to optimise your nutrition to fuel your day, come and see Nicole at:
NEST Family Clinic, 289 Kooyong Road, Elsternwick VIC 3185,

meal prep for beginners

By Nicole Bando, Family & Paediatric Dietitian & Lactation Consultant
January 25, 2020

If you’d like a more organised start to the work and school year, learn to meal prep like a boss. This really is one of the best ways to keep healthy and gets easier with practice. Mix and match combinations and change it up next week. This may seem daunting at first, but trust me, a couple of hours cooking on a Sunday wins many more hours during the week and takes the stress out of last minute cooking & supermarket dashes, amongst work, school and extra-curricular activity runs.
Recipes and shopping list included below.

Tips:

  • Avoid following multiple recipes, this is time consuming and daunting.
  • Choose something easy that you know well, e.g. spaghetti bolognaise.
  • Mix and match by choosing 1 option from each group:

1. Carbohydrate: 500g pasta, boiled, 1-2 cups quinoa, cooked, 1 loaf wholegrain bread and 1 packet mountain bread wraps
+
2. Protein: 500g grilled chicken, Plant boosted bolognaise, 6-8 boiled eggs, small cans tuna in olive oil, tinned four bean mix
+
3. Vegetable: 1 tray roasted vegetables (recipe here), 1 large bag spinach leaves, 1 bag pre-packaged salad mix, chopped fresh vegetables (carrot, cucumber, capsicum, etc.), medium potatoes and broccoli
+
4. Small amount of good fats: olive oil, yoghurt dressing, avocado, nuts & seeds

Sample meal ideas

Lunches:

  • Mountain bread wraps + boiled eggs, avocado and salad mix
  • Quinoa + roast vegetables + grilled chicken + olive oil, seeds
  • Spaghetti bolognaise
  • Wholegrain bread + tuna + avocado + handful spinach mix + chopped fresh vegetables

Dinners:

  • Spaghetti bolognaise
  • Bolognaise + jacket potato + green salad
  • Jacket potato + canned bean mix + grated cheese + salad mix
  • Mountain bread bolognaise burritos
  • Chicken + leftover pasta + bag spinach + 400g can chickpeas, drained

These meals are designed to last in the fridge roughly 3 days. Divide meals into containers and freeze chicken or bolognaise that will not be used within 3 days to ensure food safety. Simply defrost for use later in the week.

Which milk? a review of plant vs dairy milks

By Nicole Bando, Dietitian & Lactation Consultant

Cow’s milk: an excellent source of protein, calcium, phosphorous, magnesium, Vitamin A & 12, lactose, zinc. Choose full cream, 3.8% fat (unless you have diabetes, high cholesterol, heart disease or would like to lose weight, then opt for low-fat or skim (0.15-1.5% fat)

Lactose free cow’s milk: A good option for those who lack the enzyme needed to digest the natural sugar in milk, lactose.

A2 milk: Cow’s milk contains A1 & A2 proteins and a couple of studies suggested that the A1 protein increased gut inflammation, some cows have been bred to produce only A2 protein milk. Larger studies did not support this earlier finding and there is no proven benefit to drinking A2 milk. For some who experience digestive discomfort, it may be worth a try. For the rest of us, at double the price, there is no benefit.

Soy: The most similar nutritionally to cow’s milk and the best choice if opting for plant-based unless you have a soy allergy. A good source of protein, look for a soy milk with added calcium, Vitamins A, B1, B2, B12. Lactose, gluten free.

Almond: Low in protein, carbohydrates and calories. If allergic to dairy or soy, choose an unsweetened brand with added calcium. Lactose, gluten free. Rice: high in quick release carbohydrates, low in protein, vitamins and minerals. Lactose, gluten free.

Oat: Contains some protein, fibre, look for unsweetened varieties with added calcium & Vitamin B12. Not gluten free. Next best option after cow’s and soy milks.

​Coconut: High in saturated fat, low in all nutrients, including protein, vitamins and minerals and carbohydrates. Drink occasionally for the flavour in smoothies (choose unsweetened with added calcium) or curries. *If going plant-based, look for milks with added calcium (100mg per 100mls). *If your child has an allergy to dairy or soy, seek advice from a paediatric dietitian to ensure adequate nutrition for growth. ere to edit.

one more serve of veg

By Nicole Bando, APD, IBCLC

  • Make a breakfast omelette – throw in a handful of veg such as spinach, capsicum, mushrooms. Add lean ham, cottage cheese or feta.
  • Snack on a small can of corn or 4 bean mix
  • Snack on a cob of corn
  • Grate loads of leftover veg to make vegetable fritters, recipe
  • Snack on vegetables sticks & dip
  • Try roasted chickpeas/ fava beans or edamame as a snack
  • Munch on celery & cream cheese
  • Roast a big tray of vegetables and use in lunches
  • Grate some carrot into your sandwich
  • Load some raw chopped mushrooms into a wrap with tuna and avocado
  • Mix washed baby spinach leaves through pasta or rice
  • Make a loaded veg soup and eat throughout the week
  • Stock up on frozen veg and add a couple of handfuls to your meals
  • Add some sliced tomato and basil to your morning toast with cottage cheese or avocado instead of vegemite
  • Add a tomato and handful of greens to your morning eggs
Are rice crackers a healthy choice?

Thank you kindly to Victoria Hobbs for data collection.
Please note that our product review is unbiased, we receive no remuneration or commercial endorsement.

Rice crackers take up almost half a supermarket aisle and have become a daily snack in many diets; children love them. Are they are a healthy choice and how often should they be eaten? Let me cut through the marketing hype to help you make an informed decision at the supermarket.

Plain rice crackers – (Coles, ALDI, Sakata, Peckish)
Let’s take a peek at the nutrition information panel. Remember that ingredients are listed from most to least. The top 3 are rice flour, vegetable oil and salt. Refined white rice flour contains little of nutritional benefit and negligible fibre – which is not listed on some of the nutrition information panels; this is generally telling of the quality of a product derived from a grain, as it should be a valuable source of fibre. This tells us that the grain has been highly refined. In other cases, fibre is listed as less than 1g/100g – that’s negligible. (Note that a high fibre food is greater than 10g/100g).

Rice crackers have a high glycaemic index; they are rapidly digested and cause a spike in blood sugar levels, closely followed by a crash. A subsequent drop in energy levels and surge in hunger results, usually soon after eating. The lack of fibre means they are not satisfying, making it is easy to eat above and beyond the portion size. Energy, sodium (salt) and fat content are similar between brands. They qualify as a moderate to high salt food. Read on for a healthier alternative.

Flavoured rice crackers – vegetable, cheese, BBQ, sour cream and chives (Coles, ALDI, Sakata, Peckish)
This line contains a similar quantity of refined rice flour, with the next ingredients either soy sauce or cheese powder; for seaweed and cheese or pizza flavours. The sweet carrot option lists rice flour, rice bran oil and 3% carrot – that’s not a source of vegetables, and merely a marketing gimmick. The seaweed crackers are extremely high in sodium, with Sakata clocking in a hefty 971mg/100g and Coles 690mg/100g. Thirsty? (A high sodium food is classified as greater than 400mg/100g).
Energy content is similar across products; Peckish sour cream and chives contain the greatest kilojoules, though are significantly lower in sodium than the other flavoured options. Cheese, when listed is in the form of powder; which offers no nutritional benefit.

What about Healtheries Kidscare Rice Wheels?
This product is located in the health food section, a marketing ploy to lull shoppers into a false sense of security. It is targeted at parents wanting to do the best by their kids. The nutrition claims on their website (see example, below) are questionable.

  • ‘Scrummy, bite-sized, crunchy rice snacks that are ideal for healthy school lunches’

The product contains negligible nutrition, fibre and a significant amount of sodium 705mg/100g. There is not much difference in kilojoules between a packet of these and a snack-sized packet of potato chips, despite the difference in fat content. In fact some brands of chips have less salt. At least they don’t fill too much valuable tummy space in growing children, though if eaten regularly they are taking the place of more nutritious foods.
These, along with flavoured rice crackers in general are definitely classified as an occasional food, similar to potato chips.

Wholegrain, seeded and brown rice crackers
These varieties have more nutritional clout than the rest of the range, with Sakata Wholegrain Original Rice crackers the best of the options we reviewed. They are a high fibre biscuit with 9.4g/100g and moderate sodium (just).
The Coles brand brown rice and seed/grain options are lower in sodium and a better choice than their plain white rice counterparts; though are still classified as low fibre.

The verdict
The wholegrain options take the prize (Sakata specifically). When choosing rice crackers, opt for the brown rice or wholegrain varieties, reduced salt if possible. Note the suggested portion size of 10-13 crackers. Whether opting for plain or wholegrain varieties, serve with protein such as low fat cheese, tzatziki, hummous and chopped vegetables for a balanced and satisfying snack that will keep blood sugar levels more stable.

It’s OK to enjoy the other options occasionally, but a highly refined food shouldn’t feature daily in anyone’s lunch box. They are definitely the white bread equivalent of biscuits and easy to over consume, which can contribute to weight gain over time. The salt content can also contribute to high blood pressure over time.

THE BLOOD GROUP DIET: PSEUDOSCIENCE?

Developed by a naturopathic physician, Peter D’Adamo, proponents of this diet believe following a diet and exercise program based on blood group (Types A, AB or O) improves fitness, digestive health, weight loss and wellbeing. Much of the discussion appears scientific, however it doesn’t hold pH neutral water. The Type A diet suggests more fruit, vegetables and less meat products, Type AB recommends less meat, more plant protein, some low-fat dairy and the Type O is similar to paleo; more animal products and low carbohydrates.
What does the science say?
A 2015 study of 1450 healthy adults debunked the blood group diet theory. On the Type A diet, an improvement was seen in body mass index, triglycerides (fats in the bloodstream), blood pressure and waist circumference, which are risk factors for heart disease, however this was independent of the individual’s blood type. Given the Type A diet is similar to recommendations of leading health bodies – more fruit, vegetables and less meat products, it is not surprising that a reduction in risk factors was seen in this group. The claims made about metabolism ad enzyme activity based on blood type are not scientifically true. Weight loss will occur whilst following these diets, given a reduction in processed foods, a greater intake of fresh foods and the reduced variety of foods you are ‘allowed’ to eat.

The bottom line?
This is another fad. Our blood group does not dictate an individual’s dietary requirements, it’s both far more simple and complex than that. Ultimately, follow a Mediterranean or flexitarian diet, with plenty of fresh fruit, vegetables, legumes, whole grains, low-fat dairy, some lean meat, fish and good fats for a sustainable approach, with rigorously scientifically proven health benefits whatever your blood type.

Wang J, García-Bailo B, Nielsen DE, El-Sohemy A. ABO genotype, ‘blood-type’ diet and cardiometabolic risk factors. PLoS One. 2014;9(1):84749.

THE BLOOD GROUP DIET: PSEUDOSCIENCE?

Developed by a naturopathic physician, Peter D’Adamo, proponents of this diet believe following a diet and exercise program based on blood group (Types A, AB or O) improves fitness, digestive health, weight loss and wellbeing. Much of the discussion appears scientific, however it doesn’t hold pH neutral water. The Type A diet suggests more fruit, vegetables and less meat products, Type AB recommends less meat, more plant protein, some low-fat dairy and the Type O is similar to paleo; more animal products and low carbohydrates.
What does the science say?
A 2015 study of 1450 healthy adults debunked the blood group diet theory. On the Type A diet, an improvement was seen in body mass index, triglycerides (fats in the bloodstream), blood pressure and waist circumference, which are risk factors for heart disease, however this was independent of the individual’s blood type. Given the Type A diet is similar to recommendations of leading health bodies – more fruit, vegetables and less meat products, it is not surprising that a reduction in risk factors was seen in this group. The claims made about metabolism ad enzyme activity based on blood type are not scientifically true. Weight loss will occur whilst following these diets, given a reduction in processed foods, a greater intake of fresh foods and the reduced variety of foods you are ‘allowed’ to eat.

The bottom line?
This is another fad. Our blood group does not dictate an individual’s dietary requirements, it’s both far more simple and complex than that. Ultimately, follow a Mediterranean or flexitarian diet, with plenty of fresh fruit, vegetables, legumes, whole grains, low-fat dairy, some lean meat, fish and good fats for a sustainable approach, with rigorously scientifically proven health benefits whatever your blood type.

Wang J, García-Bailo B, Nielsen DE, El-Sohemy A. ABO genotype, ‘blood-type’ diet and cardiometabolic risk factors. PLoS One. 2014;9(1):84749.