The Healthy Lunchbox

WebMD Live Events Transcript

How do you curb calories when your kids go cuckoo for Cocoa Puffs and think soda is a must for lunch? For this discussion we focused on two meals: breakfast and lunch and found that with a little planning, your kid will be happier, healthier, and wiser! Our instructor, Rallie McAllister, MD, MPH, showed us how, on Sept. 14, 2004.

The opinions expressed herein are the guests' alone and have not been reviewed by a WebMD physician. If you have questions about your health, you should consult your personal physician. This event is meant for informational purposes only.

MODERATOR:
Welcome back to WebMD Live, Dr. McAllister. Is breakfast still considered the most important meal of the day?

MCALLISTER:
Yes, breakfast is indeed the most important meal of the day. It's what our moms have been telling us for years and now moms have loads of scientific evidence to back them up. Eating breakfast, especially for children, is associated with better academic and behavioral performance in a number of studies.

MODERATOR:
What are the most important factors in a healthy breakfast?

MCALLISTER:
The main thing to remember is that breakfast is when you eat and not what you eat. Adults and children do not necessarily have to eat traditional breakfast foods; they just have to eat nutritious foods. Many people skip breakfast because they don't like traditional breakfast foods. For these folks, any type of nutritious food is far better than eating nothing.

MODERATOR:
Are there certain nutrients that we should be trying for at breakfast?

MCALLISTER:
Yes, we should strive to include three items from the five basic food groups in every breakfast meal. Especially aiming for:

  • Protein group foods
  • A food rich in complex carbohydrates (such as a whole grain)
  • A food rich in calcium (such as dairy)

MODERATOR:
Can a dairy product also work as a protein?

MCALLISTER:
Yes. Milk and other dairy products, including yogurt and cheese, offer some protein and this is a very acceptable way to include some of this nutrient in your breakfast meal. If you or your children do not like or cannot tolerate dairy products, you can get protein from eggs, lean meats, or even seeds and nuts.

MEMBER QUESTION:
My daughter is in a fog in the mornings and can hardly bring herself to eat. Should I just send an extra big lunch and not worry, or is there a way to get her to eat more breakfast in her zombie state?

MCALLISTER:
Many children have groggy appetites when they wake up. Sometimes these children can tolerate certain kinds of food early in the morning, or they may be able to eat a small snack around midmorning. If a child misses breakfast, it's OK to include a little extra food at lunch as long as it's not loaded with extra fat and calories and as long as it provides important nutrients.

MODERATOR:
What are some breakfast foods that might appeal to children?

MCALLISTER:
Cereal is the old standby, but many types of cereal are not all that nutritious. Cereals marketed to children are typically loaded with sugar. Giving your child a bowl of these kinds of cereals is the equivalent to feeding your child a couple of chocolate chip cookies. Kids like all kinds of foods. You can try:

  • Peanut butter on whole-wheat toast
  • Yogurt smoothies with fruit
  • Breakfast pizza, made of an English muffin, scrambled egg, and cheese and vegetables
  • Even last-night's leftovers, as long as they're nutritious and appealing to your child first thing in the morning.

It's OK to be creative with breakfast. Your kids will love it.

MEMBER QUESTION:
Cereals can also be loaded with white refined flour. Is it as bad as they say?

MCALLISTER:
White refined flour isn't all that bad I mean, it's not like it's poisonous or anything, but on the other hand, it's just not all that good. Refined flours have had most of their naturally occurring beneficial nutrients stripped away, as well as their fiber content. Granted, some nutrients, including folic acid and other vitamins, are added back to refined-grain products, but we're much better off choosing whole grains with natural nutrients in the first place.

"Eggs have long been vilified, but they are really an excellent food, especially for children."

MEMBER QUESTION:
Is it better to let kids eat sugar cereals than to skip breakfast altogether?

MCALLISTER:
Yes, it is. It's better to eat almost anything than it is to skip breakfast altogether, especially for children. You might want to make a deal with your kids and tell them that you'll let them buy their favorite kinds of cereal as long as they mix them with an equal amount of a more nutritious cereal.

Or allow them to have their favorite cereal on the weekends in exchange for eating a more nutritious breakfast on school days. Finally, you can allow them to have a small serving of their favorite cereal, along with a small serving of something else that is more nutritious. For instance, a small amount of oatmeal or a scrambled egg, so that you know they're getting some good nutrients along with all that sugar.

MEMBER QUESTION:
My kids love bacon ( not turkey bacon). Is there any hope of finding bacon that's not just terrible for you?

MCALLISTER:
It is OK for your children to have bacon every once in awhile, especially if they aren't overweight. It's true that bacon is high in fat and cholesterol, but if your children are healthy and of normal weight, it certainly won't hurt them to eat it every once in awhile. One thing that you can do is use bacon as a flavoring instead of a main course. For instance, you can sprinkle bacon bits on scrambled eggs; that way, they'll get the flavor that they enjoy without consuming a lot of extra calories and fat.

MEMBER QUESTION:
Can you explain the current thinking on eggs? It seems they are bad guys one day and the perfect food the next.

MCALLISTER:
Eggs have long been vilified, but they are really an excellent food, especially for children. They offer one of the most desirable forms of protein which children need to grow and develop. Most children do not have cholesterol problems as long as they are thin and healthy, so we don't really need to worry about the cholesterol content of eggs at least as far as our children are concerned.

Eggs contain 6 grams of protein and 6 grams of fat. If you want to serve your child two or three eggs you can do so without giving your child a lot of fat simply by using only one of the yolks and discarding the other two. The egg yolk contains the entire 6 grams of fat. The egg white is rich in protein and fat-free. Most kids can benefit by eating an egg or two a week as part of a healthy breakfast.

MODERATOR:
Let's take about lunch. Before they reach school age, what can we do to encourage our children to have a healthy lunch?

MCALLISTER:
This is a critical time in a child's life especially as far as food preferences are concerned. Most children know what they like and what they don't like by the age of 5. How do they know this? They know this because they have been exposed to certain foods during this time. Now is the time to offer children a wide variety of foods in different shapes, textures, and flavors so that we open their minds to trying new foods and we help them develop a taste for many different foods, rather than the same old thing day after day.

MEMBER QUESTION:
Is there any nutrition left in the food they serve in school cafeterias? It seems so processed and cooked to death and it waits around in a steam tray to be served. Do nutrients "cook away" or get eliminated in the canning/freezing/forming into nuggets process?

MCALLISTER:
Schools are definitely making an effort to improve the nutrition of the foods that they offer. Still, you are right about nutrients being cooked or processed out of many foods in school cafeterias. I believe that schools will continue to improve with pressure from the government and concerned parents. In the meantime, there is little doubt that children who pack their lunches are better assured of getting meals that are lower in fat and calories and richer in vitamins, minerals, and other nutrients, than kids who make poor selections at school cafeterias.

MEMBER QUESTION:
I know our school serves a variety of nutritious foods at lunch, but the kids don't go for the good stuff. Salads get ignored but not hamburgers. What can we do?

MCALLISTER:
This is the million-dollar question. As schools try to improve their menus, they're finding that the kids won't eat the nutritious foods that they offer. Kids are more likely to choose nutritious foods when they have been taught to do so from a young age. It's difficult to start when a child has already decided on his or her food preferences. I don't know that anyone knows what to do about this dilemma.

MEMBER QUESTION:
Do you know if it's possible to find a vending company that will put something healthy in a machine for the schools they serve?

MCALLISTER:
An excellent idea. Schools often sign contracts with major beverage companies and snack-food corporations. It would be a great idea if you could find a company that offered nutritious snacks and drinks in its vending machine, rather than high-fat, high-calorie items. Unfortunately, there just aren't that many companies that offer nutritious items in vending machines, but I suspect that will change as Americans become more health conscious.

MODERATOR:
See if your school is willing and able to switch out all of the soda and change the vended offerings to bottled water, sports drinks, and juices.

"Kids love opening a lunch box or lunch bag that contains foods that spark their imaginations as well as their appetites."

MODERATOR:
For the child who is willing to take lunch to school, what can you suggest to spark up the typical sandwich, apple, and two-cookie lunch bag?

MCALLISTER:
Kids love opening a lunch box or lunch bag that contains foods that spark their imaginations as well as their appetites. You can pack a theme lunch. For instance try:

  • A lunch that reflects a subject that your child is studying in school, like a foreign country. If your child is studying Italy, you could pack a miniature bagel pizza with nutritious ingredients, or another food from that country. You could include a tiny Italian flag.
  • Or you can make a lunch that celebrates your child's favorite sports team, complete with team logo, baseball card, or similar object.

All it takes is a simple idea to trigger a child's imagination and to stimulate your child's appetite.

MODERATOR:
How do you keep hot foods hot and cold foods cold for your child?

MCALLISTER:
The good news is that these days there are an enormous number of lunch containers to choose from. Many have separate compartments for hot and cold food. We can buy an appropriate container to keep just about any foods separate for our children, and it is an excellent investment.

MODERATOR:
With that in mind, nutritious leftovers can be a terrific lunch, can't they?

MCALLISTER:
Yes, as long as they were nutritious before, they are an excellent selection for the next day. The important thing to remember is that kids have very little time to eat, once they finally sit down at the cafeteria table. Most studies show that school age children have about 12 minutes to eat their lunches. For this reason, it is very important that everything we put in our children's lunchboxes is nutritious, tasty, and easy to eat. For example cut up fruit into bite-size pieces so that everything can be easily unwrapped and quickly eaten. Eye appeal is very important. If it doesn't look good, it is very unlikely to be eaten.

MODERATOR:
How important is it to involve your child in preparing the lunch they take to school?

MCALLISTER:
Asking your child to help increases the chances that your child will eat a nutritious lunch. It doesn't do much good to fill your child's lunch with foods they will never eat. Ask your child to help pick out the foods the night before, when there's plenty of time to prepare it.

MEMBER QUESTION:
I have the double-whammy problem of a kid who gets bored with the same lunch over and over, but is going through a picky phase. What can I do?

MCALLISTER:
The picky eater is a challenge for every parent. Keep making good suggestions and keep offering the nutritious foods. When it comes right down to it, parents have very little control over what their children end up eating in the school cafeteria. Your best bet is to keep offering nutritious foods and make it easy for your child to try new things when she's feeling courageous.

MEMBER QUESTION:
Do some foods make you groggy? I want to take a nap after I eat lunch and so do my kids!

MCALLISTER:
There's not doubt about it, foods that are rich in simple sugars or simple carbohydrates are known to make people feel physically and intellectually groggy after eating them. Foods such as:

  • White bread
  • Cookies
  • Sodas
  • Chips

The reason is that simple sugars stimulate the release of a neurotransmitter in the brain called seretonin that actually makes you feel sleepy. To avoid feeling sleepy or sluggish after lunch, stick to foods that are rich in complex carbohydrates, such as whole grains. And foods that provide some protein, such as lean meats, nuts, legumes, or seeds. These foods do not trigger the release of seretonin and therefore, leave you feeling energized instead of sleepy.

MODERATOR:
Can you give us a structure for building a healthy lunch?

MCALLISTER:
It's a very good idea to try to include a food from each of the five good groups, if possible, in your child's lunch. Quality is far more important than quantity. Kids don't have a lot of time to eat at lunch. A good lunch is one that includes, for example:

  • Lean deli meat on whole-wheat bread. I usually cut my children's sandwiches with a cookie cutter to cut down on the quantity, and give them a nice heart-shaped or star-shaped sandwich that can be quickly eaten.
  • It's also a good idea to include a few slices of fresh fruit, such as cut strawberries or a small handful of grapes.
  • You can work in a small serving of vegetables by including broccoli florets or a few baby carrots with a little fat-free dip.
  • If you include a stick of string cheese, a tube of yogurt, or a small carton of milk, you've got your dairy product, and this lunch gets your child a serving from each of the five food groups.

This is a good prototype to follow. And notice, there is nothing from the sixth food group, which is junk food, in this lunch. Kids don't have time to eat it anyway.

"Prepackaged meals and snacks are certainly convenient, but they are almost always lacking in important nutrients, and they're often loaded with fat and sugar."

MODERATOR:
There are certain products marketed to kids and parents as healthy, that may be questionable, such as fruit roll-ups, yogurts with colors and candy, cereal bars made from sugary cereals, and prepackaged kids lunches. Would you comment on these items?

MCALLISTER:
That is why it is so important to read the nutrition label. Prepackaged meals and snacks are certainly convenient, but they are almost always lacking in important nutrients, and they're often loaded with fat and sugar. Parents can always count on the nutritional values of foods that they prepare themselves. It is hard to improve upon fresh fruit or fresh vegetables. Whole grains are better for our children than refined grains. The more a food resembles its original source, the better it is for us, in most cases.

As a mother of three boys, I know how difficult it is to make a lunch that appeals to each one of them. Some days it feels like work, but feeding our children properly ensures that they grow and develop physically, emotionally, and intellectually to their full potential. Any extra time and effort that we devote to our child's health is well worth it.

MODERATOR:
Thanks to Rallie McAllister, MD, for sharing her expertise with us today. For more information, please read The Healthy Lunchbox: The Working Mom's Guide to Keeping You and Your Kids Trim , by our course leader, Rallie McAllister, MD.


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