Roasted Winter Squash Seeds

Did you know that in addition to pumpkin seeds most winter squash seeds are edible and delicious? Unlike the large pumpkin seeds smaller varieties such as butternut, acorn and carnival squash are best roasted with the intention of eating the shell as shelling them is too labor intensive. Enjoy!

Directions:

• Remove seeds from squash and rinse seeds under cold water removing squash strings/pulp. 
• Pat dry for immediate roasting or lay out on baking sheet until ready to bake (the longer they dry the faster they cook; typically I bake all of the seeds from 1-2 weeks worth of squash at once).
• When ready to roast, preheat oven to 275 degrees
• Toss seeds in small amount of olive oil and garlic salt to taste
•  Bake for 10-15 increments. Stir and continue baking until lightly browned. Finished seeds should taste similar to popcorn, may literally be starting to pop and will have a crunchy outer shell easy to eat without a woody texture. 

Homemade Condensed Soups

I've ended my search for recipes for Condensed Cream of Mushroom and Cream of Chicken Soups with these delicious, quick, and freezable recipes by Simply Scratch! Making your soups from scratch allows you the ability to control the quality of your ingredients and avoid preservatives. You also might just save a trip to the grocery store.

Homemade Whole Wheat Tortillas

Making tortillas from scratch allows for better quality and more fresh ingredients! Not to mention they are far less expensive than store bought. Just be sure to give yourself time enough to make them (about 50 minutes). Here is a link to my go to quick, easy and delicious recipe found at The Lean Green Bean.

Pumpkin Zucchini Muffins

Fall is here and winter squash is in season! If you are looking for something wholesome, moist and delicious to do with pumpkin here is one idea. Full of fiber and not too sweet this is a great muffin for snacks, breakfast or a dinner side.

Pumpkin Zucchini Muffins

Ingredients

• 1 cup whole-wheat flour
• 3/4 cup wheat or oat bran
• 1/4 cup brown sugar
• 1 1/2 teaspoons ground cinnamon
• 1 teaspoon baking powder
• 1 teaspoon baking soda
• 1/2 teaspoon salt
• 1 cup fresh or canned pumpkin puree
• 1/2-1 cup grated zucchini, squeezed (optional)
• 2 eggs
• 2/3 cup buttermilk*
• 1/4 cup canola oil

Directions

1. Heat oven to 400 degrees F and prepare muffin tin** with oil or liners.
2. In a large bowl combine flour-salt. 
3. In a separate bowl, whisk together pumpkin, eggs, buttermilk, and oil.
4. Combine dry and wet ingredients and fold in zucchini if using. 
5. Fill muffin cups almost full and bake until a wooden pick inserted into the middle comes out clean, 20 to 25 minutes**.

* Buttermilk can be substituted with regular milk mixed with 1 Tbsp lemon juice per cup of milk.

** Makes 12 normal or 48 small muffins. Bake small muffins for 8-12 minutes. 

Are Dietary Changes Necessary During Breastfeeding?

I have never experienced such intense hunger or thirst as I did during the first month home with my oldest child as I adjusted to exclusive breastfeeding. Now Baby #2 is due to arrive any day and I have been stocking up on easy to eat snacks and meals available at a minute's notice. None of these snacks or meals are different than what I normally eat, but the frequency and amount that I will be eating in the days to come will vary drastically from my normal intake.

What Should I Eat?

Breastfeeding requires only a well balanced and varied diet, with slightly larger portion sizes or additional snacks to provide approximately 300-400 extra calories per day to support adequate milk production. This is not a time for weight loss attempts via calorie restriction or intense exercise, which could decrease your milk production and drain yourself of energy.

There is no worry about counting calories to ensure you are getting enough either. If you are hungry, eat! Your body will tell you through hunger or decreased energy levels that you are not getting enough food to meet the needs of you and your baby. When you promptly and adequately respond to those signals with healthy foods, the enhanced need you have for vitamins and minerals will also be met. For although your body is fairly sufficient at ensuring adequate vitamin and mineral levels in your breast milk using your own nutritional stores during the production of milk, your breast milk will in part mirror your own dietary intake. Therefore an adequate diet will make sure you avoid unnecessary nutrient deficiencies such as iron and calcium in yourself, while enhancing the vitamin, mineral, and fat composition available to your baby.

Need Food Ideas?

For practicability, don't try and follow unfamiliar meal plans when you have a new baby as this is a stressful time already. Make small changes to your diet if needed such as:

• Switch out a few refined grains such as white bread, refined pastas or white rice with whole grains. Whole grains include wheat, brown rice, oats, corn, barley and rye in which the germ and bran remain intact. Whole grain breads, pastas, tortillas and even crackers/chips are typically easy to find.     
• Add a side of eggs or yogurt with whole fruit to your breakfast routine to enhance protein and fiber content of potentially high carbohydrate main dishes with syrup (such as pancakes or waffles).
• Add yogurt or milk in place of juice in smoothies. 
• Drink milk in place of soda pop at meals to provide calcium and protein, and quench thirst with water between meals.
• Have snacks on hand such as:
• Homemade muffins (pumpkin muffins are a favorite)
• Plain yogurt with fruit and/or granola 
• Nuts and seeds 
• Hummus with vegetables
• Cottage cheese with avocados, crackers, or tomatoes 
• Tuna fish or peanut butter sandwiches
• Plain vegetables and fruit (carrots, celery, bananas, apples, etc.) with peanut butter
• String cheese

A Word on Dietary Restrictions

As I was nursing my firstborn, she developed a chronic diaper rash and I soon found myself swamped with well meaning family and friends suggesting elimination of dairy, wheat, eggs, soy and nuts from my diet. After much stress and with some variation to their recommendations, I discovered the underlying problem was excess consumption of apricots (we had a tree in season and I was eating a lot of fresh apricots), and a skin sensitivity to the diaper cream I was using. The solution was merely eating apricots in moderation and discontinuing the use of the cream with no further problems. On the other hand, I have a friend whose son had chronic eczema which only cleared up after she eliminated eggs from her diet under a doctor's direction. 

So yes, if there is a true food allergy, a mother's consumption of the allergen will negatively affect the baby as manifested in eczema, rashes and projectile vomiting. Yet, food allergies are not the only cause of these symptoms in infants, and it is best to work with a pediatrician to determine possible causes and treatments. If a food allergy is suspected, a good place to start is the elimination of known food allergens in the family. Be cautious of mass food group elimination as this causes difficulty in meeting nutrient needs. If the baby's reactions are severe, speak to your doctor and if food groups are to be eliminated reintroduce as quickly as possible to restore adequate nutritional intake. 

Another piece of advice I've heard countless times is to avoid gassy vegetables and spicy food as they can upset your baby's stomach or cause gas and colic. Although I have not taken the time to research this fully, there appears to be little evidence that these foods in moderation cause any significant changes in the baby's ability to digest your milk or impact their demeanor. In fact, variety in a mother's diet creates variety in the breast milk that may decrease picky eating later in life. 

Reference:

Samour PQ, King K. Handbook of Pediatric Nutrition. 3rd ed. Sudbury, MA: Jones and Bartlett Publishers; 2005.

Homemade Hummus

High in protein and healthy fats, hummus is a quick and cheap snack to help increase vegetable intake and satisfy hunger. Not to mention it is delicious!

Homemade Hummus

Yield: about 3 cups

Ingredients:

• 2 16-oz cans garbanzo beans, drained and rinsed
• 1 clove garlic, peeled
• 1/3 C tahini*
• 1 tsp salt
• Juice of 1 lemon (3 Tbsp)
• 1/4 tsp cayenne pepper, ground
• 1/4 tsp cumin, ground
• 1/4 tsp black pepper, ground
• 1/3 C extra virgin olive oil
• 1 handful parsley 
• 3-4 green onions (use entire onion green and white parts), sliced
• 1/3 cup water (can increase or decrease for desired texture)

Place all ingredients in food processor or blender. Adjust seasoning to taste.

Serve with pita bread wedges or fresh vegetables.

* Tahini is smooth paste made from sesame seeds. Often it is found by the international foods or peanut butter in grocery stores.

Recipe Source: USU Dietetics

Meal Plans vs Meal Planning

One of my most frequent requests upon people learning that I am a dietitian, is for me to write a meal plan for them. What is requested is a specific menu including all 3 meals and snacks. I have 3 reasons why I always refuse and why I despise and do not use a meal plan at home for me or my family:

1. Personal likes and dislikes are so different that if I were to develop a meal plan for another person (even my husband), chances are it would be rejected because it wouldn't be according to their tastes. 
2. My life, and I therefore expect to some degree everybody else's life, does not follow a strict schedule leaving further room for failure and diversion from the meal plan.
3. Variety is the key to a healthy diet, not any specific foods. Variety is best achieved with flexibility not always available in meal plans. 

My alternative to meal plans is meal planning. In my house, an ideal meal plan is a list of main dishes for the week on one side of a small paper and the grocery list on the other. Sides are sometimes included, but often they are not as I just include a variety of fruits and vegetables to my list according to season and sales and mix and match to what fits my tastes any specific night. Of course, when first starting to meal plan, you might consider including side dishes to ensure you make them each night as main dishes should rarely be served alone. Below are a few of the benefits I find in meal planning:

1. There is no set schedule. Some meals are fast while others are more time consuming, which allows me to select dishes as my week plays out.
2. A corresponding grocery list to the dishes you wish to make, ensures you will have the ingredients on hand and enhances the chance that you will make dinner and/or lunch.
3. Adaptability allows for variety, substitutions and constant introduction of new recipes. 

My basics of meal planning:

• Ensure protein variety: I plan my main dishes according to the type of protein ensuring that no type is used more than 2 times in a week. For example I might have 2 fish, 1 chicken, 1 turkey, 1 beef, 1 vegetarian (beans, legumes, cheese) & 1 pork meal one week, and perhaps 1 fish, 2 chicken, 1 beef, & 2 vegetarian meals the next week. This can be adapted to your tastes. If you don't like vegetarian dishes add more of something else.
• Vary your main dishes: I personally like variety and I often try new recipes I find online or in cook books 1-2 times a week. Some are used again in the future depending on my family's reaction to them and others are a one time deal.
• Balance: I utilize MyPlate to ensure balance which incorporates your protein (1/4 of your plate), vegetables and fruits (1/2 of your plate), carbohydrate (1/4 plate most of which are whole grains) and a side of dairy. If one of my meals is lacking in any of these areas I catch it up during snacks.
• Snacking: Eat when hungry, but remember to stop when satisfied! As stated above, snacks incorporate any missing food groups from lack of presence at meals or, in the case of my toddler, refusal at meals. For instance if she eats only fruit and yogurt for breakfast I might offer a hard boiled egg, toast or dry cereal for a snack. If she refuses the vegetable at lunch she might get a frozen vegetable or hummus with fresh vegetables for her afternoon snack. 
• Have fun and incorporate themes: I'm blessed with a husband and daughter who really aren't that picky so trying new things is not only accepted but expected. One thing that can make things fun is an International night planning a meal from a certain country or region, holiday themed dinners or simply eating outside to mix it up. Make meals fun.
• Involve the family: Kids especially enjoy making decisions and are more likely to eat when they get to choose. My toddler often gets to pick from 2 dishes I'm considering. As she gets older she will be encouraged to supply ideas for the master list.

Vitamin D Supplementation

 

Registered Dietitian Recommendation: All breastfed infants should be supplemented with 400 IU Vitamin D daily. Supplements are to begin within the first weeks of life and no later than two months of age. All formula fed infants should likewise be supplemented if intake is less than 1 liter of Vitamin D fortified formula (7). Supplementation is to continue throughout the lifespan when dietary intake does not meet RDAs for age (400 IU 0-12 months; 600 IU 1-70 yr; 800 IU >70 yr) at latitudes higher than 33 degrees or when exposure to direct sunlight is restricted (3,5,6). Institutionalized and home bound elderly should be supplemented at 800 IU. Supplements should not exceed the RDA unless directed by a physician in instances with noted deficiency (6).

Vitamin D is a hot topic within current research, with suggested associations between adequate levels in the blood and prevention of cancer and autoimmune diseases such as Multiple Sclerosis and Diabetes (1,5,6,7). While it would be inaccurate to suppose that Vitamin D is the sole cause or cure of a specific disease, Vitamin D's benefits should be appreciated and care should be taken to obtain adequate dietary intake and/or exposure to the sun.
Listed below are the known and suspected benefits of adequate Vitamin D levels in the blood:
Known roles/benefits of Vitamin D in the Body:

1. Bone formation and maintenance (1,5,6,7)
2. Reduced risk of bone fractures particularly in the elderly (5)
3. Decreased risk of falls and increased lower extremity function (5)
4. Increased oral health (5)
5. Calcium regulation in the blood (1,5,6)
6. Cell specialization and regulation of cell growth/multiplication (1,5,6)
7. Decreased risk of Colorectal cancers (5)

Possible health benefits currently under investigation:

1. Decreased blood pressure (1,5,6)
2. Autoimmune protection against disease such as Multiple Sclerosis, Diabetes, Arthritis (1,5,6,7)
3. Increased immunity (1,5) and possible reduction in infectious diseases (6,7)
4. Increased insulin sensitivity (1,5,6)
5. Prevention of various cancers (6,7)

The number one source of Vitamin D is sunlight (1,2,6,7), which produces the vitamin within the skin according to need (1). As a protective feature, Vitamin D synthesis via the sun is inactivated within the human body when levels are adequate thus preventing toxicity from that route (1,6). Dark skin further aids in this protection by decreasing the rate of the sun's synthesis of vitamin D in populations characteristically located in parts of the world receiving more direct sunlight. Therefore, when someone of a darker skin tone moves to a higher latitude of increased distance from the equator (either North or South) they need 3-10 times more exposure to sunlight to synthesize adequate levels of Vitamin D (2,5, 6,7). During the winter months all populations in higher latitudes are at greater risk for deficiency as direct sunlight exposure decreases (5). Additional risk for deficiency arises as more time is spent indoors and sunscreen or other protective measures are utilized to decrease direct sunlight exposure during the summer. Of interest, sunscreen with a SPF of 30 will decrease Vitamin D synthesis from the sun by 95% (6). Risk factors other than limited sun exposure and dark skin, include obesity (4,5,6), residence at latitudes greater than 33 degrees (5,6) exclusively breastfed infants (7) and age (5,6).
Maintenance of Vitamin D via dietary intake is also becoming more difficult as consumption of natural sources such as milk and fatty fish (herring, salmon, tuna, sardines) is decreasing. Additional natural dietary sources include beef, egg yolks, cheese, butter and liver. Fortified sources may include yogurt, cheese, margarine, orange juice, bread and cereal depending on the manufacturer (1). When dietary intake fails to meet age specific Recommended Dietary Allowances (RDA) of 400 IU (0-12 mo), 600 IU (1-70 yr), 800 IU (>70 yr) at latitudes greater than 33 degrees or when exposure to direct sunlight is restricted (3,6) supplementation should be initiated to decrease risk of deficiency. It should be noted, that breast milk is not a good source of vitamin D with levels between 25-78 IU regardless of maternal supplementation. Therefore, exclusively breastfed infants should be supplemented with Vitamin D (7). Supplements should not exceed the RDA unless directed by a physician in instances with noted deficiency (6). In correlation with Vitamin D's role in bone health, deficiency is characterized by improper bone development in infants and children identified as Rickets and decreased bone density in adults known as osteomalacia (1,6).

Learn More
References:

1. Gropper SS, Smith JL, Groff JL. Advanced Nutrition and Human Metabolism. 5th ed. Belmont, CA: Wadsworth Cengage Learning; 2009.
2. Weishaar T, Vergili JM. Vitamin D status is a Biological Determinant of Health Disparities. J Acad Nutr Diet. 2013; 113 (5): 643-651.
3. Institute of Medicine Food and Nutrition Board. Dietary Reference Intakes for Calcium and Vitamin D. Washington, DC: National Academy Press; 2011.
4. Au LE, Rogers GT, Hariss SS, Dwyer JT, et al. Associations of vitamin D Intake with 25-Hydroxyvitamin D in overweight and Racially/Ethnically Diverse US Children. J Acad Nutr Diet. 2013; Article in Press. Accessed September 2, 2013.
5. Bischoff-Ferrari HA, Giovannucci E, Willett WC, Dietrich T, DawsonHughes B. Estimation of optimal serum concentrations of 25-hydroxyvitamin D for multiple health outcomes. Am J Clin Nutr. 2006;84(1):18-28.
6. Holick MF, Binkley NC, Bischoff-Ferrari HA, et al. Evaluation, treatment, and prevention of vitamin D deficiency: An Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2011;96(7):1911-1930.
7. Wagner CL, Greer FR. Prevention of Rickets and Vitamin D Deficiency in Infants, Children and Adolescents. Pediatrics. 2008; 112: 1142.

Optimal Sugar Intake

RD Recommendation: Added sugars are to be eaten in moderation not to exceed 5-10% of total dietary intake in order to assure consumption of essential nutrients and to help prevent chronic disease. The following are tips for maintaining appropriate sugar intake:

1. The 90/10 rule- eat healthy foods full of nutrients at least 90% of the time and eat treats or foods high in fat and sugar no more than 10% of the time. 
2. Save high sugar foods or treats for holiday celebrations and special occasions rather than general everyday use.
3. Drink only 100% juice and do not give to children until after the age of 1 (1,7).
4. Limit juice intake to 1/2 - 3/4 cup daily from age 1-7 years old and 1 - 1 1/2 cups daily from 7 years of age into adulthood (6,7). 
5. Omit or restrict to occasional use all other sugary beverages including soda pop, energy drinks and sports drinks (5,6,7). 

Sugar naturally obtained from a healthy diet (found in fruit, milk and grains) is sufficient to meet the body's needs for energy and for glucose essential in brain function (1). Additional sugar added to foods in production or at the table, provides no nutritional benefit and can displace essential nutrients for proper growth and development in children (1,4,7). The following childhood and adult health problems have also been linked to excess sugar intake:

1. Dental cavities (1,6)
2. Obesity (3,5)
3. Insulin resistance (3)
4. Heart disease (3)

​Sugar is an integral part of American society, and is often used at social gatherings and at holiday celebrations important for mental and social health. It is therefore important to accept a general practice of eating sugar in moderation rather than total elimination of all added sugars from our diets. Parents should teach their children by example that there is a time and place for sugar consumption rather than free daily intake, and they should provide healthy alternative treats (such as fruit) and drinks (including milk, small portions of 100% juice and water) for everyday use (7).

Learn More
References:

1. US Department of Agriculture, US Department of Health and Human Services. Dietary Guidelines for Americans, 2010. http://health.gov/dietaryguidelines/dga2010/dietaryguidelines2010.pdf. Accessed September 12,2013.
   
2. Briefel RR, Wilson A, Cabili C, Dodd AH. Reducing Calories and Added Sugars by Improving Children’s Beverage Choices. J Acad Nutr Diet. 2013;113:269-275.
   
3. Kosova EC, Auinger P, Bremer AA. The Relationships between Sugar-Sweetened Beverage Intake and Cardiometabolic Markers in Young Children. J Acad Nutr Diet. 2013;113:219-227.
   
4. Ruottinen S, Niinikoski H, Lagstro¨m H, et.al. High Sucrose Intake Is Associated With Poor Quality of Diet and Growth Between 13 Months and 9 Years of Age: The Special Turku Coronary Risk Factor Intervention Project. Pediatrics. 2008;121(6):1676-85.
   
5. DeBoer MD, Scharf RJ, Demmer RT. Sugar-Sweetened Beverages and Weight Gain in 2- to 5-Year-Old Children. Pediatrics. 2013; 132(3): 413-20.
   
6. Marshall TA, Levy SM, Broffitt B, Warren JJ, et al. Dental Caries and Beverage Consumption in Young Children. Pediatrics. 2003; 112(3): 184-191.
   
7. Gidding SS, Dennison BA, Birch LL, et.al. Dietary Recommendations for Children and Adolescents: A Guide for Practitioners. Pediatrics. 2006; 117(2):544-59.