Q&A with dietitian and nutritionist Jane Clarke about family nutrition - ANSWERS BACK

[RachelMumsnet]

We're running a Q&A about family nutrition with dietitian and nutritionist Jane Clarke. Jane last joined us for a webchat in February 2011 when she talked about the best diet for those with different medical conditions, the best foods to keep energy levels up and how to deal with children's fussy eating habits. We're offering you another chance to tap into Jane's expertise.

Jane Clarke, BSc (Honours) SRD, is Britains most trusted Nutritionist and a trained Cordon Bleu Chef. Her mission is to change peoples lives through the power of nourishment and she has pursued this ambition through her extensive writing, TV presenting, personal appearances, charity work and private practices, which she has run for over 15 years. Janes philosophy recognises that people want to hear what they can eat, not what they must avoid. Through her love of good food, and thanks to her skills as a chef, nutritionist and a dietician, Jane creates recipes that enable people to lead a better, healthier life  food thats good for the mind, body and soul. 
 
Whole Earth producers of natural and healthier foods, has teamed up with Jane Clarke to help families get their nutrition back on track and give everyone the chance to put their questions and concerns to an expert. Could a change in nutrition improve you or your childs mood and behaviour? Are you mistaking hunger for thirst? What foods keep your guts feeling healthy and functioning properly? Post your questions to her before the end of Monday 23rd September and we'll post Jane's answers back on 30th September.

If youd like to hear what Jane has to say on the subject of nutrition and put a question to her live on air you can also join a live webinar on Thurs 19th Sept @ 3pm. Alongside Whole Earth brand controller, Nikki French, Jane will be talking through her advice on issues such as breakfast-time and how to make snacks part of positive nutrition. To join this webinar and put a question to Jane please register here. Following the webinar Whole Earth be sending out jars of peanut butter samples to attendees.

This Q&A is sponsored by Whole Earth

[mignonette]

Thank you Jane and how time passes, cannot believe that Maya is eleven!

[fakeblondie]

Hello Jane,
I have very high blood pressure and mild stage 1 renal failure but at 43 this is not good.
my main problem diet wise is that I am a busy working mum of 4 and am finding it difficult to eat healthily myself.
I am not overweight ( well prob a few pounds ).

As a family I think we eat very well but low salt is not something I'm familiar with.
we tend to cook everything from fresh and I would really like to adapt our established foods rather than radically change.
could you advise me on staple foods to buy in which would be very low in salt to fit in with this at all ?
breakfast cereal or porridge
Packed lunch ideas pref easy to prepare
dinners primarily meat veg pasta we seem to start main meals with an onion lots of garlic a couple of tins of tomatoes and add meat accordingly to make chilli or bolognase ect.
I'm also struggling to understand the food labelling ?
Is meat ok ?
bread ?
We Don't add salt to anything and steer clear of tinned baked beans now which is a shame because beans on toast was my emergency meal every week !
I would really appreciate any pointers and thank you.

[ButteryJam]

Thank you jane!

[DoItTooJulia]

It's great that Jane answered my question. She recommends I read a child's nutrition text book....is there anyway you could find out a couple that she recommends....there are just so many!

[HeatherMumsnet]

Jane's answers are now posted. Thanks to everyone who participated.

[JaneClarke1192]

@mignonette

Hi Jane,

I still make your fish fingers w/ oat and rye crust that was first published in the Observer Interview w/ you in which you also talked about your gorgeous Daughter.

The recipe is amazing and open to experimentation w/ other ingredients too such as the spice Achiote which mixed into cornmeal and rye, makes a fabulous tasting crust too. Your recipes are very flexible.

Your book 'Yummy Baby' was great for small children. Have you thought of writing a nutritional 'field guide' for 'owners' of teenagers? it could accompany them when they go off to university or leave home too....

Thank you for your lovely question. I definitely will think about the field guide - it’s a great idea. Can you believe my daughter Maya, who still loves the fish fingers is now 11!

With regards to your husband’s daughter, all you can continue to do is to continue encouraging her to see her GP. Perhaps you might like to buy her a nutritional book that has some inspiring things she can try without overwhelming her if she’s feeling out of sorts.

As an additional thought, how about stocking her freezer up with your delicious home made things - she won’t be able to resist I’m sure!

[JaneClarke1192]

@TravelinColour

Hello Jane
How can I stop certain foods being seen as a 'treat' 'reward' etc by my son and help him see them as things it is good to only eat occasionally. I really dislike the rigid Good / Bad labelling of food. I also worry that schools are very behind on nutrition science and that I will be giving conflicting information to him (e.g on saturated fat).

I think you can but lead by example and come up with the treats every so often. I agree that the labelling is far from constructive at times, as this does encourage children to think they either should be eating lots of them, or steering well clear of, but it sadly is what we have at the moment. I’m sure you will do a great job as a parent, and with the School Dinners project I worked on with Jamie Oliver, which is still an enormously powerful and proactive campaign, and the amazing Leon team-led initiatives, we will get things right in schools. But you as his parent will instil, I’m sure, many of the great messages into him.

[JaneClarke1192]

@GeordieCherry

What could bf mothers eat more/less of to support their babies round immunisation time? Thanks

There isn’t anything specific around this time, as the issue is that an immunisation is when a small amount of a foreign body is introduced to your child at the right time, so that they can develop an appropriate immune response to. By eating a wonderful and overall nourishing diet, full of all the classic nutrients you will help them do this, but there isn’t anything specific to avoid.

[JaneClarke1192]

@ButteryJam

My DD has silent reflux and I am exclusively breastfeeding her, she's 3 months. What should I avoid in my diet?

Also, I've heard cow's milk has hormones in them that are not good for you. Is organic cows milk free of them? I think cows milk upsets my tummy a bit but I love it!

I suggest that you keep a diary of what you’re eating. Note down yours and your little one’s tummy and reflux problems, as this may well show specific things which are causing upset. It may be things like garlic, onions or citrus fruit.

As for the milk question, ordinary cow’s milk is completely fine for you, unless you find that it upsets you, in which case possibly think about also having other non-dairy milks as part of your diet, such as almond, hemp or coconut milk, as it may be that cutting down on the amount of the cow’s milk may help ease your symptoms.

[JaneClarke1192]

@smearedinfood

After reading the BMA report on children, I got totally freaked about iron levels for my 3 year old. He does veggies, fruit, fish and carbs, dairy. Quite against sauces. Not a fan of meat. (i was just like this as a child and was diagnosed with very low iron levels when i hit puberty).

Tips please on how to get more iron rich foods into my toddlers diet pretty please.

Delighted! You can make soups with great iron-rich dark green leaves – such as spinach soup, based on a good home made stock – and classics, such as spinach and feta pies, in which you can swap the spinach with other dark green, iron-rich vegetables, such as chard, kale, etc.

Eggs are also a source of iron, which opens the door to quiches, soufflés, an egg on toast for tea or a simple pasta dish with egg and spinach. Dried apricots contain some iron too, but watch that they don’t give tummy ache, perhaps try just a few and better still soak them and then have as a pudding with some yoghurt, or chopped finely and put into salads and dishes, such as couscous.

[JaneClarke1192]

@noblegiraffe

Hi Jane, my son has just started school and is having packed lunches. I'd like to put in a carton of fruit juice or a smoothie but the news lately is that these are as full of sugar as a can of coke and bad for you.

Is sugar from fruit so bad for you that we should be avoiding fruit/fruit juices in our and our children's diet? The 5 a day message, and a carton of juice being 'one of your 5 a day' suggests that it's healthy!

Having a small carton of fruit juice is completely fine. The detail behind the news story is that people have been consuming vast quantities of them, thinking that they’re harmless, when in reality too much isn’t good for us. A carton, or small tetra pack, each day is fine, just encourage him to drink plenty of water to hydrate too.

Another option would be to put the juice in a good sealed drink bottle and dilute with some water as this is more economical and keeps the fruit sugar levels down. This is what I do and it can make a big difference.

[JaneClarke1192]

@VerySmallSqueak

I have changed recently to organic skimmed milk. Our diet is mainly non- organic because of cost but I try to shop organic as much as I am able.

What would you recommend as being the more important things to consider buying organic if someone wishes to be as organic as possible but has to be selective?

I agree that choosing organic milk is something to do if you can, but although I am a huge fan of some very good organic producers, it’s not always necessary. You can get some amazing non-organic produce too. It’s very much a personal thing, but perhaps having some assurance when it comes to meat, poultry, dairy foods would sit most comfortably with you and use other ingredients, such as pulses, beans and wholegrain to make the organic ingredients go further money-wise and provide more stomach satisfaction.

I use organic chicken but would then serve with loads of vegetables to make the meal stretch and also, if using cold left over chicken, I would make something like rissoles by adding chickpeas and fresh herbs.

[JaneClarke1192]

@stillstanding29

Hi Jane - Do you have any ideas for snacks for teenage boys after school? My boys are absolutely starving when they get in at about 4 and can eat a whole pack of biscuits etc each. They are 6ft and sporty and muscly and not overweight at all. But what would be better for them and maybe stop them crashing out on the sofa as the rubbish energy from the carbs whizzes in and out of their systems? Hope that makes some sense.

How about something nutritious, yet quick to make, such as Whole Earth peanut butter on wholegrain toast or a big bowl of homemade soup – you can keep a stash of soup in the fridge, so that they can literally grab what they want and it only needs heating up.

A sandwich made with wholegrain bread and something lean, like cold roast chicken or lean ham would be another option.

Make sure they have plenty of water as often the hunger is exacerbated by being overly thirsty. Another idea would be to have some cold pasta in the fridge, simply drizzled with olive oil and a little cheese, from which they can have a small bowl to fill their stomachs, before they have their main meal later on. You might also try just having a lean ham or roast chicken cold in the fridge for them to attack!

[JaneClarke1192]

@Pagwatch

Hi Jane
My question is very specific.
My DD is just turned 11
She is very sporty and eats well but I struggle with her schedule
On two days a week she finishes school but goes straight to the school gym team for two hours training. I then pick her up (at 6.00pm) and drive her to the swimming pool where she swims with the club from 6.45 until 9.05
At the moment she gets a sandwich and fruit between gym and swimming and something hot in a flask or at home before bed. The problem is she struggles to eat between the two sessions and is too tired afterwards.

What can I give her? Would a protein shake help?
Thanks

Luckily it’s not every night as on the other evenings you will be able to get her back into a better state. This is a classic problem with children who do sports clubs after school, especially those which run on so late. If you are managing a great sandwich made with wholegrain bread, filled with a good lean protein, some soup afterwards and a fruit hit then she is getting a good selection of nutrients on those two evenings.

I wonder if her spots are largely hormone related. You could try her on some really good aloe-vera juice, as this may well help the skin, as could an omega 3 supplement.

I wouldn’t suggest a protein shake, as they are commonly just full of cheap protein and you’d be better having a homemade smoothie, perhaps made with some added almond milk.

[JaneClarke1192]

@MacNCheese

There is alot of talk about 'cheap meat' being bad for our children.
Why? I thought offal was good for you.

Offal can be good for you. It’s rich in iron and a good source of protein and B vitamins, but the issue is that with some cheap meat, it’s not the lean offal which is added; it can be all sorts of parts from the carcass that are used, which can be high in fat and also the wrong sort of fat.

[JaneClarke1192]

@DoItTooJulia

Hi,

We are vegetarian and I wonder how much protein I should be giving my 8 year old son and 10 month old son?

And should they be taking vitamin supplements?

This may sound a simple question to ask, but it’s a complex issue to address. I would suggest you look at a children’s nutrition book, as you will see that there are several very important things to check up on – not just the protein – such as iron, and the right balance of fats. I’m sorry not to be more help, but it’s not a question of a figure, it’s about getting the overall balance right.

And should they be taking vitamin supplements? You may need to give them something, but again, check out the text books and then seek professional advice.

[JaneClarke1192]

@MajesticWhine

My children (aged 13 and 11) often say that they don't want breakfast and that they don't feel hungry at breakfast time. I sympathise because it is quite early, they leave at 7:30 or earlier, and they are usually in a rush, but I feel it is so important to have some breakfast before school so they can concentrate through the morning. I can usually persuade them to have an innocent smoothie or a yoghurt drink. Can you make any suggestions for a nutritious home-made smoothie / milkshake or similar that I could make for them? Thanks.

Smoothies are the easiest thing to make. By simply adding fruit to the blender, alongside yoghurt and all nourishing things such as ground almonds, milks and oats you can have some real fun mixing the wide variety of fresh and frozen fruits together. Let them create recipes at the weekend, but I would put some yoghurt in them, as this will help slow down the absorption of the sugars from the fruits. You could also make some homemade wholegrain-based biscuits, or a great (not too high in sugar) homemade flapjack with some dried fruits in them to eat in the car or on the bus.

Sitting, even if it’s just for ten minutes together, however early in the morning can be an invaluable moment to share as a family.

[JaneClarke1192]

@violetwellies

I think DP may have IBS or something similar, he works long hours on rotating shifts, he's not over keen on meat or processed foods and has the most horrendous (flatulence, diarrhoea) tummy if I feed him lots of pulses, or 'winter' soup. Suggestions for pack ups, or family meals that fussy DS (2) will also eat would be wonderful. Im dairy intolerant so I do a lot of vegan cooking (parp)

The first thing I would try is to give him a good probiotic supplement, as this should help to relieve some of the wind issue – there are some good ones out there from trusted brands. It may take a few weeks, but it should start to reduce. I wonder if you’d be better off for now staying away from the wind producing vegetables, such as the cauliflower, broccoli, artichokes and too many of the lentils and beans, just whilst the gut calms down a bit.

It’s worth him keeping a food and symptom diary to see if, after a week or so, you can identify any particular triggers. Shift work doesn’t help, but if things don’t ease, he should see a doctor to check that there isn’t anything medical which should be done to help.

[JaneClarke1192]

@jellyfl00d

My DS has had bad reflux disease since birth (now medicated quite well), he is quite a fussy eater, likes interesting flavours but his problem is textures and veg and some fruit. He also has issues with things he perceives as too hot or too cold eg ice cream.
What advice can you offer?
Also he is dark rings under his eyes, he gets enough sleep, could he be nutritionally deficient in something?
Thanks

Regarding the dark rings under the eyes, the one thing to check out is whether he is deficient in iron, as this can give this symptom – a simple blood test at the GP can find this out.

With the reflux, he probably has built up fear as reflux is so unpleasant, so I would suggest that you try the classic ‘reward chart’, but for him to only manage small amounts of the new or feared food, as soon he will start to build up confidence, as will you. His diet doesn’t sound too limiting, but I would suggest you reward him for trying new things and he will, if the reflux is continuing to be controlled, (and hopefully he may, as many do grow out of it), soon branch out more.

It would be worth steering away from the citrus fruits if he’s not used to them, as they are most likely to aggravate.

[JaneClarke1192]

@PenguinBear

One of my DDs is very fussy and particular with food. She knows what she doesn't like but can't think of much she does. She has a few favourite meals such as Lasange and moussaka, but I can't cook these 24/7 as I worry about her red meat consumption.
I do not have a good relationship with food myself (I had bulimia as a teenager and food is still very much an issue for me - although I try not to show this Infront of the children).

Any advice on getting us back on track? She is reluctant to try new things (or if she does, still doesn't like it).

This is a hard question to cover online, as there are so many components to helping you both. I suspect that she may be picking up some of your unease, which isn’t a point of blame in any way, but they have incredibly in-tune antennae!

I wonder as a first step, if going to some delicious farmers markets would be a good idea. The food will be wonderfully laid out and there would be little things to try, or maybe take her to a fantastic cheese shop, where they will let you try little morsels of cheese. There are great food magazines too as well as the recipe books, which you could take some time to flick through and find something you can cook together.

Ideally you could find something you would both be comfortable trying – this would be a good step forward. I’d be delighted to see you in my practice, as it may be you need some more practical and specific help.

[JaneClarke1192]

@Calypso2

Hi Jane, I used to read your column in The Observer every week. My question is also about teenagers. My daughter is going through puberty but is a very fussy eater. At home she eats some meat, some fish, eggs, cheese, milk, rice, couscous, noodles and 2 varieties of vegetables (although I make sure she has some everyday). No fruit although she drinks lots of fruit juice. At school she seems to have chicken and rice everyday.

The problem now is that she goes out a lot at weekends and during school holidays etc and so I'm unable to monitor what she eats as much as when she was younger, though I know there's a fair bit of fast food seems to get eaten. Do you have any advice on how I can ensure she has a suitable diet for her age (14). Would you recommend that she takes supplements?

I’m glad you used to enjoy the columns – I loved writing them!

Teenage years can be very tricky, as you’re finding. One thing to point out first is that although she drinks fruit juice I don’t think this shouldn’t be seen as a good substitute for eating fresh fruit, as there isn’t the fibre there and there can be an awful lot of sugar in them.

On the fruit side, there must be something she loves. If she likes the juices you could try to get her to make a homemade smoothie, or to add some of the fruits, such as the berries, to yoghurt etc.

I suspect that whilst she is away she won’t be gleaning much nourishment from the fast food, but I bet she will soon kick into the ‘I’m going to be really good about what I eat’ phase, especially if she sees you eating well. There is probably going to be a moment when a symptom, such as poor skin or PMS, will lead to a conversation when perhaps you can persuade her to look at what she is putting inside her body as it can, as you know from my columns, make an enormous difference.

There also wouldn’t be any harm in her taking a good-quality multivitamin and mineral supplement, as peace of mind for you whilst she pushes her way through this stage.

[JaneClarke1192]

@Leviticus

Hi Jane. My 2.5 yo DS won't drink milk. He eats cheese and yoghurt but I worry he isn't getting enough calcium. Is it a problem? Should I be making sure he has a set amount of other dairy every day or can I relax about it?

If your son won’t drink milk, try as you are doing to ensure he has the other dairy sources in his diet. It’s too hard to come up with a set amount per se, but perhaps use milk in sauces, such as delicious cauliflower cheese or lasagnes where the béchamel sauce contains a lot of milk. It is incredibly important to glean enough calcium from the diet at this young age, as this is the time when they lay down their strong bones. The non-dairy sources of calcium are of course small boned fish like sardines, which can be delicious mashed on toast.

[JaneClarke1192]

@busymummy10

Hi Jane, my DD is 3. After turning 1 she became a real fussy eater. I manage to get veg down her but only when it is in disguise ie. minced up. She helps me cook and knows there is veg in her food but when she sees it whole in her food mixed up or as a side she refuses to try it. She really only likes dry food, mostly foods that have no colour. I have tried a rewards system ie. bubble bath if she eats all her dinner etc and a prize if she tries something new but this is not working for anything with sauces, soup, lots of colour etc. do you have any ideas? She has lunch at nursery but will not eat the proper meal. This means she has pasta without the sauce with some chees, or jacket potato without the baked beans, or veg shepherds pie without the filling?!! And absolutely no pudding which is the best part!! Help

This must be really tough but I think at the age of three there is still time for the habits and the ‘reward chart’ to work. I just wonder if you need to hold a bit of a tough stance for a while and say that she needs to eat what’s put in front of her, otherwise there isn’t anything else to eat. There will be screams and a few hungry hours but I think a little pain for you in dealing with this will reap rewards in the long run. It will also help if you eat with her as much as possible, so that she sees there is a social element of reward for eating well. I wish you all the luck!

[JaneClarke1192]

@sharond101

My DS is 16mo and only eats fruit and vegetables if it's pureed into his meal. He will eat everything else as finger foods but refuses every kind of fruit and vegetable except raisins and prunes. I am wasting so much (expensive) food offering it to him every time and having him pick it up and drop it or squeeze it but not actually eat it. Sometimes he puts it to his mouth but mostly I think the texture he feels in his hands puts him off. Any ideas??

I think that although living with this day-in day-out can feel like a lifetime especially as if you’re not getting anywhere, but stick with it and I will be very surprised if you aren’t any further forward in a few months’ time.

It can be heart-breaking and exhausting introducing new textures and foods, but firstly reward him, even if he puts a little in his mouth, by using a verbal praise, and secondly, try as much as you can to sit with him and eat the same foods so that he is more likely to copy.

The easiest thing is to give up and just give him the foods he will eat, but stick to your guns and he will soon realise that he needs to eat what’s put in front of him. With the practical point, I would really use your freezer well and make batches of things so that you don’t end up throwing good food away.

Throughout all the years of treating little ones who go through a phase of fussy eating, the thing which usually helps turn the corner is when you as the parent hold a steady nerve and show them that by eating the same foods as you, happiness all around is achieved. As an aside to the nutritional value of cooked and textured foods verses raw, cooked vegetables can provide some very useful vitamin C and indeed other useful vitamins, such as beta carotene, so this is another reason for parents to persevere and try to get some cooked, as well as raw vegetables inside your child.