Difference between revisions of "Diet"

Revision as of 12:50, 17 April 2007

From my reading of late and my old country doctor's advice, we have this quote, "Eat breakfast like a KING, lunch like a PRINCE, and supper like a PAUPER." This is in reverse of the typical American order of things but it makes so much sense. Add that to my further reading that recommended breakfast be protein-dense, lunch a little less so, and supper be carb-dense. The rationale is that the carbs raise metabolism during sleep and help burn off fat, plus carbs help you sleep better. That improved sleep will cause less food-cravings during the day and thus help control weight. The slower-burning protein coming from breakfast and later at lunch will release energy during the day when we need it most. So, you combine the "when" and the "what" of eating to get better results.

This makes so much sense to me and is sure worth a try. We have found that a light supper works best with Erin when we are trying to lose/maintain weight and adding the carb-dense foods may help that happen even easier.

Sample Diet #1

This is a sample of Kian's diet. We are always tweaking it.

For breakfast: 2 omega-3 eggs scrambled in canola oil, half a banana, a few sips of skim milk

lunch: Stonyfield fat free yogurt, a couple of tablespoons of lentil soup, a few sips of skim milk

dinner: Stonyfield fat free yogurt and some strawberries and a few sips of skim milk (our dinner would be a dark green salad with vinaigrette, baked salmon, and strawberries)

Kian drinks a lot of water throughout the day. He doesn't really snack, except maybe bananas. At this point he shows no interest in food. Any snacking he does is really related to our eating. So, anything we happen to be eating as a snack we offer him (fruit, popcorn, yogurt). We offer him whatever we eat for dinner at well, but he is not a big salad eater and professes to be a vegetarian.

Kian also gets 1/2 g of fish oil in the morning and 1/2 gram of fish oil at night. Kian is 2 1/2 and is 50th percentile for height and 50th percentile for weight.

Sample Diet #2

Here are some of the foods that would work for us.

Breakfast: turkey bacon, eggs/egg-beaters, high-protein/high-fiber Kashi cereal, cheese (once a week only), tofu-based sausage (Boca, etc.)--plus some fruit

Lunch: almond butter on fiber crackers, turkey on triscuits, peanut butter on apples or high-fiber waffles--these plus fruit and/or vegetables

Supper: Fruit and vegetables, brown rice, high fiber cereal, oatmeal, brown-rice pasta, potatoes (yukon gold, usually), sweet potatoes...I still add some protein for supper, just not much, because even though I want to help with sleep, I am still concerned about avoiding blood sugar spikes.

I'm sure there are a zillion other combinations, but these are what came to mind first.

What we've seen so far....We've been doing this for only a few days and we're coming out of a sinus infection so she hasn't been feeling so good, but I can clearly see that her sleep is better. She woke up a couple of days ago and said, "Wow, Mom! That was the best sleep I have ever had. No bad dreams. I feel refreshed!" (That's the old soul in her coming out with the "I feel refreshed!") She falls asleep quicker than usual, and that's saying something since she's always fallen asleep quickly. The other thing I notice is that she is sleeping more soundly. I check on her a couple of times before I go to bed and before, as soon as I walk in her room, she would often wake up, sit up and kiss me, then go back to sleep. Now, I can walk in, straighten her covers, stumble over her shoes, etc., and she still sleeps.

I haven't checked her weight this week (bad PWS mom!) but I will this weekend and see how that has gone. We haven't had good experiences with carbs to date so maybe I'm avoiding this part of it. :) I'll let you know how it goes.

So far, I like what I see in terms of sleep at night. What I am watching for is sleepiness during the day. She has been using a decongestant because of this lousy sinus infection and that makes anybody sleepy. I've noticed her being a little draggy during the day so now that we are off of the meds and trying to wash them out of her system, I'll be watching her energy level closely during the day, also any changes in hunger patterns. More news at 10....

Incorporating flax

You can also buy cinnamon flavored flaxseed oil, which I like. I put it on toast in the mornings for my breakfast. My second born also liked it that way and had it as breakfast for years. Then she decided it was yucky. ;-)

We do heavy protein (2 omega eggs) with Kian in the morning.

One alternative to flaxseed oil is ground flax meal. This must also be kept refrigerated. We put this in Kian's yogurt and he likes to mix it. Plus, you can bake with it and substitute out a lot of other fat when baking. I do this with banana bread on special occasions and the kids like it. Kids at school like it as well. They have no idea how healthy their birthday treat is!

Oh, and one other thing. In Chicago we can buy yummy Natural Ovens breads that are baked with flax meal and have high flax content. We can also get flax meal frozen waffles. Both of these are very popular at my house.

Importance of Protein

Yesterday we had a pretty horrible experience that we are trying to learn from. Kian’s BMI is 50th percentile and we don’t really limit his portions, but we do control the food we put in front of him. Typically we feed him something like:

Wake up: ½ banana Breakfast: egg scrambled in canola oil, ½ cup skim milk, ¼ cup homemade brown rice pudding Snack: handful of cheerios and a few sips of milk Lunch: hard boiled egg, ½ cup fat free yogurt, ¼ cup vegetable soup, ½ cup skim milk Snack: ½ banana Dinner: ½ cup fat free yogurt, ½ cup brown rice, few bites of fruit, few bites of meat, 1 cup skim milk

Yesterday we ran out of eggs for the first time in maybe 2 years and we fed him:

Wake up: ½ banana Breakfast: few bites of skim milk yogurt, ½ piece of whole wheat toast, 1 cup skim milk with a bit of chocolate Snack: ½ cup of dried blueberries Lunch: ¼ cup cottage cheese, couple of bites of peas

At no point did we limit what he ate (other than when he intentionally spilled the rest of his dried blueberries allover the back seat of the car!). In other words, he chose when to finish those meals and there were things on his plate that we gave him that he chose not to eat (fruit, hard boiled eggs, turkey). I would also note that he was a bit snuffly and he had some GI thing going on (diarrhea).

!t 2:00 (1 ½ hours after lunch) he had his first (ever in his life) huge temper tantrum, yelling over and over that he needed to eat and that he was hungry, really hungry and that he wanted food. We gave him a banana. He inhaled it and continued to scream that he was hungry, really hungry.

What made this worse was that we were meeting with our endo at the time. Kian was sweet and compliant and funny through 3 nurses and one resident. Then Dr. Carrel walked in and within 5 minutes Kian was a different boy. It was bizarre and scary and a bit embarrassing since we had just told 5 people that Kian doesn’t have hyperphagia. Unfortunately, Dr. Carrel saw Kian as the “typical” kid with PWS with behavior problems, and perseverance and hunger.

We drove Kian home (3 hours). During this time, he was either complaining of hunger or eating or sleeping. On the way home we stopped by the grocery store and bought eggs and I immediately made him two scrambled eggs. He had that and ½ cup apple sauce and a few bites of skim yogurt for an early dinner. He was very happy with dinner and said yum a couple of times during it. After dinner he was our regular little boy.

Of course, this could be the beginning of a life of behavioral problems and hunger. But, pushing those fears aside and concentrating on what is in front of us, I wonder, if maybe the behavior/hunger may be the result of the difference in his diet. Typically, his diet is relatively high protein and low carb. Yesterday he was high carb/sugar and low protein, I know that Rachel and others have commented that their kids have had problems with carbohydrates before, but yesterday was shocking to me.

Oneida has notes here: http://www.pwsdots.org/ResearchNotes/ModifiedProtein-sparingFasting

And she highlighted this old abstract for me yesterday that I pasted below. Anyone else have anything to add to these observations? One more thought. I do not think that this emphasis on protein is commonly discussed. If I remember the red, yellow, green diet correctly, the emphasis is more on calories and what kids can’t have, not on what kids should have. I am wondering if anyone else has noticed what I have noticed. If so, do you think that some of our observations warrant more research and/or a paradigm shift?

N Engl J Med. 1977 Apr 7. Metabolic aspects of a protein-sparing modified fast in the dietary management of Prader-Willi obesity. Bistrian BR, Blackburn GL, Stanbury JB. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?itool=abstractplus&db=pubmed&cmd=Retrieve&dopt=abstractplus&list_uids=840278

Four adolescents or young adults with the Prader-Willi syndrome (hypotonia, mental retardation, hypogonadism and obesity) received a protein-sparing modified fast consisting of 1.5 g of meat protein per kilogram of ideal body weight and meeting vitamin, mineral and fluid requirements. Evaluation of nitrogen and energy metabolism revealed the development of starvation ketosis and a positive nitrogen balance. Serial whole-body potassium measurements in two patients confirmed preservation of lean tissue despite continuing loss of weight. Clinical diabetes mellitus in two subjects was rapidly ameliorated by the regimen. Short-term weight loss greater than 18 kg occurred in three of the four subjects, and reduced weight persisted during observation periods of 26 to 44 months. This degree of outpatient diet adherence by mentally deficient subjects, who do not normally experience satiety, suggests that hunger is eliminated or at least reduced by modified, protein-sparing fasting.

Snacks

One think that we all know is that our children are members of a family and we need to nourish them while at the same time working within a framework that supports our entire family. Oneida has a lot of great thoughts on this and I listen a lot to her as well to our pediatric nutritionist Melanie Silverman (www.feedingphilosophies.com).

So, as near as I can tell, a snack should be protein and fat and maybe a little bit of high fiber carbs. Hmmm… Tough enough if you are an adult, even tougher if you are a little kid living in a Goldfish society. So, I am going to start off a list. Can others add to it, and or tell me why some of these are bad ideas? BTW, my little boy won't eat meat. I would think that a bite or two of chicken or turkey would be a good snack for most kids.

Good snacks for our kids: Hard boiled eggs Beans dribbled with olive oil Handful of walnuts Avocado Homemade trail mix made with various nuts and a sprinkling of dried coconut and small amounts of dried fruit Pemmican

Special diets

Some parents have luck with casein-free diets and gluten-free diets. These are described in detail on Healing Thresholds.