“A lot of times the students are receiving a lot of their meals at school but in the summer months that primarily falls on the parent,” said Maya Rashad, nutrition program coordinator at Cook Children’s Health Care System.

According to data from the Cook Children’s Center for Community Health 2024 Community Health Needs Assessment, about 390,100 children from birth to 17 years old live in households that sometimes or often couldn’t afford nutritious meals. 

To help address those needs Cook Children’s Health Care System's Nourishing Communities program partners with R.E.D. Mobile Market, the Good for You Healthy Hub, and other Texas Health Resources Healthy Hubs to fight food insecurity and continue expanding community partnerships.

Free Summer Meals for Kids

Healthy breakfast, lunch, or to-go meals are available to children 18 and under all summer long.

• Fort Worth ISD Summer Food Program: Schedules and school locations
• USDA Summer Meals Site Finder: Find local distribution sites near you

“Healthy diet is the foundation of a healthy life,” said Rashad.

To put those words into action, Rashad hosts cooking classes twice a week at the Las Vegas Trail Neighborhood Health Center focusing on eating healthy while on a budget.

Lily Han, M.D., a pediatrician at Cook Children’s Windhaven and Rashad share practical tips families can use to stay healthy during the summer without breaking the bank.

“The summer is a great time to introduce new fresh, colorful and fun foods,” said Dr. Han.   

 One key strategy is choosing seasonal produce. Look for fruits and vegetables at their peak, like berries, avocados, watermelons and tomatoes.

Balancing Energy and Hydration

Nutrition during the hot summer months is also about maintaining proper hydration. With children constantly on the move between sports clinics, day camps, pool days and play dates, structured eating can easily slide.

Dr. Han said it is important for families to aim for three meals a day and two to three snacks to keep energy levels stable.

“Keep in mind you are fueling for both energy and hydration,” said Dr. Han.

Experts recommend keeping easy, ready-to-eat items on hand to curb hunger, stabilize blood sugar levels and provide sustained energy throughout long days of play.

Smart on-the-go snack options include:

• Trail mix
• Nut butter and whole grain crackers
• Frozen yogurt tubes
• Veggie sticks and fresh fruit
• Granola and cheese sticks

Related Stories:

• Texas Summer Safety for Kids: Hydration, Heat Illness Signs and Sun Protection Tips
• Bridging the Gap: How Cook Children’s Health Plan is Transforming Las Vegas Trail
• From Our Kitchen to Yours: Inside the Demonstration Kitchen at the new neighborhood health center serving the Las Vegas Trail Area

For the last week, Cook Children’s Center for Community Health provided mindfulness games and stress-relief techniques for kids, job training and oral health tips with free dental-care kits and cavity-prevention demostrations. KERA shared their family resources with children and parents. JPS shared QPR training, workforce development and lactation education. Friday focused on vehicle safety with Cook Children’s Center for Community Health, JPS Community Outreach & Education and JPS Trauma Injury Prevention. There was booster seat education and sign-ups for free car seat checks, car seat education and installation with a certified child passenger safety technician and motor vehicle crash prevention.

Thank you to everyone who joined us for these past 30 days! Keep an eye out for more events to come in the future!

This fourth week of our 30 Days of Wellness events at the neighborhood health center in Las Vegas Trail was full of fun!

Cook Children’s Center for Community Health shared activity dice games and easy 5210+ lessons. JPS stopped by to give lactation education and a behavioral health overview. Cook Children’s, JPS Health Network, TCC, and Workforce Solutions provided on-site job training information, registration, and answered any questions. The Demo Kitchen held its second nutrition class with practical meal ideas for picky eaters and growing appetites. We had more guided walk-throughs of the facility for local agencies to learn how to collaborate for community care. The week ended with JPS’s Connection Program Engagement and Cook Children’s Health Plan Engagement Table.

We had lots of smiling faces at our third week of our 30 Days of Wellness events at the neighborhood health center in Las Vegas Trail!

To kick off the week, The Parenting Center shared tips on discipline, positive communication and stress management while KERA Family Resources offered their services for kids and parents. JPS Connections program explained their financial resources and JPS Women’s Services provided support for breastfeeding families. The American Heart Association stopped by with lifestyle coaching to prevent or manage type 2 diabetes. Cook Children’s Center for Community Health brought fun fitness stations for every age and ability. Wednesday focused on poison prevention with Cook Children’s Center for Community Health and poison education with North Texas Poison Center. Jacob’s Journey stopped by to distribute naloxone as well. The Demonstration Kitchen hosted its first infant nutrition class alongside Mother’s Milk Bank.

The week wrapped up with CHAMP Texas having peer-led discussions and referral information. Cook Children’s, JPS Health Network, TCC, and Workforce Solutions had on-site job training information, registration, and answered questions. JPS Community Outreach provided information on behavioral health service lines, programs, and clinic locations. Cook Children’s Center for Community Health had several nutrition booths providing information on growing healthy foods, making healthy snacks, and promoting healthy development in your family.

We loved having our second week of our 30 Days of Wellness events at the neighborhood health center in Las Vegas Trail! It was the first full week of events and we were thrilled to see so many new faces stop by.

To celebrate the first week of school, the NHC Demo Kitchen invited kids to create quick, nutritious treats they can make at home for an after school snack. Cook Children’s Center for Community Health had multiple events throughout the week covering various topics such as asthma action plan basics for kids, safe sleep education, infant resources and parenting tools for communication, routines and resilience. JPS also hosted several events about their Connection Program, behavioral health services, diabetes education as well as lactation education. My Health My Resources (MHMR)  shared early-childhood development screening and support referrals. Lastly, Cook Children’s had art projects that teach kids to identify and express emotions and support coping skills.

This week kicked off the first few days of our 30 Days of Wellness events at the neighborhood health center in Las Vegas Trail! Volunteers from the Parent Pass phone app stopped by to explain how to navigate the app and share about all the local events and opportunities in the area. Cook Children’s Center for Community Health’s “Aim for Safety” initiative leaders and the JPS Trauma department shared hands-on firearm safety knowledge and safe storage resources. The Fort Worth Police Department demonstrated child-proofing essentials and gave tips to secure your home. It was a successful first three days and we are looking forward to more!

Join us for a full month of free wellness activities, education and family-friendly celebrations designed to help our community thrive. Every weekday (Aug. 6 - Sept. 5), you’ll find hands-on demos, health screenings, safety workshops, nutrition classes and more, all hosted by Cook Children’s and trusted local partners. No registration is required unless noted.

When: Aug. 6 – Sept. 5, 2025
Where: The neighborhood health center in Las Vegas Trail
2800 S. Cherry Lane, Suite 100
Fort Worth, TX 76116

CCHP joined forces with the Tarrant Area Food Bank, Arlington Independent School District (AISD), and the American Heart Association at a three-day event held at AISD Food and Nutrition Services from May 6 - 8. The partnership event, which was a first for the organizations, served as a one-stop hub, offering families application assistance for programs like Medicaid and SNAP (Supplemental Nutrition Assistance Program), as well as education and resources focused on healthy living.

For CCHP, the focus on nutrition during Texas Health and Human Services’ Healthy Texan Week underscores a fundamental belief that access to nutritious food is a cornerstone of good health.

"Cook Children’s Health Plan is more than just a Medicaid provider. We live in the community we serve and know first-hand the struggles families face,” said Blanca Rodriguez, manager of Community Marketing Department of Member Services at CCHP. “Food insecurity is a significant challenge in North Texas, and we are dedicated to finding innovative ways to support families in accessing the healthy food they need."

Addressing food security is not new for CCHP. In 2023, the health plan funded the R.E.D. Mobile grocery store (Resource and Education Delivered), a truck that brings free, nutritious food directly to underserved neighborhoods in Denton, Wise, and Cooke Counties. A similar truck, known as the R.E.D. Bus, was also parked at the event this week in Arlington.

As Eleanor Rakestaw, director of community resources at TAFB, explains, the R.E.D. initiative goes beyond simply handing out groceries.

“Our primary goal for the R.E.D. Bus is to provide education, resources, and assist with SNAP applications, so that we can help families purchase their own food and groceries in the future,” said Rakestaw. “It’s about empowering the people we serve to achieve long-term food security.”

For Cook Children's Health Care System as a whole, the link between food access and health is a major focus. Earlier this year, Cook Children’s Center for Community Health announced its funding of the new Healthy Food Hub at the Eastside YMCA in Fort Worth.

“We’re grateful to collaborate with other community organizations to keep hearts and bodies healthy,” said Hilda Colunga, Community Impact Director at the American Heart Association in North Texas. “Providing healthy recipes and nutrition resources aligns with our mission to improve cardiovascular and overall health and well-being of everyone everywhere.”

This week’s events in Arlington are a key example of how CCHP differs from for-profit insurance companies – who CCHP members may soon be forced to enroll with if the Texas Legislature doesn’t act soon.

As a nonprofit organization, CCHP channels resources back into local needs – not out-of-state shareholders. These not only include programs addressing food insecurity but also outreach efforts focused on asthma, drowning prevention, gun safety, and nine Neighborhood Health Centers. These centers provide physical, behavioral, and dental health services to children in underserved areas of Tarrant County.

The loss of Cook Children's Health Plan would mean losing a trusted community partner that pours resources back into the local ecosystem. Taxpayer dollars allocated for Medicaid would be redirected to for-profit insurance companies, many based outside of Texas, who prioritize shareholders rather than local families.

“Cook Children’s Health Plan is more than health coverage. It’s a community where you are taken care of,” said Rodriguez.

Texas lawmakers have until June 2 to pass a bill that would allow CCHP to remain operating. Learn more at savecookchildrenshealthplan.com.

The United States Food and Drug Administration (FDA) banned Red Dye 3 on Jan. 15, 2025. The FDA approved the dye in 1960.  Janet Gaytan, a registered dietitian nutritionist at Cook Children’s Health System, explained the FDA ban was based on the Delaney Clause of the Federal Food, Drug, and Cosmetic Act. This clause allows the ban of food or color additives if they are found to cause cancer in humans or animals.

Studies have shown an increased risk of thyroid cancer in male rats exposed to high levels of Red Dye 3, said Lily Han, M.D., a pediatrician at Cook Children’s Pediatrics Windhaven.

Red Dye 3 imparts a bright cherry-red color to foods and medications, said Dr. Han. The dye is often found in fruit punch, colored sprinkles, red frosting, medications, and a variety of snacks.

 In 1990, the FDA previously banned Red Dye 3 from cosmetics. “Of note, the FDA reports there has been no evidence yet of cancer in humans,” said Dr. Han.

Manufacturers have until January 2027 to remove it from food products and until January 2028 to remove it from medications.

Dr. Han, an obesity medicine specialist, emphasized the importance of nutrition.

“Nutrition is the fuel for our body, not only does it provide us with an energy source,” said Dr. Han.

She explains nutrition enables strong muscles, bones, and teeth; improves mental health, helping us think clearly and be more alert; maintains a healthy weight; prevents chronic diseases; and boosts immunity.

Gaytan advised families to examine food labels. She recommended looking for options low in saturated fat, sodium, and added sugar, as consuming large amounts of these items may cause future health issues. Instead, she suggested choosing options high in fiber, iron, calcium, or vitamin D.

Families should follow the MyPlate guidelines for well-balanced nourishment.

“Aim to make half of your plate whole fruits and vegetables and the other half lean proteins and whole grains,” Gaytan said. “Pair your meal with low-fat milk, fortified soy milk, or water.”

Han advises to look for these alternatives to Red Dye 3.

“Look for natural coloring from fruits or vegetables,” said Dr. Han. “Avoid products with artificial colors, especially Red Dye 3.”

Alternatives to Red Dye 3:

·         Beet or Elderberry juice

·         Anthocyanin (coloring from purple cabbage and berries)

·         Beta carotene (orange to reddish coloring)

Although Red Dye 3 is now banned, Red Dye 40 is still approved for use. 

“While some studies suggest it (red dye 40) may cause hyperactivity in sensitive individuals, most children do not experience any effects and the FDA continues to monitor ongoing research regarding its safety,” said Gaytan.

She adds everything in moderation can be part of a balanced diet.

“So do not feel bad about enjoying your favorite ‘fun foods’,” said Gaytan.

For questions regarding your child’s nutrition, ask your provider or a registered dietitian.

The rising prices of eggs, meat and other foods can make the cost of groceries hard to swallow these days.

But knowing some tricks for savvy shopping could help cut your grocery bill without sacrificing the nutritional value of the food you buy.

There’s no better time than National Nutrition Month -- in March -- to talk about the importance of fueling children and adolescents with the optimal foods for the growth and development of their bodies and brains. What we eat impacts energy, the risk for obesity, certain diseases, blood sugar levels, learning and more. 

Guidelines from the U.S. Department of Agriculture lay out the core elements that make up a healthy diet: Vegetables and fruits of all types and colors; whole grains, dairy including milk, yogurt and cheese; proteins including lean meats, seafood and nuts; and oils including vegetable oils. Children and teens need a variety of nutrients, such as calcium for strong bones, protein to build muscles, iron for oxygen-rich blood and fiber for easier bowel movements.

Kaitlin Smith, M.S. R.D. L.D. meets with patients in the Cook Children’s Endocrinology Clinic for issues such as diabetes and obesity. Smith and her dietitian colleagues at Cook Children’s provide education on weight management, counting carbohydrates and other nutrition-related topics.

In recent months, she said, more families in her consultations have voiced concern about inflation driving up the price of healthful foods. When the subject comes up, Smith coaches those families on affordable ways to eat nutritiously.

“It doesn't have to look like you're buying grass-fed beef or free-range chicken. That's what a lot of people picture, is we have to buy these expensive health foods or have top-of-the-line everything, and that's not true,” she said.

Smith outlined a few strategies for nutritional value at lower cost:

• Buy frozen or canned vegetables and fruits. “You're still getting good nutrients. They’re going to last longer, and it’s usually cheaper.” Look for fruit cups with fruit juice, not syrup.
• Seek out the more nutritious versions of food – for instance, brown rice instead of white rice, whole-grain pasta instead of pasta containing refined flours. “You're getting more nutrition for your dollar.”
• Eat more beans. “Beans are so affordable and nutrient dense. Beans of any kind are a great source of protein, fiber and iron.”
• Stock up and freeze meat when it goes on sale.
• Buy generic. Name-brand labels tend to cost more for foods with the same nutrient components as the generics.

The Academy of Nutrition and Dietetics points to additional key steps for preparing nutritious meals on a tight budget. How? Stick with a shopping list. Incorporate meatless meals a few days each week. Buy nonperishable staples, such as dried beans and lentils, in bulk. Use produce and other perishables first. Eat leftovers the next day for lunch. Freeze what you won’t eat right away.

“The key to smart, budget-friendly grocery shopping is planning ahead,” according to the Academy. “Plan meals around fresh produce, lean protein foods and low-fat dairy items that are on sale and in season to save money while eating healthy.”

Take breakfast, for example. Smith recommends oatmeal with a little milk and fruit as a low-cost option. Lunch could be turkey and cheese on whole-wheat bread, with a side of carrots or fruit.

“We have protein, we have fiber, we have fruits and vegetables available, and that's way cheaper than if you picked up a sandwich at a drive-through place,” Smith said.

For dinner, Smith suggests stir fry using a bag of mixed vegetables and a little chicken or beef over noodles or rice. Frequent dinners in her home consist of burrito bowls made with brown rice, black beans, avocado and cheese – affordable, and yummy to her young son.

Families can stretch their food dollars by turning to recipes such as Slow Cooker Vegetarian Chili Mac - Kristine's Kitchen (kristineskitchenblog.com), which yields six servings at a cost of $1.66 per serving. Smith pointed out that a fast food meal for one person costs $6 or $7 on average. 

“For the amount of money that you're spending on fast food or convenience foods, a much more nutritious option can be made at home. You’re getting less calories, less fat, less salt from not eating as many of those highly processed foods,” she said. “And if you're cooking at home, there are usually leftovers that you can eat throughout the week, which saves you money. It’s an all-around better option.”

Smith encourages families to take small steps to improve their nutrition routine. Changing too much all at once probably won’t establish a lasting habit, she said.

“Healthy eating does not have to be perfect,” she said. “Even if we swap out one to two fast food meals per week, that is still progress. Incorporate a vegetable into one meal every day, and then just build off of that. Just try to make realistic goals that are attainable for your family.”

National Nutrition Month highlights the importance of wholesome foods – and the dietitians who help children and teens make informed choices about what they eat. 

“I love simplifying healthy eating for my patients and reminding them that it doesn't have to be about a fad diet or expensive supplements or expensive health foods. I just love when I can empower people to take ownership of their health and make those small consistent changes to reach their overall health goals.”

During routine yearly checkups, we ask about your child’s nutrition including soda consumption. When I ask this, parents often respond, “no doc, we don’t give him/her soda," but add that if they do drink soda, it's clear, such as Sprite, 7up, Sierra Mist), etc. But parents wonder, are clear sodas really healthier than dark sodas?  It looks clear, it’s not brown, it smells like lemon-lime…it must be OK, right? Not so much. Let’s look into this a little further.

So first let’s first start with the simple fact that clear sodas are still soda! We discourage sodas for several reasons but mainly for the sugar content. For example, a can of Sprite has 38 grams of sugar and a can of Coke has 39 g of sugar. So you can see there’s not much of a difference between the two. That’s about 9 teaspoons of sugar in one can!!

Studies show that kids who drink more than 10% of their daily calories from added sugar are more likely to have abnormal cholesterol levels and a higher chance of getting Type 2 diabetes.

The other main reason we discourage sodas is the caffeine content. It is true that clear sodas do not have caffeine. However, there are many other options for a hydrating drink without sugar such as good old-fashioned water. If your child does not like water, try adding fresh fruit or mint or from time to time try a zero-sugar sparkling water to satisfy that craving for “fizz.”

So what about diet sodas?  Most experts would recommend that children should avoid diet sodas in kids. Many diet sodas are sweetened with artificial sweeteners and long terms effects are still not clear.

There you have it! Clear soda is not a healthy choice for a drink. Opt for water!

Nutrition experts at Cook Children’s want parents to know that lunch in the school cafeteria presents unique challenges and opportunities for students to form healthy eating habits.

First, the challenges …. Foods that some kids don’t like or won’t try. Too little time to eat.  Vending machines. And famished kids and teens who skip lunch and go home so hungry they eat meal-sized snacks after school.

And the opportunities …. Appropriate portion size. Attractive options. Nourishment helps students concentrate in the classroom, power through PE, and hit their growth milestones.  

As the 2022-2023 academic year gets underway with new lunch routines, families are encouraged to have ongoing conversations with their children about what they’re eating or not eating. Best practices will incorporate vegetables, lean proteins and whole grains in every meal. Getting your child’s input on preferences can help make the most out of their lunch period.

“Look at the menu ahead of time and make a plan so that they’re being mindful about eating veggies and other healthful foods,” said Kathryn Wheeler, D.O. at Cook Children’s Pediatrics Clearfork. “Preparation will help empower the kids to make good choices.”

Lunch Line Options

The Journal of the Academy of Nutrition and Dietetics reported that youth between 2-18 years old get almost half of their daily calories from added sugars and solid fats in sodas, fruit drinks, desserts, pizza and whole milk. The National School Lunch Program sets limits on sodium, saturated fat and calories. Five components are included in school-served lunches:

1. Fruits (fresh, frozen, dried or canned in light syrup or juice)
2. Vegetables including dark green, red/orange, beans or peas (fresh, frozen or canned)
3. Grains  
4. Meat or meat alternatives such as beans
5. Low-fat milk

Registered dietitian Lauren Williams works in the Risk Evaluation to Achieve Cardiovascular Health (REACH) program, which serves children and teens with high cholesterol, lipids disorders, diabetes and obesity at the Cook Children’s Endocrine Clinic. Williams sometimes hears complaints about school lunch from her patients.

“They might only eat the fruit because they don't really like the main entree, or they might only eat the main entree because the vegetables are overcooked or unappealing,” she said. ‘They might only like one or two components out of the five that are served. And if they don’t supplement with something from home, they may be left hungry.”

Another concern is inadequate time to eat lunch, which forces children to eat so quickly that they don’t respond to the fullness cues sent from the stomach to the brain. In a hurry, they overeat.

“What they're being inherently taught by having 10 minutes to eat is ‘I have to eat this quickly because if I don't eat right now, I don't eat,’” Williams said. This may also lead to the habit of eating quickly at other meals. Or if their lunch break happens at 10:45 am, they might be hungry and overindulge in snacks later in the afternoon.   

Williams recommends that parents talk to their children about what they ate at school. Bonus points if this is a conversation had around the dinner table since family dinners are another important part of healthy eating. If they’re not liking what the cafeteria serves, then bring a lunch from home.

Packed Lunches

Consider making sandwiches, wraps, pasta or salads. Include a protein (such as turkey or ham, cheese, Greek yogurt, beans or nuts); a starch (beans or whole-grain bread or tortillas); and fruit and vegetables for fiber (carrots, celery sticks, bell peppers, apple slices).  Williams also suggests a side of hummus or a dip to keep things fun and entice kids to eat more vegetables.

“It doesn't have to be fancy,” she said. “It just has to fill their tummy with some nutrition to get them through the day.”

More back-to-school advice from the dietitian:

• Rely on familiar favorite foods. “If you know that your 8-year-old is perfectly fine with having carrots most days with lunch, then that's OK,” Williams said.
• Ask your child about anything that might make them apprehensive in the cafeteria environment, especially on a new campus. Normalize the discussion of their lunch routine. “Don't be too hard on your kids if they don't choose the broccoli or green beans. Find out why.”
• Keep a handy stash of nutritious foods for after-school snacks. Her top picks include peanut butter crackers, non-fat yogurt, cut-up veggies and low-fat cheese sticks. Keep in mind that snacks should bridge the gap until dinner and not be meal-sized portions.

“You can't always guarantee that a child is going to choose fruit over a cupcake or cookie, but having it there and accessible makes it a whole lot more likely,” she said.

At annual check-ups with her patients, Dr. Wheeler talks with children and families about the benefits that come from consuming the right foods. She emphasizes the role that nutrition can play in preventing diseases down the road, one small step at a time, such as eating less processed foods and more fresh produce.  

“We know that all those good habits they have in childhood lay the foundation for a healthy lifestyle as they grow up,” she said. “Parents can be such great models.”

But what is the healthiest way for young competitors to muscle up? If you are raising an athlete, chances are you’ve heard a coach tell your child to do just that. Bulk up. Gain weight. Get stronger. Improve your power.

The natural inclination of any driven young athlete can be to hit the weight room and add calories to pack on the pounds. But it’s not that cut and dry.

“When we tell a 14-year-old to bulk up, they’re immediately going to think that they need to start lifting heavier and heavier weights,” said Jacky Arrow, PT, DPT, SCS, COMT, Cook Children’s clinical coordinator of sports rehab. “They may start trying things they have seen others doing and that they may not really know how to do. Weightlifting is great, but it could lead to issues and injuries if it isn’t done appropriately, and done with supervision and the right technique.”

All Things Are Not Equal

Muscles aren’t one size fits all. Every sport and what it requires of the athlete and their body size, shape and structure is different. What football demands of a future Division-1 lineman isn’t the same as what baseball demands of a pitcher, or soccer demands of a goalie, or tennis demands of a pro.

“There’s an important need in all sports for a general level of physical preparedness,” said Savana Turner, ATC, a certified athletic trainer at Cook Children’s. “We need to move well, have good mobility in our joints, have good strength and good flexibility. Then, when we’re getting into the higher levels of sports, a sprinter needs a different level of power than maybe a baseball pitcher. They need to be working on very differentiated programs that have the same base level, but can be specialized more into strength versus power versus endurance, depending on what their sport requires.”

Things like age and genetics also factor into a kid’s ability to bulk up. A child’s body can only do so much until it reaches a certain maturity. While kids and teens can improve their performance in a given sport by learning how to most effectively use the muscles they have, it isn’t until they hit puberty that they can see a change in muscular size associated with their strength programming.

“No scientific evidence indicates that participation in a supervised resistance training program will stunt the growth of children or damage developing growth plates,” said Nicole Pitts, D.O., a sports medicine physician at Cook Children’s-Prosper. “Although there is no evidence-based minimum age for participation in a youth resistance training program, all participants should be able to accept directions and follow safety rules. Generally, when youth are ready for sports participation, approximately ages 7 or 8, they are ready for some type of resistance training as part of a well-rounded fitness program. Then, I would say, they can progress to heavier weight around puberty but should wait to do powerlifting or Olympic lifting until they reach skeletal maturity.”

For some, making a big jump in size just isn’t in the cards.

“Some kids are just not going to get big,” said Carolyn Mullins, PT, rehab services manager at Cook Children’s Medical Center. “It’s not in their genetic makeup, and they need to keep those things in mind and be safe about choices that they’re making. You can push and push but if your body’s not built to be a lineman, then your body just isn’t built to be a lineman, and there is not a safe way to do it.”

Before your athlete jumps into the weight room or adopts a diet plan, the most important thing to have in place is supervision. Lean on professionals to design a program that is appropriate for your child and considers their age, progression through puberty, body type and sport.

Know the end game, too, be it increased velocity for the pitcher or girth for the lineman. Is the goal to add weight or gain muscle? What is the definition of “bulking up” for your coach, trainer and sport? Are you looking for more upper body strength or lower body strength, and why? Understanding what you are trying to accomplish and having a plan supervised by a professional will help you reach your goal while minimizing your risk.

The Building Blocks for Bulk

You need three things to build muscle.

●     Strength and resistance exercises that challenge the muscle.

●     A well-balanced diet that includes muscle-feeding protein.

●     Time for muscle recovery and rest so that muscle fibers can rebuild, making you less prone to injury.

Dr. Pitts, who knows a thing or two about the needs of elite athletes as a former professional tennis player, recommends starting your muscle-building journey by using your own body weight as resistance. Once you’ve mastered that, you can progress to very light resistance using lower weights with high repetitions before puberty. As you get older, you can increase both of these.

A good muscle-building program will include both training and nutrition. Without adequate nutrition, you don’t have the building blocks to increase muscle strength and size. But the right nutrition without the right training and practice won’t get the job done either.

Food is Fuel

All calories are not equal when it comes to a well-balanced diet that promotes muscle growth. A diet full of sugary drinks, junk foods and fast food may help you pack on the pounds, but it can lead to fatigue and poor performance, even for kids who seem to have an endless well of energy.

“Our society has been greatly impacted by childhood and adult obesity, so general advice to ‘gain weight and bulk up’ can be very challenging to navigate,” said Rachel Hill, RD, CSO, LD, CNSC, a registered dietitian at Cook Children’s Medical Center. “Being an active teen does not eliminate the risk that comes with a weight that is too heavy for the child’s frame or eating a diet that far exceeds the body’s needs or is laden with junk foods. While the risks of eating a junk food diet may not be obvious to a teen at first glance, they are robbing their body of essential nutrients for optimal growth, development, function and performance.”

As a general rule, kids should eat a diet rich in whole foods that includes a mix of carbohydrates, protein and fat. Doing so will not only fuel your body with healthy, energizing calories but also give you the vitamins, minerals, fiber and other nutrients you need for peak performance. Once puberty hits, males often require more protein and females more iron.

“Athletes need about 1 to 1.4 grams of protein a day per kilogram of body weight to help with muscle building and repair,” Dr. Pitts said. “It’s a little bit more than their non-athletic peers. So for a 150-pound athlete, having about 80 grams of protein, or 20 extra grams of protein compared to someone else a day, is ideal. If you end up going beyond that, the body doesn't always utilize it. A lot of times athletes will take three times the amount of protein that they need a day.”

Beware of using supplements to add protein. This can actually add more protein than the teen body needs. Supplements also may contain substances like creatinine, which can cause renal failure if used improperly and is not recommended for teens, according to Dr. Pitts.

When it comes to powering the athlete, timing is key. What you eat before, during, and after activity helps fuel your performance and recovery.

“The foods we eat provide fuel for our bodies in the form of calories,” Hill said. “Calories come from three sources: carbohydrates, protein, and fat. While all three are important for a well-balanced diet, carbohydrates are most important prior to a workout to provide enough fuel for the workout. Without enough carbohydrates, the body defaults to breaking down muscle to fuel the workout. Incorporating a little bit of protein into the pre- and post-event snacks can also help protect muscle mass.”

Teen athletes should eat a meal or snack at least 30 minutes before and after exercise to fuel their performance and protect the hard-earned muscle mass they’ve built.

Take A Break

Allowing time for your muscles to rest and recover isn’t slacking, it’s actually muscle-building. If the muscle fibers broken down during activity aren’t given the chance to rebuild, you’ll actually interrupt the muscle-building process, end up losing mass and make yourself prone to fatigue-induced injury. If you are strength training, don’t work the same muscle group two days in a row. Put one to two days of rest in between. The American College of Sports Medicine recommends two to three non-consecutive days of strength training per week for teens.

Dr. Pitts also warns about specializing in a single sport too early. Branching out into other sports creates a well-rounded athlete with cross-trained muscles and skills. It also protects the athlete’s mind and body from burnout.

“Taking care of your body as a whole is really important and is a really difficult thing for a child or a teenage athlete to keep in mind,” Arrow said. “It’s that end-game mindset. Sleep. Drink water. Eat a well-balanced diet. Participate in a broad variety of activities. Taking time off from your sport and focusing on moving well over putting more weight on the bar is the key.”

The bottom line if your teen wants to be an athlete to be reckoned with? Train well. Eat healthy. Play hard. Rest. And, above all, enjoy the game!

It’s a common question to ask your pediatrician. "What is the daily calorie need of your infant or child?"

Here’s a chart that covers the normal daily calorie need to sustain healthy growth. Average weight and lengths are listed for reference for infants. Base the calorie needs of your growing infant more off of their weight and height, rather than their age, until age 2. Also listed is the approximate number of ounces of breastmilk or formula your infant should consume to obtain the daily necessary calories (for a solely breastfed or formula fed infant, it does not take into account the calories from pureed baby foods).

These daily calorie counts are a general guideline, but other factors such as chronic medical conditions, medications, and extreme physical activity can change what your child actually requires in a day. If you are concerned your child is not eating enough, or is eating too many calories in a day, schedule an appointment with your pediatrician.

But I hear from my patient families all the time that it's anything but relaxing.

The American Academy of Pediatrics recommends doctors ask parents three questions about mealtime:

1. How anxious are you about your child’s eating?

2. How would you describe what happens during mealtime?

3. What do you do when your child won’t eat?

When offered a healthy, well balanced meal with fresh fruits, vegetables, and lean proteins, kids will stop eating when they are full. Children will naturally refuse to eat when they are not hungry. We often describe these as normal appetite slumps. We can disturb children’s natural satiety cues by either forcing them to eat or by offering foods high in added sugar or salt when they won’t eat. This results in a child who will “only eat chicken nuggets.”

Parents are most successful in feeding their children more fruits and vegetables when they model healthy eating, set appropriate limits, and have a positive attitude at mealtime. “The parent determines where, when, and what the child is fed; the child determines what to eat.” ⁽¹⁾ In other words, “parents provide and kids decide”. ⁽²⁾ 

Here are some tips on eating mindfully and encouraging your kids to eat in a manner that gives them more energy and helps them avoid chronic disease. These are easy ways to change your lifestyle that don’t involve a ton of work and expensive supplements.

1.Drink more water. Kids should not drink juice or soda except on special occasions.

2.Drink milk with meals. Children from age 1-2 should be on whole milk. After the age of 2, low fat or skim milk is recommended.

3.Vitamin supplements are not needed unless your child does not drink milk. Vitamin D is essential for bone health and immune function and may play a role in prevention of chronic disease.

4.Serve 5-9 servings of fruits and vegetables daily. Encourage your children to at least take a bite of everything you serve. Remember that children will need to taste a food 10-15 times before they decide they like it. Lean protein like fish and baked chicken might be better accepted if you add ketchup as a condiment.

5.Add healthy protein likes nuts (for older children) and legumes. Peanut butter is fine for younger children and new allergy immunology guidelines suggest that early introduction of peanut may actually decrease the risk of peanut allergy.

6.Eat more meals at home. Keep staples such as eggs, whole grain pasta, pasta sauce, yogurt, carrots, frozen vegetables, chicken breasts, and fruit stocked at all times so that in a pinch you could throw together a simple meal.

7.Double your recipes and freeze 1 meal at the same time that you cook the other meal. This will save you from making a trip to a fast food restaurant when you have that go to meal in your freezer.

8.Serve only whole grain breads and pastas.

9.Avoid buying, eating, or serving processed foods (chips, cookies, cakes).

10.Avoid fried foods and fast foods.

To read more about nutrition needs of children at different ages, I highly recommend the book “Nutrition: What Every Parent Needs to Know" available on the American Academy of Pediatrics (AAP) online bookstore.

See choosemyplate.gov for more information about how your child’s plate should look at meal time.

Realize that children’s tastes will change over time. They will sometimes refuse foods they readily accepted in the past, and they will readily accept foods that they refused in the past. Involve your children in shopping and meal planning. Let them help in the kitchen! Take them to a local farmer’s market and let them choose something new for everyone to try.

Take a matter of fact and pleasant approach to meal times and ENJOY YOUR FAMILY! Create wonderful childhood memories.

References:

1. “A Practical Approach to Classifying and Managing Feeding Difficulties” Pediatrics Volume 135, number 2, February 2015

2.Nutrition: What Every Parent Needs to Know. AAP

“They often times ask me if they should give their child a vitamin,” Dr. Mangham said. “Generally speaking, kids do not need to take a multivitamin or any supplements, for that matter.”

What is better than a multivitamin a day?

1. A good night’s sleep - every night.
2. A healthy, well-balanced diet.
3. Exercise and outside time
4. Good hand washing before meal time.

Dr. Mangham said going back to the basics with the above recommendations will boost your child’s immune system much more than any supplement could.

Recently, the New York Attorney General’s office cracked down on many major retailers, saying the herbal supplements they were selling didn’t live up to the promises on the label.

Joel Steelman, M.D., an endocrinologist at Cook Children’s said the quality testing program that stores such as GNC plan to put in place is a positive start, a lot of the herbal supplements have little hard science to really back up effectiveness.

“In my opinion, herbal supplements don’t really have a place for use in children,” Dr. Steelman said. “I’ve done research in the past on behalf of families asking about alternative treatments to use along with their child’s diabetes care. Most of the research is very weak. I suspect that very weak describes most data on use in children, and there’s a variety of medical case reports on negative effects of supplements on children.”

Jessica Holy, a Cook Children’s dietitian in Neurology, is frequently asked what vitamins and/or supplements are worth taking. She said that answer differs for parents and their children.

“Most of us have heard that if we tend to eat a variety of foods, then we don’t need a vitamin/mineral supplement. There is truth in that,” Holy said. “If you usually eat several servings of fruit, vegetables, whole grains, calcium-rich dairy and quality protein sources daily, then you are likely meeting your need for most vitamin and minerals. But how many of us have diets like that? Even though I’m a dietitian, I freely admit that I do not have a perfect diet. The busy pace that most of us keep makes it difficult to plan healthy meals for ourselves and our family. We often find ourselves turning to grab-and-go options at the grocery store or fast food. If this resembles you, then taking a regular, adult multivitamin daily may be a good idea.”

In children, a multivitamin might be needed during times of fluctuating appetite and food jags (only eating a few specific foods). For instance, children who aren’t getting enough iron in their diet may need to take an iron supplement for a period of time, until they begin eating more protein.

For the most part, children are able to get their needed vitamins through what they eat. Infants get their necessary vitamins through breastmilk (including routinely fortified with supplemental vitamin D) and/or formula intake and toddler and school-aged children are often able to achieve their need for calcium and vitamin D by drinking milk.

But beware excessive milk intake (greater than 24 ounces daily).

“Milk has some good nutrients, but it is lacking in iron,” Holy said. “Children who drink large quantities of milk are not often hungry for regular meals that provide iron-rich foods.”

If your child is allergic to milk, talk to your pediatrician for alternatives.

Commonly recommended ways to prevent constipation are to drink water, exercise, and eat fruits, vegetables and fiber-rich foods. Yet even when we use these techniques, our children still sometimes get constipated. Whether its contributing to stomach ache, delayed toilet training, bedwetting, or missed school, constipation is no laughing matter.

“But my child poops every day! My child can’t be constipated!”

Even if your child stools every day, he or she may be constipated. Think about your office desk; you may clear papers off regularly, but if you are not clearing as many papers as are building up, you will soon have a messy desk. Children may poop every day and still not be fully emptying their intestines. When constipation develops, the extra stool causes the intestines to stretch. Once this happens, the intestines may not be able to move as well, which leads to more constipation, and it becomes a vicious cycle. In infants constipation can be particularly hard to recognize because in this age group it is can be normal to have less than one stool per day.  Parents should look for a change in the frequency of stools along with firm stools when considering constipation. 

“What now?”

The good news is that constipation can often be treated with dietary changes. The key to making the treatment stick is continuing it long enough. If you stop too soon, the intestines have not had time to heal, and the constipation returns. As a physician who often sees this condition, I recommend treating constipation for as long as it has been a problem. For example, if constipation has been an ongoing problem for one month, treatment typically lasts at least one month. Treatment also depends on your child’s age.

• For infants over the age of two months, ask your pediatrician about giving small amounts of prune juice or pear juice.
• For a toddler, in addition to pear, apple, or prune juice, consider adding high fiber foods such as pears, peaches, and whole-grain cereals to his or her diet.
• School age children or teenagers can learn about which foods will help improve their symptoms and can then get involved in choosing foods that are fiber-rich and appealing to them.
• In cases that do not respond to dietary changes or are more severe, your pediatrician may recommend a medication to help treat the problem.

Contact your child’s doctor if you have any questions or concerns about your child and constipation.

The report published in The Lancet states the amount of children and adolescents rose to 124 million in 2016, compared to 11 million in 1975.

More than 20 percent of children in the United States were found to be obese in the age groups of ages 5 to 19 years of age.

While the study focuses on children, experts at Cook Children’s say the parents have to take accountability in keeping their children healthy.

Joel Steelman, M.D., an endocrinologist at Cook Children’s, said unhealthy food choices are more accessible with the increase of fast food choices across the world. These foods are usually higher in sugar and lower in not only nutrition, but cost of the food.

The other factor in the increase in obesity is sedentary behavior. But Dr. Steelman said increasing activity is easier said than done for many families, who are faced with children relying more on electronic media for entertainment and parents facing unsafe environments to let their kids go outside and play. Still, he said changes begin with the entire family making as many health changes as possible.

“Families have to be involved in helping a child with weight management,” Dr. Steelman said. “Often times this is not just a child issue, but a family-wide issue that needs to be addressed. I think that the biggest issue for families though is not to become militant and overly rigid in trying to help a child with weight management. Definitely, no shaming. The things you can do right now are pretty basic. That is changing your diet and encouraging more physical activity. I know it sounds simple, but this seems to be the best solution.”

Don Wilson, M.D., an endocrinologist at Cook Children’s, is the medical director of the Risk Evaluation to Achieve Cardiovascular Health (REACH) Clinic. The clinic is committed to improving the lives and well-being of children who are at risk or affected by obesity.

“The only way to be successful in the struggle with obesity is for all adults and children (with the assistance and encouragement of their parent/caregiver) is to embrace therapeutic lifestyle changes,” Dr. Wilson said. “Success starts with a positive self-image and a ‘can do’ attitude. We in the medical profession can help educate and encourage, but need to avoid blame and comments that demean the victim. Obesity is, and always has been, a disease. It should be treated as such. In general the public needs to understand the short-term and long-term consequences of obesity, including diabetes, premature heart disease, and several forms of obesity-related cancer. Only then will successful management/prevention be achievable.”

Virginia Landrum, a dietitian in clinical nutrition in Gastroenterology at Cook Children’s, said she stresses to parents and children that the entire family must be involved in making changes.

She lets her patients who are working to lose weight not to look at their changes as diet, but as a lifestyle change.

Landrum advises parents to help their kids get healthier by taking these steps:

1. Help your children be involved in the meal. Let them pick out some healthier food options that they may want to try.
2. If they are old enough, let them be involved in food prep.
3. Offer new foods. Studies show it can take as much as 20 times for some children to accept new food options. Landrum said parents may have to start by simply placing the new food item on the plate.
4. Parents have to set the example. Eat the healthy foods with your child. Let your child watch you eat vegetable. Go outside and walk with your child, play a sport or ride a bike.
5. Turn off the TV, video games and eat together as a family.

At least not yet, but both school districts are considering adopting a policy and Dallas ISD could have one by the end of the day.

That news makes Kim Mangham, M.D., a Cook Children’s pediatrician in Keller, both relieved and happy. Dr. Mangham focuses on nutrition and activity with her patient families and she believes this is a good start for area schools to get kids moving.

As early as January 2007, A Clinical Report in the Journal of Pediatrics emphasized the benefits of free play for children, “but since that time it seems we have drifted farther and farther away from this concept,” Dr. Mangham said. “Kindergarten and even preschool curriculums are emphasizing academics over social and emotional development, and kids are presenting at younger ages with anxiety and depression due to academic pressures.”

For all children, especially those with ADHD, Dr. Mangham said it is vital that they are offered unstructured free time to allow them to process the information they have learned and to get their exercise. Only then can they return to the classroom and focus.

Children have an innate need to be outside and run and play, according to Dr. Mangham. This helps them to connect socially with their peers and allows them to settle back down in the classroom and learn again.

“I hear from so many of my parents that their children do so much better with homework if they are allowed to play outside after school,” Dr. Mangham said. “Kids are so worn out by the end of the day, they need to decompress and let their brains rest before they can focus again on school work. I tell my parents that if they want well behaved children, to let them run and play outside and to burn off all of their energy. “

Why not focus on the things that are free from side effects and cost nothing? We have so much to gain, says Dr. Mangham.

Children have so much adult-directed time – in the classroom, with sports, with extracurricular activities and with chores in the home. Adults even try to interfere with free play. Children need that free time to learn to share, play nicely, make up games, follow rules, get along and just enjoy friends.

As reported in December 2015 by KERA news and a recent segment on the Today show, schools are starting to see the benefits of recess.

Cook Children’s offers Go Noodle to 18 ISDs (including public, private and charter elementary schools in Cook Children’s six-county region) and 515 schools. The 120,619 students and 4,918 teachers have logged over 35 million aggregate minutes of physical activity.

“My 12 year old daughter started sixth grade this year,” Dr. Mangham said. “Her biggest complaint is not being able to be outside all day. Their only break is the four minute transition time between classes and lunch. “She says, ‘I miss being outside and seeing the sky and the trees.’ My 8 year old son loves climbing trees. The reflection and relaxation he gets while sitting in the top of his tree is just as important as the exercise he gets while climbing.”

About the source

Kim Mangham, M.D., is a Cook Children's pediatrician at 1601 Keller Parkway in Keller, Texas. She earned her medical degree at University of Texas Southwestern Medical School in Dallas. She completed the pediatric residency program at University of Oklahoma Health Sciences Center in Oklahoma City. Her interests include breastfeeding education as well as disease and injury prevention. Dr. Mangham is board certified in pediatrics.

Then, I was blessed to have a beautiful son...

….who decided that I needed to be re-taught a few things about children.

And by a few things, I mean everything.

Don’t get me wrong – you don’t have to be a parent to be an excellent doctor. I still dish out the same advice. The books and studies are spot-on and I’m going to give it to you straight. Breastfeeding does provide the best nutrition for babies. But I understand the pain you’re going through to meet that goal. And I understand the frustration of having a child who just won’t latch on. And I understand now why you look at me, with a crazy twitch in your eye, when I tell you to try an extra pumping session a day to build up your supply, mama. I hated that thing, too. Can anyone say “dairy cow”? And guess what – formula isn’t poisonous. I wasn’t physically able to meet my full breastfeeding goals with my kid – there’s no judgement here if you grab that can. And it’s okay if it makes your relationship with your child happier, healthier and more fulfilling.

Our car seat remains rear-facing at 18 months. It’s been proven to be five times safer than forward-facing. I’m sorry for my lecture during your little one’s checkup. And oh yes, I too want to rip my hair out when I can’t reach over far enough to give my kid that 400^th toy to keep them quiet on the trip to grandma’s.

“Crying it out” was a tough one for me. Pre-child, it was so easy to coach parents - encourage them to drop the constant rocking, the running into the nursery at all hours of the night, the fear of allowing their child to cry in order to learn put themselves to sleep. Then I went through it with my son. Let’s just say I give the same advice now (it really does work) …and recommend a glass of wine for every 15 minutes of crying. I probably cried more than my kid did. Motherhood helped me give this advice with a much softer tone. I get it, mom and dad. And I feel your pain (and exhaustion).

Pacifiers – I missed that thing so much. So, so much. Oh man I missed that thing when it had to go. I think I needed one myself when the time came to get rid of it.

As for the well-rounded, healthy meals I recommend offering your child throughout the day – I now understand why there are food shortages in some parts of the world. It’s because all that food is currently on the floor of my kitchen. Where my son threw it. I get it. And I’m here to help you find tricks to make things better. Tried and tested in my own home.

In all seriousness, motherhood has been the most exhausting, challenging, humbling thing I’ve ever experienced. But I can say without a doubt that it’s made me a better doctor for your child. Because helping you get through those everyday challenges is a huge part of what being a pediatrician is all about.

I recently polled some physician mom colleagues to get their take on how motherhood changed them:

• “I am that much more in awe of the composure, patience, faith, resolve my patients' families have, especially considering how chronically sick the kids are that I see, and how too not-infrequently, limited the treatments are. I see my son in every patient. Everything is different. Every heartache is my heartache. Each illness, each story seems to hit home that much harder. I am so so appreciative.”
• “I am much more empathetic and practical in some advice. I think that I am much more emotionally available post having kids and can understand a variety of stresses parents who go through NICU may encounter.”
• “You come to understand that "by the book" is not always what is possible in real life!”
• “I feel like when the kids have a tougher diagnosis - cancer- it hits closer to home and I hold my kids a bit tighter. Likewise, little pearls and tricks that I used help make it more of a village caring mentality for the family which has been lost over the last 30-40 years.”
• “My medical advice is not too different, but I understand the unspoken worry so much better now. So I try to address the emotional stuff first in ways that would not have occurred to me pre-kids. Now I'll directly say things like "you are a good mother even if you need to use formula," or "this lymphadenitis/rectal bleeding/etc is NOT cancer," or "they are not dangerous, but constant viral illnesses all winter TOTALLY SUCK.” I think it has made me a much better pediatrician.”
• “One of my favorite attendings in peds residency told me, as I was a mess after coming back from maternity leave with my first, that a little part of your heart will always be on the outside, dangling like a vulnerable little wisp in the wind that is parenting- and that little wisp makes you so much stronger and so much softer- all for the good....it's so true.”

Happy Mother’s Day, everyone!

The CDC points out that commercial toddler foods and infant or toddler snacks, desserts, and juice drinks are of potential concern due to sodium or sugar content. 

But it doesn't end with toddler foods.

Food and drink companies are finding ways around the U.S. Food and Drug administration (FDA) regulations to mislead consumers into thinking their products are healthy. We highlight a few deceptive terms frequently used on food and drink labels that you should know about.

1. “All Natural”

The FDA currently has no definition for this claim. Foods and drinks that do not contain added color, artificial flavors or synthetic substances are allowed to write “All Natural” on their labels. This allows a lot of room for interpretation for the food companies.

2. “Reduced Fat/Sugar”

Beware of claims about reduced amounts of fat and sugar. According to the FDA definition for “reduced”, the item only needs to have 25 percent less of the claimed nutritional value than the original referenced item. Many times items that claim to be reduced are not necessarily healthier. Companies make up for ingredients taken out in other areas. For example, a reduced fat item might increase the amount of sugar in the product to keep the taste consumers prefer. Always check the nutrition label to see if the product is actually healthier.

3. “Zero Trans Fat”

In the U.S., if a product contains less than 0.5 grams of trans-fat per serving it can be advertised with “Zero Trans Fat.” In this case, the nutrition label will often read 0 grams of trans fat. The problem is once you eat more than one serving the product no longer has zero trans-fat. Make sure to check the ingredients for hydrogenated oils which indicate trans fat in the product.

4. “Organic”

There is a common misconception about the powers of the term organic. Organic refers to the way a product is produced. It has to be produced by an approved method sanctioned by the U.S. Department of Agriculture (USDA). People think buying organic is the key to weight loss, but buying organic items does not necessarily cut down the calories. Just remember to look at the nutrition and ingredients labels, even if the product is organic.

5. “Cage-Free and Free-Range”

Most people read this claim and picture chickens running free in an open farm pasture. This is not the case. The term cage-free only implies that each hen is not locked in an individual cage, but in an open barn. Many times these hens are never given outside access. Similarly, the USDA only regulates that a free-range hen must have access to outdoors.

We spoke to Lisa Pegram, a registered dietitian at Cook Children’s, about how parents can decipher through marketing messages and know which foods are actually healthy. Pegram teaches her patients that “fresh is best.” The fresher the food, the more nutrients it will give you. Look for nutrient rich items in the grocery store. It is important to consume calories that give you nutrients which make you feel full. For example, eating a chocolate chip cookie gives you a lot of calories, but no nutritional benefits. It can leave you feeling hungry and unsatisfied.

Don’t rely solely on the wording on the front of the label. Pegram said, “I always tell parents to turn the food product around and look at the ingredients list to see what you are actually buying. If you see a chemical equation, you should probably do away with it.”

Pay attention to the order of ingredients listed on a label. The first few ingredients listed are the most used ingredients in the product. Pegram said that in most cases, the fewer ingredients, the better. The final thing to look at is the serving size because companies will often make it far less than a consumer would normally eat. Pegram warns that if you are going to eat double the serving size, you need to double the calories, fat, sugar, etc.

Parents have the most influence over what their child eats on a daily basis. Make a commitment to learn about these deceptive marketing tactics used by food companies to trick consumers. You and your family will feel better and live a healthier lifestyle.

For more information on food and drink regulations, visit the FDA and USDA websites at www.fda.gov and www.usda.gov.

Now she prays for Tre’s caregivers to make her son all better.

Tre, who is 9 years old, has been seen by the Rehabilitation Services team at Cook Children’s since his parents adopted him as an infant. Most of those issues centered on his articulation skills. Tre’s history with Rehabilitation Services started with audiology and other physician specialists; speech therapy services began at 7 years old working on articulation skills. 

Then about 15 months ago, Sara Adams, Tre’s speech pathologist, received a call from Jennifer to say her work with him would have to go on hold indefinitely.

Tre was involved in a horrible boating accident. He sustained a head injury and was in a coma at another hospital. But the miracle for the Faulkner family occurred and within two weeks, Tre was up and walking.

After his accident, Tre returned to therapy at Cook Children's Urgent Care and Pediatric Specialties – Mansfield and worked with Occupational Therapy, Physical Therapy and Speech Therapy to regain skills that were lost after his brain injury.

A year later, much of Tre’s care takes place at the Cook Children’s Rehabilitation Services at Mansfield. The focus is on Tre’s short-term memory loss and his severe ADHD, as a result of the injury.

“God has blessed us so much,” Jennifer said. “The Mansfield community has been with us since the beginning, I’m so thankful. I’m also thankful for the amazing care Tre has received since his injury. At Mansfield, Tre has really been helped in many ways, through his physical, occupational and speech therapy. They have helped him so much with his memory and his balance. It’s truly been miraculous.”

The rehab at Mansfield is working for Tre. Academically, Tre’s test scores are in the average range for a child his age. His mom says he’s learning and making strides every day.

And Tre’s doing very well physically. He recently received his gold belt in karate. Makes sense for a kid who has proven time and time again how tough he is.

“The progress Tre has made since his accident is truly remarkable,” Adams said. “Tre still has some struggles with his attention and memory that impact him every day. However, he continues to improve and learn how to work through these struggles. Tre’s sense of humor, determination, and supportive family are his greatest strengths. Tre is such a funny kid! He loves to tell jokes and riddles. One of his favorite jokes is: ‘Why don’t ducks tell jokes when they are flying? … They might quack up!’”

To see how far Tre’s come since his injury it’s hard not to smile at the miracle that’s occurred and the occasional duck joke.

For more information

At Cook Children's, we provide more than 60 pediatric medical and specialty clinic offices throughout Texas. Thanks to our skilled group of clinicians who support the leading-edge technology found among our specialty services, Cook Children's is the destination when it comes to taking care of your children.

Cook Children's Urgent Care and Pediatric Specialties - Mansfield is located at:

801 Matlock Road

Mansfield, TX - 76063

To make an appointment, call 817-347-8400.

Specialty services at Mansfield inlcude:

• Endocrinology and diabetes
• Gastroenterology and nutrition
• Nephrology and dialysis
• Neurosciences
• Orthopedics
• Pediatric surgery (inpatient/outpatient)
• Psychiatry and psychology
• Rehabilitation
• Urgent care

Strength:  As these athletes push themselves to achieve the lifting goals set by coaches, is their form being supervised by someone trained to observe any breakdowns?  Complex lifts such as cleans, snatch, push-jerks, etc. put enormous strain on the athlete’s muscles, especially when they are younger and still developing, but if their form is poor it also makes them susceptible to back, shoulder, knee and neck injuries. Often the athlete lacks the core strength and stability to provide a solid foundation so that the body can move correctly. Core strengthening should be an integrated part of every strengthening program. Unfortunately, many of our athletes are never taught to control their core in basic sitting and standing postures, but yet we expect that they will somehow find their core while in the weight room or on the field. If you think core strengthening is all about abs, then you are missing the bigger picture.

Conditioning/ nutrition/ hydration: Cardiovascular conditioning is often an area that coaches hit pretty hard in the offseason, and most athletes have been working on some kind of conditioning program. However, the nutrition and hydration components of this area are often over-looked. Understanding how to fuel your body for peak performance is just as important as knowing how to perform the activity. Working with a nutrition/dietitian specialist can give your athlete the tools needed to unlock their full potential.

Flexibility: This is one of the most overlooked areas of a good training program for a football player getting ready for middle or high school ball. There is nothing glorious about stretching. There is also nothing glorious about missing a majority of the season while sitting on the bench due to a pulled hamstring. Flexibility training is about preparing the body to perform.  Dynamic stretching (moving stretches) prepares the body for immediate performance and should be used before any type of physical activity. Static stretching (prolonged holds) help prepare the body for tomorrow’s workout and promotes having the muscle length needed to achieve the greatest power. Use of a foam roller can also help improve flexibility by preparing the muscles for stretching.

Neuromuscular control: Why is it that the pros make it look so easy?  The ability to cut-back, stop-start, and change directions centers on the way an athlete’s brain can control the body. A physical therapist or trained professional can use any number of functional movement assessments to see how the body is moving and recommend corrective exercises and/or cues to improve these patterns. Learning the best patterns means the athlete can generate more power, more quickly, and in more directions. The best movement patterns also keep the body in the best alignment, and less likely to become injured.

Overtraining: The AAOS also recommends avoiding the pressure that is now exerted on many young athletes to over-train. Listen to your body and decrease training time and intensity if pain or discomfort develops.

See a physician if you begin having pain. This will reduce the risk of injury and help avoid “burn-out.”

Related links:

• Football injury prevention
• SPORTS resources
• Does your child play one sport?
• 9 ways to prevent injuries in young athletes
• Cheerleader injuries
• Top 10 questions parents have about sports injuries
• Young athlete's injury prevention guide
• Strength training in children/adolescents (5-15 years)
• Rise of overuse injuries in school-age athletes
• The basics of sports injury prevention for kids
• When growing pains are not growing pains
• Preventing children's sports injuries

About the author:

John Stanley, a physical therapist and SPORTS Rehab Clinical Coordinator at Cook Children's. The Cook Children's Sports Performance Orthopedic Rehab Team Specialists (SPORTS) program offers care to children and adolescents with orthopedic or sports-related injuries.

I was immediatley interested when I chanced on a recent radio interview with the author, Michael Moss, who has written a new book about the inner workings of the processed food industry. The book deals specifically with the reasons that these companies use three key additives – salt, sugar and fat – in the processed food they create and market.

The term processed foods sounds somewhat sinister, but some of the ways that food is processed such as pasteurization or freezing are quite beneficial to people for both health reasons and convenience. The primary goal in most processing of foods is creation of a food product that is near ready to eat and is stable on the shelf or in our homes for a long period of time. This particular goal and the goal of making tasty processed foods according to Mr. Moss is where the problem begins.

In the book, Moss interviews food scientists in many of the large processed food companies. These scientists are tasked with making tasty food products that apeal to a large group of people. Moss describes the use of the three key additives to mask odd or bitter flavors that develop during manufacturing and to hook consumers on taste.

Moss argues that company pressures to create new appealing snacks, grow market share and improve profitability often result in unhealthy foods that contribute to the U.S. and global obesity epidemic.

The interview concluded with the debate about what steps can be taken to reduce these activities and make healthier foods. The debate no doubt will continue between different philosophies of strict government regulation and independence of consumer choice.

I’ve downloaded the eBook and look forward to learning more and examining different viewpoints. In the meantime, my family and I will continue to see fresh ingredients and discover new recipes.

More information is available if you are interested with links to the NPR interview and the book.