August 23, 2012

Nutritional biochemistry

Hey Peter, what does your daughter eat?

Read Time 7 minutes

If there’s one question I get asked often, it’s this one.  And I understand why.  Anyone who knows me, and knows how obsessed I am with everything I do, knows there is one thing on earth I cherish more than anything else – my daughter.

Any of you reading this post who are parents know exactly what I’m talking about.  My daughter, and I know the same is true for Gary with his boys, is one of the greatest driving forces behind us founding NuSI.  Why?

Picture the United States as a cruise ship.  Overall, it’s a wonderful place to be.  We have so many things to be thankful for (as do many folks outside of the U.S.).  But, there are icebergs out there.  If we continue the course we’re on, our fate will be similar to that of the Titanic.  Unlike the Titanic, though, we actually have several icebergs in our path.  That is, there are many different forces in the world today that – if left unchecked – could easily disrupt our way of living.  I won’t go into detail about what I think the list of potential threats to our economic and social freedoms are – pension overhead, national security, energy security, structural problems with education – but I’ll assert my opinion on the first problem we need to get a handle on.  If we don’t figure out a way to curb the twin epidemics of obesity and diabetes, our healthcare spending alone will bankrupt us.  No one can pinpoint the day this will happen, but if not in my lifetime, I’d bet anything it will be in my daughter’s lifetime.  In other words, of all the icebergs we need to skirt past, this one is the closest to our vessel.

So, back to the question.  While we wait a decade or so for NuSI to fund the type of science that will unambiguously resolve the jugular question — What should people eat to maximize their chances for greatest health? — what do we do?  If you’ve been reading this blog, you’ll certainly have a great idea for what I do, based on my interpretation of the data currently at our fingertips.  But ambiguity remains, especially when asking an even more important question than what do I eat.  Since my daughter (and presumably your children, for those of you with children) is infinitely more important to me than anything else, including myself, how do I interpret current data around what she should eat?

Principle 1: Excess sugar is not conducive to good health for anyone

I don’t think I need to spend any additional time reviewing the harm of sugar (e.g., sucrose, high fructose corn syrup, beet sugar, cane sugar, brown sugar).  If you do want a quick refresher on this, you can read this post. If you can only make one intervention in the dietary pattern of your child, make it this one.  Based on our experience and the experience I’ve had with clients, friends, and family, a trend has emerged.  It seems the longer you wait to make changes in this area, the more difficult it can be.  Not always, but often.  Sugar is very habit forming, and from a neurochemical standpoint an addiction to sugar is not unlike an addiction to gambling, alcohol, or heroin.  Yes, they all have nuanced differences, but each of these addictive patterns or behaviors results in stimulation of the dopaminergic pathways of the brain.

How do we translate this intent into practice?  The easiest thing to do is to minimize the amount of sugar brought into the house.  This means we don’t have soda, cookies, candies, cakes, cupcakes, and other similar nutritional weapons of mass destruction lying around.  This doesn’t mean we never have them lying around.  Invariably, a grandparent or neighbor will bring over a lollipop or some cookies, but this is an exception, not a rule.

Furthermore, we don’t have any juice in our house.  Our daughter (who is 4) drinks whole milk and water.  That’s it.  Amazingly, she no longer finds sweet beverages enjoyable.  Recently, at a birthday party, she was given one of those Capri Sun sugar-syrup drinks.  She took one sip and asked for a bottle of water.  It was actually too sweet for her.

As I explain below, she still gets some sugar in her diet, but it’s probably about 20% of what the average kid her age is consuming.  And she gets plenty of fructose in the form of fruit.  But when she eats fruit, it’s usually lower fructose fruits (e.g., raspberries, blueberries, strawberries) rather than higher fructose fruits (e.g., watermelon, banana).

Principle 2: The less processed the food is, the better the food probably is

As an extension of the first principle, if you always make trade-offs in favor of cooking your food, rather than pulling it out of a box or jar, you’ll win many of these day-to-day battles.  At least half the week our daughter asks for cereal for breakfast (instead of bacon and eggs).  Rather than dump her a bowl of sugar-laden cereal, my wife or I will make her steel-cut oatmeal, to which she’ll add milk and a few raisins and walnuts.  Sure, it’s more carbs in one meal than I eat in 3 days, but it doesn’t contain sugar (beyond the fructose in the raisins).

When she wants spaghetti for dinner, we make her real sauce out of real tomatoes and garlic.  No added sugar, of course.

This requires extra work, as you can imagine. It’s much easier to dump cereal out of a box or pasta sauce out of a jar.  But if I need to sleep 15 minutes less or my wife needs to cut her run short 15 minutes to make it happen, is it worth it?  For us, the answer is yes. But, it is a choice – of both time and money – every parent needs to make.

Principle 3: Insulin and insulin-like-growth-factor (IGF) are important for childhood development

This topic is highly complex.  For anyone who has studied IGF-1, GH, IGF-BP3, STATb5, or any of the hundred other molecules involved in the highly regulated pathways of growth, don’t be offended.  It would take another series the lengths of the cholesterol series to give this topic its fair shake.  However, a few key points are worth noting.  There is sufficient evidence, for me at least, that a growing child needs a modest dose of insulin to capture their genetic (vertical) growth potential.  In fact, stunted growth is one of the documented side-effects of children on ketogenic diets, though there may be several factors accounting for that beyond the role of insulin and IGF (e.g., protein deficiency, caloric deficiency).

Ketogenic diets are a medically accepted treatment for recalcitrant seizures.  About half the children whose seizures don’t respond to any medications almost immediately stop seizure activity once they are in ketosis. Some investigators, including Dr. Elizabeth Thiele, Director of the pediatric epilepsy program at Harvard’s Mass General Hospital, are investigating this approach in adults.  I had breakfast with Dr. Thiele recently and had an amazing opportunity to learn from someone with enormous experience treating children with ketogenic diets (over bacon and eggs, of course).  According to Dr. Thiele, who described some really amazing in vivo and in vitro research, the reason for the effectiveness is not entirely clear.  That is, it’s not clear if the seizure activity is ameliorated by the presence of B-OHB (beta-hydroxyburyrate) or the stark reduction in glucose or the insulin, or some combination of these, or even something altogether different.

Of course, having too much insulin-like-growth factor is even worse.  There are numerous medical reports that describe the opposite “growth” scenario – too much IGF-1, for example, being associated with increased childhood malignancy.

Everyone wants to know if my (non-epileptic) daughter is on a ketogenic diet.  The answer is no.  If I had to guess, she probably gets 40% of total calories in the form of carbohydrates, and very few of them are sugar.  That said, she’s so used to seeing her daddy give himself “boo-boos” on his finger every day to check his ketone levels that I think she’s getting curious…but that will have to wait a long while.

Principle 4: Fat is fine

As much as you’ve heard me espouse the benefits of fat intake in adults, it’s equally or even more true in children.  As the Harvard anthropologist Daniel Lieberman points out, as we evolved from chimps to homo erectus about 1.5 million years ago, and to homo sapien about 200,000 years ago, we required an increase in our storage of body fat (from about 4-5% to 7-8% to 12-14%).  Why?  Most likely to support the requirements of our rapidly growing and developing brains.  At no point in our development is this more necessary than as children.

My daughter certainly consumes less fat than I do, but she still gets about 35-40% of her total caloric intake via fats – saturated, monounsaturated, and polyunsaturated.  Perhaps her favorite breakfast of all is bacon and eggs with cream cheese.  She likes to wrap a piece of cream cheese and scrambled eggs with a strip of bacon which she calls a “cooc-a-mooc.”  Don’t ask me how she thought of that, but she loves them.  She drinks whole milk (it’s always struck me as strange that the American College of Pediatrics recommends children switch from whole milk to skim milk abruptly at the age of 2), avocado by the truckload, and a wide variety of quality meats.

Principle 5: They are, after all, still children

My wife and I agreed a long time ago that we were not going to restrict our daughter’s eating when she was at birthday parties, on Easter egg hunts, out for Halloween, or on other “special” occasions.  A few weeks ago we took her to Disneyland for her 4th birthday.  (Anyone want to guess what it’s like for an ISTJ to spend 2 days at Disneyland?  Were it not for the look on her face, I’m not sure I could have survived.)  We decided, for these 2 days, she could eat whatever she wanted.  The day started with a bag of cotton candy larger than her head.  I couldn’t resist looking at the package to see that it contained 90 gm of sugar.  I did the quick math on converting that dose of sugar from her weight (35 pounds) to mine (165 pounds) and realized it was like me eating 450 gm of pure sugar in 20 minutes – the length of time it took her to inhale it!  That’s about 12 cans of soda.  She went on to have pretzles and cookies for lunch and, of course, a cake for dessert after dinner.

The entire time I was watching her mainline sugar – more in one day than I consume in a year – I couldn’t help but chuckle.  I sent pictures to my friends all day long.  In the end, she was pretty sick of all the junk she consumed and welcomed her usual meals. But, for a couple of days she ate just like most any other 4-year-old would on her birthday.

Principle 6: No two kids are the same

As you’re reading this keep in mind, this is an anecdotal account of my life and my child.  Yours will be different.  What works for our child may not work for your child or children.  Don’t worry about it!  In the end you’ll be the best judge of what the optimal zone is.  I really believe my daughter will live a healthier life because of the way she eats growing up.  One day, of course, she’ll have to make her own choices.  Will she completely rebel against everything we’ve tried to teach her?  Perhaps, but I don’t think so.  I really believe that kids are the product of the example set by their parents.

I used to always wonder where my tendencies came from. Not surprisingly, much of who I am today is the result of the behaviors I observed in my parents.  It’s my belief that if my daughter grows up in an environment where an emphasis is placed on eating well, it will become a natural extension of her behavior, too.

Photo by Foodie Factor on Unsplash

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264 Comments

  1. Peter

    Asked you about swim training in Boston and have since seen you weren’t kidding when you said you are a swimmer. My daughter is 13 and trains 5-6 days per week. The team just held a nutrition session and……(wait for it)……suggested chocolate milk!

    I believe you said you worked some with Matt Grevers. Since I KNOW Chocolate Milk and pancakes are wrong–what should she be eating? The workouts are about an hour and half. I ordered some super starch just to try it but are the 1 1/2/ hour workouts even long enough to worry about pre and post diet outside of regular paleo eating habits? Do you have suggestions outside of Super Starch? Are 2 minute “all out” races even conducive to SuperStartch? Is there a resource you can point me to if you don’t have time to write a big long response to this?

    Thanks

    Cameron

    • I have not worked with Matt, but have worked with others at his level. You’re correct to point out that such swimmers race in a purely glycolytic state (i.e., their races are all-out exertions less than 2 minutes). However, as you know, their training is typically north of 4 hours per day, and much of it is aerobic in nature. So in my experience, even athletes “only” working out a few hours to compete in very short bursts, still find benefit (performance and health) in substituting SS for the typical sports drinks and products.

  2. I ask my daughter, ‘what would you like for dinner?’

    Elsa (6): ‘what are my choices?’

    me: ‘pig, elk, or fish’

    elsa: ‘what kind of fish? one we caught or from a farm?’

    me: ‘farm. but not the one you’ve been to’

    elsa: ‘ummmm, . . . . pig! . . . wait! pig from aunt Jaime or the store?!’

    me: ‘aunt Jaime’

    elsa: ‘yeah! lets have pig!!’

    (the pig in question is ground meat from a 1/2 berkshire, 1/2 landrace, killed at 180lbs, fed barley and canola, no corn – sausage is loaded with fresh fennel)

    Kids are natural foodies. They have a wonderful response to what is good and what is not. I’ll back Peter up on the Capri Sun antidote as I’ve experienced quite exactly the same thing – and several dozen other processed food aversions.

    If YOU want to eat better, go out of the way to cook some better stuff for your kids, their resistance to the triple bleached, ultra-processed FDA-approved gruel will motivate you to feed yourself better. You go to McDonalds because your kids want to and it is too much effort to fight them . . . why not make that the case for beet chips, Berkshire pork, Criollo beef, and pumpkin curry?

    All cheaper than fast food. As if that matters.

  3. Dr Attia,
    I agree with several of the arguments/statements you make.
    I understand you to be a professional who focuses on evidence based medical science and cognizant and capable of being able fulfill the burden-of-proof to validate your advocacy/arguments/statements/hypothesis with objective scientific proof.
    Would you also be willing to share with us your daughters medical health test records?

  4. We eliminated all sugar and grains from my 5 year olds diet 3.5 years ago. She used to have to take miralax everyday. Poor thing would get so constipated. No more crap food, no more miralax, just like that. To this day if she spends too much time with grandma she comes back constipated and we have learned she can absolutely have no more than one treat (grains, desserts, binding starches) at most a day. So i ended up with a 5 year old who eats mostly meat, fish, raw veggies, fruit, full fat dairy and nuts, in the end she and her younger sister are healthier for it and i feel like a good mom. Question: do you have any ideas about supplementing fish oil for kids? I used to put chocolate flavored fish oil in her full fat greek yogurt when she was smaller, but i was always slightly concerned that I could be giving her too much as it was very very concentrated. I’ve never found any guidelines about this for children….

    • I read a pretty good study in the journal Pediatrics that showed benefit in children when supplementing omega-3. BUT you need to be very careful and not do so without measurements of EPA and DHA levels in the blood, to ensure you’re not giving too much. Too much can actually lead to easy bruising and even bleeding, which is easier to happen in children because of their size. I am not familiar with Pediatric guidelines and would only suggest doing so under the careful eye of your pediatrician.

  5. I realize this might not be the right place to ask the question, but not sure where the right place would be. I teach a high school Biology class for home schooled students. We only meet once a week for an hour for class (they have an hour with another teacher for lab), but we use moodle during the week to communicate and I give them assignments etc this way. Anyhow, we’ve gotten to the “Nutrition and Digestive System” chapter. EEK! It’s making me crazy. It’s based on the food pyramid and extols the virtues of canola oil, corn oil, and a grain based diet. Because I have such a limited time, I really won’t be able to dispel all of this nonsense. Last week (while talking about the nervous system) we already got into a conversation about some of this as I was talking about how essential good fats were for proper nervous system functioning – some of the girls were freaking out about the “saturated fats” I was talking about. I was also explaining about how sugar can cause problems with the nervous system and one very athletic male student said he’s prediabetic and has a very fast metabolism so has to eat sugar and carbs because of his metabolism. I tried to explain that he could avoid the prediabetes progressing to type2 diabetes with dietary changes. Anyhow, all of this to say I want these kids to learn more about nutrition than what I can pack into next weeks lecture, most of which needs to cover the digestive system.

    Do you know of any resources, articles or online movies/clips, on good nutrition that would be appropriate for a high schooler? Thanks for taking the time to read this long comment!

    • Hi Trisha,

      Would approaching it from another angle – i.e. carbohydrate intolerance, be helpful? Perhaps it is more straightforward explaining why/how many people are carb intolerant instead of explaining why saturated fat is good and how sugar can cause problems with the nervous system???

      In any case, there is a short presentation I put together for my aging parents on what carb-intolerance is given that my father was recently diagnosed as a Typ II. It is floating around in this blog somewhere but I cannot seem to fish it out with the search….it is on a file sharing site called “The Box” and if you search for “Carbohydrate Intolerance” I’m sure you’ll find it.
      Good luck! Michele

  6. Hi Peter

    Great post, i think its nice to see that everyone online is in fact human and live ordinary lives too!
    For sure your daughter is eating much better than I did at that age.
    Just wondering what your thoughts are on why it seems to be an innate response in us to seek out sugary, high-carb foods if in fact we need relatively minimal amounts to survive at an optimal level of function (ie your diet of <50g/day carbs). Why did we evolve to seek/enjoy sweet foods, which are typically high sugar and thus a food not necessary for survival?
    It seems humans are programmed to seek and thoroughly enjoy high-carb foods from a very early age.? (which the food industry has identified and milked). I only thought of this as it seems your daughter who rarely eats much sugar still enjoyed copious amounts in a short space of time.
    And I know I was the same, numerous fillings at the dentist!

    • Joe, this is a question that would require a great length of time to respond to properly and many others have written about it. Stephan Guyent has written a lot about this idea of certain food (e.g., sugar) being “hyperpalatable” and addictive. There is a lot of neuroscience evidence supporting this. Of course, this area is debated for reasons I won’t go into here, but I do think there is a growing body of evidence to suggest that sugars may be doubly bad.

  7. Peter,

    My husband and I have been following a ketogenic diet since discovering your website and the wealth of knowledge contained within. I might add that we’ve both met with great success with this type of diet, but we’re about to embark on a totally new journey together – parenthood. I’m 6 weeks pregnant with our first child and it seems that the literature is pointing against a ketogenic diet for me. I would assume that you and your wife follow a similar eating regimen – perhaps you could shed some light on my options for maintaining some kind of consistency throughout the next 8 months while still giving the growing baby all the nutrients needed for proper development.

    • Congratulations, Kristin, to you and your husband. The literature on ketosis and pregnancy is so spotty I would just assume there is none. I can’t really tell you what to heat, but if my wife were pregnant, should we consume a modest-carb, very low sugar diet. The carbs would be low GI carbs, and she’s get appropriate amounts of SFA, MUFA, and PUFA. Normal protein. Only really limit, therefore, would be sugar and high GI carbs. Fats would fill the gap, but not ketotic.

  8. Hi! I´ve been reading your articles and find them really interesting as I´m also very concerned on giving my children a healthy diet. I´ve been reading a lot on how terrible milk is and how after the age of 2 we dont need it (this would include dairy). What´s your opinion on this? I stopped giving milk (not cheese ) to my children after 2 and give them rice milk, but now reading all this on carbs and sugars I´m not sure anymore!
    Thanks!

  9. Thanks for your good work. I just came across low carb diets in the past month through triathlon podcasts, and have now read all I can get my hands on (including Gary Taubes, Lustig, Phinney and Volek). I have a 9 year old son, who is a bit chubby. After reading all that I have, I suspect that he is very sensitive to carbohydrates. I have a history of obesity in my family, and he has always loved sugary, starchy foods more than the average kid. (And obviously all kids seem to – but observing him and my daughter around other kids – he has a super sized sweet tooth. She is much more typical). We have always fed whole foods, healthy diets, but every chance he has to eat sugar, he eats as much as he can. (We tried to manage it rationally, as you have with your daughter. But he’s been really drawn to the sweets.) Grade school has been extremely challenging. It seems that every other day that is some event deserving of sweet treats in the classroom. The school discourages it, but the other parents all want “special days” for kids birthdays or think “kids should be kids.” It’s frustrating.

    Since reading these books, I’ve switched to whole milk, and encouraging higher fat meals and further reducing carbs. But with the outside opportunities for junk in grade school, it is a real challenge.

    • I can not imagine. I guess you do what you can and hope a change at home offsets the horror of school feeding. Even if you could eliminate sugar, without worrying about non-sugar carbs, it would likely help.

  10. Hi,
    I just started the low carb high fat diet 2 months ago. I limit myself to 20-21 carbs a day. I check my ketones but am rarely in ketosis. I try to be more and more precise in checking the number of carbs but think I must be off somehow.

    I eat as dessert of pecans and Calif walnuts, missed with cinnamon with whipping cream or sour cream.

    I love the steak with butter salt and pepper.

    I have been having colds and lung infections (allergy? asthma?) ever since I started this diet. I had not had a cold in years. So I’m taking inhalers, phlegm looseners and Benadryl a lot. Even supersweet Nyquil once.

    I did cheat yesterday. Had a croissant from the new local French bakery. It tasted like super sweet paper.

  11. Hi Peter, having recently realised that my previous low carb attempts were simply not keto enough and that now i’m doing it right it’s totally amazing, i want to get better information when looking to put family members on the diet. My son is autistic and epileptic, i think that putting him on a keto diet could be very helpful in quieting down the ‘noise’ in his head. My wife is quite against this but is slowly coming around to it. when we do try i don’t want any errors in approach to allow those against the idea to decide that it’s not worth the effort, otherwise we may never see a result.
    So my question, can you recommend anyone or any resouce to help us plant this transition in advance?

  12. Hi, thank you for a fantastic blog, I just found it! I am an MD in Sweden, just discovering low-carb, or actually LCHF as we call it here, low-carb-high-fat, (much like what you are eating it seems) and I am going through a lot of great benefits for my health and are having all those “aha!” moments that other MD’s describe when the pieces are finally falling into the right place. One of the things that motivated me to look into LCHF was the things my daughter chose to eat from the time she was introduced to food at 6-12 months. I have always tried to be guided by her reactions to food, when deciding what to serve, and not to “push” anything. She ate meat very early, and loved butter (but licked it off the bread and left the bread), ate cheese and a lot of vegetables and fruits gradually but also pasta (and a lot of juice and gradually lemonade). She didn’t even like candy until 3-4 yrs old. She refused to eat processed “jar-food” so we had to make our own pasta sauce on mostly ground beef ourselves from the beginning.
    So now she is 4,5 and my husband and I started cutting down on carbs a few months ago, but are now down pretty low. We reasoned much like you and your wife and decided to just start serving water or whole-milk for our daughter (which we did a lot earlier too) and serve the things that were pretty LCHF that she liked already, cheese, ham, butter on thin slices of bread with bell pepper or cucumber (she still mostly eats the butter :D) and just leave out sweetened yoghurt, juices etc. She asked for yoghurt the first morning, but we said we ran out. Then, amazingly enough, she has not asked for it any more! At dinner she eats what we eat (eg meat, fish, poultry, salad, vegetables low in carbs, butter- or cream (40% fat)- based sauce etc) but additionally some pasta or rice. She asks for an ice cream occasionally and then she gets one. But it is interesting how she is starting to ask questions spontaneously now, like -Why don’t you eat pasta anymore? and so on, and I simply answer that I found it was making me feel bad in some ways so I think I am better off without it. Then, of course, she wants to know if it is dangerous to her and I just say no, you are growing. But when she asked about candy, I answered that I think it is ok if children eat it sometimes but that it is not at all good for “your body to work well” (health is a concept she cannot yet understand of course) and she seems to take that in and has only asked for candy once or twice the past 3 weeks. So I totally agree with you that being an example, eating and feeling well, enjoying food, and not “banning” foods for the kids, might be a good way if you start early. If they are older I guess it is much more complicated for them to find their “way back” to more healthy and, perhaps, instinctually prefered foods.
    I think this will be a life-changer for me (in ketosis now and had the most chocking experience with dramatic increase in performance yesterday when out walking) hopefully I can work with LCHF in the future, I wish you all the best with the NuSI!

  13. Hi Peter,
    This is a great blog and an important post. I just read through all 197 comments and it was a breath of fresh air to be amongst so many like minded parents. I’m an acupuncturist, specializing in treating infertility and one of my professional goals has been to educate my patients about the importance of a truly healthy diet before conceiving their baby. Once they’re pregnant, I send them home with books and information on feeding their baby.

    I have a 9 year old son and a 1 year old baby and I’ve always viewed how I fed my family as one of my most important jobs as a parent. Many parents have shared how they feed their kids and educate them about food here and I enjoyed everyones’ posts. Thank you! Since my older son was a baby, I’ve talked to him about food and why we don’t eat junk. Somehow he absorbed that information and has made good decisions on his own since he was 3 years old in preschool.

    Unfortunately, I couldn’t trust my son’s teachers to prevent him from eating junky snacks brought in by the parent helper of the day, so I had to train my son. If a mom brought in cupcakes, he would ask her if she made them. He didn’t eat store bought cupcakes. He refused the juice and asked for water. I was most proud of him for refusing Goldfish. The teachers were shocked and were sure to tell me that he opted for the alternative snack that day.

    At a birthday party, they had a Thomas the Train store bought cake when my son was about 4 years old. He chose to have some cake and when he pooped blue poo, he freaked out. I’ve always told him and showed him the artificial colors used in candy and sweets and described it like a kind of paint. He came running out of the bathroom and told me that the blue paint from the cake was in his body. He was horrified.

    We’re not purists, but we try to be conscious. Most importantly, I want my son to understand what is truly healthy food and what’s not, so that he can make his own decisions. My husband is a chef and we cook his school lunches. One of the lunch monitors is always commenting on my son’s healthy, gourmet lunches. We eat real organic, pasture raised food, consume raw full fat dairy, cook with coconut oil and palm kernal oil, and avoid grains and beans (mostly). We don’t consume sugar or wheat. My husband and I don’t consume bread, pasta, potatoes or rice. We give the kids non-wheat based starches. We love all fat!

    I have started using Xylitol when baking with soaked, non-wheat flours and I wonder if anyone has experience or information on the use of Xylitol. I don’t do it often, but when I want to bake a treat occasionally, I’ll use it. I don’t use it in anything else really, as I want us to be able to appreciate the taste of Earl Grey tea or hot cocoa without needing it to be sweet. I try to keep the baked goods from being too sweet, of course. When I was a kid, I used to bake a lot with my grandma, so I love baking for my boys, and I appreciate the challenge of using the soaked, non-wheat flours.

    Another thing that we do is make kombucha, milk kefir and water kefir for the beneficial flora. I try to let them ferment for ages, so use up the sugar, but I’m still concerned that we’re probably getting too much sugar from these drinks, even though they aren’t really sweet. Does anyone have experience with kombucha or water kefir? The sugar issue is really bothering me with these, but I like the other health benefits.

    We went to Disneyworld for my oldest son’s 7th birthday and that was crazy! It was the worst food selection that I’d seen in a long time. We stayed at a Disney resort, so we were eating in the main cafeteria in the morning. We ate scrambled eggs. Next time, we’ll stay in a condo and cook breakfast and bring some food with us into the park. What a carb fest!

    In terms of letting our son be a kid, we let him make his own choices to a certain extent. He eats the crap at birthday parties if he wants to or at other social functions. Sometimes we go out for an ice cream or some other treat. He gives his Halloween candy to the Halloween witch in exchange for a gift (kind of like the Easter Bunny.) The Easter Bunny generally brings a nice chocolate treat and he usually takes a month or two to consume the 4 oz of chocolate.

    I don’t believe in subscribing to super strict diets like a religion. I think that each person has to find what works best for them. I like that my son thinks about his food and he understands the direct connection to his health. He’s not perfect and neither am I, but we both know when we’re eating something that’s not good for us. I think that being informed and proactive regarding food and health is crucial in today’s world.

    Thank you Peter for starting this very important conversation. It’s my dream to be able to host some of the great food films that are out at my son’s school and encourage a dialogue similar to what has happened here. I look forward to learning more from you in the future. Warmest regards.

  14. Yes, definitely! Thank you also for sharing your story about back-pain, very important, and I also know how much one learns from such experiences as an MD. All the best to you and your family!

  15. I really enjoyed your take on LCHF, even for children. I have been eating LCHF for 2+ years for health reasons( ie losing weight). I have been very successful so far. I have been told by many not to have children eating this way, that they need these carbs for nutrients and growth. But I have read you blog and two others stating the opposite. It is a relief to me. My son is short in stature but he is only 10 so I am sure he will grow a bunch when he starts puberty, as that is how his dad and one of his half brothers grew. Both 6′ Tall as adults. My only concern is what is a good amount of protein for kids in general eating this way? I know how much I should be eating, but not sure how much protein is a good rance to start with. Or what percentage of their diet should be protein and fats. I just want to do it right the first time. We have started to reduce the carbs down in general already. To 1-2 servings daily( starchy). Eventually would like it to be once a week, and the rest of the week carbs from fruits and veggies. And by once a week I don’t mean a binge day, just a regular portion. I just want them to eat healthier and grow up with a healthy attitude towards food and be able to make healthy choices. I used to eat very horribly over processed food. I hated veggies, didn’t eat fruit barely ever, and had non celiac gluten intolerance since a child I never knew why I was ill all the time until 2 years ago until I went on atkins. Because all the stomach aches, gas, and frequent bathroom trips went away. My daughter has the same issue with gluten, so the kids eat brown rice noodles when they have pasta. So if you know of a general percentage range that might be good for a preteen and a teen for protein that would be awesome if you could let me know….or if you have a link to another source that explains it. I know how to do low carb…I have read lots of bookss on it and have put it into practice for me. But they aren’t adults, and I just want to be safe. Great info on your site! I really appreciate it. It was just what I needed to read today!

    • Michelle, it sounds like you’ve found a great balance for your kids. In my limited experience, children start out a bit more insulin sensitive than adults. I think if you can just keep their consumption of sugar and highly refined carbs to a minimum, the rest will take care of itself.

  16. Hello Peter,

    I am a pediatric speech-language therapist in private practice in San Diego that works with lots of children who have significant neurological impairments, many of them also have significant emotional regulation issues (e.g., anxiety, attention difficulties). I believe for many of these children their diets have a dramatic impact on the severity of these symptoms. I am amazed and very concerned by the lack of recognition that parents have about how their child’s diet impacts their behavior. As a parent myself who recognizes the huge impact my kids’ diets have on their health and behavior, I also know how difficult it is to have your child stick to the type of diet you know is best once they enter school. It is truly astonishing to see what children eat at school. It is also incredibly frustrating to watch my children make poor food choices offered to them by their friends. I am passionate about the need to educate children about the importance of choosing healthy foods for themselves.

    Do you have any recommendations for an experienced, pediatric dietician/nutritionist that we can recommend to the families we see?

    Thanks for sharing your insight and information!

    • Nicole, unfortunately, I don’t. I wish I did, because I would also ask that person to spend time at my daughter’s school, where apparently sugar in the form of candies, juices, and cookies are part of the official food groups. I’m sure such entities exist, but I’m not sure where they are, especially locally.

  17. Hello Peter and readers–

    Great blog and I really appreciate that you find time in your obviously crammed life to do this. Thanks! It’s truly important work. I have a seven year old and three year old twins, all girls. My husband and I are LCHF eaters with an emphasis on local, grass-fed animal products whenever possible. I used to be a whole-grains, low-fat vegetarian but I came to this way of eating after having gestational diabetes with the twins and never truly pulling out of it (still very glucose-intolerant– having children in your 40s is hard on your body but that’s another story).

    Anyway: It is REALLY hard to get the kids to eat this way since they all seem predisposed to crave pasta, bread, and sugar and that’s what surrounds them in this world. But we’re trying and I guess my mantra is “baby steps”. I too am extremely curious if anyone– Peter or a commenter– has information on whether or not low carb baking fits in this regime. I have been making some cakes, cookies, etc using almond and coconut flours, butter, eggs, and using stevia and erythritol as sweeteners. They have been well-received and seem like a way to wean the kids away from sugar-laden treats. Good idea or not? Opinions? Data? Thanks so much!

    And finally, yes, the school food system sucks on so many levels and in so many ways that we simply must change it!

    • My wife has found a way to use almond flour with a tough of xylitol to make astonishing stuff that I nibble on from time to time and our daughter seems to like. I still think if you can keep sucrose and HFCS out of your house, the steel cut oats with raisins and the pasta with homemade sauce is fine. Hopefully you’re catching them before it’s too late.

  18. I read your article but did not read through all the comments. So I apologize if I am repeating anyone. My daughters are 18 and 21. I eat low carbs but have not converted them. My older daugher is more open to eating more good fats, avocados, olive oil, bacon. But my younger daughter is overweight, in college, and her eating habits are atrocious! They will both be home this summer. Any suggestions on how to convert and convince?

    • I agree with Peter’s comment – you can’t force change on your adult children. I have two sons about the same ages living at home, and I make it a point to always have a lot of high-fat meat and eggs around, and since that’s about all I eat, and losing a lot of weight and feeling great in the process, they’re learning the benefits of eating that way. Also, they’re now eating more of that kind of food since it’s generally readily at hand, so their consumption of, say, pizza and pasta had declined considerably.

  19. Hey Peter,

    I just watched your TedMed talk. It was beautiful, and I’m not
    even talking about the science.
    I’m a product of Hopkins myself, but have never seen such
    humility anywhere, in or around Hopkins. Kudos to you, for
    being able to change your outlook towards your patients.
    I’m guilty of the same. I come from a family of overweight
    people. When I started gaining weight without any change
    in my diet is when I started to feel terrible about the notions
    I had harbored about my family members.

    Anyway, I’m a vegetarian by choice now. Although my staple is
    rice, I have desisted it and shifted to whole grains – Quinoa,
    Oatmeal, barley etc. when I do have rice, I eat only brown rice.
    I have been able to cut down on fat a lot, using only spray oils.
    I have totally cut down my salt intake. My sources of protein are
    eggs and legumes(beans and lentils, And off course quinoa!) I
    eat a lot of fruits, including bananas (with my old fashioned
    oatmeal and raisins, every morning), apples, pears, peaches,
    all berries, plums.
    Being from India I know the high sugar content of mangoes.
    So, I try to have it only a few times in summer. I eat loads of
    veggies in salads and curries.

    Despite all these changes to my diet I do not seem to be
    losing weight. Any insight ???

    Do you have any suggestions I need to make in my diet
    as a vegetarian. I need to lose about 40 pounds to reach my
    desired weight of 130 lbs. I also want to participate in a
    marathon. So, any suggestions you are giving should allow
    me to train for this too.

    • There is a lot of compassion there, I know it, but sometimes it’s hard to find, in any hospital. I worked with a number of amazing and compassionate people there. As for your question, it’s tough (for some) to find the right balance on a vegetarian diet. Though for others, it seems to work very well. There is at least one study going on right now that is looking at genetic and epigenetic markers to help understand this phenomenon.

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