Healthy Snacks for Kids

It's that time of the year where parents start to ask me for healthy snack ideas. It seems there are ice cream trucks, candy stands, donuts and other things to tempt our kids all throughout the summer. It can be difficult to get them to eat healthy all the time but don't stress too much about situations you can't control. We don't want to raise our kids to have an unhealthy relationship or feel the need to hide or sneak unhealthy food. 

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I always start with a breakfast that has a balance of healthy fat and protein. I give my son two eggs cooked in pasture butter. This may get paired with gluten-free waffles or toast, topped with nut butter or protein/fat based pancakes. I try to avoid including fruit at breakfast to reduce the sugar impact and save fruit for snacks. Although fruit is fun to use as decorations.

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For lunches I encourage kids to come inside to get a break from the sun and eat something healthy. Again, make sure there is protein and healthy fat. Hard-boiled eggs are fun, particularly with an egg slicer. Jerky, sausages, pepperoni, nitrate-free lunch meat and cheese are also easy.  I like to add fresh vegetables, such as sweet peppers, cucumbers, carrots, celery, jicama. These are all refreshing on a hot day. You can pair with hummus, guacamole or a dip made from healthy ingredients. Kids are more tempted to eat vegetables when they are sliced and arranged in a fun way.

When it's hot out, kids will naturally gravitate towards fruit. Have refreshing fruit on hand, like peaches, apples, oranges and melons. Grapes and cherries are also easy things to snack on and can satisfy the hand to mouth desire. A good rule of thumb is to try to pair the fruit with some fat, such as nuts or nut butters. Cheese is another pairing option but that can be difficult to keep chilled on a hot day. 

Water is very important, particularly on a hot day, and many people mistake hunger for thirst. Stay away from fruit juices but you can make some fruit infused water. You can also add some electrolytes to water if it's really hot. I like Nuun tablets. I also like some of the sparkling kefir drinks for kids. They are good for the gut microbiome and are a great replacement for soda. My son loves Doctor D's apple.

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Smoothies or homemade "ice cream" are popular. Use full-fat dairy or dairy alternative as your base (full-fat Greek yogurt, full-fat coconut milk, whole milk...), add some fruit and fat (coconut oil, nut butter...), a handful of greens and part of an avocado. Avocado is key to making it rich and creamy. If you have a Vitamix you can use some of the same ingredients to make it into a thicker mixture like ice cream or sorbet.

Homemade popsicles are easy to make, but just be sure to add a little fat to reduce the sugar rush. You can also simply freeze fruit, such as grapes. Kids love them!

An alternative to chips is homemade popcorn. Pop organic corn in coconut oil and top with more coconut oil, pasture butter or ghee and sea salt. I typically make an extra batch on movie night and have that available for snacks. If you do serve chips, the best options are those with the smallest ingredient lists and fried in healthy oils, such as coconut or avocado oil. Some good brands are Boulder, Jackson's Honest and Kettle.

Other snack options:

Smoothie recipe (for one child):
1 cup coconut milk
1 tbsp nut butter
1/2 banana
1/2 scoop chocolate protein powder
1/2 avocado
Handful of greens
Ice
Blend until smooth
 

Digging Deeper to Perform Better - Testing for Athletes

When athletes come to me as new clients, they are often seeking to improve their race performance, minimize gastrointestinal (GI) distress or determine individualized race nutrition. But once we begin working together, it is not uncommon for me to find bigger body imbalances preventing them from achieving their goals.

In addition to a thorough intake form that allows me to begin to understand underlying issues, I may use biomarkers and lab tests to give me a glimpse under the hood, so to speak.

These are common tests that I consider:

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  • Comprehensive blood panel – This can be obtained from the client’s general physician and is often
    covered by insurance. I recommend everyone have a full panel of blood tests at least once
    a year. From a comprehensive blood panel I can see the following:

o Nutritional deficiencies that may impair performance

o Blood sugar, which many athletes manage poorly due to a high intake of sugary sports nutrition drinks or bars, or excessive use of carbohydrates to fuel training sessions

o Inflammation, which can negatively impact recovery and can lead to other health problems like leaky gut, arthritis and eczema

o Bone and muscle health, which can indicate when there may be an increased risk of injury

o Hormonal deficiencies that can be precursors to overtraining or even prevent proper recovery and increase risk for injury

o Electrolyte imbalances, influencing hydration needs

o Iron and other oxygen transport levels, affecting performance

o Liver and kidney health, which can be damaged during endurance events

  • Organic Acids Test (OAT) – This test looks at metabolites in the urine, which are found in much higher concentration than in blood. The test provides a great look into an athlete’s health and metabolism, providing more than 70 markers. (https://www.greatplainslaboratory.com/organic-acids-test/) Athletes typically invest a significant amount of money on bikes and other equipment to improve performance, but this test will actually help to improve the “engine.” It shows the following:

o Ability to generate ATP (energy currency in the body) from fat or carbohydrate

o State of blood sugar management

o Vitamin and mineral deficiencies

o Intestinal health, including bacterial and fungal overgrowth, which can be common due to poor digestion during training and races

o Levels of oxidative stress, which is a concern for all athletes due to excessive generation of reactive oxidative species during training

o Neurotransmitter levels, which can affect mood and the desire to train

o Oxalate levels, which can be a concern and are linked to a number of health disorders, including kidney stones, fibromyalgia and anemia

o Ability to detoxify and flush toxins from the body

  • Dried Urine Test for Comprehensive Hormones (DUTCH) – Too often I see female athletes struggle with amenorrhea (in which women stop menstruating) or male athletes that have low testosterone. Many times this is due to overtraining and excessive stress leading to cortisol imbalances. The DUTCH test offers a chance to see where hormone levels currently stand, including sex hormones, stress hormones and melatonin. https://dutchtest.com/ All hormones affect each other, this test gets to the big picture and where the problems lie.
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  • Metabolic Testing – This test shows me how well an athlete burns fat and gives me the data to prepare a customized training and racing nutrition plan. Learn more about it here: http://n2finc.com/blog/2017/4/10/the-value-of-metabolic-testing
  • Comprehensive stool testing – When an athlete struggles with GI distress during races, I probe more and find that he or she may deal with GI distress outside of training, as well. That’s a pretty good indicator that something is amiss in the GI tract. The stool test can tell us levels of bacteria, both good and bad, if there are parasites present and can even indicate how well an individual is absorbing nutrients

Without being able to see inside an athlete’s body, these tests provide an in-depth look at the overall health of the body and, as I say, health first, performance will follow. These are some valuable tools that all people should consider. Invest in your health!

My Thoughts On Exogenous Ketone Supplements

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You have probably seen posts all over the internet promising weight loss, sports performance, mental clarity and more from using exogenous ketones, but are they safe and will they help you achieve your goals?

First, you may want to understand what exogenous ketones are. “Exogenous” refers to something that is not produced within the body. Alternatively, “endogenous” describes something produced within the body. The liver will naturally produce ketones from fatty acids during extended periods with low blood glucose.¹ Glucose, free fatty acids and ketones are able to supply energy to the mitochondria of cells, which are our aerobic energy powerhouses. But unlike free fatty acids, ketones can cross the blood brain barrier and can be used for energy by the brain cells and the central nervous system. This can be especially important during times of low blood glucose. When there are sufficient levels of ketone bodies in the bloodstream, the body is said to be in “ketosis.”

This ability for ketones to provide energy when glucose levels are low would have been especially important when we could not just go out to any grocery store, fast food restaurant or into our pantry to eat something for energy.

Some benefits, as listed below, have been observed during times when the body is producing its own ketones. This can be done through starvation or nutritional ketosis, which involves reducing insulinogenic foods (carbohydrates and protein) and increasing fat to a level that reduces blood levels of glucose enough that the body believes it needs ketones for fuel.²

Based on these benefits, companies have started to produce synthetic ketones that we ingest in order to increase blood levels of ketones: exogenous ketones. Some manufacturers state that these can be taken to get the body into “ketosis” without any modification to diet. But that means that if a person were to use these exogenous ketones while still eating the Standard American Diet (SAD), he would have both glucose in his blood, as well ketones. This is not a natural state and the glucose in the blood is still going to cause an insulin spike.

If the idea of ketosis is to retrain the body to use ketones for energy, artificially supplying ketones will not aid in this goal. In addition, we are looking for long-term improvements through dietary and lifestyle changes. Popping a pill or drinking a supplement without other changes is not a long-term solution.

Additionally, supplemental ketones are generally very high in sodium and potassium, which may not be healthy for everyone and can cause blood pressure issues, especially when taken numerous times per day.³

Purported benefits of exogenous ketones:

·      Weight Loss – One exogenous ketone supplier claimed that exogenous ketones can lead to weight loss, but no studies were provided to back this up. The vendor's website only provided studies showing that endogenous ketones helped with weight loss (obviously as they are made from fatty acids so stored body fat is broken down to make them), quickly jumping to the conclusion that the two must lead to the same results. Two of the experts on using ketogenic diets for health state that exogenous ketones have not been proven to help with weight loss. ⁴ Additionally, several studies show that using exogenous ketones reduced lipolysis (the breakdown of stored fats for energy).⁵

·      Provide energy – Exogenous ketones will provide energy, since they are a direct energy source, but if there is also glucose in the bloodstream, insulin will increase, which puts the body into a storage mode, pushing glucose into fat storage.

·      Sports performance – One study concluded that there is not enough evidence to support the claim that ketones can support sports performance.⁶ But another study showed that exogenous ketones helped to increase endurance and reduce lactic acid accumulation.⁷ In addition, a third study showed that exogenous ketones can spare glycogen use. But while this may help to sustain longer endurance exercise, it is spared through a reduction in carbohydrate oxidation⁸ possibly compromising higher intensity efforts during the endurance event (i.e. that last kick to pass someone or cross the finish line under a time goal may be at risk).  Overall, there is really no consensus on the effects of exogenous ketones on sports performance and more studies are needed. I think it’s also important that studies be done on steady state endurance athletes and athletes that need to constantly move between fat and carbohydrate burning, such as cyclists or mountain bikers.

·      Decrease appetite - A recent study found that supplementing with ketone ester lowered the amount of ghrelin, sometimes called the “hunger hormone,” which led to decreased appetite.⁹ Most of the exogenous ketone supplements on the market today are ketone salts, not ketone esters. Ketone esters are raw ketones that enter the bloodstream more quickly than ketone salts, which elicits a quicker response but the esters taste pretty bad and can lead to GI distress. For that reason, most of the exogenous ketone supplements on the market are ketone salts.

·      Improved mental clarity - Some people report better mental clarity and energy but most reports like this are anecdotal and there are few studies that point to proof of these types of benefits.¹⁰

Despite all this, there are times that exogenous ketones can be beneficial:

·      They can help with energy when a person is transitioning from a higher carbohydrate diet to nutritional ketosis. Exogenous ketones have been found to help avoid the “keto flu.”

·      They can help for some additional mental clarity if used in conjunction with a lower carbohydrate diet.

·      If an athlete is already metabolically flexible (able to burn both carbohydrate and fat efficiently for fuel), exogenous ketones may help with sports performance.

I have experimented with Keto/OS and Perfect Keto. I did not notice any change with Keto/OS but noticed a slight improvement in mental function and reduction in appetite with Perfect Keto. The chocolate sea salt flavor was pretty darn good in my fatty coffee.

Based on what we know about how ketones and glucose function, I don’t feel that these expensive supplements are worth the cost when we can use our bodies to produce ketones in a healthy way using nutritional ketosis. 

¹ https://link.springer.com/chapter/10.1007/978-1-4684-5931-9_5
² https://www.medicalnewstoday.com/articles/180858.php
³ https://blog.undoctored.com/beware-exogenous-ketones/
⁴ https://optimisingnutrition.com/2016/08/08/ how-to-make-endogenous-ketones-at-home/
⁵ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5309297/ 
⁶ https://optimisingnutrition.com/2016/08/08/how-to-make-endogenous-ketones-at-home/
⁷ https://www.sciencedaily.com/releases/2016/07/160727140039.htm
⁸ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5309297/
⁹ http://onlinelibrary.wiley.com/doi/10.1002/oby.22051/pdf
¹⁰ https://www.ketovale.com/exogenous-ketones-reviews/