Good Bites by Central Health

Vitamin D deficiency is one of the most common deficiencies worldwide and in the United States.  Approximately 1 billion people worldwide are Vitamin D deficient, while about 50% of the US population has Vitamin D insufficiency.

Vitamin D is the only vitamin that is also considered a hormone.  It can be made in the skin when exposed to sunlight.   The amount of sunlight needed is dependent on geographical location.  Populations that live in year-round cooler temperatures means less sun exposure to the skin.  Even in a warm and sunny climate like Central Texas, people that work and play indoors or wear full clothing and sunscreen may not have adequate exposure to the sun.   Vitamin D production is also limited by the amount of melanin in the skin (This is the pigment that determines skin color).  The more melanin in the skin or the darker the skin, the less Vitamin D will be produced with exposure to the sun.  On average, it can take 20-40 minutes of sun exposure per day to produce adequate Vitamin D. 

In addition to sun exposure, Vitamin D is added to fortified foods and beverages such as dairy products including milk, yogurt, cheese, and butter.  These foods are also good sources of calcium.  Other foods such as egg yolks, flounder, cod, sardines, mushrooms, and beef liver are also good sources of Vitamin D.

While Vitamin D plays a role in the nervous system and immune function, the most important function of Vitamin D is for healthy bones and muscles.  Vitamin D helps calcium stay in our bones and teeth.   Vitamin D deficiency is often linked to bone fractures and tooth loss.  Without enough Vitamin D, calcium will not be well regulated in the body.

Low levels of Vitamin D and calcium can lead to conditions called osteopenia and osteoporosis, which are generally seen in adulthood.  Both osteopenia and osteoporosis are diagnosed with a bone density test, which is an easy and painless medical test.  These bone loss disorders occur when calcium has leached out of the bone, or possibly there was never an adequate supply there in the first place.  Calcium is best absorbed during childhood and adolescence when the bone is still growing, and calcium absorption is at its highest.

Having low intakes of Vitamin D and calcium during adolescence can further increase the risks for bone loss later in life, especially when Vitamin D rich beverages, such as milk, are replaced by sodas, which is high in phosphorus.   Phosphorus can limit calcium absorption.

Phosphorus is an important mineral in the diet and needed for multitudes of biochemical pathways in the body, however, because of food additives found in sodas and even packaged bakery products, it is easy to consume more phosphorus than calcium consumed (Other food sources of phosphorus include edamame, mushrooms, potatoes, rice, cereals, milk, meats, beans, and eggs).  Ideally, calcium and phosphorus would be consumed at a 1:1 ratio.  It is estimated that the average American consumes a calcium to phosphorus more like 1:3 because of the vast variety of foods naturally containing phosphorus and the addition of phosphoric acid in processed foods to maintain extended freshness.  This unbalanced ratio creates an undesirable absorption situation where less calcium is absorbed.  In addition, calcium is found in a lesser variety of foods (listed above).

During adolescence, calcium is absorbed in the bone like a water into a dry sponge, but sometime in late teens to early 20s, that sponge becomes resistant to absorbing calcium and continues to decrease.  Complicating matters even more for females is pregnancy and breastfeeding.  Calcium intake during pregnancy is vital for both mom and baby.  If mom is not consuming adequate dietary calcium, the calcium will be leached from mom's bones and teeth to meet the needs of the baby.  Prenatal vitamins generally contain 100% RDI for iron and minimal amounts of calcium.  This is because iron deficiency is the most common and acute deficiency during pregnancy.  Calcium is not added at the full recommended dose in prenatal vitamins because it will inhibit the iron absorption.  The best alternative is to take the prenatal vitamin (or if you are not pregnant and take a multivitamin/multi-mineral supplement) at one end of the day and a calcium supplement at the opposite.  For example, if dairy products are consumed at breakfast, the calcium supplement would be best in the morning, and the iron containing supplement with the evening meal when consuming protein rich foods, to reduce and chance of interaction.

In cases where Vitamin D and calcium rich food intakes are low or not tolerated, Vitamin D and calcium can be supplemented easily with traditional dietary supplements or newer versions, such as calcium chews fortified with Vitamin D.  The calcium chews are often preferred to traditional supplements, as the chocolate or caramel chew is pleasant and delivers the same dose contained in the more traditional supplements.

Vitamin D and calcium intake are important for bone health.  Lots of Americans are at risk for deficiency.  If you have limited intakes of foods rich in these nutrients, talk to your provider and get screened for deficiency.   Your bones and teeth will thank you!

March is National Kidney Month. Our kidneys are vital to our health to excrete wastes from the blood in the urine. Each kidney gets rid of about 1 to 1.5 liters of urine per day. The two kidneys together filter about 200 liters (about twice the volume of a mini fridge) of fluid per day. It is especially important to keep the kidneys functioning at a high level.

Proper nutrition is necessary to keep all the organs functioning properly, but certain foods that contain special compounds called antioxidants can help keep the kidneys healthy. Antioxidants can help neutralize free radicals and protect the body. Foods high in antioxidants are a healthy choice for maintaining good kidney function and are also good for people experiencing chronic kidney disease (CKD) or those on dialysis.

Top 8 Healthy Foods for Keeping the Kidneys Healthy

1. Blueberries. Blueberries are rich in fiber, antioxidants, Vitamin C, and full of compounds that help reduce inflammation. They may help protect the brain from some of the effects of aging. Blueberries can be consumed fresh, frozen, or dried. Try them in cereals, smoothies, and a topping for yogurt.
2. Raspberries. Raspberries contain a colorful nutrient, giving the fruit its bright color, which helps reduce and prevent cell damage. Raspberries are a good source of Vitamin C, fiber and folate, and B vitamins. Raspberries also have properties that inhibit cell growth and tumor formation. Raspberries are delicious additions to desserts, salads, yogurt, and cereals.
3. Strawberries. Strawberries are rich in antioxidants, giving them their red color. These special compounds also help protect the body’s cells and protect against oxidative damage. Strawberries are also a major source of Vitamin C, manganese, and fiber. They may also provide heart and cancer protection.
4. Garlic. Seasoning your food with fresh garlic is a delicious and healthy alternative to salt. Fresh garlic has antimicrobial properties that also helps lower cholesterol and reduces inflammation.
5. Onions. Onions are also a healthy alternative to salt and add lots of flavors to foods. Onions are low in potassium and can be enjoyed by those experiencing kidney disease. Onions are available in many varieties including white, yellow, and red. Raw onions can be enjoyed on burgers or salads or cooked can be added as a caramelized topping. Cooking onions with meat adds addition flavor, particularly when combined with bell pepper, garlic, and onions.
6. Fish. Fish is a major source of protein, omega 3 fatty acids, and Vitamin B-12. The healthy fats can help fight cancer and heart disease. It is recommended to consume fish twice per week by the American Heart Association and the American Diabetes Association. Fish with the highest levels of white fish, striped bass, herring, mackerel, and salmon.
7. Egg Whites. Egg white are an excellent source of protein, with less phosphorus than egg yolks or meat. Powered, fresh, or pasteurized egg whites. Make an egg white omelet or egg white sandwich, add tuna or salad, or add to salads.
8. Red Bell Peppers. Red bell peppers are flavorful and are good for the kidneys. They are also excellent sources of vitamin C and vitamin A, folic acid, and fiber. Red bell peppers are also against certain cancers. To enjoy bell peppers, try pairing them with hummus, or mixing them into tuna or chicken salad. Bell peppers are delicious served raw, using them as a topping on a salad.

Keeping your kidneys healthy can be tasty and colorful by adding a variety of colorful fruits and vegetables, while also limiting added salt.

March is National Colorectal Month and its time to get comfortable talking about the number 1 problem associated with number 2!

Let's face it-No one likes to talk about excretion patterns (or lack thereof), especially constipation. As a dietitian, I have the "opportunity" to talk about poop, "Code Brown", or Number 2 often.  After all what goes in, must come out!  Unfortunately, constipation is a BIG problem in America, due to many factors, such as eating the "typical" American diet (low in fruits and vegetables), lack of physical activity, and lack of adequate fluid intake.   Constipation refers to inconsistent, infrequent, or hard to pass stool.  Other symptoms can include abdominal pain, bloating, and the feeling of that there is unpassed stool in the rectum.

Chronic constipation can be problematic and be a real pain in the backside (literally).   It can result in hemorrhoids, anal fissure, fecal impaction, and even increased risk for colon cancer.  In fact, colorectal cancer is the second deadliest cancer in the United States.  If you are over the age of 45, it is time to get checked for colon cancer.  Screening can find warning signs of colon cancer or detect colon cancer early, making it much easier to treat.

How often should I go Number 2?

Experts agree that there is a wide variance in "normal" bowel patterns.  Typically, normal frequency is considered from 2-3 times per week to 3-4 times per week in adults.  (Please note, individuals that have had bowel surgeries, gastric bypass, etc... will experience vastly different excretion patterns in most cases from their pre-surgery habits).  The most important thing to monitor is what is normal for you.  If you normally go Number 2 daily, and then you notice that your bathroom time has decreased to 3 times per week, that will definitely indicate a change in normal bowel habits.

 What can I do If I am constipated?

1) Make sure that you are eating plenty of fiber.  The recommended amount of fiber is 25-30 grams of fiber per day.  For children, the recommend amount is the child’s age + 5.  Fiber content is listed on our food labels of packaged foods under the "Carbohydrate" heading.  Some packaged foods, such as fiber rich cereal, bars, and canned legumes can have a significant amount of fiber.  Whole fruits and vegetables (with the skin) are rich sources of fiber.  Dried beans and peas are also excellent sources, with a 1/2 cup of beans containing 6-8 grams of fiber. 

A Word of Caution about Fiber: If you have not been consuming much fiber, (let's say 10 grams per day), and suddenly increase your intake (to 30 grams the next day), then you are very likely to experience some not so pleasant side effects such as gas, foul smelling flatulence, loose stools.  Instead, if you recognize that you need to increase your daily fiber intake, proceed slowly, adding 2-3 grams per day, to avoid the nasty side effects. 

2) Drink Plenty of Fluid

If you increase your fiber intake, then it is very important to increase your fluids.  I like to use the swimming pool slide analogy.  When I was a little girl, I used to go to a public swimming pool that had a small slide with two water spickets that were supposed to wet the slide.  However, the slide was old and the water spickets did not adequately wet the slide.  I would climb to the top of the slide, and about halfway down, I would hit the dry area of the slide and literally get stuck midway on the slide.  This is exactly what happens in the bowel when someone eats a lot of fiber, without consuming adequate fluid.  The stool sticks in the bowel, resulting in abdominal pain and distention, which can be quite uncomfortable.

 3) Get Active! 

Make sure that you are being active.  This means that you are moving around throughout the day, engaging in physical activity, and reducing the time spent sitting.  The movement in the gastrointestinal tract, known as peristalsis, is more active when the whole body is active.  Active people have more regular bowel movements and less reported constipation and bloating.

The Ounce of Prevention is Worth the Pound of Cure!

Chronic constipation can increase your risk of colon cancer and other digestive issues.   Constipation can be managed by eating enough fiber, drinking plenty of fluid, and engaging in regular activity and exercise.   One in 24 people will be diagnosed with colon cancer in their lifetime.  Remember, early screening and detection is key to making a difference.

5 Ways to Bring Food Sustainability Home

March is National Nutrition Month and this year’s theme promoted by the Academy for Nutrition and Dietetics is “Fuel for the Future”.  Eating with sustainability in mind is a healthy way to nourish our bodies during every phase of life while protecting the environment.

1. Check yourself. March is the beginning of Spring and a great time to assess your habits.  Are you in a food rut?  Have you been eating convenience foods and take out too much? Eating a variety of food prepared at home is the best way to save time and money, while also protecting the environment by not increasing paper, plastic, and Styrofoam wastes.
2. Focus on getting 5 servings of fruits and vegetables per day. March is a perfect time to try a new vegetable recipe or a different fruit.  Both fresh and frozen fruits and vegetables are tasty, nutrient-dense ways to fuel your body and practice conscious eating.
3. Try to eat more meatless meals. The production of meat produces more greenhouse gases than the production of vegetables in our environment.  Eating more vegetables can help lower cholesterol, help maintain a healthy weight, promote gastrointestinal health, and decrease health risk, while also improving air quality and the environment.
4. Plan meals. Making a list of foods for weekly meals helps families plan for health meals.  Preparing food ahead of time saves time and money. Also, utilizing leftovers to make new meals helps to stretch the food dollar and helps eliminate food waste.  Consider the amounts of plastic bottles, cans, and single serve trash that you are producing and ways to decrease your carbon footprint.  Some environment-friendly options are to chill cucumber water in the refrigerator instead of using disposable water bottles and using reusable lunch storage containers instead of prepared single-use convenience foods.
5. Get the family cooking. Everyone can participate in food prep. This is a great way to teach kids about good nutrition, cooking, and sustainability.  Even small children can help measure, pour, stir, and mash.  Studies show that children that help with meal prep are more likely to try new foods and be more engaged in mealtime.

 Fueling your future can be a fun way to connect with your family, make nutrition a priority, and be kind to the planet.  Happy National Nutrition Month!

February highlights heart health focusing on the prevention of heart disease.  Heart disease continues to be the number 1 killer of both men and women in the United States, accounting for about 30% of total deaths per year.

No one single factor "causes" heart disease, however, predictive risk factors that can help identify individuals at the highest risk for a cardiac event, including heart attack, stroke, or atherosclerosis. Some of our risk factors are inherited or can result from aging, however, most risk factors are a result of our lifestyle choices.

There are some risk factors that are inherited. These include being male and over 45 years old. Being male doesn't cause heart disease but increases cardiac risk at an earlier age than females. Females have an elevated risk for heart disease after age 55. In addition, being African American increases risk for high blood pressure and stroke, while Caucasians are at a higher risk for heart attacks. Family history is also important in assessing heart disease risk, especially of a parent had a cardiac event before the age of 40 years old.

The good news is that most of our risk factors are daily choices that we make!

What Are the Risk Factors for Heart Disease That I Can Control?

1. Tobacco Use: Smoking cigarettes or using smokeless tobacco products cause vasoconstriction of blood vessels, contributing to hypertension or high blood pressure. It also lowers the levels of oxygen that reach our cells and also contributes to lung disease. Smoking is a choice that increases heart disease risk.

2. Uncontrolled Hypertension:  High blood pressure is associated with increased occurrence of cardiac events.  The good news is that hypertension can be controlled with one or more of the following treatments, including lowering sodium intake to 1500 mg per day, weight management, exercise, stress management techniques, and sometimes prescription medications.  As a Registered Dietitian, I recommend the least invasive strategies first such as a therapeutic nutrition program as well as an exercise regimen.  If elevated blood pressure continues to persist, it may be time to consider a more aggressive approach, such as medication.  The most important factor to consider with your health care professional is the most effective way to control your blood pressure.

3. Elevated Blood Cholesterol:  Like the other risk factors, high cholesterol does not cause heart disease, but it is a significant risk factor and predictor of future disease. More than100 million Americans have increased cholesterol, or roughly half of the US population. Cholesterol can only be assessed by obtaining a blood sample, typically at your doctor's office or clinic. Total blood cholesterol levels should be less than 200 mg/dL. Individuals with cholesterol levels more than 240 mg/dL are at twice the risk of a heart attack. The most effective ways to lower blood cholesterol levels to maintain calorie control (not consuming more calories than you need to maintain a healthy weight), decreasing added sugar consumption, and controlling fat intake. It is important to note that we make cholesterol in the body. In fact, approximately one third of the cholesterol found in our blood is contributed to our liver's ability to produce its own cholesterol from fatty acids. Some individuals are highly "efficient" cholesterol producers and produce more cholesterol in the liver than what is normally expected. Like hypertension, it is important to control hyperlipidemia or fats in the blood and sometimes it is necessary to include the use of statin medications, a classification of medications that help to help lower cholesterol. Your best option to decrease your cholesterol should be discussed with your health care provider. Generally, a combination of treatments is most effective.

4. Physical Inactivity: It has been said that "Sitting is the new smoking”, Exercise is very important to the prevention of heart disease. It has been shown to be a vasodilator and helps to open up blood vessels, lowers blood pressure, lowers stress levels, lowers cholesterol, and contributes to the maintenance of a healthy weight. All types of exercise are beneficial and should be included in a healthy regimen including aerobic activity such as walking, strength training such as light weight lifting, and flexibility and stretching. There is really no downside to exercise.

5. Being overweight or obese: Having an elevated weight or BMI greater than 25 is an indicator of being overweight or obese. Excess body weight is also a risk factor for the development of heart disease, especially if it is centered around the trunk of the body, imagine an "apple" shape versus a "pear" shaped individual. Typically, individuals with a "big belly" are at higher risk than those with a "big bottom. Exercise, diet, and stress management can all be helpful in achieving a healthy weight.

6. Having Diabetes: Diabetes mellitus or having “elevated sugar” also increases the chances of having a cardiac event. Type 2 Diabetes Mellitus or adult onset is typically associated with high BMI, obesity, low levels of physical activity, increased insulin resistance, and poor carbohydrate metabolism. Controlling blood sugar levels, exercise, and weight management are all priorities in helping to manage this risk factor.

7. Uncontrolled Stress: Stress is a factor in everyone's life. Some people handle stress better than others. There are many effective strategies to deal with stress including yoga, meditation, and exercise. Poor ways of dealing with stress including "eating your feelings", internalizing feelings, and self-medicating with drugs or alcohol. Sometimes counseling or therapy may be helpful.

8. Alcohol Usage: Moderation for alcohol means 1 drink per day or less for a female and 2 drinks per day or less for a male. Alcohol intake above a moderate level increases cardiac risk, particularly increased hypertension leading to higher risk for stroke. Alcohol also is a significant calorie source and can increase body weight and body fat.

Managing your risk factors for heart disease is the most important thing you can do to prevent this devastating disease. The best part is that your heart health can be managed by your daily choices!

3 Myths About Behavior Change

As we ring in the New Year, we often reflect about the things that we want to keep in the upcoming year and thing we want to change.  Old habits can be hard to leave behind and new habits can be challenging to begin.  

According to the American Psychological Association, a habit is defined as a “well-learned behavior or automatic sequence of behaviors that is relatively situation specific and over time has become motorically reflexive and independent of motivational or cognitive influence; meaning, it is performed with little or no conscious intent.

Habits have three parts:   cue, repetition, and automation.   Habits are triggered by cues.   Some examples of cues include location, time, routine, mood, and other people.  Repetition refers to the developing of habits (both beneficial and not beneficial) develop by repeating behaviors.  Once a habit has been repeated for a prolonged time, it becomes automatic, which means they occur without intention.

There are several myths that occur about forming new habits and positively changing your behavior.

Myth #1: It takes 21 days to form a new habit.

If you have tried to change a behavior, you may already realize that it is a difficult task.  The good news is that science supports that this is normal.  According to a recent study in the European Journal of Social Psychology, actually it takes an average of 66 days to form a new habit.  The actual time may range from 18 to 254 days, with an average of 66 days!  With that being said, we shouldn’t judge ourselves so harshly if we struggle to change.   Be patient, stay the course, identify your pitfalls.  Otherwise, the failure to change in 21 days leads to disappointment and frustration, followed by decreased motivation, which leads to quitting.

Myth # 2: Willpower is the key to change.

Habits are deeply embedded in our brain.  Habits can be tied to memory and can be temporarily inactive.  Old habits may be revived by cues, such as a location, a smell, our friends and family, and our work environment, willpower alone will not disrupt the habit association.

Myth # 3: Lasting change is impossible.

Every new year, we see the cover of magazines touting people that have lost half of their weight, or make some other highly remarkable change, and it is easy to begin to wonder what is wrong with ourselves and why we have not accomplished such great results.   We do know that old habits can be changed and new ones can be formed by using multiple Behavior Change Techniques at the same time as outlined in the figure below.

Stopping an Undesirable Habit

The truth is that change is hard, but not impossible.  Work on changing one behavior at a time.  Write it down and tell a trusted someone your intentions.  Ask for their support in helping hold you accountable.  Most importantly, be patient with yourself while you break old habits and establish new ones.

Millions of us have made lofty "New Year's Resolutions" as part of the tradition of self-improvement that occurs each January.  The most popular proclamations include losing weight, quitting smoking, or to cut out junk food.  Although these are all great aspirations, our approach may need some improvement. Stating the goal in a positive manner may actually help achieve those desired positive results.  For example, instead of  a goal of losing weight, perhaps we should focus on improving eating habits or increasing our fitness abilities. Psychologically, we are in a happier place to think of our goals as gaining something instead of giving something up.

Once you have goal in mind (aka resolution), increase your success rate by following the SMARTER method.

S-Specific:
Be clear about what you want as you set a positive specific goal. Instead of saying "I am going to eat better, state specifically how you are going to improve your eating habits. For example, "I am going to follow MyPlate to increase my vegetable and fruit intake, follow portion control measures, and lose 1-2 pounds per week”.

M-Measurable:
The goal should be measurable. Using the example above, you could track the number of servings and amounts that you consume to know whether you are meeting your goal.

A-Achievable:
Focus on behaviors that you can control. For instance, you can't directly control how much weight you will lose this week, because you may retain fluid one day or hit a plateau one month. However, you can control the behaviors that lead to weight loss, such as eating a set number of servings and doing physical activity. So, instead of setting a goal of "losing 2 pounds this week", phrase your goal to "this week I will consume 5 servings of fresh fruits and vegetables per day for 7 days".

R-Realistic:
I see advertisements, especially this time of year, promising quick, rapid weight loss, such as "Lose 10 pounds in 2 weeks". These types of unrealistic expectations can be incredibly devastating emotionally and sabotage your goals. Being realistic means setting a goal that is challenging but not overwhelming, so you can experience success and build confidence in your ability to conquer bigger challenges. A more realistic goal is focusing on 1-2 pounds per week.

T-Time bound:
Setting specific start and end times for your goal will help you commit to a time frame and to avoid restarting each Monday!

E-Evaluated:
It is important to look at your goals and see how you are progressing. In the example above, did you consume the fruits and vegetables per day? If not, what happened? Were there certain challenges or problems with meals or certain days? Evaluation of your own behavior can help you to plan for possible diversions and learn how to have a positive plan when problems occur.

R-Rewarded:
Celebrate your success!! Acknowledge your progress by rewarding your achievements with non-food treats! We are more likely to achieve goals when there are both intrinsic and extrinsic rewards. Make a list of rewards. It can even be fun to put the rewards in a bowl and draw each time you achieve a milestone.

Making a positive goal and following through with these steps can help turn those resolutions into a reality! Wishing you all a happy and healthy New Year!

Thanksgiving is time of family, friends, and fellowship.  The schedule for this beloved American holiday is often food and football, but unfortunately can be followed by a bad case of food borne illness if food safety is overlooked.  Food borne illness often presents with moderate to severe stomach symptoms including nausea, vomiting, or diarrhea.  The Centers for Disease Control and Prevention (CDC) estimates that 48 million, or 1 out every 6 of us, will get sick from food borne illness during the holidays.  Infants, children, elderly, and those with compromised immune systems are especially at high risk. 

According to the CDC, the two leading causes of food borne illnesses are eating raw or undercooked foods such as meat, poultry, seafood, and eggs; and allowing food to remain at unsafe temperatures too long.  It is important to make sure that you keep your food safe this Thanksgiving by remembering a few simple rules. 

1. Purchase foods that have been stored at the appropriate temperatures.  If you are buying frozen food, it should be thoroughly frozen in the store.  If you are buying frozen food, it should be thoroughly frozen in the store. Cold foods should be held at 40 degrees or below and hot foods should be held at 140 degrees or above.  The danger zone for high microbial growth in food is 60 degrees to 120 degrees (where we also find "room temperature"). 
2. Check expiration dates on cartons and cans.  Make sure that you are using safe and fresh ingredients.  Old or expired products can taint dishes before the holiday even begins. 
3. Avoid buying dented or bulging cans.  These can be signs of foods affected with the toxin, Cl. botulinum, which can be life threatening or deadly. 
4. Plan ahead to thaw raw meats and poultry properly.  It is important to keep in mind that it may take several days to safely thaw a frozen turkey. 
5. Cook meat, poultry, and other dishes to safe internal temperatures.  Properly using a meat thermometer can assure that your food is at a lower risk for contamination. 
6. Keep cold foods refrigerated below 40 degrees and hot foods at 165 degrees until ready to serve.  This can be done by keeping the food in the oven, using heating elements to keep food warm, and warm or cold packs for insulated casserole dishes. 
7. Most families serve Thanksgiving in a buffet style where there are no sneeze guards, hand washing police, or heating and cooling elements to keep foods at their preferred temperature settings.  These factors can increase your risks. 

Following these guidelines can help you have a safe and enjoyable Thanksgiving Day and extended weekend.  Do your part to encourage friends and family to prevent having a sick Turkey Day! Happy Thanksgiving and Healthy Eating!

Trick or Treating is a fun and traditional way to celebrate Halloween and is often the kick-off to the holiday season.  Many parents struggle with what to do with the excess Halloween Candy and how to keep the fun of the season without promoting undesirable eating habits.  The calories in Halloween candy can range from 25-130 calories per piece.  As a result, the calories and negative effects can add up quickly.  Here are some tips to include the treats in a healthy lifestyle and avoid getting tricked!

1. Encourage your kids to eat the healthy Halloween snacks such as pre-packaged pretzels, popcorn, apples, and baked chips.
2. Eat the candy in moderation. Allow your kids to pick a certain amount of candy per day (depending on their age) and place in a Ziploc bag to practice portion control.  
3. Use Halloween to remind your kids about dental health. Candy that is gooey or tends to stick in teeth or candy that stays in your mouth for a long time (like suckers) will be more likely to cause tooth decay. Remember to brush teeth and floss after eating candy. Tooth decay is one of the leading causes of malnutrition.
4. Freeze extra candy. It can be used as a treat throughout the year.
5. Use it to make a gingerbread house for Christmas.
6. Have your child trade their candy with the “Halloween Fairy” for a new toothbrush and a low-cost toy or privilege.
7. Teach your kids how to give back.  Donate the candy to such organizations as the Military, Ronald McDonald House, or your local women’s shelter.
8. As a reminder, throw out items that are homemade (unless you know and trust the origin), unwrapped candy, or any item that may have been tampered with.

Have a safe and fun Halloween!