In general, sodium (salt) intake is much too high in the United States. The American Heart Association recommends a limit of 1,500 mg of sodium per day for adults. One teaspoon of salt contains 2,325 mg of sodium alone. The average adult American consumes 3,000-4,000 mg of sodium per day which obviously is higher than the recommendation. High sodium intake has been linked to serious health problems such as high blood pressure, heart disease, and complications of Diabetes.

People generally fear that they won’t be able to eat anything they like if they have to follow a lower-sodium diet. However, that does not have to be true with some planning and creativity. Below are three ways to reduce sodium in several traditional Thanksgiving foods.

1. Turkey

Choose turkeys that have not been injected with a sodium solution. This has become a common practice of retailers to enhance flavor and texture and to increase shelf life. This significantly increases the sodium content of a food that otherwise would be relatively low in sodium. A 3 1/2 ounce serving of fresh turkey breast has 50 mg of sodium. The same amount of the “enhanced” (injected) version has a whopping 350-400 mg sodium. Product labels must declare if they have added a sodium solution, so read your labels carefully.

2. Green Bean Casserole

This is a tradition in many homes and is made with two very salty main ingredients- canned green beans and cream of mushroom soup. Processed and canned foods generally are very high in sodium compared to their fresh counterparts. However, there are options to at least attempt to reduce the sodium intake by using reduced-sodium products.

Sodium content per serving of green beans:

• Regular canned: 380 mg
• Reduced sodium canned: 200 mg
• Frozen: 10 mg
• Fresh: 0 mg

Sodium content per serving of cream of mushroom soup:

• Regular canned: 870 mg
• Reduced sodium: 400 mg

Just with these two ingredients – not accounting for those yummy fried onion rings – you can make a green bean casserole with 1,250 mg sodium per serving or 410-420 mg per serving. This is a significant reduction in sodium content, yet you can still have your green bean casserole. The same can be true for many of our Thanksgiving favorites.

3. Gravy

Gravy and seasoning offer an opportunity to decrease sodium. Instead of canned or packaged gravy, make your own from the meat drippings and flour (the old fashioned way). Try salt-free seasoning blends. There are many ready made ones available at stores or try making your own using the seasoning recipes listed below.

Italian Herb Mix

• 1 tablespoon dried oregano
• 1 tablespoon dried basil
• 1 teaspoon dried marjoram
• 1 teaspoon dried thyme
• 2 teaspoons crushed rosemary
• ½ teaspoon black pepper
• 1 teaspoon garlic powder

Cajun Seasoning

• 2 ½ teaspoons paprika
• 4 teaspoons oregano
• 1 teaspoon garlic powder
• 1 teaspoon white pepper
• 1 teaspoon black pepper
• 1 teaspoon cayenne pepper
• 1 teaspoon ground cumin

Post a comment and share your tips for reducing sodium in a Thanksgiving meal. Have a happy and healthy Thanksgiving!

~ Linda Walker, RD, CSP, CD, renal and ketogenic dietitian, Children’s Hospital of Wisconsin

Halloween parties!

Shift the focus off of candy and onto dressing up and playing games. Host a party with friends or family, featuring costume contests, mummy making (wrapping each other up in toilet paper), bobbing for apples and healthy snacks.

Here are some recipes that make fruits and vegetables dangerously delicious:

Banana Pillars

• One banana
• Creamy peanut butter
• Pretzel sticks
• Two mini chocolate chips
• A red fruit snack or a piece of red licorice

Slice the banana into 1-2 inch pieces. Spread a layer of peanut butter between each slice of banana. Break the pretzel sticks in half and press into the sides of the banana slices. Place of dollop of peanut butter onto the chocolate chips and stick on the front for the eyes. Dip the licorice or fruit snack in peanut butter and place that on the front of the banana for the tongue.

Witches Fingers

• Baby carrots
• Sliced toasted almonds
• Cream cheese

Simply paste the almonds on the tip of the carrots with a dab of cream cheese.

Now, dip in your favorite veggie dip and enjoy!

Apple Bites

• Apples
• Slivered almonds

Just quarter and core an apple, cut a wedge from the skin side of each quarter, then press slivered almonds in place for teeth.

Tip: If you’re not going to serve them right away, baste the apples with orange juice to keep them from browning

Transform trick or treating!

Set a good example for children by choosing healthy alternatives to candy for trick or treating. Pass out small packages of nuts or trail mix, granola bars, 100-calorie pack snacks or reduced-sugar hot cocoa packets. Or, forego food altogether and pass out fun things to play with! Glow-in-the dark bouncy balls, stickers, pencils, bracelets, temporary tattoos, and glow sticks make great alternatives to candy.

Worrying about what to do with your kid’s loot? Let them know that they can keep a small amount and a “magic pumpkin” will transform their extra candy into a special prize overnight. Look for local dentists that will buy candy by the pound to get rid of it.

Also, be sure to follow Children’s Hospital of Wisconsin on Facebook and Twitter throughout October. Every day this month we are sharing a valuable tip focused on keeping Halloween safe for children.

Have a hauntingly healthy Halloween!

~ Jennifer Crouse, RD, CD, CDE, Children’s Hospital of Wisconsin

Why are we worried about childhood obesity? Because we know that if a child’s BMI is greater than 95 percent for age and gender, it increases the risk of certain complications. Those complications may include high cholesterol, high insulin levels, bone and joint problems and more. Long-term effects of these problems can lead to heart disease, type 2 diabetes and other chronic health issues.

Are you worried yet?

So, what can you do? Talk to your child’s pediatrician if you have concerns about your child’s growth. Children’s Health Education Center provides good habits to support a healthy BMI through a program called 3 2 1 0 Blast Off to a Healthier Family. Every child, regardless of weight, can benefit from this program. It includes:

• Three meals a day. Regular, well-balanced meals helps the body use energy more efficiently.
• Two hours or less of sedentary (sitting in front of a screen) activity. Sitting more makes you burn fewer calories. What do you do in front of a TV? Eat, of course.
• One hour of physical activity a day. Getting your heart rate up helps to burn calories and build good muscles.
• Zero sweetened beverages. Lots of extra sugar and calories are hidden in flavored milks, juices and other drinks. It is nutritionally better to eat the fruit than drink the juice.
• Family – Sit down to a table or a counter to eat with the TV off. This will help you enjoy and remember what you are eating. Plus, family time helps you keep up with what your kids are doing.

As parents, we can be great role models for our children. I encourage you to do all of these things with them.

For your child’s BMI and more information on BMI, ask your pediatric primary care provider. Also visit:

• Centers for Disease Control and Prevention
• USDA’s MyPlate
• American Dietetic Association

Parents, I invite you to post a comment and share how you support good habits with your children.

~ Denise M. Kilway, MSN, RN, CPNP, certified pediatric nurse practitioner, Children’s Hospital of Wisconsin

As a clinical dietitian specialist, I encourage you to incorporate fruits and vegetables into the day. For example, try Chef Wayne’s Grilled Fruit Skewers with Spicy Maple Glaze. Another one of my favorites is a high protein dish called Texas Caviar with Baked Tortilla Chips.

Instead of spending 3-4 hours on the couch, try to incorporate some activities and add some friendly competition into the game. We like to play touch football before the game and at half time. The “winners” get to make the “losers” do things during commercials such as push-ups, jumping jacks or getting beverages. Be creative! If Wisconsin weather does not allow for football outdoors than come up with your own game that can be played indoors. Kids love fun games and competition. It could be as simple as doing the crab walk across the living room floor or playing Simon Says.

Just remember, you can enjoy the Packers, have fun and be healthy all at the same time!

Do you have a favorite green and gold recipe you’d like to share? If so, please post a comment below.

~ Kari De Fouw, MS, RD, CNSD, clinical dietitian specialist, Children’s Hospital of Wisconsin

~ Wayne Roe, executive Chef, Children’s Hospital of Wisconsin

• Choose leaner meats.
• Increase fruits and vegetables.
• Increase whole grains.

High-fat meats are among the most significant sources of saturated fat and cholesterol. Limit beef, sausages, hot dogs and fried or battered foods. Choose lean meats such as chicken, turkey and fish. Try baking, grilling and broiling meats instead of frying.

Fruits and vegetables are filling and low in calories. They also have soluble fiber to help lower cholesterol. Five to nine servings per day of fruits and vegetables are recommended, but most people aren’t getting close to that. Start with a goal of having one more serving of each per day.

Whole grains are another important way to include fiber in your diet. Instead of white, rye or Italian bread, choose 100 percent whole wheat bread. Instead of sugary cereals, try cereals high in fiber and low in sugar.

Learn more about heart-healthy diets from the American Heart Association.

We’d love to hear from you. Post a comment and share your favorite heart-healthy grill recipe or family secret.

~ Jennifer Crouse, RD, CD, CDE, Children’s Hospital of Wisconsin

The program empowers families to become healthier by teaching them to:

• Become smart grocery shoppers.
• Adjust serving sizes.
• Choose healthier snacks and beverages.
• Increase activity and play time.

Kids look to their parents to be role models in all aspects of life. When parents make good decisions and take steps to improve their health, it’s a great example for their children.

NEW Kids at the Y is a great partnership between Children’s Hospital of Wisconsin and the YMCA of Metropolitan Milwaukee. The program is offered at the following YMCA centers:

South Shore YMCA: Thursdays from 6 p.m. – 7 p.m.
West Suburban YMCA: Wednesdays from 6 p.m. – 7 p.m.
Northside YMCA: Thursdays from 6:30 p.m. – 7:30 p.m.
Tri-County YMCA: Wednesdays from 6 p.m. – 7 p.m.
Feith Family Ozaukee YMCA: Mondays from 6 p.m. – 7 p.m.

For more information about enrolling in the NEW Kids at the Y Program, contact Stephanie Navarre at (414) 274-0832.

~ Erin Ruenger, YMCA of Metropolitan Milwaukee

Whole grains have fiber, vitamins, minerals and more. Good examples of whole grain foods include:

• Whole-grain pasta.
• Whole-grain bread.
• Whole-grain crackers.
• Brown or wild rice.
• Barley.
• Low-fat popcorn.
• Oatmeal.

A good way to see if food contains whole grains is to look for a whole grain stamp. This stamp means the food has at least half a serving of whole grains.

If you can’t find a stamp, check the product’s ingredient list. Food with whole grain listed as the first or second ingredient can be good for you. Don’t be fooled by products that include enriched flour at the beginning of the ingredient list – these are not whole grain!

According to the Whole Grains Council, an average person eats less than one serving of whole grains per day. The U.S. Department of Agriculture’s choosemyplate.gov recommends at least three servings or more of whole grains each day. Encourage your family to eat healthier by gradually introducing more whole-grain products. The benefits will do you a whole lot of good.

~ Heather Fortin, RD, CSP, CD, clinical dietitian specialist, Children’s Hospital of Wisconsin with Stacy Brand, RD, CD, manager, Patient Services, Children’s Hospital of Wisconsin

At the same time, structure and order help put parameters around our lives. It helps us know when to get up in the morning, when to go to bed at night, when to eat and how to spend our time.

During the summer, some kids become more active. Others spend their days conquering new video games, spraining their thumbs while texting and updating their social networking sites. Some kids wander in and out of the kitchen, finding new things to eat. Others get so busy they forget to eat meals. This lack of structure can create an environment where kids can find themselves in a world of weight loss trouble.

During summer vacation, parents should set their children up for success. Set a bedtime, wake-up time, schedule of daily activities and a menu. This structure will help children make significant strides in managing their weight, even while enjoying summer vacation.

~ Brian Fidlin, PsyD, director, NEW (Nutrition, Exercise and Weight Management) Kids Program

• Is it the journey or the destination? For your next picnic, take some time with your kids to plan the menu. My kids love taking part in planning meals and helping in the kitchen. We each choose a favorite recipe for part of the meal and then put it all together to create the menu. Try one of Chef Wayne’s favorite picnic foods, the basil 5-bean salad. Sometimes, we even take a trip to a local famer’s market. June in Wisconsin can bring tasty salads, sandwiches or quiche that are prepared using seasonal asparagus, potatoes, peas, broccoli, corn or carrots. Also in season are strawberries and raspberries. These berries are great when eaten alone, used in fresh drinks or added to desserts.

• Take time to smell the roses. I still remember helping my grandmother in the kitchen and spending hours with her and my mom talking and laughing. Time spent in the kitchen preparing meals with kids makes for great memories. Young kids can help by adding premeasured ingredients into bowl, stirring cookie batter or frosting cupcakes. Older kids can shop, read recipes or assemble sandwiches. When kids help in the planning and preparation of meals, it can lead to improved trial and acceptability of new foods.

• Temperatures really do matter. Perishable foods, such as raw or cooked meats and poultry, have the potential to cause food-borne illnesses if not handled or stored properly. Bacteria will grow rapidly between 40°F and 140°F. Store hot foods in insulated containers. Cold foods should be stored using ice, cold packs or even frozen juice boxes. Perishable food should not be left out for more than 2 hours. Lastly, pack only what you think you will eat and leave the leftovers home in the refrigerator.

• Special touches show you care. To add color, bring an empty mason or jelly jar to add flowers that were cut from your yard. Or, try rolling utensils in napkins that are tied together with a fun fact or joke for your kids to read while eating. Pack fun games to play with your child such as a flying disc or ball and glove.

~ Beth Polzin, MBA, RD, CD, is a clinical dietitian specialist at Children’s Hospital of Wisconsin. Wayne Roe is the executive chef and manager of Nutrition Services at Children’s Hospital.

1. Always include a serving of fruit. Ideas include any fresh fruit, canned fruit packed in its own juice or dried fruit.
2. Always include at least one vegetable serving. Fresh vegetables cut into fun shapes makes them more appealing. Include a small container of ranch dressing or salsa for dipping.
3. Include a source of calcium. The best and easiest option is to have the child purchase white milk at school. This will include calcium and vitamin D, avoid the added sugar of flavored milks, and the school will keep it cold. If your child will not drink white milk, pack low-fat yogurt or string cheese.
4. Variety in the entrée. Get creative with the sandwich. Cut it into different shapes. Use different breads such as tortilla wraps, pita bread, English muffins or mini bagels. Substitute a salad topped with cooked chicken, tuna or a hard-boiled egg for the traditional sandwich.
5. Lunch does not need dessert or chips. Kids occasionally may enjoy those items but should not expect them every day. Parents should ask, “Is the food I am placing in my child’s lunch going to help their health or make them happy?” To help brighten a child’s day, include a personal note, sticker or pencil instead.

Keeping these tips in mind will help keep lunches healthy and fun to eat.

~ Heather Fortin, RD, CSP, CD, clinical dietitian specialist, Children’s Hospital of Wisconsin