My Clumsy Kid: Hayden's tale of low muscle tone (Hypotonia)

This is my son's story (so far). I originally posted this on May 6, 2009 on another personal blog of mine. I am no longer maintaining that blog but so many people have found it and written to me with their children's own stories. I have to keep it online, so I am reposting the original post here and will be posting updates as Hayden grows!  If you or someone you know has a child with hypotonia, I would love to hear from you if you have any questions or just want to share your story.  There isn't much out there about it (especially for those children with congenital benign hypotonia), so I hope this helps.


After a very normal pregnancy, Hayden's birth was much rougher than I could have imagined. After twelve hours of induced labor and two and a half hours of pushing, Hayden ended up having an “assisted” delivery (I was only one push away from having an emergency c-section) but with help of forceps the doctor managed to get Hayden out. He wasn’t breathing at first, but quickly recovered. Looking back, I think he was born with low muscle tone and it probably contributed to the rough birth. (Our physical therapist has also mentioned that the rough birth might have caused the low muscle tone. It’s a bit of a chicken-and-egg thing – which came first?


Hayden’s condition has always been borderline. It is still not immediately apparent to most people (though more apparent the older he gets and is around other children). Being his mother, I always knew that something was different with him and it took four years to get a professional diagnosis of low muscle tone (hypotonia). Even now, it’s still confusing as low muscle tone is really a symptom, not a disease or condition (as stated by the pediatric neurologist we just saw). Hayden doesn’t have a disease, thankfully, and his “condition” isn’t degenerative – he is showing some improvement with growing older and physical therapy, and his tone isn’t getting worse. It’s just pretty much staying at the same level for him. (More about that later.)


Hayden wasn’t really a floppy baby, but he did feel much heavier than other babies his age (even though they all weighed the same). He did not support his weight as well, and was content to lay or sit in one place for a long time (keeping busy with his hands). He has a large head and we assumed that he had more trouble than most supporting it. He sat up around 7-8 months, but fell over often. He didn’t crawl until 11 & ½ months or walk until 13 & ½ months – nothing too far out of the norm. He always had a slack jaw and his mouth was open most of the time (he still is this way most of the time now). It really wasn’t until the following year or two, when he was a busy toddler, that something seemed off. Hayden has always been “clumsy”. I have affectionately referred to him as my Inspector Clouseau. He has always tripped and fallen frequently, though it doesn’t seem to hurt or bother him much. You can see that he’s going to fall a second or two before he does, because it’s as if his legs just give out from under him or he gets off-balance.(Hayden’s balance has always been poor – it is very difficult for him to stand on one leg.) His pediatrician always responded that he would outgrow it; that his bones were still moving into position from babyhood. Everyone shrugged it off (except for me).


Hayden was a healthy child, but when he did get a cold, it always moved straight to his chest and he ended up with one bronchial infection after another. The doctors call it “cold-related asthma”, meaning he only gets asthmatic when he has a cold, not on a regular day-to-day basis. In fact, Hayden doesn’t have any allergies or sinus issues.  As the years progressed, Hayden’s colds turned more and more quickly to upper-respiratory infections and even pneumonia. (It got to where every time he showed the first sign of a cold we started him on Albuterol, and kept him on Flovent throughout the winter.) Looking back, I think it was the low muscle tone which contributed to his inability to keep his lungs clear. Hayden was also delayed at writing and had trouble with his speech in articulating. At almost five, he is finally drawing representational pictures (you can tell what the object is supposed to be), writing letters and his language has improved enough that we can stop speech therapy.


The main thing that alerted me that there was more to all of this, though, was his posture, especially when he is sitting on the floor. Hayden has always hunched, but more from his waist than his back. When he was three, almost four years old, and sitting in a circle at preschool, I was alarmed at how he looked almost doubled-over, folded in half!  The other kids in his class didn’t have perfect posture, but it was nothing compared to Hayden’s posture! He also “cheats” when sitting on the floor and playing with toys, in that he almost always has one knee up supporting his head and chest (instead of making his muscles do the work). I decided that it was finally time to seek another professional opinion. I called a local children’s physical therapy office and asked if we could get an appointment to have Hayden evaluated.


The physical therapist took one look at him, and said she could see it right away.His low muscle tone was especially apparent in his face (the slack jaw, hanging cheeks, etc.) and in his chest (which has always looked inverted).She asked his to raise his arms over his head and pointed out how his rib cage moved with them, instead of staying in the same position as it should.She had Hayden lay on his stomach and try to keep his chest and head off the ground while doing a puzzle or reaching for a toy.After only a few seconds, his abdominal muscles couldn’t support it anymore.Watching the evaluation, I couldn’t believe how obvious it seemed.It was more severe than even I had realized (though certainly mild compared to others physical disabilities).Still, I was so relieved to have someone else finally validate the concerns that I had been expressing for so long that I broke down in tears.Now we had a name for it and more importantly, some understanding of what it was and what to do about it.


Hayden has been in physical therapy for just over a year now, going once a week. While he has made improvements, his gross motor skills are still of someone almost half his age. We consulted with a pediatric neurologist earlier this week, and even, it was a relief to know that he doesn’t have anything more serious than low muscle tone. He is growing and developing at his own rate, and not regressing, which would be cause for a lot of concern. As the neurologist put it, we probably don’t have a star athlete on our hands, but we never have wished for that. He will excel in certain things, but physical sports probably won’t be one of them (though the doctor felt he would probably take to swimming).


Moving forward, my husband and I will make sure that Hayden gets plenty of exercise and continues to be a happy, healthy, active boy. I have found toys and activities to help him develop the gross and fine motor skills where he needs improvement. I also continue to bolster his emotional strength and self-confidence. I have witnessed his sadness and frustration at not being able to keep up with his friends at school. The boys at his preschool like to run laps around the playground and Hayden can only keep up with them for about ¼ to ½ of a lap before he needs to stop or lags way behind. He sometimes starts sobbing, thinking that they are running away from him. It stabs me right in the heart, this emotional pain that he sometimes experiences, but I know that every child experiences it at times. Hayden is such a loving, funny, wonderful child and I will help him to realize that everyday. I will redirect or refocus him away from his limitations, and we will concentrate on his abilities, interests and most importantly, his joy. I hope this post helps those of you who are going through the same things, or maybe are just starting out with younger children.Trust your instincts.You know more about your child than ANYBODY ELSE! Persevere, do your research, talk to others, find support and be your child’s best advocate!


An update from October 2011: 


 I'm so glad to read that everyone has found this post helpful. I haven't continued this blog but keep it online because it is coming up in search results. Hayden is now a 7-year-old first grader and doing really well. He receives physical therapy at school, and has a couple of special "seats" that he uses in class to help support his weight and train his muscles at the same time. He doesn't let the hypotonia stop him from playing with his classmates, or from completing physical challenges. He is always the last one in from running laps, but he finishes them! 


He had a great time over the summer taking swim lessons and we took gym classes at a wonderful place called Great Play! There was even another boy in his class with hypotonia. The two looked so similar when they moved! I still describe Hayden as the Scarecrow from The Wizard of Oz - when he walks or runs, gravity starts pulling him down and he'll stop and correct himself and keep going! He still can't ride a bike, but he loves to ride his scooter (not a Razor scooter - that didn't work for him at all, but the Micro Scooter I have posted here on the blog under toys). He hasn't had issues with the cold-related asthma much - the doctors had said that because it started before he was three years old, he would probably outgrow it and it seems that he has. Anyway, I'm so encouraged by all of your stories and by the fact that you are finding this blog helpful! Keep advocating for your children - if your doctor blows it off, find a new doctor! Thanks, everyone.


And finally, an update today (April 19, 2012) in response to a new email I received from a reader:


Hayden is turning 8 years old next month!  He's a happy, busy boy who doesn't let his low muscle tone stop him from playing and being active. He does receive physical therapy at school, which is a relief as our health insurance wouldn't cover his therapy outside of school because he doesn't have an injury or disease. He has a special "pad" on his chair that he sits on to gently work his muscles and improve his posture while at his desk. So far he is able to play most of the games in gym (physical education) at school but we tend to shy away from sports outside of school for now. He still cannot pedal a bicycle but he loves riding his scooter and he does well at swimming. He loves throwing balls, and wants to learn soccer. He is tall and thin, and gravity still likes to pull him down often. He recently sprained his thumb playing a game at school, but usually just gets a few scraps and bruises. He does get tired easily, and by the end of the school week, he's exhausted. We try not to schedule too much for him outside of school. 


Fortunately, he did outgrow the cold-related asthma! Now he recovers from colds pretty much like any other kid. His doctor told us that kids whose airways are over-reactive before the age of three usually outgrow it, and it appears that he has. Hayden is getting fit for orthotics finally! Unfortunately the podiatrist he saw when he was three told us to wait, that it wasn't necessary to start him wearing orthotics so young.  I have since read articles about how kids with hypotonia should start wearing them from about the time they learn to stand on.You will want to look into it for yourself, if you feel that they could help your child. 


I have recently found some good information about it on the "Live Strong" website. Here's a link to their information, which even includes some information on nutrition (which I've never seen before): http://www.livestrong.com/hypotonia/ 


I hope this helps. Keep trusting your instincts!

Make Time For Healing: The Flu

It's been quiet on here this week because I've been quiet this week. Five days ago I came down with the flu, and I am just now starting to feel a bit better. I am learning a few things - about influenza, about preparing for illness and giving in when things are out of your control.

I haven't been this sick in many years. I haven't had the actual flu, either, for over 15 years. (I might add that I have only had the flu vaccine twice in all of those years, and that was both times I was pregnant.)  Most of us would probably be surprised to learn that true influenza is not what most people refer to as "the flu" (or "stomach flu"). According to the CDC, people who have the flu often feel some or all of these symptoms:

• fever* and/or chills (*not everyone with the flu will have a fever)
• cough
• sore throat
• runny or stuffy nose
• muscle or body aches
• headaches
• fatigue
• Some people may have vomiting and diarrhea, though this is more common in children than adults.

It's not uncommon for symptoms to last for at least 5-7 days, and the flu is highly contagious (before, during and after you have symptoms). So all around, it really sucks.

I wish I had seen it coming. I would have created a "sick kit" and will now in preparation for the next one of us to topple. Here's what I would put in it:

1. Gatorade, Ginger Ale and bottled water (if you don't have decent tap water). Of course, water is the best but Gatorade helps replace electrolytes (important if you have diarrhea or vomiting), and ginger is a natural remedy for nausea.
2. Crackers - Saltines, Oyster (soup) crackers, graham crackers or dry snack toast. 
3. Popsicles - Of course, most would have to be kept in the freezer, but recently I found a great variety at Whole Foods and Central Market that come in a box (and you don't freeze them until you need them).  They are called Smooze All Natural Fruit Ice, and they are made from coconut milk and fruit purees.  Our favorite is the Coconut + Mango.  (They sell in the retail stores I mentioned for about $4-5 per box.)
4. Cough drops - We're partial to Ricola (I love their cranberry drops) and Luden's Honey Drops.
5. Top Ramen - Who doesn't crave the salty goodness of Ramen noodles when they're sick (or not)?
6. Underwood White Meat Chicken Spread - I know.  I blame this one on my mother.  This was her go-to food item when we were ill, and damn it if I don't still turn to the little yellow can when I'm not feeling good.  It goes against so many of my food principles, but I feel like I'm allowed a pass when I'm down and out.  It fits the bill in so many ways - it's bland, salty and has barely any texture (strange for a chicken spread, huh?).  It starts out fairly innocently enough - white chicken meat, chicken broth, cooked chicken skin (what the...?), seasoning blend (trying to overlook the partially hydrogenated soybean oil in the seasoning blend, especially since "seasoning" and this spread don't seem to mix), dehydrated potatoes, salt, and then a bunch of stuff I can't pronounce.  It's the "Don't Ask, Don't Tell" in my foodie world.  It's one of those pairings that I can't explain - like how I only drink Bloody Mary Mix on airplanes.  Spread it on toast or crackers and down the hatch!
7. Some may add Jell-O or pudding here.

Want to know if the flu has hit your area and if so, how rampant it is currently?  You can check your state's weekly activity on the CDC's website here.  For those of us in Washington, we've been bumped up from "local" to "regional" in terms of activity level within the past week.  (The highest status is "widespread", which is just above "regional".)  So it's on the move, people.

So please take it easy, get plenty of sleep, wash your hands every chance that you get (with soap) and I hope you can avoid this.  If you do get it, please let me know what gets you through it.

Make Time For Useful Applications

A few of my favorite iPhone Applications:

Whole Foods Market Recipes - The most useful part of this application is its "On Hand" feature.  Add several ingredients that you have "on hand" at home and this app will show you what you can make with those ingredients.  You can also add ingredients from their recipes to your shopping list, and it will automatically list the correct quantity.

Groupon - Never miss a great deal!  With the Groupon app, you can buy deals, access your purchased Groupons and redeem them electronically (no need to print them out)!

Urbanspoon - Can't decide where to eat?  Hungry for a particular type of cuisine and need to find someplace nearby?  Looking for a last minute reservation.  This application can help you out with all of that.

Momento - A journal on your phone.  You can type in funny things that your kids say or a diary entry, import photos or your Facebook status updates, and Momento organizes and stores everything by date.  It's even password-protected, like a lock and key on your old diary.

Period Tracker Lite - Ladies, how many times has the nurse asked you to recall the first date of your last period, and you have no idea because who keeps track of that stuff?  Well, now you can with this application.  You input the first and last days of your period on the calendar, and if you're trying to conceive (or not conceive), it displays when you're likely to be most fertile.

Shazam - Next time a song comes on the radio that you're digging (but have no idea what it's called or whose it is), pull out your phone and hit the button on your Shazam app.  Within a few seconds, Shazam displays the song title and artist.  You can think hit another button to download the song from iTunes or post it to your Twitter or Facebook page.

Red Laser - Out shopping and about to make a purchase, but wondering if you're getting a good deal or paying too much?  Curious how healthy that food item or beverage is before you eat it?  Pull out your phone and click on the Red Laser app, then follow the instructions to scan the barcode of the item.  Within seconds, you will see a list of results - from where you can buy it and who has the lowest price, to nutrition facts (supplied by DailyBurn) to Google search results.  Really cool!

Hipstamatic and Pocketbooth - Two essential iPhone camera apps.  (I wrote recently on my photography blog about the Hipstamatic camera app, and can't recommend it enough.  Read more at www.teddiyaeger.blogspot.com)

Scrabble - I try to play at least one round of Scrabble every day (you know, to try to recover my pre-kids brain).

Make Time For Cooking: A Few, New Favorite Ingredients

Ghee - Ghee is butter that has been slowly melted, so that the milk solids are separated from the golden liquid which rises to the surface.  Then this clarified butter (which is excellent for dunking crab legs into and such) is simmered until all of the moisture evaporates and the milk solids begin to brown, giving it a nutty, caramel-like flavor and aroma.  This extra step gives ghee a longer life and higher smoke point is raised to almost 375 degrees, making it ideal for sauteing and frying.  You can make your own, but I bought mine at Central Market in Mill Creek (next to regular butter).  Though more expensive than regular butter, a little goes a long way as its so big on flavor.  Try drizzling it over steamed vegetables, fry or saute in it - even put a little on your popcorn.

Goat Cheese - Trader Joe's now sells individual goat cheese medallions, which are perfect for breading and frying, then adding to a salad (preferably spinach, with dried cranberries and candied walnuts or pecans).  You can shape your own small rounds of goat cheese, but TJ's makes it very convenient.  

Fried Goat Cheese Medallions
To bread each round of goat cheese, dredge it lightly in flour, then one beaten egg and then coat in panko (Japanese breadcrumbs).  Saute in canola or olive oil until golden brown on each side, about 3-4 minutes per side.  Serve atop a nice green salad (see above).


Greek Yogurt - As mentioned yesterday in the Farfalle with Yogurt and Zucchini recipe, plain, whole-milk greek yogurt makes a great (and healthier) substitute for heavy cream, buttermilk and such, in your favorite recipes.  It's also amazing frozen, if you like the tangy frozen yogurt served up at such places as Red Mango, and of course, good on its own for breakfast (stir some fruit or honey into vanilla Greek yogurt, if you like it sweet).  I even used it this morning to make pancakes, after realizing that the recipe called for buttermilk and I didn't have any.  Try it here for yourself:

Hayden's Special-Occasion Chocolate Chip Banana Pancakes (recipe by Tyler Florence)

2 cups all-purpose flour
1/4 cup sugar
3 teaspoons baking powder
2 teaspoons baking soda
3 large eggs
2 cups buttermilk (or plain, whole-milk greek yogurt)
4 tablespoons (1/2 stick) unsalted butter, melted and cooled
1/2 cup chocolate chips
2 bananas, sliced 1/4 inch thick
Powdered sugar (optional)
Maple syrup (optional)

In a medium bowl, whisk together the flour, sugar, baking powder, and baking soda.  Combine the eggs and buttermilk (or yogurt) in a large bowl and beat to incorporate.  Add the flour mixture to the bowl and stir quickly just until combined; do not overmix.  Stir in the melted butter and 1/4 cup of the chocolate chips.  Heat a griddle or large nonstick pan over medium-low heat, and coat with nonstick cooking spray.  Ladle the batter onto the griddle, using 1/4 cup for each pancake.

Cook until the pancakes are covered with bubbles, 3-4 minutes; flip and cook until golden brown on both sides, another 2-3 minutes.  Sprinkle with powdered sugar, a few chocolate chips and top with sliced bananas.

Make Time for Snacks: D-I-Y Microwave Popcorn

I haven't eaten much in the way of microwaveable popcorn in years, thanks to partially hydrogenated oil.  While there are a couple of brands out there without it, packaged popcorn is still very high in sodium and fat.  Until recently, I had forgot that microwaving your own popcorn is extremely simple, cheap and much better for your health.

Here's all you need to do:

1. Add about 1/4 cup of popping corn kernels to an unused brown lunch bag.  (There's no need to add oil!)
2. Fold the top of the bag down twice, stick the bag in the microwave and cook on high for approximately 1.5-2 minutes.  
3. Listen until popping slows down - over 3-4 seconds between pops - then remove the bag carefully from the microwave.
4. Now add your own toppings - melted butter and salt, salt and a bit of lime juice, Parmesan cheese, or even a bit of finely grated chocolate (use a micro plane for best results).  

You have a healthier and tastier version of microwaveable popcorn for a fraction of the price of store-bought varieties!

Make Time For Dinner: Healthy Pasta "Cream" Sauce

I didn't expect to like this as much as I did, and I certainly didn't expect my husband to go for seconds (or whatever you call cleaning the pot). I wanted to make pasta with peas and prosciutto, but every recipe I could find called for heavy cream or creme fraiche (neither of which I had). I did have Greek-style whole milk yogurt, and remembered a recipe I had read recently for Farfalle with Yogurt and Zucchini. I figured that I could substitute peas for the zucchini and Orecchiette for the Farfalle. I swear you would never know you were eating a yogurt sauce - it was so good! Plus it's a healthier alternative to heavy cream.
Here is the original recipe and then my variation:

Farfalle with Yogurt and Zucchini - From On Top of Spaghetti by Johanne Killeen & George Germon (as reprinted in Food & Wine's Best of the Best, Vol.10)

(4-6 servings)

1 lb Farfalle
4 med. Zucchini, coarsely shredded
4 tbsps unsalted butter
1 cup plain whole-milk Greek yogurt
1 cup grated Parmigiano-Reggiano cheese
Grated nutmeg
Kosher salt and freshly ground pepper

In a large pot of boiling water, cook the pasta until al dente; about one minute before the pasta is done, add the shredded zucchini to the pot. Drain, reserving 1/4 cup of the pasta cooking water.
Meanwhile, in a large, deep skillet, melt the butter. Remove from the heat. Stir in the yogurt and the cup of grated cheese and season with nutmeg, salt and pepper.
Add the pasta, zucchini and reserved pasta cooking water to the saucepan and cook over low heat, tossing, until the sauce coats the pasta. Transfer to bowls and eat.

Orecchiette with Yogurt, Peas and Prosciutto Variation
Substitute frozen peas for the zucchini (add to boiling pasta during the last 2 minutes of the pasta's cooking time).
Add small strips of Prosciutto to the pasta, peas and sauce before serving.

Enjoy!

Make Time For Your Health: Watch This

Tomorrow (Tuesday, February 1st) at 4:00 pm (and then again at 9:00 pm), watch Michael Pollan and others talk about meat, and how Oprah's staff did for one week on a completely vegan diet.  Should be enlightening!

To see the listing and a preview, click here.
Michael Pollan & A Vegan Challenge on Oprah tomorrow (Tuesday)

Make Time For Your Health: Eating Well

Over the past couple of weeks, I have lost 10 lbs (10 of about 50 that I need to lose), and I've been asked a few times how I'm doing it.  There's no big secret.  I'm eating healthier than I ever have and starting to exercise again.  I have put it off for so long because I've felt that there just wasn't the time.  When I'm not spending time with the family, taking care of the house and pets, I'm working (any chance that I get).  When you have your own business and work for yourself, there never really a time that you're not working (or at least thinking about work).  So exercise has seemed like a luxury I just didn't have time for.  But I know now that I have to change that way of thinking.  If I get too run down or sick, if I'm not in good shape and energetic, then everything else is going to suffer too.  (Take care of mama and mama will take care of you.)
I started with my diet.  I have been writing down every single thing I eat and drink in a journal.  I've been counting calories, and trying to stay under 2,000 (or even 1,800) per day.  I try to keep my daily amount of sugar below 60 grams.  I'm not vigilant about counting every calorie, but know enough now thanks to the sources I mentioned below to know what's a good choice (and not so good one).  I've been starting to move more - even doing Wii Fit - and find that the more I move, the more energy I have and desire to keep moving.  Eating well and exercise are both contagious, which is a good thing.
So I hope to share some tips with you, and hope you'll share some with me, as I'm just learning.  Try some of this out and let me know how it works for you.  Here are a few to get you started:

• Read Labels and Count Calories - As I mentioned in the earlier post about the book What to Eat by Marion Nestle, to lose weight you have to eat fewer calories.  If you're not sure about a product, don't have a label for it, what to plan your next shopping trip or be prepared to eat out, go online!  I like the website Calorie Count, as it shows the nutritional labels for a huge variety of products.  You can also go to the manufacturer's website itself and look for its nutritional information (here's a direct link to Starbuck's Beverage Nutrition - www.starbucks.com), and plan before you go out.
• Don't Drink Your Calories - You'd be amazed at the calorie and sugar count of most packaged/bottled beverages out there.  I used to love drinking AriZona iced teas and Lipton's green tea with honey.  A single (8 oz) serving of AriZona's sweet tea has 90 calories and 23 grams of sugar!  That's probably not surprising given it's a sweet tea.  But 8 oz of their bottled/canned green tea has 70 calories and 17 grams of sugar.  (Given that 8 oz is pretty small and most of us probably drink at least 3-4 glasses of these kinds of beverages per day, that can add up to at least 300 calories per day and over 68 grams per sugar on these drinks alone!)  Lipton's PureLeaf Green Tea with Honey has 60 calories and 16 grams of sugar per 8 ounces.  Sounds healthy, but guess what?  Not so much.  I know that I would much rather save my daily cache of calories on food instead of beverages.  (Smoothies and the occasional latte are my exception, but I treat them like a dessert.)  Throughout the day I drink water (add flavor by dropping in a slice of lime, lemon, cucumber, etc.), hot or iced tea (made myself so there are little to no calories), and occasionally a glass of 2% milk (122 calories and 12 grams of sugar).  Skip juices or again, treat them like a whole snack, and watch the amount you give to your kids!  Just 1 cup of apple juice has 120 calories and 26 grams of sugar!  For the (now) occasional coffee, I order a Tall Cinnamon Dolce Latte with 2% milk and no whip. I know from reading their nutritional guide that it has 200 calories and 29 grams of sugar, so it's definitely a dessert!  I could switch to the sugar-free syrup but I'd rather have a really delicious drink every once in a while instead of drinking something I don't like the taste of more frequently.
• Have a Small Snack Before Meals - A handful of plain nuts (almonds, walnuts, etc.) or an apple are great choices.  The help you to feel fuller and not eat as much when you sit down for a meal.  
• Avoid Eating Out & When You Do, Be Prepared - Since I started eating better, I have only eaten out on one occasion.  It's much easier to keep track of what your eating and its nutritional value, not to mention cheaper, to make meals at home instead of eating out.  Don't get me wrong - eating out is a luxury to me (especially when done without the kids) - but it's very difficult to know what to order to stick to your diet.  Take time to plan ahead by doing some research.  Take Starbucks again.  There are times when I just absolutely need a drive-through.  I think of Starbucks as a great alternative to the fast food drive-throughs around here.  My favorite:  Roma Tomato & Mozzarella Sandwich (380 calories, 18 grams of fat, 40 carbs, 2 grams of fiber and 16 grams of protein).  Ask them to heat it up so that the cheese is gooey.  It's got basil and roasted red peppers for sweetness.  Their pumpkin bread - another one of my favorite items there - has 390 calories, 15 grams of fat, 60 carbs, 2 grams of fiber and 6 grams of protein.  I'd rather have the sandwich, personally.  I used to order the Reduced-Fat Cinnamon Swirl Coffee Cake, but even though it only has 9 grams of fat, it still has 340 calories, 62 carbs and only 4 grams of protein.  Again, the sandwich would be a better bet.   For the kids, we used to order the Protein Artisan Snack Plate and it's still a good choice for anyone.  We just found that we could make it ourselves at home and pack it to take in the car.  It consists of one hard-boiled egg, a few apple slices, some grapes, a couple of small slices of cheese, a small package of Justin's Peanut Butter (available in these single serving packages at Central Market, Safeway (in the organic section), Fred Meyer, etc.).  It also includes a muesli flatbread but no one in my family likes that taste of that thing so we pack our own multi-grain bread or crackers.  Total calories for the Protein Pack is 370, with 19 grams of fat, 36 carbs, 4 grams of fiber, 17 grams of sugar and 13 grams of protein.    

That's it for now!  I will share more soon, but look forward to your comments.  

Make Time For Your Health

What To Eat by Marion Nestle
is an excellent guide to food - what to eat, what not to eat, how to shop smartly. It delves into the lengths that food industries will go to in order to convince us that their food is good for us (when it's not). It will (hopefully) change the way you eat. It's thick but I found it to be a pretty quick read.  I borrowed it from our local library (to save money) but may have to buy a copy.  It is that helpful.  (And only $11.66 in paperback on Amazon.com.)

Here are the main guidelines that I took away from this book:

• EAT LESS AND MOVE MORE.
• Count Calories:  When it comes to losing weight, it's the calories that count.  You need to eat 2,000 calories or less per day to lose weight or maintain your weight if you aren't very active.  
• 3,500 calories = 1 lb of body fat.  To lose one lb. of body fat per week, you have to eat 500 fewer calories per day (or increase your activity levels so that your body uses 500 more calories than usual).
• Pay attention to the actual "serving size" listed on a food's nutritional panel!  And eat smaller portions than you are currently.
• Read Labels:  When shopping for food, start by reading the ingredient list - the shorter, the better.  (My own rule:  If I don't recognize the name of an ingredient or couldn't tell you what it is, I don't buy that product.  Or go by Michael Pollan's advice in In Defense of Food: An Eater's Manifesto (another excellent book):  Don't eat anything that your grandmother wouldn't recognize as food.)  Then check the food product's serving size, number of calories, amount of fat and saturated fat (don't buy anything with TRANS FAT) and sodium.  If these are larger percentages of the daily value, don't buy this product (or only buy it on occasion).
• Sugar:  Try to limit your intake of sugars to 10% or less of your daily 2,000 calories.  That would be no more than 60 grams (about 4 tbsps) of sugar per day.  If a product has more than 15 grams of sugar per serving, consider it a dessert and treat it as such.
• Shop the Outer Perimeter:  For the healthiest (i.e. least processed) foods, stick to the outer perimeter of the grocery store.  That's where you'll find fresh produce, dairy, meat, seafood and usually breads/grains.  The more processed foods are shelved on all of those middle aisles.  Look for food products with the least amount of processing - those that are pasteurized, frozen, jarred or canned are usually healthier choices than boxed items.
• Stop Buying Your Children "Special" Foods:  You would never know it by going to a supermarket, but children are supposed to eat the same foods that their parents eat.  The best way to get kids interested in real food is to teach them how to cook it.  Better yet, teach them how to grow it.

Some of my own guidelines:

• Food is healthier, cheaper and tastes better if you make it yourself.  And I promise it doesn't take that much time, either.  For example, I love potstickers (Gyoza, dumplings, etc.).  Instead of eating out or buying the frozen variety, I decided to try making them myself.  (I'll be posting the recipe here soon.)  Not only was it so much easier and tastier than I expected, but I fed the whole family for less than $10.00 (including a second batch that I froze for another meal).  The ingredients:  Ground pork, bok choy, ginger, garlic, egg white and Gyoza wrappers.  (I dare you to pick up a bag of the frozen variety and find a list that short!)  This is an easy and fun recipe to let your kids help with as well (up to the frying part)!
• Remember that food is processed to preserve it for much longer than Mother Nature EVER intended.  The shorter the life-span of a food, the healthier because the ingredients used to preserve that food through the next decade isn't good or anything that your body recognizes.  Exception:  If you do your own canning (or buy jarred goods from a reputable source who does not use preservatives like partially hydrogenated oils).  

Marion has her own blog at www.foodpolitics.com I can't recommend following her enough, or getting one of her books.  I am constantly learning from people like Marion and Michael, and hope they will open your eyes as well.