Controlling screen time for kids can be a challenge. Between TV, smartphones, iPads and tablets, computers and video games, the added time between all of the devices can easily escape parent’s notice and suddenly, kids are spending several hours a day with recreational screen time. Limiting devices in the home, having screen free days and setting time limits are all ways to try to control time spent by children. The American Academy of Pediatrics recommends no more than 2 hours of combined screen time for kids and none for children under the age of 2.
Screen time coupons are one way to try to control and monitor screen time. By having coupons that kids have to “cash in” for every designated time allotment on screen time, parents can help control the time in a week. Kids can learn to manage their weekly allotment and when the coupons are gone, they are done for the week. Let’s see you allow 10 hours a week, with maybe a 2 hour limit per day and you give the coupons out on Sunday. By the next Friday, if they have used all 10 hours, there is no screen time for that weekend. Kids may have some leeway to earn some extra time, of course, within limits.
Download the screen time coupons by clicking here.
The European Union (EU) banned the use of synthetic hormones in meat and meat products in 1988. The EU is presently carrying out an additional risk assessment of the safety of hormones in meat and its effect on humans.
The FDA in the United States continues to reassure consumers that hormones are safe in meats because of the tiny amount that is used in animals and only a small fraction is transmitted to the humans who consume meat. These hormones, anabolic steroids, are used in the United States and other countries (like Australia and Canada) to make cattle larger and leaner.
The hormones are administered to the animal by a small implant under the skin, so only a tiny amount is released. In April 1999 the EU banned beef imports from the United States starting on June 15, 1999. The EU’s commission stated, “This action has been taken to protect consumer health in the EU.”
In addition, dairy cattle are injected with a genetically engineered growth hormone, called bovine somatotropin (BST) or recombinant bovine growth hormone (rBGH), to increase the production of milk by the cow. In a press release in March 1999, the Chairman of The Cancer Prevention Coalition, Dr. Samuel S. Epstein, shared concerns about rBGH and has called on the FDA to immediately ban milk from cows injected with this hormone.
Scientific studies from the EU have shown elevated levels of insulin-like growth factor-1 (IGF-1) in milk from these cows. Epidemiologic studies indicate a link between excess levels of IGF-1 and breast and prostate cancer. He also shared concerns about the antibiotic use that is necessary in these cows because of the high rate of mastitis (breast infections) in these cows.
The use of antibiotics in our meats is a concern. Some 60 to 80 percent of all cattle, sheep, and poultry in the United States will receive antibiotics at some point. Researchers are trying to determine if and how much of a role this widespread antibiotic use may have in creating antibiotic resistance of bacteria in humans.
A report from the National Academy of Sciences stated, “Bacteria that resist antibiotics can be passed from food animals to humans, but not enough is known to determine the public health risks posed by such transmission.” As consumers, we need to make our choices, but concerns are appearing about the safety of meat and meat products. We need to make informed decisions about these choices. We know that people who maintain vegetarian diets are healthier with lower risks of heart disease and cancer.
We know that fruits and vegetables are loaded with protective antioxidants to fight disease. Could there also be a link between excess exposure to toxins in our meats and meat products that also contribute to an increase in disease processes in meat eaters?
As with many things, we need more information and research, but are we putting our children at risk with a heavy meat diet? This is a decision every family and person must struggle with, but it seems that moderation is important when it comes to meat.
Organic milk and other dairy products are more available now. Organic milk is found in many large-chain supermarkets. The US Department of Agriculture recently ruled that meat and poultry may seek organic certification. To fulfill organic requirements, these meats will have no antibiotics or growth hormones and the animals will be fed 100 percent organic feed.
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We all want to enjoy food and sometimes as we get our kids to try to eat the healthy choices, we label foods as “good” and “bad.” This is not an effective way to talk to kids about food, especially the younger ones, as when they eat the “bad” foods it makes them “bad.” I teach families that we should be able to enjoy all foods, but some foods should be more often and these can be called “Go” foods or “Energy” foods. Other foods can then be called “Slow” or “Whoa” foods that should be eaten less often. I also like to talk about “Joy Treats,” these are special enjoyable foods that should be savored, like a special homemade cake, or dessert when eating out, or ice cream. The idea you can create with “Slow” foods and “Joy Treats” is that they should be enjoyed and eaten S-L-O-W-L-Y. Teach your kids to savor each bite.
What have researchers discovered about the link between allergic processes and nutrition? The following is a summary of some of this research. Most of these studies have been done in adults.
Vitamin C is a major antioxidant substance in the airway surface liquid of the lung where it could be important in protecting against environmental oxidants. A study from the American Journal of Clinical Nutrition showed that a diet low in vitamin C was a risk factor for asthma.
Patients with asthma who reported a high dietary magnesium intake had better lung function and a reduction in the relative risk of wheezing. Animal studies have shown that magnesium deficiency increases the amount of histamine released into the blood. Histamine is a natural chemical in our bodies that, when released, causes many of the symptoms of allergies.
Low selenium levels were observed in patients with asthma when compared to a group of patients without asthma.
In a group of 20 patients with exercise-induced asthma, two grams of vitamin C was administered and lung function was tested. In nine patients, a protective effect on their exercise-induced asthma was documented after vitamin C was given.
A dietary questionnaire used to determine intakes of different nutrients in patients with asthma and allergic rhinitis, and then in control patients without disease, showed that those with the lowest intakes of vitamin C and manganese were associated with more than five-fold increased risk of asthma. Also those with low intakes of zinc had increased risk of symptoms of seasonal allergies, and those with low magnesium intakes had increased risk of asthma.
Children who ate fresh oily fish had a significantly reduced risk of asthma. No other food groups or nutrients were significantly associated with either an increased or reduced risk of asthma. This study concluded that consumption of oily fish may protect against childhood asthma.
A study of 17 adult asthmatics found that when their diets were supplemented with daily dosages of 400 IU of vitamin E and 500 milligrams of vitamin C there was an 18 percent increase in the peak flow capacity (a measure of lung function) over those on regular diets.
A diet significantly deficient in vitamins A and E and lower in other nutrients was found in the diets of brittle asthmatics compared to non-brittle asthmatics and healthy controls. Brittle asthma is characterized by repeated life-threatening attacks despite appropriate medical treatment. In addition, selenium, magnesium, and vitamin C intake was somewhat lower in brittle asthmatics.
Proanthocyanidins (found in grape seed extract) have been found to have an antihistaminic effect.
According to a new book entitled How to Get Kids to Eat Great & Love It! by Christine Wood, M.D., the risk of developing degenerative diseases such as cancer, diabetes and obesity can be significantly reduced through proper nutrition beginning in childhood and continuing through adulthood.
Wood, a practicing pediatrician for 14 years and a leading spokesperson on children’s nutrition, also outlines in this book ways of dealing with other non-degenerative diseases such as allergies, asthma, ear infections and attention deficit disorder (ADD) with preventative measures and with nutritional supplementation and a balanced childhood diet.
Wood’s book, a result of her years of reviewing nutritional research, is divided into three basic sections.
The first section identifies the toxic conditions present in our environment today and why instilling lifelong healthy eating habits in our kids will help them battle the environment’s negative effects on their bodies.
The second section specifically outlines proper nutrition for every age group: infants, toddlers, preschoolers, school age children, and teens.
The final section provides research, case studies and tips on how environmental measures and in some cases, proper nutritional supplementation may reduce symptoms of common diseases such as allergies, asthma, ear infections, and ADD. She also presents compelling research on why certain nutrients may have an impact on our children’s future risk of degenerative diseases of aging, like heart disease and cancer. This is information that the parents who read this book will be able to apply to themselves.
In addition to providing nutritional information, guidelines and case studies, How to Get Kids to Eat Great & Love It! also includes several related appendixes with charts, tables and additional resource information.
“My goal for writing this book was to create an easy to understand, simple, but thorough, guide that instructs parents on how to teach their children to enjoy eating a balanced diet and living a healthy lifestyle. “
“As parents, we hope that our kids will be healthy and stay healthy. By understanding how to use nutritional supplements as protection against today’s environmental dangers and teaching a lifestyle of healthy eating habits and exercise, we can give them this gift,” Wood said.
Soft bound, 8 ½ x 5, 220 pages, indexed, fully footnoted (126 footnotes), references, charts. Areas of interest: Nutrition, Health, Children, Medical , Parenting.
Christine (Ito) Wood, M.D., C.L.E. (certified lactation educator) is a practicing pediatrician with interests in healthy nutrition for children and the environmental and nutritional impact on health and disease. She is a compelling voice on the subject of children’s nutritional issues.
She is the author of the book, How to Get Kids to Eat Great & Love It! (second edition, Griffin Publishing Group, 2002). Filled with practical, easy-to-understand information for parents, she backs it up with science-based research to emphasize the nutritional links to disease. She maintains another website, Call Your Pediatrician, that was launched in 1997. It is a website for parents designed to give information on common illnesses, like colds, ear infections, diarrhea, vomiting, fever, and more. Kids Weigh to Go is her program targeting families with overweight children.
Dr. Wood lectures to physicians and other health professionals (nurses, lactation consultants, dietitians, school nurses and others) on the topic of nutritional medicine for children and she gives seminars to parents on healthy lifestyle practices for children. She has lectured throughout the United States, Canada, Australia, New Zealand, and Japan. Dr. Wood is a spokesperson for an international nutritional company, USANA, and serves as the current Chairperson on their Medical Advisory Board.
Newsweek has had her as a guest writer for a special edition released in October 2000, called “Your Child.” Her interviews and articles have been published in magazines including: Redbook, Fit Pregnancy, Family Life, Exceptional Parent, Great Life to mention a few. A frequent guest on radio shows and also a noted expert on satellite media tour, she informs parents about the critical need for proper nutrition for children. If you would like to contact her regarding print interviews, speaking engagements, radio or television spots, please click here.
She is currently practicing pediatrics at El Camino Pediatrics. She attended the University of Detroit for her undergraduate degree and received her medical degree from the University of Michigan. She completed her pediatric residency at Children’s Hospital of Los Angeles. She received her lactation educator certification from the University of California, San Diego.
Dr. Wood explains that she found a need to address the questions her patients repeatedly ask regarding the role nutrition plays in the health of their children. Dr. Wood says, “Parents need to realize what an important job they have to teach their kids healthy eating habits, to use proper nutritional supplementation and to participate in regular physical activity. Parents must start today and model a healthy lifestyle and do all they can to create children who will eat healthy and be active. It is perhaps the greatest gift we can give our children . . .the gift of health now and long into the new millennium.
In lecturing to many different groups of health professionals, I find that there is a new, attitude on the horizon. Most traditionally trained health professionals are trained to understand the disease and the pharmacological approach to treating disease. We could call this “prescription pad medicine.”
However, the trend of consumers who use alternative therapies, such as acupuncture, chiropractic care, massage, vitamins and minerals has been steadily rising. In turn, many traditional physicians find that they must keep up with this trend, so that they may understand how these non-traditional therapies may impact their patients.
When I teach medical students in my office, I tell them that those we are willing to learn and accept certain non-traditional treatments, will be sought after by patients and offer a great service to their patients. Those that choose to remain close-minded will be left behind in this rapidly changing world.
It is not to say that non-traditional therapies are not without risks and certainly we know that they are not the cure for many diseases. Our role as a traditional physician or nurse is to understand a little more than our patients and be able to support or redirect them when we feel a non-traditional therapy is not worthwhile. However, to throw out the possibility of ever using alternative or complementary medicine, would be throwing away the possibility of helping certain diseases or maybe just making the patient feel better.
Remember, our first job is “to do no harm” and if we live by that standard, we should be able to “do more good.”
In speaking to my fellow pediatricians, we must recognize where we have been and where we may be going. Where we have been includes:
Folate was first recognized in the medical literature as preventing neural tube defects in infants when given to pregnant mothers in the 1960’s. It was not until 1992 that the U.S. Public Health Department recommended that folate be given to all women who may become pregnant and who are pregnant.
In the 1950’s, pediatricians took to the baby formulas as the best nutrition for infants. We certainly now all understand the tremendous health benefits of breast milk and support the American Academy of Pediatrics position on strongly urging women to breastfeed.
And where we may be going?
The fatty acid, DHA (docosahexanoic acid) was recognized as being important for infant brain development and the Food and Agriculture Organization and The World Health Organization Joint Expert Committee in 1994. At that time, they recommended that all infant formulas include DHA. DHA was added to infant formulas around the world (over 60 countries by 2001).
In 2001, the FDA completed a favorable review of Martek’s Generally Recognized as Safe (GRAS) notification regarding the use of its DHA and AA (arachidonic acid) oil blend in infant formulas for the U.S. Now in 2002, companies have now launched infant formulas supplemented with DHA and AA (Mead-Johnson, Lipil®) http://www.enfamil.com/lipil/ and Beech-Nut has introduced the first baby food line, First Advantage®, supplemented with these important fats. To learn more about these fats, see my essential fatty acids page.
Mercury may be the next lurking toxin that will receive more attention in the pediatric literature. Mercury clearly affects the nervous system and public awareness of sources of mercury needs to be raised. I still find that many pregnant women have not heard the FDA recommendations to limit fish intake during pregnancy and breastfeeding to protect their developing infant from the possible devastating effects of this toxin.
Issues in the area of environmental toxins and its affect on our pediatric population and simple nutritional strategies and supplementation to decrease risks of disease need to continue to be researched and brought to the attention of those taking care of our young children. I challenge you to think of “nutritional pharmacology” and prescribe dietary interventions and lifestyle changes as freely as we prescribe antibiotics. The proper balance of “prescription pad medicine” and “nutritional medicine” in the right doses could do a world of difference.
There is a constant battle going on in the homes of many families, and this war has to do with food choices. In my own pediatric practice, some parents are concerned because of the lack of healthy food in their child’s diet. Some parents show little concern about their child’s eating habits. However, on further questioning, I find their child’s diet is filled with unhealthy food choices, lacks fruits and vegetables, or does not come close to reaching the recommended calcium requirements.
Poor Eating Habits Evident in Our Children. A study from the journal Pediatrics surveyed 3,307 children, two to 19 years of age in the United States. Only one percent, that is 33 children, met all recommendations for the Food Pyramid Guide. Those that met all recommendations had nutrient intakes above the recommended dietary allowances and their diet was generally too high in fat.
Our children are growing up in a fast-food world, and they are being marketed to by advertisers with many unhealthy food choices. The truth is that most children are not getting the nutrition they need.
Cancer on the Rise in Children More than Ever Before. Federal health experts have concerns about why cancer rates are on the rise in children. There are about 8,000 new cases of cancer in children under 15 years of age each year in the United States. Childhood cancer has risen steadily over the last 15 years. Acute lymphocytic leukemia is up 10 percent and brain tumors are up more than 30 percent in the last 15 years. Cancer has become the leading cause of death due to disease among children. In recent years, deaths from cancer have declined because of earlier detection and improved treatment, but experts are concerned that survival rates could be eclipsed because of the rising rates of new cases. Many experts, including Dr. Kenneth Cooper, author of the Antioxidant Revolution, feel that environmental toxins are in part responsible for this increase. Some experts estimate that as many as 80 percent of childhood cancers are caused by environmental factors.
Allergies and Asthma
Allergies and Asthma Now Affect Millions of Children. Statistics from 1994 from the Center for Disease Control found that asthma affects nearly 14 million Americans. This is nearly double the rate from 1980. Almost five million of these asthmatics are children. Asthma is the most prevalent chronic condition among children. Allergic rhinitis, commonly known as hay fever, affects 26 million Americans. The role of air pollution and other toxins have been implicated in contributing to this rise in allergies and asthma.
Environmental Toxins and Unsafe Food
Exposure to Environmental Toxins and Unsafe Food on the Rise Daily. Experts have concerns about the hazards of various toxins on the health of children. For example, studies on safety levels of pesticides are based on the adult male. We do not really know what that safety level is for children. The contamination of food has become an issue as the media brings attention to cases of Salmonella, E.coli, and hepatitis transmitted via unsafe foods.
Hot dogs and bologna are typical “kid foods,” but they contain risks if eaten in large amounts. Nitrates are preservatives found in virtually all cooked and cured meats. Nitrates have a cosmetic function in that they preserve the pinkish color of meats. The concern with nitrates is that when they combine with gastric juices in the stomach, they form a chemical called nitrosamine. Nitrosamines have been found to be carcinogenic in most species of animals tested. Antioxidants like vitamin E, A and C when consumed at the same time may offer protection against its cancer-causing effects. The US government requires meat packers to add ascorbic acid (vitamin C) to meats with nitrates.
Nitrates also have an effect on the hemoglobin which carries oxygen in the blood cells. High levels of nitrates cause “blue baby syndrome,” a condition caused by lack of oxygen in the blood. Because infants have less hemoglobin, they are at risk for side effects from nitrates. Nitrates are banned from baby foods because of this recognized toxicity. Other symptoms of nitrate toxicity can include difficulty breathing, dizziness, headaches, nausea, and vomiting. Some European countries have banned nitrates from their food supply.
For this reason, foods with nitrates should be given sparingly to children. Look for nitrate-free meats and hot dogs in the freezer section. Vegetarian hot dogs do not contain nitrates. If your child does eat food with nitrates, have them eat or drink something high in vitamin C at the same time. Also marinating meats in honey marinades can reduce the nitrosamine formation in grilled foods – but remember honey is not to be given to infants under a year of age.
Much of the decline in diet quality for children occurs between the age groups two to three and four to six. During this period, the percentage of children having a good diet falls from 35 to 16 percent, and the percentage having a diet that needs improvement rises from 60 to 75 percent.
For young children, an extra 50 calories a day of unburned calories (not used for growth, activity or metabolism) can create five extra pounds of fat a year.
Between one and two years of age, normal weight gain is about 2 to 3 pounds a year. Between three and eight years old, expected weight gain is about 5 pounds a year. So those extra 50 unburned calories a day can double the expected weight gain.
Currently 22% of the US Adult population has a body mass index (BMI) greater than 30 and 3% have a BMI greater than 40 – about 100 pounds overweight. See Health Trends.
If a baby between 6 months and 5 years of age is overweight, he has a 20% chance of being overweight as an adult. An overweight 7 year old has a 41% chance of being overweight as an adult. If the child is between 10 and 13 years of age and overweight, the chances are 70% he/she will be overweight as an adult.
Children who were overweight at age seven were more likely to have multiple risk factors for heart disease as an adult. There was more risk for having increased insulin levels, high blood pressure, and high cholesterol. Reduction in the rate of weight gain during childhood or adolescence had the potential to reduce the levels of young adult cardiovascular risk.
Children may think they are being active, but a research study showed that when kids (ages 11 to 13) were electronically monitored they were spending far more time sitting around than they thought. Children who said they played vigorously for one hour a day, actually had spent about 2 minutes being vigorously active.
Soft drinks contribute significantly to the increased sugar load in our diets.
Americans are eating more processed snack foods a day than ever. There are about 12,000 new foods introduced annually each year.
What is a parent to do when faced with the challenge of a child who is overweight?
What is overweight?
First we need to define what it means to be overweight. Growth charts need to be used; you can’t always tell by looking. Sometimes an overly concerned parent, may assess their truly normal-weighted child as being overweight. On the other hand, studies have shown that many parents tend to overlook their child’s obesity. New growth charts have been released by the Center for Disease Control and you can download the “Individual charts with all percentiles” at http://www.cdc.gov/growthcharts. Especially important are the “weight-for-length,” “weight-for-stature,” and “body mass index for age” charts for your child’s age group. Body mass index (BMI) has advantages over other methods of monitoring obesity in children and adolescents and the charts can be downloaded for children 2 to 20 years of age. It correlates closer to actual body fat measurements.
Here is how to calculate Body Mass Index:
BMI = (Weight in pounds ÷ [Height in inches ]2) x 703 Example: A 33 pound child is 37 inches tall
(33 ÷ [37 x 37]) x 703 = (33 ÷ 1369) x 703 = 0.024105 x 703 = 16.9
BMI = Weight in kilograms ÷ [Height in meters]2 Example: A 17 kg child is 106 cm tall (NOTE: 1 meter = 100 cm)
17 kg ÷ (1.06 m x 1.06 m) = 17 ÷ 1.1236 = 15.1
Here is how we can interpret BMI percentiles:
Underweight: BMI-for-age 5th percentile At risk of overweight: BMI-for-age 85th percentile Overweight: BMI-for-age 95th percentile
Now let’s say you have identified your child as being overweight or at risk for being overweight. Maybe you have just started to notice a recent trend of increasing BMI. First, check with your health care professional to make sure that there may not be a medical cause for weight gain. Occasionally, hormone disorders like hypothyroidism, may cause subtle weight gain without the child appearing ill. Once you are comfortable with a medical examination, think about changes in eating habits or caretakers that may be contributing to weight gain. Sometimes a change in the child’s lifestyle can be identified as a contributor to overeating or just eating more unhealthy food choices. Here are some questions to ask yourself:
Is there a daycare provider, nanny, or relative that allows constant snacking or frequent, unhealthy snack choices?
Have family activities or busy schedules allowed more fast food on the run to creep into the family menu?
Has there been environmental changes that don’t allow exercise – new neighborhood without playmates or the convenience of outdoor areas to play, family stress, more sedentary activities around like Nintendo, Game Boy, computers, TV in the bedroom of the child, off season for your child’s usual sport activity?
Does your child have a physical problem that may limit activity, like asthma, orthopedic problem?
Are other family members also struggling with weight issues or more recent weight gain because of family lifestyle and eating habits?
Sometimes, in examining these questions honestly, we can identify risk factors or changes in our lifestyle that may be contributing to our child’s weight gain.
Fats for Toddlers
Toddlers should not be restricted in their fat intake. There brain is laying down lots of new neuronal cells that need fat. See Essential Fatty Acids for more information on this concept. It does not mean allowing unlimited high-fat, high-sugar foods. Here are some guidelines for toddlers:
Make sure you are offering whole milk, not two percent, one percent or non-fat until after two years of age. Toddlers need the extra fat for brain development. They may receive more than 40 percent of their daily calories as fat.
This does not mean allowing unlimited fat and butter.
Once children have reached two years of age, decrease milk to one percent or two percent. If you feel your toddler is overweight, talk to your pediatrician to see if this is really the case. Many toddlers appear chubby, but are proportional on the growth curves. If your toddler is on the heavy side, you may want to use one percent milk.
The American Society for Nutritional Sciences and the American Society for Clinical Nutrition are looking to give children their own dietary guidelines. Rather than insisting that children consume a low fat diet (less than 30 percent of calories derived from fat) after age two, the 1995 Dietary Guidelines Advisory Committee recommended that there be a gradual change in dietary fat intake between the ages of two and five towards the heart-healthy diet.
Practical Tips of Controlling Weight Issues
Remember, that prevention is the key. If your child is at risk according to BMI calculations and over two years of age, you can start to take some simple steps to intervene. Being overly concerned about a child’s weight may lead to the development of eating disorders. If your child is slightly chubby and worried about their weight, try to make him feel comfortable about his image. Even if he is markedly overweight, let him know he is still special!
Having family members accuse a child of being fat is destructive to the his self-esteem. The key with overweight children is, not making them go on a diet or go hungry, but by offering them healthy food choices, cutting out high fat snacks, and encouraging exercise. Nagging, criticizing, and pressuring them is not the way to handle the overweight child.
It also has to be a family-oriented issue and not just directed at the overweight child. Most often, it is about the family lifestyle or eating habits. If dad is allowed to eat candy and sweets in front of the child and the child is told, “No,” resentment and battles will most likely follow. The most successful weight-loss programs for children are those that are also directed to an overweight parent losing weight, also.
Children have the advantage over adults in that they are still gaining height. Usually, the goal is not necessarily weight loss, but a slow up in the rate of gain. This is often enough to create a thinning effect as they age.
Here are some practical tips for controlling weight problems and overeating in children:
Prevention is the key. Following growth throughout childhood can identify children at risk. If children are overweight before adolescence, the goal is to try to maintain the same weight. This way, as children gain in height, they will thin out.
Have the whole family model healthy eating patterns. If the child is discouraged from certain food choices, but other family members are allowed those choices, the child will feel singled out as having a problem. Make healthy eating a family choice.
Add a family physical activity, like walking or biking.
Don’t calorie-restrict children. Don’t take the message of dieting or low fat or no fat eating to the extreme. Don’t obsess with your child over every fat gram and sugar calorie. The goal is to make better choices, but still fulfill a normal eating pattern.
Decrease fat intake. With many lower fat choices of foods available, this is getting easier. However, don’t be fooled. Even low fat foods in excess quantities can lead to weight gain, and some low fat foods are high in sugar.
Don’t forbid junk food and the less healthy foods, just use them less often.
Limit fast foods.
Cook at home with low fat cooking techniques.
Share meals when eating out. Pick healthier choices off the adult menu, rather than limiting their choices to the Kids Menu.
Use more grains, soy (like tofu), and beans instead of meats.