For my upcoming baby I´m thinking to explore and try Baby Led Weaning (BLW), an alternative way of complementary feeding that originated in UK, is trendy in the US and has an increasing popularity in Latin America. BLW is a method for introducing solid foods that doesn´t involve spoon feeding and purees. If you are not familiar, here are the basics of BLW that every RD should know:
Why? After 6 months of exclusive on demand breastfeeding where the baby regulates the amount he eats, BLW allows him to continue with this self-regulation in a natural way. The initial goal is more didactic than nutritional: it aims for the baby to develop its autonomy, to learn how to coordinate and to explore textures, tastes and sensations.
When? At 6 months (and not before), when the baby can sit and hold pieces with his hands and shows interest in food. Always recommend moms to discuss BLW with the pediatrician.
How? Adults have to offer (by putting directly on the chair tray) healthy, varied and soft foods that the baby can take with their hands.  The food is not given by parents. It´s recommended to place baby highchair at the family table and to adapt family meals instead of cooking a totally different meal. Some BWL food examples are:
Pumpkin, potato, sweet potatoes and carrot cubes or sticks
Strips of avocado or ripe fruit such as pear, banana
Steamed broccoli pieces
Chicken or shredded meat
Pieces of egg
Soft pasta/noodles
Apple & oat muffins
Puffed cereal
The baby decides whether to grab food and how much is taken to the mouth (goodbye to the spoon and the airplane!). There are not too many food restrictions but to avoid addition of salt and sugar, honey, whole nuts, large fish and seafood, foods with “empty calories” and excess fats.
Pros? The purpose of this practice is to develop a more positive and natural relationship with food. It allows to respect baby´s hunger and interest of food without pressure. Food is not a reward or punishment. Even so, there is no evidence that BLW prevents childhood obesity. More studies are needed to confirm potential benefits.
Cons? Prepare yourself for messy meals and it may demand more time to end a meal. A recent study confirms that babies fed in this way do not have more episodes of choking than those who use traditional feeding methods. Moreover, the UK Department of Health recommends foods in pieces from the beginning of complementary feeding.
No more spoon feeding? Not necessarily. You can easily combine this method with some baby purees with spoon feeding once and then. BLW is not for everyone, some babies (and moms) prefer purees at least at the beginning and later introduce finger foods. It´s essential, whatever the method, not to push or force food when feeding babies, introduce new foods every three or four days and be patient! As professionals, it´s important to support parents in the decisions they made for their child, providing the best information available.

Any experience to share?

Romina

References
Brown, A., Jones, S. W., & Rowan, H. (2017). Baby-Led Weaning: The Evidence to Date. Current Nutrition Reports, 6(2), 148–156. 

​Who could possible be able to memorize more than 10,000 recipes, considering tastes and textures of 2,000 ingredients, within different cuisines and special diets and, based on all this, be able to propose instantly more than 16 billions of different combinations? Chef Watson from IBM can. I discovered it recently and I'm already using it to create recipes.  I have so much fun with Watson, I’m now more open to new ingredient combinations and I can expand (not replace) my creativity.

This technology is very intuitive and easy to use: select the ingredients you want to use, the type of dish or occasion (drink, dessert, main, breakfast, etc) and if you want, special diets (such as vegetarian, paleo, gluten free). Then, the proposed recipe can be personalized and of course it has to be tested. Artificial intelligence (AI) does not replace human thinking because these recipes have to be tested and with our feedback Watson keeps learning from us.
Chef Watson works using algorithms which calculate the level of pairing of flavors and based on the psychology of what pleases or not human taste buds. You may find combinations that a priori sound awful, (like combining champagne with milk). But why don’t we try Chef Watson suggestions? Chef Watson helps culinary professionals when investigating new recipes. For those food and nutrition expert who work developing recipes or designing menus in schools or hospitals, Chef Watson can help to do it more efficiently.

Chef Watson is just a sample of the multiple applications that may have systems of AI (such as IBM Watson). AI aims to help people make more successful decisions, based on the analysis of big data. Health care is the main sector where IBM Watson is having greater interest. Centers like New York Genome Institute or Mayo Clinic, are working with IBM Watson to deliver personalized treatments to their patients. "In an area like cancer — where time is of the essence — the speed and accuracy that Watson offers will allow us to develop an individualized treatment plan more efficiently, so we can deliver exactly the care that the patient needs," says Steven R. Alberts, M.D., chair of Medical Oncology at the Mayo Clinic Cancer Center.

Another example, Food Print™ by Nutrino, an app that uses this type of technology, demonstrated a significant reduction of hypoglycemia episodes in patients with type 1 diabetes (presented at the last meeting of the American Diabetes Association). We will increasingly see more AI in nutrition and health. I was a little reluctant at first, but as food and nutrition experts we have to be prepared to use this technology that will help us to do our work better and to empower people to make healthier food choices.  See the following videos for more info.

In my recent trip to Florida, I stayed a few days on a house hosted by this gracious Cuban guy who cooked great breakfast and one day we prepared malanga fritters. Then I when to some food markets and local produce stores to find produce that was new at least for me. 

​What is Malanga root? It is a potato like vegetable, a staple in Cuba and Puerto Rico, that grows in the Caribbean, part of South America and other tropical parts of the globe (it ‘s also being cultivated in Florida and California). It has an elongated shape and the skin is bumpy and patchy, brown. The flavor is nutty and earthy with a waxy, starchy consistency when it's prepared. A 1/3-cup serving of cooked malanga contains 70 calories; along with 3 grams of fiber and 1 gram of protein (while same amount of boiled potato has 45 calories and 1 gram each of fiber and protein).  How to cook with Malanga? It cannot be eaten raw because it can be toxic (contains calcium oxalate), but cooking eliminates the chemical. Malanga is easily digested and is often used in baby food. It is usually prepared mashed, baked, boiled, sautéed or deep fried. Malanga flour can be used for baking.  

​I also have the chance to taste for the first time the exotic dragon fruit or pitaya. Originally from Central America and north South America and cultivated also in Southeast Asia, Australia and US, it’s hard to find in the Argentinean market.  And I loved its eye catching pink color and its refreshing taste. It’s a fruit of the cactus family with a leader exterior and a juicy flesh that can be white or red with tiny black seeds (similar to kiwi seeds) that contain small amount of monounsaturated and omega 3 fatty acids (similar to kiwi seeds). Dragon fruit and other exotic fruits are gaining popularity in many cuisines worldwide.  Dragon fruit is promoted as a superfood, but like many other fruits full of antioxidants, fiber and vitamin A, C and potassium.  

Finally, I came across of the widest selection of citrus fruit I have ever seen! Florida is a synonymous of citrus. My favorites were the tangerines or mandarines, specially the Pixie variety (though is an hybrid originated in Southern California). Mildly sweet, seedless with a medium-orange flesh and easy-to-peel. Also, I love blood oranges and tangerines with red colored flesh as they add great color to salads. Perfect for our picnics at the beach!

Whenever you have the chance to travel, don’t miss the chance of going to local food markets to become familiar with foreign vegetables and fruits. When I was a child kiwi and mango where exotic (actually didn’t knew they existed) and now are commonly found in most supermarkets around the globe. 

En Español

National Nutrition Month ® 2017 theme “Put your best fork forward” remind us that each bite counts and invites us to cook more at home. Considering that home cooked meals are usually healthier, teaching kids how to cook becomes a life saving skill we can help develop. The benefits of involving kids in the kitchen are short and long term: it helps broaden their palate, cultivates an appreciation for real ingredients, builds math skills and develops confidence. Plus, it’s a lot of fun! I have great memories of my mom and I cooking together and I’m now passing down the tradition to my 4-year old daughter. Parents may be afraid that cooking with kids will just mean more mess and more time. So, here are some tips to help parents get started:
​
1. Plan ahead and start small. You may need more time when cooking with kids, especially at the beginning and with younger kids.  Choose one meal per week for which a child can be kitchen helper. Invite kids to be part of the recipe and ingredient selection. You may want to start with an easy side dish or dessert.

2. Find doable, age-appropriate tasks. It varies from child to child, but the following are some of the tasks they might be able to do at different stages:
​     2-to 3-years old: mixing and pouring ingredients, stirring and mashing, washing and drying produce, picking fresh herb leaves off stems and ripping them into small pieces, tearing up lettuce, peeling fruit with hands (tangerines, bananas), kneading dough, brushing oil with a pastry brush.
         4- to 5-years old: all of the above plus cracking eggs, using a pepper grinder, measuring dry and wet ingredients, decorating cookies.
       6- to 7-years old: all of the above plus whisking, grating, peeling, dicing and mincing fruits and vegetables (with supervision), greasing pans, shape patties and meatballs, plating.
      8- to 9- years old: continue with the above tasks or decide if they are ready to take on more sophisticated tasks to follow an entire recipe and cook on a stove with supervision.
       10- to 12- years old and up: after assessing how careful they are with heat, sharp tools and food safety, they might be able to work independently in the kitchen with an adult in the house.

3. Accept that not all children like to cook.  In this case, they can help grabbing ingredients, washing produce, setting and clearing up the table, tasting dishes for seasoning. Their curiosity and interest in the kitchen may change over time.

4. Safety is a priority. An adult should always supervise cooking until you are certain that your child is old enough to handle the responsibility. Part of cooking with kids is teaching them kitchen and food safety.

5. Consider this experience as an investment! These mini chefs are more likely to eat what they made and become more audacious in trying new foods. Plus, by the age of 12 they can help prepare dinner before you get home.  And by the time they leave home, you’ll feel good knowing they don’t need to rely on delivered or frozen dinners. 

En Español

​Who would imagine a store where you pick your groceries and just leave without going to the cashier? The future is now. Tech companies, supermarket chains, and thought-leading visionaries are working to reinvent your trip to the grocery store. It's been years of people going to one supermarket for all their shopping, but that is changing:
Online, personalized purchases.According to the Nielsen Global Report, “The Future of Grocery”, one-quarter of online respondents say they order grocery products online, and 55% are willing to do so in the future. Growth of online grocery shopping is driven in part by the maturation of the digital natives—Millennials and Generation Z. They are not just calling to order groceries, they better use the seller mobile app. Online retailers can fulfill unique customer needs, such as the desire for better-for-you foods as well as specialty-needs products.  Additionally, in the last couple of years, the market has been flooded with app-based grocery delivery companies like Instacart, AmazonFresh, Google Express App, which basically pick food from a variety of vendors and have it delivered to your door. So, will clicks replace bricks? Not so fast. For many food buyers (including myself), there are powerful sensory experiences we don´t want to lose, like smelling freshly baked bread or checking for freshness of perishable products. At least for now, that is impossible to replicate online.  
Smart carts & shopping apps. To compete with online purchases, some retailers are working on a prototype that is not new, tablet-laden smart carts with kinetic and body recognition sensors, which can provide aisle maps, calculate the best route through the store, tick items off your shopping list, give you recipe recommendations, and even save you for pushing a heavy cart. On the other hand we have lots of available grocery shopping apps in our smart phones like Anylist, Buy Me a Pie!, Grocery iQ and some retailers own apps. These are designed to create grocery shopping list, share lists with others, use coupons, find deals, store recipes and organize your meals. 

​Cashier-less stores.Amazon Go, an innovative concept that’s being piloted in a downtown Seattle grocery store that lets customers walk in, grab food from the shelves and simply walk out again, without ever having to wait in a checkout line, no cash or credit cards, just you need your phone and the company account. Walmart already launched (in two locations) the app Scan & Go where customers scan items with their phone as they shop, pay via the app and show the receipt from their phone on their way out.  
Recreating the supermarket experience. Companies are focusing on how to create an experience, a reason to come to the store (considering that potential customers are doing groceries online). Some supermarkets offer wellness and health services, while others have brew pubs and restaurants inside to attract millennials. 

Last Saturday I was happy to conduct an educational session to a group of mothers and families of the city of Lanus, as a volunteer (and recipient of a mini-grant) for Kids Eat Right. Kids Eat Right is an educational campaign of the Academy of Nutrition and Dietetics Foundation to promote educational projects that address the problems of overweight and obesity in children. Also, there is an international chapter called Kids Eat Right International (KERI) that carries the goals of the campaign to a global level by providing international educational resources for professionals in each country, contributing to better nutrition for children in the world.  
The topic of the session was Tossed Treasures: How Can We All Waste Less Food from the initiative The Future of Food. I have adapted the Spanish version of the toolkit presentation to the Argentinean audience. It was great to help many attendees who didn’t know how to use a thermometer in the kitchen, and was very fun to see how they created healthy recipe ideas with leftovers!
If interested in having the Argentinean adapted presentation, let me know!

Want to learn more about Kids Eat Right? Check out the website for articles, tips, toolkits, recipes and videos! If you would like to be on the Kids Eat Right International (KERI) mailing list, please email Jamie Wise at KER@eatrightoverseas.org.
Become a Kids Eat Right Campaign Volunteer here!

En Español

Can you imagine 10400+ food and nutrition experts getting together to learn, network and (why not) have fun in the city of Boston? I was thrilled to be present at the world largest dietitians’ conference with colleagues from the US and from all over the globe. Of course it was hard to choose from more than 130 educational sessions during the four-day event and visit 350+ exhibitors on the expo floor. But, the richest part was networking with friends of the AODA (the international affiliation of the Academy of Nutrition and Dietetics), presenting the work we did with my colleagues in Argentina in the poster session, have fun with pals from Food and Nutrition Magazine, catch up with old friends and attend board meetings.  I came home with millions of ideas and people I want to connect!
Here, I would like to share selected “take home messages”:

1. EMPOWERING OPENING SESSION: I loved what the Academy President Lucille Besseler remarked as useful for dietitians in any field:

• Be flexible while maintaining your beliefs and vision.
• I have watched individuals lose exciting opportunities because they were unable to compromise. 
• Don’t be afraid to change your mind when new information is presented. 
• And take the time to develop relationships that make the work easier and more rewarding. 
• In the words of my practice coordinator: “Teamwork divides the task and multiplies the success.” 
• Always say “yes” – and figure out the details later. 
• Some of the most successful projects I have embarked on occurred when I had no game plan when I started. 
• Jump in and learn to swim. 

A very special moment here was when Naomi Trostler, a very own AODA member and international dietetics leader, received the greatest award, the 2016 Marjorie Hulsizer Copher Award. I have the honor to meet and work with her, she is so sweet!

2. GOING INTERNATIONAL:  I was happy to see my country both in the ed and poster sessions! The Argentinean Association of Dietitians and Nutritionists (AADYND) presented their initiatives to tackle nutrition problems in our country.  A great interest was seen on global initiatives and networks.

4. BRAIN HEALTH & NUTRITION: I went to 2 different sessions about nutrition and prevention of cognitive decline, especially on Alzheimer’s disease. One was the lecture of Dr. Nancy Lombardo, who spoke about Memory Preservation Nutrition® (MPN™), an evidence based program she developed with her team. The primary foods recommended are rich in antioxidants and anti-inflamatory nutrients and include fresh fruits and vegetables, especially leafy green vegetables, specific spices  (cinnamon, ginger, turmeric, rosemary, sage, oregano, parsley), green tea, chocolate, whole grains, and foods containing omega-three fatty acids. The Memory Preservation Nutrition® program also focuses on reducing cholesterol and substituting healthy fats (omega 3 and mono-unsaturated fats) for saturated and Trans-fat foods. Another major feature of the program is reducing the amount of refined sugar and high fructose corn syrup in the overall diet. Don’t miss the selected slides of the presentation, Dr. Lombardo shared strategies to implement dietary changes specially in the elderly, who frequently have processed,  sugary or fatty foods in their pantries or in their long term care menus . The other session about brain nutrition was the MIND diet (Mediterranean Dash Diet Intervention for Neurodegenerative Delay developed by Rush University. In the slide from Dr. Lombardo you can see some of the differences between these two approaches for brain health.

5. THE REDUCTIVE MINDSET: ACHIEVING OPTIMAL RESULTS USING THE TOOLS OF WHITE SPACE: Juliet Funt discussed how we must consider the use of WhiteSpace: White Space is a strategic pause taken between activities or business. The term came from literally looking at the white space on the calendar and realizing that on the days where there was more literal white space, people were more effective and projects moved faster. It can be used in tiny sips as small as 10 seconds or in longer stretches, and these thoughtful pauses laced through the busyness of the workday are the oxygen that allows everything else to catch fire. So..Do less, have time off , use filters, reduce email checking, take off your hands off other peoples' work. If you are interested: http://www.whitespaceatwork.com/
“When talented people don't have time to think, business suffer”
​

 6. DIETS, SUPPLEMENTS AND CANCER THERAPY: WHAT SHOULD WE TELL OUR PATIENTS? This one was a very interesting and controversial session! First, Donald Abrams, MD (integrative oncologist) went through the Alkaline, Paleo, Ketogenic, Macrobiotic, or Vegan diets and the rational and evidence behind them as anti cancer diets. He mentioned a systematic review (Huebner et al, 2014) that found no clinical evidence in support of any of these diets and some may have potential harm.  However, Dr. Abrams recommend its patients to eat ORGANIC + PLANT BASED + ANTIOXIDANT RICH + ANTI-INFLAMATORY RICH + WHOLE FOODS.  Many dietitians in the public didn’t agree in recommending all organic (because lack of access for many people and lack of supporting evidence) and to eliminate dairy of the diet, something that Dr Abrams recommends. Secondly, Mary Marian, RD, spoke about the use supplements and botanicals in cancer patients. Due to drug interactions it’s important to avoid certain botanicals during chemotherapy, like tumeric or resveratrol. If a multivitamin is needed (oral intake < 50% estimated needs, deficiency present) use one that not exceed 100% of the Daily Value. However, some chemo regimens need folate and B12 and some patients may become vitamin D deficient during chemo.  See here the presentation slides: 

7. GOING COCONUT OVER SATURATED FAT, WHY SO MUCH CONFUSION? Even though the media promotes coconut oil and “butter is back” the evidence does support reduction of saturated fats and increasing plant based PUFAs and MUFAs within calorie limits. Coconut oil health claims are based MCT benefits but they are not the same. Coconut oil contains only 58% MCT and has 44% lauric acid which behaves more like the long chain saturated fatty acids in digestion and metabolism. Cholesterol is not a nutrient of much concern, as some persons respond to dietary cholesterol and other not. However, for prevention follow the Dietary Guidelines for Americans and for subjects with cardiovascular disease less than 200 mg/day is recommended. ​

8. TRENDS AT THE EXPO FLOOR: the food stars this year where easy to digest foods like low FODMAP food products (the new gluten free?), pre and probiotics, fermented products. Also sugar free flavored waters and sodas, pulses, convenient whole grains, vegetable noodles and emphasis on sustainable sourced and plant based. Culinary demos (even at each exhibitor) and yoga classes in the expo floor!

Hope to see you in Chicago FNCE 2017 to celebrate 100th Anniversary of the Academy!

En Español

From Argentina to Boston, I will be attending to FNCE (Food and Nutrition Conference & Expo), the annual meeting of the Academy of Nutrition of Dietetics that congregates thousands of colleagues from the US and all over the world. Can’t wait to be there!  and participate on high level educational sessions, present our hospital research poster and network with colleagues and friends.
I notice that I will not have much time left to travel around the city, so I did my homework and I have the list of places to visit and specially the places to eat and have a taste of Boston’s cuisine. After reviewing the nice article “The Best of Boston” from  Today’s Dietitian, the restaurant list from the Food and Culinary Professional Group resources and my own research on tripadvisor, these are my picks:
Restaurants:
Union Oyster House (historic seafood restaurant, near Faneuil Hall)
Flour Bakery & Café (breakfast, salads, sandwiches, multiple locations)
OAK Long Bar + Kitchen at Fairmont Copley Plaza (American Brasserie, Back Bay)
Warren Tavern (historic American Tavern, Charlestown)
Harvest (local fare, Harvard Square, Cambridrge)
Yankee Lobster fish market (Seafood, local flare)
​Joe’s American (American, Seafood, waterfront location)
Babbo Pizzeria (modern Italian, Fan Pier, Mario Battali’s Restaurant)
Coppa (enoteca, Italian, South End)
There are many other Italian restaurants that I didn’t choose because I prefer to eat more Bostonian.  I’m used to eat good Italian in Buenos Aires.

Food Markets:
Faneuil Hall and Quincy Market
Boston Public Market

MUST SEE Places:
Freedom Trail
Boston Common
North End & Little Italy
Sam Adams Brewery tour
Waterfront
Beacon Hill


Stay tunned for updates on facebook and twitter. Hope to see you there!!

Click aquí para español 

Last week the Argentinean Association of Dietitians and Nutritionists Dietitians (AADYND) held the 1st AADYND Congress of Food and Nutrition in Buenos Aires. Many colleagues from the country and from Latin America were presents and I had the pleasure to be invited as a speaker. Because of my experience in the US and in the international dietetics field, my topic was “Dietary Guidelines around the world, the Dietary Guidelines for Americans (DGA) 2015-2020”. The DGA have been always of a great interest at international level, especially because of its repercussion on food industry.  The session was very interesting; a colleague presented how the latest 2015 Argentinean Dietary Guidelines (ADG) are being implemented. The ADG have a nice round icon similar to a plate were consumption of vegetables and fruits, drinking water, less salt and more physical activity are emphasized as many of the dietary guidelines in other countries (see pictures).  There are 83 dietary guidelines around the world, but only represents 38% of the countries (and only 6% of low income countries have dietary guidelines). Only 4 dietary guidelines mention sustainability and environmental issues: Brasil, Qatar, Sweden and Germany. We concluded that food and nutrition experts are key players to communicate Dietary Guidelines and to empower people to make small dietary changes to improve their nutrition and health.