Nutrition: Fruit juice labels don’t tell

Bites nutrition Fruit juice labels don’t tell the whole story

BY MELISSA ERIKSON

Bright images of apples and berries on the packaging of children’s fruit drinks may be misleading parents. Confusing or exaggerated labels are blurring the distinction between drinks that are acceptable for children and those that contain added sugar or sweeteners.

To solve the problem children’s fruit drinks need new, clearer labels, according to a study from the NYU School of Global Public Health. The Food and Drug Administration last passed new regulations for fruit and fruit drink labels in 1993 and they haven’t been updated since, said Jennifer Pomeranz, assistant professor of public health policy and management at NYU School of Global Public Health and the study’s lead author.

“The area of food labels is one of the most deceptive. Parents don’t realize. Juice drinks are definitely a problem,” Pomeranz said.

“Our research shows that the way in which children’s drinks are labeled makes it very difficult for parents to select healthier drinks for their children,” Frances Fleming-Milici, director of marketing initiatives for the Rudd Center for Food Policy & Obesity.

Pomeranz and Fleming-Milici analyzed children’s drink labels and found similar nutrition claims, such as “good source of Vitamin C” or “no high fructose corn syrup,” on both fruit drinks with added sugar and 100% fruit juice.

Turns out the fruit featured on a drink label may only reflect its flavor rather than actual ingredients.

“Surprisingly, we found that images of fruit appeared on 85% of children’s sweetened drink packages regardless of whether the product contained any fruit juice,” Fleming-Milici said. “Top-selling children’s drink pouches and boxes have a range of products, including sugary fruit drinks, 100% juice and juice/

water blends, that look the same in terms of packaging and claims, but have different ingredients.” Most parents would be shocked that many drinks advertised as appropriate or even healthy for children contain added sugar plus zero- or lowcalorie sweeteners such as sucralose and acesulfame potassium, the same sweeteners found in diet soda, Fleming-Milici said. This can be hidden on the labels, which may read “low sugar” or “less sugar.”

“These claims appeal to parents who care about reducing sugar in their child’s diet, but hide the true ingredients,” Fleming-Milici said.

The American Academy of Pediatrics recommends that parents do not provide products with low-calorie sweeteners to children.

Thoroughly analyzing a drink’s ingredient list and understanding all the chemical terms is too difficult and time consuming for parents, Pomeranz said.

“Beverage manufacturers should clearly indicate on the front of children’s drink packages that a product contains added sugars and/or low-calorie sweeteners and the percent juice content,” Fleming-Milici said. “The U.S. Food and Drug Administration should require that products with nutritionrelated claims on packages meet minimum nutrition standards and prohibit the use of fruit and vegetable images on packages of drinks that contain little or no fruit juice.”

A small amount of 100% fruit juice can be a part of a healthy diet, but children should stick with plain milk (up to 4 ounces per day for toddlers and up to 8 ounces for older kids) and water, Pomeranz said.

“The recommendations advise limiting juice because even 100% fruit juice can contribute to cavities, and drinking more than the recommended amount can lead to other negative health impacts such as weight gain,” Fleming-Milici said. “Generally, providing children fruit instead of fruit juice is recommended.”

Chewy Chocolate Chip Granola Bars

A perfect snack whether you’re sending the kids off to school or keeping them home for virtual learning. These chewy no-bake granola bars can be customized with any additions you want.

Ingredients

6 tablespoons butter 1/3 cup brown sugar 1/4 cup plus 2 tablespoons honey 1 ½ teaspoons vanilla extract Heaping 1/8 teaspoon salt 2 cups quick-cooking/instant oats (do not use old-fash ioned oats) 1 ¾ cups crispy rice cereal 1/2 cup sliced almonds 1/4 cup wheat germ 1/3 cup mini chocolate chips (or other additions: dried cranberries or other dried fruit, peanut butter chips, etc.)

Directions

Line a 9x13 baking pan with aluminum foil. Spray the foil lightly with nonstick cooking spray. In a large pot, combine the butter, brown sugar and honey. Bring the mixture to a boil over medium heat, stir ring constantly. Lower the heat and simmer until the sugar dissolves and the mixture is slightly thickened, about 2 min utes. Remove from heat and stir in the vanilla and salt.

Add the oats, rice cereal, almonds and wheat germ to the pan and fold in with a rubber spatula until well com bined. (Note: If you are substituting dried fruit for the chocolate chips, mix it in now.) Transfer the mixture to the prepared pan and press down lightly with a rubber spatula into an even layer. The mixture should be tightly compacted in the pan. Sprinkle the min iature chocolate chips over top. Press down with the spatula so the chips stick. Cool in the refrigerator for 2 hours. Once cooled, transfer the mixture to a cutting board, and use a sharp knife, cut into rectangles. Store the bars in an airtight container in the refrigerator. Use parchment paper between layers to keep them from sticking.

Laurie Silva Collins, known affectionately as Goose by her grandkids, is a nurse, mother and grandmother who is happiest when she’s in the kitchen, cooking and baking for those she loves. She learned to cook from her parents, and has perfected her recipes over the years while raising three daughters… and spoiling seven grandchildren.

Bites

goose’s goodies

Get ready to return to play 10 tips for sports parents

BY DR. LYNN PANTUOSCO-HENSCH WESTFIELD STATE UNIVERSITY

After the unprecedented break from organized sports during the COVID-19 pandemic, youth sports teams will soon resume play. While there will surely be a mix of emotions and safety concerns, a return to youth sports is exciting for many of us.

As a mom, youth soccer coach, and college professor, I’ve been researching and planning the return to organized sports for my family and my teams. There is a plethora of return to play guidance, including a valuable Return-to-Play Guide from the Aspen Institute at https://www.aspenprojectplay. org/return-to-play.

I’ve compiled some recommendations for parents who want to help their children get ready to return to play organized sports. These 10 tips can be implemented during the month of August and into the fall season. Each tip is based on the most current research on athletic development, with practical strategies or resources for families. For best results, combine training efforts with a healthy diet and enough quality sleep. With your help, when your community gets the green light to restart sports, your children will be ready to go!

1. Make the most of time off

For many of us, these last few months are the first real break we’ve gotten from the rat race of youth sports in years. Experts report a reduction in overuse injuries in kids and recovery rates that are better than ever. Why? Because kids are actually taking time off! This respite from organized sports has been valuable for many young athletes and their families. Take advantage of this time for rest and rejuvenation both physically and mentally.

I’ve emphasized to my teams and my own children the importance of making the most Dr. Lynn Pantuosco-Hensch’s four sons have been participating in daily fitness challenges over the summer.

of this time off. Now is a great time to focus on development over winning. Spend time with your children helping them to improve athletic weaknesses, try new skills, and practice with a purpose. In my work on LongTerm Athletic Development (LTAD), my recurring theme is to “Build Good Habits Over Time.” There has never been a more opportune time to develop new and better athletic habits with our children.

2. Embrace a fresh start to fall sports

With time off comes the opportunity to reflect on our children’s youth sport experiences. Many experts have called for a reimagining of youth sports that is more childcentered and less dependent on travel, expenses, and scheduling demands. I couldn’t agree more. While my focus is on what parents can do to help their children restart organized sports, I highly recommend embracing a fresh start in the fall. For more, go to the Aspen Institute to read Tom Farrey’s article on How Sports Can Rebuild America (https://www. aspeninstitute.org/blog-posts/ how-sports-can-help-rebuildamerica/).

Perhaps the startup of youth sports doesn’t have to mean the end of family dinners and bike rides. And just maybe, there could be less travel, fewer tournaments, and a greater emphasis on community sports. In my family, we’re already talking about a return to sports that doesn’t cause us to be as overextended as we were preCOVID. Talk with your children about what they want their sports participation to look and feel like. And better yet, talk with your local youth sports coaches and administrators about any changes you’d like to see. The Positive Coaching Alliance, postivecoach.org, has some valuable resources that can easily be implemented in our communities.

3. Develop intrinsic motivation

My husband and I have four sons who play a combination of soccer, hockey, basketball and lacrosse throughout the year. During the quarantine, it has been interesting to observe how they play at home and which sports they gravitate toward on their own. We are fortunate to have a big family, with cousins next door, so the pick-up sports have been plentiful. Interestingly, our kids have played a variety of sports in waves, including non-traditional sports like tetherball, mountain biking, and skateboarding.

By observing kids during free play, parents can gain some insight about where their children’s passions really lie. Research suggests that free play improves both creativity and intrinsic motivation in athletes. Help your athletes cultivate a love of the game, whatever game that may be. Encourage creativity, deep practice, experimentation, and fun. Over the course of the summer, gradually add in some structured practice. One of the best life skills derived from sports is intrinsic motivation. Athletes who are intrinsically motivated generally go farther with their athletic careers (as do intrinsically motivated professionals in other fields).

4. Communicate with coaches

As you embark on more structured at-home practice or small groups in your community, try to focus on a few key areas of improvement. To begin, reach out to your children’s coaches. Ask for their opinions on skills your child can improve on. Also, ask the coaches for sport-specific resources. There is an abundance of content out there now. Try to narrow the options and focus on topics your children can really benefit from during their pre-season practice.

In general, I advise athletes to combine fitness with sports skills. This form of functional training keeps practice fun and purposeful. For older children, ask coaches about pre-season fitness assessments or target goals. Use the month of August to train toward those specific benchmarks.

5. Create a 4-week plan

In order to successfully accomplish a pre-season to do list or meet target goals, develop a game plan suitable for your child. August is the time for action! Now is the time to create a routine – focused on your children’s needs and interests – and get them ready for a competitive season ahead. Establish a routine that includes fitness, sports skills, and foundational athletic skills. Like a good summer reading program: keep a journal, set goals, and use incentives.

My kids are using shared Google documents and spreadsheets to create, edit, and share workouts within our family. Developing and sharing workouts across friend groups can also be fun. For instance, my sister, who is also a coach, started a daily fitness challenge with a group of kids. Over text, the kids report in about their 50 push-ups or 1,000 jump ropes a day challenges. Planning, logging, and sharing fitness plans is a great way to get in shape and stay motivated. At SHAPE America there are many printable, monthly calendarstyle resources to use: https:// www.shapeamerica.org/covid19- resources.aspx.

6. Learn the FITT principle

When planning the August

training routine, be sure to teach your children about the FITT principle. It’s a commonly used acronym in the exercise science field which stands for Frequency, Intensity, Time and Type of exercise. Most children can do cardiovascular exercise 3-6 days a week, muscular fitness exercise 2-3 days a week and exercises for flexibility 5-7 days a week. Intensity should be moderate to vigorous. Time can be 20-60 minutes (or more). The FITT principle provides an outline for a well-rounded fitness routine. Add sport specifics to better prepare your children for fall sports.

Also note that the research on youth strength training and conditioning is incredibly positive if done properly. The American College of Sports Medicine (ACSM) provides supporting evidence and debunks common myths. https://www.acsm.org/docs/ default-source/files-for-resourcelibrary/smb-youth-strengthtraining.pdf?sfvrsn=85a44429_2.

Specifically, children should follow the principle of progression. Start simple and build to more complex exercises. Additionally, children should follow the principle of overload by gradually increasing training volume over time (about 5-10% a week is the recommended norm). A progressive increase in training volume over the course of a month or more will have your children ready to take the field this fall.

7. Focus on the ABCs – Agility, Balance, Coordination

Parents should focus on their children’s athletic foundation, as much, if not more than on specific sports skills. An athletic foundation starts with the ABCs: agility, balance, and coordination. Learning to move efficiently is necessary for all sports. Children can build their physical literacy with locomotor skills such as galloping, sliding, skipping, hopping, and jumping. Use these skills in fun games of tag, capture the flag, or even obstacle courses. If you don’t have exercise equipment such as hurdles or ladders, improvise with anything children can jump over or run around. I often use sidewalk chalk for an “agility ladder” or even creative hopscotch patterns. Dust off your jump ropes and get a family competition going. These games and challenges can help children across a variety of sports and development levels.

These classic movement skills have not gone out of style. More than ever, children need to build a strong athletic foundation to avoid injuries and boost performance. A well-established athletic foundation also allows children to pivot between sports over time. Our youth sports system generally rushes into sports skills instead of focusing on the basic building blocks. Use this break from organized sports to focus on doing the basics well. It’s as easy as ABC.

8. Improve cardiovascular fitness

After a spring of virtual everything, hopefully summer provides a much needed transition for children to get outside and play. Children will likely need to improve their cardiovascular fitness to be ready to compete in full-length games. While aerobic activities like bike riding or jogging are helpful, it is better to focus on running as it relates to sports. Younger children will need parental guidance to determine distance and speed, but children middle-school age and older can begin to learn how to train themselves. Introduce interval running, with a combination of jogging and sprinting. Children can sprint between driveways, mailboxes, or telephone poles and then jog between a few, creating their own pattern of sprints/jogs/walks. Of course, a community track is another useful alternative. Using a track to run fartleks (yes, that’s a real word for alternating faster springs and slower jogs) is a beneficial way to train for most sports.

Whether your child is running in your neighborhood, on a track, or eventually in a gym, instead of running at the same pace for a distance, be sure to change speed and direction. The best way to be ready for the cardiovascular demands of organized sports is to play smallsided pick-up games. While this is safer at the moment for noncontact sports like baseball or tennis, soon we should be able to safely engage in small-group contact sports.

9. Build muscular fitness

Children of all ages can safely build muscular fitness, provided they follow the principles of progression and overload – and focus on safety! Start with body resistance exercises like push-ups, sit-ups, planks, squats, lunges, pull ups, toe raises, and more. Pay close attention to technique and form. Provide feedback and encouragement. Using a mirror or video will help children learn to self-monitor. With children, the emphasis should always be on quality over quantity. Have children begin with single sets of 10 and gradually increase training volume. Help children to understand what a set and repetitions (reps) are and how to progress over time. In our family, we do sets of push-ups to match our age with our younger children (e.g., our 6 year old does 6 push-ups). Meanwhile, our teenage son is ready for more advanced challenges like a push-up and sit-up pyramid (10 of each, 9 of each, all the way down to one push-up and one sit-up).

Eventually, children will be ready to use small free weights and learn basic weight lifting techniques such as: bench press, bicep curls, triceps extensions, and overhead press. Children can also safely add free weights to exercises like squats, lunges, and toe raises. August is an opportune time to workout with your kids.

10. Check in on mental health

During the COVID-19 pandemic, we’ve seen families demonstrate resilience, especially those with essential workers. Helping our children learn a variety of mental health skills, like resilience, will bode them well in sports and in life. Now is the time to get gritty. Expert, Dr. Angela Duckworth says parents can teach children grit by being supportive yet demanding. Her Tedx is well worth the six minutes: https://youtu. be/H14bBuluwB8. Encourage children to work toward what they want to accomplish. Define performance goals and create a corresponding workout plan to reach those targets.

As previously suggested, a return to play will bring a medley of emotions. Many children may feel anxious about being rusty or keeping up with their competition. As an expert in motor development and behavior, I can assure you that your children’s sports skills will come back to them. Children have a powerful ability to catch up and get back on trajectory. Reassure your children that their worries are normal and

to focus on what they can control about their own return to play. There is plenty right now that none of us can control. While you may not be able to create game-like intensity in your backyard, you can help your children be fit, focused, and ready when more realistic opportunities strike.

Final Thoughts

If nothing else, for many of us this gift of unstructured quarantine time is an opportunity to cultivate both the physical and mental skills that will enable our children to be successful long-term athletes. Use these tips to maximize preseason time while it lasts.

Build Good Habits Over Time… and get ready to return to play!

Dr. Lynn Pantuosco-Hensch is an Associate Professor at Westfield State University in the Movement Science Department. She is also a licensed soccer coach with the United Soccer Coaches. Her current research is on LTAD and youth sport specialization. She thanks Paula Leahy Welch for her editorial support. Reach her at: lhensch@ westfield.ma.edu or https://www. lynnpantuosco-hensch.com

What school might look like this fall With COVID-19, districts face many requirements

BY DOUG PAGE

Despite the worldwide COVID-19 pandemic, which closed the Bay State’s K – 12 public schools last March, forcing them to cobble together remote learning plans on the fly, the goal, say state education officials, is to return students and teachers to the classroom this coming academic year. (Editor’s note: These plans for returning to school are current as of baystateparent’s late July presstime.)

“There is no substitute for in-person instruction when it comes to the quality of students’ academic learning,” says the Massachusetts Department of Elementary and Secondary Education (DESE) in the opening pages of its document listing requirements school districts must follow to reopen their schools this fall. “In-person school plays an equally important role in our ability to support students’ socialemotional needs, including their physical health, and in mitigating the impacts of trauma.”

DESE, which oversees the Commonwealth’s K – 12 public schools, issued a 28- page reopening guidance in June, listing safety and health stipulations each district must meet before opening their schools for in-person instruction.

School districts are required to submit reopening plans to DESE in August, the Department’s report says. The plans must detail how schools will operate with students and teachers inside the buildings, how they will operate should it become necessary to implement remote learning again, and, finally, show how they will teach in a hybrid fashion, with students instructed both at home and inside school.

When asked if DESE could reject those plans, Colleen Quinn, a spokeswoman for state Secretary of Education James Peyser, said: “DESE will not reject (reopening) plans but will work very closely with school districts to ensure what they are proposing complies with the medical requirements released in the guidance.”

“The medical community supports the return of our students to in-person learning, with appropriate health and safety guardrails in place,” DESE’s report says. “With adherence to a comprehensive set of critical health and safety requirements, we can bring our students, staff and families safely back to school.”

DESE says they spoke with infectious disease physicians, medical advisors and with members of the Covid-19 Command Center’s Medical Advisory Board, which includes two Massachusetts General Hospital doctors, Rochelle Walensky and Paul Biddinger.

July’s statistics from the state’s Department of Health show that of the more than 8,300 deaths from COVID-19 in Massachusetts this year, no one was younger than 20. The majority of deaths, well over 80 percent, were people 70 and older.

Of the more than 111,000 Covid-19 cases in the Bay State this year, the majority infected were people 50 years and older while there were only 6,100 cases among children and young adults up to the age of 19, according to the state’s Department of Health in July.

When school resumes, DESE says, everyone, starting with second graders, as well as teachers and staff, will be required to wear face masks. Time will also be allocated for “mask breaks,” when students will be allowed to remove them.

Students will need to be at least three feet away from one another both inside the classroom as well as in the hallways and, if possible, kept “in the same group throughout the day” to “minimize the number … who would potentially be exposed to COVID-19” if someone contracted the virus, DESE’s guidance report says.

“COVID-19 is primarily transferred via respiratory droplets that travel less than three feet,” said Dr. Cody Meissner, a pediatric infectious disease specialist at the Tufts University Medical Center in Boston. “The Centers for Disease Control has built in an extra three feet to make it six feet for social distancing but it’s hard in school to maintain six feet of distance.”

Schools, says DESE, are required to provide “COVID-19 isolation space” – which needs to be separate from the nurses’ offices – in case students display virus symptoms.

Teachers, staff and students will be expected to wash their hands throughout the day, DESE says, and schools are required to place hand sanitizer dispensers at building entrances, cafeterias and in the classroom.

School superintendents and principals are also expected to create “alternative spaces in the school,” turning the cafeteria, library and auditorium into classrooms “to increase the amount of available space to accommodate” social distancing rules, DESE says.

While DESE has yet to issue requirements or suggestions for transporting children on school buses, they will be forthcoming, the guidance report says.

DESE’s guidance document also recommends that school superintendents find out how many parents will send their children back to school should they reopen.

“It’s a parent’s prerogative to look out for the safety of their child,” said Todd Gazda, superintendent of Ludlow

Schools, noting that some students and parents are immunocompromised. “For any parent who says their child will not return to school in Ludlow, we’ll have a fully remote option.”

“Superintendents are strongly committed to bringing the kids back to school,” said Tom Scott, executive director of the Massachusetts Association of School Superintendents. “But the wildcard is how the teachers’ unions feel about this.”

“A lot of educators are uneasy about the guidelines that DESE put out,” said Scott McClennan, a spokesman for the Massachusetts Teachers Association (MTA), the Bay State’s largest teachers’ union. “The guidance from DESE is leaving everyone confused.

“There’s no talk about any job action but people are concerned about this and how it manifests itself,” he added.

He also says MTA President Merrie Najimy is talking about crafting “a phased-in approach for reopening schools with face-to-face instruction being the goal.”

Medical Reasoning

COVID-19 starts as an infection in the lungs, and in an adult, it seems to trigger the immune system to overreact and that appears to be what causes death, according to some published reports.

“The immune system of kids seems more adaptive than the immune system in an adult which is more set in its ways,” said Dr. John O’Reilly, a pediatrician at the Baystate Medical Center in Springfield.

“I think we’ll find that certain people are genetically predisposed to having an exaggerated inflammatory response, and it’s those people who get in trouble with COVID-19,” said Dr. Meissner.

DESE notes that children “are less likely than adults to be infected with COVID-19.”

“Why children are less likely to become sick from COVID-19 than adults is a fascinating question,” said Meissner. “Remember there are four conventional coronaviruses that cause the common cold. It could be that one of those conventional coronavirus infections confirms some degree of protection against the disease.”

In fact, he says, the risk of a child or an adolescent becoming infected with Covid-19 is higher at home than it is at school.

“In most of the cases at Tufts, (infected) children come from families where a family member, usually an adult, was diagnosed with COVID-19,” he said.

“If you go back and look at the number of cases in Massachusetts when Gov. Charlie Baker closed the schools, there was no change in the number of cases in the slope of infections,” said Meissner. “Closing the schools didn’t do anything to limit the spread of the virus.

“That’s why I feel children should get back to school. Kids need to socialize and participate in athletics,” he added.

He suggests, where possible, keeping classrooms ventilated by keeping windows open because it will reduce the likelihood of the virus’s spread.

Meissner also stresses that children and parents be vaccinated against the flu this fall.

“There is preliminary evidence that says the death rate of someone infected with influenza while simultaneously being infected with Covid-19 increases the possibility of

death four or five times,” he said. “Only about 50 percent of the population is immunized. Hopefully, we’re going to get that number higher.”

Remote Learning

Soon after the Bay State’s public schools closed, many started attempting to teach students remotely, either by sending homework assignments via email or setting up video classroom instruction via digital providers.

“Kids generally thought they were learning less in a remote environment than in a face-toface setting,” said Peter Dillon, Berkshire Hills Regional School Superintendent, about his students. “In an interesting shift, parents thought kids could be assigned more homework but kids thought it was just right.”

The Unknowns: Athletics, extracurricular activities and music

While DESE’s document doesn’t provide requirements or suggestions about how school districts should handle gym class, athletics, music instruction, bands or extracurricular activities, Jacqueline Reis, DESE’s spokeswoman, says it will be out in the coming weeks.

“I have no problem with field hockey or football,” said Meissner, when asked about them being played this fall. “On an outside field, transmission is low.

“I’m a little more nervous about basketball because it’s inside,” he added, noting the aerosols players exhale are at greater risk of landing on another player.

Music is also worrisome, Meissner says, citing a case from Washington state earlier this year, when a member of a choir, who didn’t know they were infected with COVID-19, managed to infect nearly 90 percent of the choir members at rehearsal one night. Two of them died. The median age of the choir members that night was 69.

“More aerosols are expelled when one sings than when one talks,” he said, noting they’re also expelled greatly when someone plays a wind instrument, like the flute, trombone, clarinet or saxophone.