Selected Podcast
Nutrition for Pediatric Asthma Patient
In this series from the asthma symposium, LaDonna Aebischer RD & CSP discusses nutrition for pediatric asthma patient.
Featuring:
LaDonna Aebischer, RD & CSP
LaDonna Aebischer, RD & CSP is a Certified Specialist in Ped Nurtition and Registered Dietitian.
Transcription:
Expert Insights is an ongoing medical education podcast. The Carle Division of Continuing Education designates that each episode of this enduring material is worth a maximum of 0.25 AMA PRA category 1 credit. To collect credit, please click on the link and complete the episode's post-test.
This podcast forum is brought to you to share expertise and insights within our integrated delivery system to help us improve the health of the people we serve and achieve world-class accessible care. This is Expert Insights. Here's your host, Melanie Cole.
Melanie: Welcome to Expert Insights with the Carle Foundation Hospital. I'm Melanie Cole. And today is part of the Asthma Symposium. We're covering nutrition for pediatric asthma patients. Joining me is LaDonna Aebischer. She's a registered dietician and certified specialist in pediatric nutrition at the Carle Foundation Hospital.
LaDonna, I'm so glad to have you here. So as the incidence of asthma has risen in the United States during the past few decades, many researchers are believing that changing our diets may have had something to do with this, whether it's our immune systems or, you know, all the processed foods. Give us your opinion on this theory. Tell us what you've seen in your own practice as far as asthma in pediatric patients.
LaDonna Aebischer: So what we have seen is children who are overweight tend to have more asthma symptoms. And in my research taking care of these patients, infants who have high birth weights or children at a young age who are overweight tend to receive a diagnosis of asthma later in life.
So this information alone, not specific to diet, allows us to know that the importance of healthy eating and maintaining a healthy body weight starts at a young age even during infancy. So the importance of a healthy diet and a healthy lifestyle is imperative to preventing and managing a patient who has asthma.
Melanie: I agree completely, you know, and as an exercise physiologist, I've seen an increase in my own practice with asthma in the obese kids and in the teenagers. So is there evidence that you can point to that people who eat a healthier diet maybe higher in vitamin C, E, beta-carotene, any of these things, would have lower rates of asthma? Or if they did have asthma, that it's under better control?
LaDonna Aebischer: So what we recommend for our patients with asthma is a healthy balanced meal plan that is very minimal in processed foods and promotes just whole base nutrition and food items. We have seen a lot of parents who tend to have the misconception that drinking milk, fluid milk can increase the mucus production and might worsen the asthma symptoms, but this is a false assumption. So when we see those patients who are avoiding dairy, we often see lower intakes of calcium and vitamin D, which are very much important in these types of patients. So that is a misconception we see that we tend to do a lot of education with our patients.
Melanie: Certainly, an old wives tale, right? That milk makes mucus. I used to hear that as a kid myself. So what else does affect asthma? We mentioned a little bit about some of those comorbid conditions. Tell us a little bit about GERD or obesity or sedentary lifestyle, how these things might affect asthma and how eating a healthier diet could possibly help some of those symptoms.
LaDonna Aebischer: Certainly being overweight or obese can contribute to worsening asthma symptoms or put you at a higher risk to develop asthma. That's something that we want to start managing as soon as we see a change in growth. So as young as we can, we'll give these patients the greatest chance of not developing this type of disease.
And in addition to asthma, being overweight, there are patients who are at risk for high blood pressure or type 2 diabetes. So all of them kind of go together, but the treatment is the same. The treatment is a healthy diet and regular physical activity.
Melanie: So are there any foods that you could point to that do make asthma worse? Is there anything that does maybe cause inflammation or any of those immune responses that could exacerbate asthma?
LaDonna Aebischer: So overall, there's not one specific food that we encourage families to avoid or a certain food group. We just recommend a healthy diet and a healthy body weight.
Melanie: What does that mean? Can you give us a little bit more? Like if you were working with a pediatric asthma patient, how do you work with them and the families to kind of help get that under control and keep their nutrition really at as much an optimal level as you can with kids?
LaDonna Aebischer: So dieticians, we work closely with children and their families. We'd set up specific nutritional goals to achieve whether it's a healthy weight or maintaining a weight until their growth is increased. But we tailor the medical nutrition therapy to what the patient and the family needs, so the challenges and obstacles that presents to them. So in general, we recommend a balanced healthy meal plan that includes a variety. A variety is very important. We recommend a healthy lifestyle instead of a specific food or "diets." So, like I mentioned previously, kids should be eating whole foods, minimally processed foods and less packaged and convenient food items.
Melanie: And what else? As a certified pediatric nutrition specialist and registered dietician, getting kids to eat those healthy foods is not always the easiest thing. So how do you work with families to help them to encourage that healthy lifestyle?
LaDonna Aebischer: I've seen over the years, there are so many obstacles that families have into providing healthy meals to their children. Some of the big takeaways that I've seen that have been working the most for my patients, the first one is just being a role model for your child. So we can't expect children to eat vegetables with their dinner if we're sitting with them and eating potato chips. So we must model that behavior to children.
Another thing that I've seen that has made a huge improvement is cooking more meals at home and getting the children involved in shopping and preparation. When I see children who eat out a lot or are using takeout from restaurants, those foods have more added sugar and unhealthier fats. So overall, eating at home can have a huge impact on children's health.
Something else that's been really helpful is just having parents keep healthy snacks available. So encouraging plenty of fruits and vegetables, drinks without any added sugar, plenty of water. This keeps kids from snacking on unhealthier things like soda, chips, and cookies. But lastly, I think, you know, making meal times more about healthy food, but also just encouraging families to sit down together and spending time together and bringing them together is just as important for a meal time.
Melanie: One-hundred percent agree. So wrap it up for us, LaDonna. Tell other providers what you'd like them to know about referral to the experts, the nutrition experts at the Carle Foundation Hospital, when you feel it's important that they refer their pediatric asthma patients for nutritional help and counseling and your best advice for helping their patients to live that healthier lifestyle we've discussed today.
LaDonna Aebischer: I would say every encounter you have with a patient, so that initial visit, peek at their growth chart, have they had an increase in weight? Has it jumped a curve unexpectedly? I think at that first noticed, start educating on the healthy diet. Ask them, are they ready for change? Are they ready to meet with someone to talk on some more specific goals? And if they are, referring to a dietician is so important. If we can work on this before we've already gained a lot of weight or even before the symptoms get worse, we can start working on it, I think that is the most crucial time to start working on dietary changes.
Overall, families to eat together; consume a variety of fruits, vegetable, whole grains, lean proteins, and low fat dairy; and also staying very active, so enjoying doing an activity together at least an hour a day would be where I would start for our providers.
Melanie: Great information. It's such great advice. Thank you so much, LaDonna, for joining us today. And that concludes this episode of Expert Insights with the Carle Foundation Hospital. For a listing of Carle providers and to view Carle -sponsored educational activities, please visit our website at carleconnect.com for more information. I'm Melanie Cole. Thanks so much for listening.
Expert Insights is an ongoing medical education podcast. The Carle Division of Continuing Education designates that each episode of this enduring material is worth a maximum of 0.25 AMA PRA category 1 credit. To collect credit, please click on the link and complete the episode's post-test.
This podcast forum is brought to you to share expertise and insights within our integrated delivery system to help us improve the health of the people we serve and achieve world-class accessible care. This is Expert Insights. Here's your host, Melanie Cole.
Melanie: Welcome to Expert Insights with the Carle Foundation Hospital. I'm Melanie Cole. And today is part of the Asthma Symposium. We're covering nutrition for pediatric asthma patients. Joining me is LaDonna Aebischer. She's a registered dietician and certified specialist in pediatric nutrition at the Carle Foundation Hospital.
LaDonna, I'm so glad to have you here. So as the incidence of asthma has risen in the United States during the past few decades, many researchers are believing that changing our diets may have had something to do with this, whether it's our immune systems or, you know, all the processed foods. Give us your opinion on this theory. Tell us what you've seen in your own practice as far as asthma in pediatric patients.
LaDonna Aebischer: So what we have seen is children who are overweight tend to have more asthma symptoms. And in my research taking care of these patients, infants who have high birth weights or children at a young age who are overweight tend to receive a diagnosis of asthma later in life.
So this information alone, not specific to diet, allows us to know that the importance of healthy eating and maintaining a healthy body weight starts at a young age even during infancy. So the importance of a healthy diet and a healthy lifestyle is imperative to preventing and managing a patient who has asthma.
Melanie: I agree completely, you know, and as an exercise physiologist, I've seen an increase in my own practice with asthma in the obese kids and in the teenagers. So is there evidence that you can point to that people who eat a healthier diet maybe higher in vitamin C, E, beta-carotene, any of these things, would have lower rates of asthma? Or if they did have asthma, that it's under better control?
LaDonna Aebischer: So what we recommend for our patients with asthma is a healthy balanced meal plan that is very minimal in processed foods and promotes just whole base nutrition and food items. We have seen a lot of parents who tend to have the misconception that drinking milk, fluid milk can increase the mucus production and might worsen the asthma symptoms, but this is a false assumption. So when we see those patients who are avoiding dairy, we often see lower intakes of calcium and vitamin D, which are very much important in these types of patients. So that is a misconception we see that we tend to do a lot of education with our patients.
Melanie: Certainly, an old wives tale, right? That milk makes mucus. I used to hear that as a kid myself. So what else does affect asthma? We mentioned a little bit about some of those comorbid conditions. Tell us a little bit about GERD or obesity or sedentary lifestyle, how these things might affect asthma and how eating a healthier diet could possibly help some of those symptoms.
LaDonna Aebischer: Certainly being overweight or obese can contribute to worsening asthma symptoms or put you at a higher risk to develop asthma. That's something that we want to start managing as soon as we see a change in growth. So as young as we can, we'll give these patients the greatest chance of not developing this type of disease.
And in addition to asthma, being overweight, there are patients who are at risk for high blood pressure or type 2 diabetes. So all of them kind of go together, but the treatment is the same. The treatment is a healthy diet and regular physical activity.
Melanie: So are there any foods that you could point to that do make asthma worse? Is there anything that does maybe cause inflammation or any of those immune responses that could exacerbate asthma?
LaDonna Aebischer: So overall, there's not one specific food that we encourage families to avoid or a certain food group. We just recommend a healthy diet and a healthy body weight.
Melanie: What does that mean? Can you give us a little bit more? Like if you were working with a pediatric asthma patient, how do you work with them and the families to kind of help get that under control and keep their nutrition really at as much an optimal level as you can with kids?
LaDonna Aebischer: So dieticians, we work closely with children and their families. We'd set up specific nutritional goals to achieve whether it's a healthy weight or maintaining a weight until their growth is increased. But we tailor the medical nutrition therapy to what the patient and the family needs, so the challenges and obstacles that presents to them. So in general, we recommend a balanced healthy meal plan that includes a variety. A variety is very important. We recommend a healthy lifestyle instead of a specific food or "diets." So, like I mentioned previously, kids should be eating whole foods, minimally processed foods and less packaged and convenient food items.
Melanie: And what else? As a certified pediatric nutrition specialist and registered dietician, getting kids to eat those healthy foods is not always the easiest thing. So how do you work with families to help them to encourage that healthy lifestyle?
LaDonna Aebischer: I've seen over the years, there are so many obstacles that families have into providing healthy meals to their children. Some of the big takeaways that I've seen that have been working the most for my patients, the first one is just being a role model for your child. So we can't expect children to eat vegetables with their dinner if we're sitting with them and eating potato chips. So we must model that behavior to children.
Another thing that I've seen that has made a huge improvement is cooking more meals at home and getting the children involved in shopping and preparation. When I see children who eat out a lot or are using takeout from restaurants, those foods have more added sugar and unhealthier fats. So overall, eating at home can have a huge impact on children's health.
Something else that's been really helpful is just having parents keep healthy snacks available. So encouraging plenty of fruits and vegetables, drinks without any added sugar, plenty of water. This keeps kids from snacking on unhealthier things like soda, chips, and cookies. But lastly, I think, you know, making meal times more about healthy food, but also just encouraging families to sit down together and spending time together and bringing them together is just as important for a meal time.
Melanie: One-hundred percent agree. So wrap it up for us, LaDonna. Tell other providers what you'd like them to know about referral to the experts, the nutrition experts at the Carle Foundation Hospital, when you feel it's important that they refer their pediatric asthma patients for nutritional help and counseling and your best advice for helping their patients to live that healthier lifestyle we've discussed today.
LaDonna Aebischer: I would say every encounter you have with a patient, so that initial visit, peek at their growth chart, have they had an increase in weight? Has it jumped a curve unexpectedly? I think at that first noticed, start educating on the healthy diet. Ask them, are they ready for change? Are they ready to meet with someone to talk on some more specific goals? And if they are, referring to a dietician is so important. If we can work on this before we've already gained a lot of weight or even before the symptoms get worse, we can start working on it, I think that is the most crucial time to start working on dietary changes.
Overall, families to eat together; consume a variety of fruits, vegetable, whole grains, lean proteins, and low fat dairy; and also staying very active, so enjoying doing an activity together at least an hour a day would be where I would start for our providers.
Melanie: Great information. It's such great advice. Thank you so much, LaDonna, for joining us today. And that concludes this episode of Expert Insights with the Carle Foundation Hospital. For a listing of Carle providers and to view Carle -sponsored educational activities, please visit our website at carleconnect.com for more information. I'm Melanie Cole. Thanks so much for listening.