Packing the School Lunchbox

It's been many years since I had to prepare lunches for schoolchildren. But I did do it for more than a decade, and mostly on a budget. With hot lunches at many schools being costly or of poor nutritional value, it is certainly wiser and healthier to pack your own. While there is a proliferation of individually packaged lunchbox items, they are rarely a good value and rarely the healthiest option for your child(ren). I realize that time constraints need to be weighed, along with health benefits and nutrition, so I'm hoping to bring some fresh perspective to that age-old chore of packing school lunches. Feel free to chime in (using the comments section) on items that you have found work well. The more, the merrier.
They say variety is the spice of life, and it can be important to youngsters as well. While there is that occasional child who will only eat pb&j with barbecue potato chips every day for six months, most children like to see something different and have new surprises in their lunch bag. And speaking of bags, if at all possible, try to convince your child that a reusable lunch bag (thermally insulated) or old-fashioned lunch box is the way to go. They even have plain metal lunchboxes that children can decorate and personalize. If they are feeling really adventurous, you could buy them a bento box (like this one), tiffin (a 2-tier one or 3-tier), or the Earth-friendly Goodbyn (see image on right) to use for lunch (some kids just like to be unique). These are all earth-friendly options.
Main CourseThink outside the box on this one; deviate from that turkey, roast beef, salami sandwich. Find interesting breads to use, like marble rye, cinnamon raisin, pita, tortilla, or bagel. Maybe your store has a great bakery with some really tasty whole wheat sourdough dinner rolls, which make great mini-sandwiches (think 2 or 3 in a lunchbox). Mix up the fillings by preparing a batch of egg salad, which is cost-efficient and tasty. Another family favorite is cream cheese and chopped olive, which I make with a block or two of softened cream cheese and a can of chopped black olives. This goes well on a tortilla that you roll up, or any kind of bagel. Instead of PB&J, try PB&Honey or PB&Banana on whole grain or cinnamon bread.
Most children have no access to a microwave at school, so leftovers do not always work so well. But you can get creative with leftovers. Take that extra plain pasta and make a cold pasta salad with cut up carrots, celery, cheese cubes, and any other veggie your child will eat, toss with a vinaigrette and you have a healthy lunch. Cold barbecued chicken can be packed in a lunch as is, or you can cut off the meat, chunk it up and add it to a pita with some lettuce and Ranch dressing. Kids also like finger foods, so cubing cheese and salami/hotdog/cooked sausage and packing them with pretzels to spear the cubes is a good substitute for a sandwich.
Side DishMost of us grew up having chips in our box lunch. The salty, crunchy complement to the sandwich works really well. But there are more creative options. My kids love Chex mix, and I make double and triple batches and store in big Ziploc bags. Also on the salty side are edamame, which are fun to pop out of their shells and eat. Trail mix is salty, and can be combined with raisins, dried fruit, or sweetened with chocolate chips. We also like the Japanese snack mix, with white crackers shaped like flowers, dried peas, sesame sticks and the like. If there is a way to keep things cold, yogurt (with or without granola), carrot/celery sticks, cucumber rounds, and jicama sticks all work well (a little seasoning salt adds a pop of flavor). Hard-boiled eggs were a favorite of mine (with those little wax paper packets of salt and pepper), as were black olives and big dill pickles.
SweetsMy kids always liked fresh cookies, especially in their lunch box. Realistically, it can be hard to make one or two batches of cookies a week, and to keep them fresh and lasting. I found a way that makes life easier. I make a double batch of my kid's favorite cookies, Tollhouse chocolate chip (with some healthy oatmeal added), triple ginger, peanut butter. (Double batches take only an extra minute to make but yield twice the benefit.) Then I bake two trays full in the oven for more immediate consumption. While those are baking, I line two cookie sheets with wax paper and take my small ice cream scoop and scoop out balls of dough onto the wax paper. Once the tray is full (and they can be quite close together), I stick them in the freezer for 30 minutes. Once frozen solid, I put the little balls into a Ziploc or plastic storage container, marked with the type and cooking time/temp and put it back in the freezer. Anytime I want fresh, hot cookies for guests, or cookies for that lunch pail, you just preheat the oven, take the balls out to defrost on the cookie sheet and within 20 minutes you have piping hot goodness. For a healthier option, you can make your own granola bars, which will no doubt be healthier and more cost conscious than anything you will find in the store (recipe below). These can be customized to your children's tastes or to what you have on hand in the kitchen. The batch I made yesterday had pecans and dried cranberries and they were such a hit, that I'm gonna have to make a second batch!
FruitHow many times do your children return home with that whole apple in their lunch bag? Large pieces of whole fruit can be intimidating and time-consuming to eat, and not very interesting at that. And with so many children wearing braces, whole fruits can be difficult to eat or leave significant residue in the brackets. I've noticed that several companies now make sliced apples packaged in bulk or in snack servings. There are several organic brands that use a combination of calcium and ascorbate to keep the slices from going brown. I also like to make fruit kabobs. I cut up pineapple and melons into squares over the weekend and keep them in sealed containers for use during the week (breakfast, snack or lunch). Using wooden skewers, wooden chopsticks, or even popsicle sticks, I thread these and stemmed strawberries onto the stick. Makes it easy to eat and keeps the fingers clean, too. Alternately, cut-up fruit of any kind can be put into a plastic container, and drizzled with some lemon juice to keep it from going brown. Periodically I will sprinkle with raisins, mini chocolate chips, or grated coconut to add some interest.
There are a million ways to get creative with the lunchbox, and I know I've only touched on a few, but kick the school year off right with healthier lunchbox options.
Granola BarsThese are easy, take only about 15 minutes to make, and are not the rock-hard, break-your-teeth variety. You can substitute almonds, cashews or most any kind of nut for the peanuts, and use almost any kind of dried fruit-raisins, apricots, mango, pineapple, apple, cherry, cranberry. You can also add in carob or chocolate chips at the very end (mini chocolate chips work best).
2 cups oats3/4 cup flax seed3/4 cup sunflower seeds1 cup peanuts, chopped2/3 cup brown sugar1/2 cup honey4 Tbsp butter2 tsp vanilla extract1/2 tsp salt8 oz. dried fruit. chopped
Preheat oven to 400 degrees. Mix the oats, flax seed, sunflower seeds and chopped nuts and place on a baking sheet with sides. Toast for 10-12 minutes, turning periodically. Meanwhile, line an 11x13 pan with wax paper (with an extra length coming up the sides of the pan) and spray with nonstick spray.
Combine brown sugar, honey, butter, vanilla and salt in a small saucepan and bring to a simmer, stirring constantly. Into a large bowl, pour oat mixture, dried fruit, and liquid mixture and stir quickly, making sure to coat all the ingredients with the liquid. Pour the mixture into the prepared 11x13 pan. Spread out as evenly as possible with a spoon, and then fold over the extra sides and use to push the mixture down and compact it.
Cool for 2-3 hours, then turn out onto a cutting board and cut into individual bars (smaller for the younger kids, larger for the older ones). You can wrap them individually in plastic wrap, so they are ready for the lunch box. If you store in a container, make sure to layer the bars with wax paper so they do not stick together.

Natural Bug Bite Remedies

Summer is here, the season of outdoor activities, and since mosquitoes tend to multiply in hot climates, summer is also the season of bug bites. Whether it is a mosquito bite or a bee sting, spraying your skin sticky with offensive-smelling bug repellants is only going to make you uncomfortable and possibly keep humans away from you as well. When I was a kid, my grandfather made my brother and I slather cotton balls in regular yellow Listerine and rub it on every part of skin that was showing before we were allowed outside. Thankfully, there are other natural remedies that keep the bugs—or if you have already been bitten—the sting and itch away.
Probably the safest way to keep bugs away from your home is to prevent your yard from inviting bugs. You can plant little repellent gardens all over your yard, front porch, or back patio to ward off unwanted bugs. Using nature-friendly plants like lemongrass (also known as Citronella, popular in mosquito-repelling candles), lemon thyme, catnip, and citrus-smelling geraniums which contain up to 60 percent of the power of popular spray DEET along with other commercial products, you can reduce your family’s bite ratio and reduce the amount of toxins they are subject to.
Another option is lotions and sprays found at natural health food stores or herbalists thar contain essential oils and herbs that are used to keep these pests away (like eucalyptus, bay laurel, thyme, or lavender). One of these natural oils, gaining in popularity, is neem oil. Made from the neem tree, this extract is used in Indian Ayurvedic cures; the oil is bitter and repels bugs while still being able to keep your friends close by. Although many of these lotions and essential oil-based solutions should not be used on infants, children under 2, or pregnant or nursing mothers, you can always spray their clothes or the area around them for protection. A safe-for-children remedy is to coat a stroller or toddler’s chair with pure vanilla bean extract or add a few drops to their regular skin lotion for use on their sensitive skin—or yours.
If you have already been stung or bitten, treating those bites can be a chore. Anti-inflammatory remedies like peppermint oil dropped onto the bite uses menthol to increase circulation and move the chemicals around that the bug left behind to physically reduce the sore. You can also use regular oatmeal on bites to pull any remaining toxins out of the body. Let a tablespoon of oatmeal marinate in water until a paste forms. Spread onto the bite until a crust hardens and rinse off. An easier way to pull toxins out of your body is to apply a slice of freshly cut eggplant on the wound, while a fresh cut cucumber slice also works to reduce swelling.
After the itch and pain are gone, unsightly bumps can still appear on the skin. Cover with easy at-home tricks like calendula and aloe vera to prevent against infection, which can be found over the counter in sprays and gels. Redness associated with a bug bite can be irritating in itself and again Ayurvedic medicine comes to the rescue. Alum, found in the spice aisle, is in powder form and can be dissolved in water takes away the unwanted physical aspects of the bite and even helps with any lingering itch you may have.
Don’t hesitate to call 911 if you suspect there is an emergency. Allergic reactions to bug bites can happen, either from bees, spiders, or other unknown insects that you may not realize you are allergic to. People can go into anaphylactic shock from certain bites or stings and they should be watched if any of their symptoms get worse. Even though run-ins with bugs can be annoying, they can also be dangerous, so don’t ignore the warning signs: pain at the site for longer than a few hours, nausea, vomiting, fever, unstoppable itching, muscle pain, difficulty breathing, extreme swelling, or causes confusion in the victim.

Getting Closer to an AIDS Vaccine

SEATTLE — At least 2,000 students at Washington State University have reported symptoms of the H1N1 flu virus, university and local health officials said, in what appeared to be one of the largest outbreaks of the virus on a college campus.
“It’s real,” Sally Redman, a registered nurse who works in student health services at Washington State, said Saturday. “We’ve had a constant stream of people.”
So far, the cases at the university have been relatively mild, although at least two people in the area who are not students were hospitalized. The university, based in Pullman, in eastern Washington near the Idaho border, has about 19,000 students at its main campus.
Ms. Redman said the outbreak appeared about Aug. 21, during fraternity and sorority rush but before classes started. After that, she said, “it was rampant.”
As many as 200 students a day have visited or called student health services, reporting sore throats, fevers as high as 104 degrees, muscle aches and coughs.
Dr. Timothy J. Moody, the public health officer for Whitman County, which includes Pullman, said that after a few sample tests at the university were found to be positive for swine flu, students with similar symptoms were also classified as having the virus. He noted that since the spring, nearly all influenza viruses tested from people nationwide with flu symptoms had been H1N1.
In most cases, Washington State students have been told to stay home, rest and take fever-reducing medication. They are not to attend class until at least 24 hours after they have had no fever without taking fever-reducing medication. The university does not have a quarantine program in place, as some other universities do, Ms. Redman said.
The reports from Washington State follow a survey by the American College Health Association, based on data collected from 165 universities in the United States through Aug. 28, that said just over 2,000 students on college campuses nationwide had reported being affected by flulike symptoms.
Dr. Moody said he believed other college campuses that start classes later this month could report outbreaks as students return. He noted that, in general, young adults have proved more susceptible to the virus than older adults, and that students may be particularly vulnerable because they “tend to congregate more, they often live in dorms, they share a lot of things.”
Dr. Moody said local health officials had become concerned as the virus spread beyond the campus. Two members of a local family were hospitalized after they showed symptoms, though both had other health complications, Dr. Moody said. He said they had since been released.
Ms. Redman, the nurse, noted that Saturday’s football game between Washington State and Stanford, in Pullman, was going forward as planned, though university officials urged people with higher health risks to consider not attending. The athletic department planned to distribute antibacterial hand sanitizer at the game.
Ms. Redman, who has been a nurse at the university for 29 years, said the pace of student flu reports appeared to be slowing somewhat, down to about 140 per day, but that it was unclear whether the outbreak was subsiding or students were simply diagnosing themselves.
“They’re motioning to me,” said Ms. Redman, explaining that she would have to end a telephone interview. “I’ve got calls coming in.”

Consistent Condom Use Can Reduce Risk of Herpes by 30 Percent

Practicing safe sex is one of the best preventative health measures a person can take, and the best form of safe sex, outside of abstinence, is the condom. Not only do condoms safeguard against unwanted pregnancies, they also protect against infection from various sexually transmitted diseases (STDs), such as HIV, gonorrhea, Chlamydia and trichomoniasis; discharge diseases that are transmitted through infected semen or vaginal fluids. However, researchers say condoms provide a lesser degree of protection against the spread of another STD—genital herpes—because it can be transmitted through contact with infected skin that isn’t covered or protected by the condom, but the exact protective effect has remained unclear.
To get a more definitive idea of how useful condoms are in preventing herpes, researchers at the University of Washington analyzed data on a total of 5,384 people; two-thirds of whom were male, 94 percent were heterosexual. All study participants were free of infection when the studies began, but over a follow-up period of 12 to 19 months, 415 became infected with the herpes simplex virus 2 (HSV-2), the virus that most often causes genital herpes. For those who reported using a condom 100 percent of the time, the risk of contracting the virus was found to be 30 percent less than those who did not use condoms. “Although the magnitude of the protective effect was not as large as has been observed with other STIs, a 30 percent reduction in HSV-2 incidence can have a substantial benefit for individuals as well as a public health impact at the population level,” said lead author Dr. Emily T. Martin of Children’s Hospital Research Institute at the University. “Thirty percent is partial protection, but its protection.”
The researchers said the risk of being infected was reduced 7 percent “every additional 25 percent of the time condoms were used during anal or vaginal sex” and increased with the frequency of unprotected sex. There was no significant difference in condom effectiveness between genders. “It’s the consistent use of the condom that’s important,” Martin said. “If you don’t know the STD status of your partner, a condom is always a good idea.”
Dr. Jeffrey D. Klausner, director of STD Prevention and Control Services at the San Francisco Department of Public Health, said the study provides more scientific evidence that condoms work. “We know condoms can prevent the spread of sexually transmitted infections like HIV, herpes, warts, hepatitis, gonorrhea, Chlamydia and syphilis, but it’s always been hard to show that in research studies,” he said. “If condoms can hold air and water, I never understood why folks thought they would not prevent the spread of germs, which are much, much larger than air or water molecules.” Klausner added that these findings should help in efforts to get condoms into the hands of sexually active adults and teens.
As many as 50 million Americans—about one in five adults—are infected with the genital herpes virus, with about one million new infections each year. As many as 80-90 percent of those infected fail to recognize herpes symptoms or have no symptoms at all. People with herpes may spread the disease even though they don’t realize they have an infection or while their disease appears to be inactive and no sores can be seen. Herpes is a lifelong disease with no cure, but antiviral drugs can partially control the duration and severity of episodes.
The study is published in the Archives of Internal Medicine

Circumcision Doesn’t Reduce Male-to-Female Transmission of HIV

In recent years, the male foreskin—a double-folded tube of skin and mucous membrane that covers the head of the penis—has taken center stage in the battle against HIV. The foreskin is rich in Langerhans cells, immune cells that are particularly easy for the virus to access. Following infection, these cells not only serve as reservoirs for replicating the virus, but also transport it to nearby lymph nodes where HIV spreads to other immune cells. Studies have shown that removal of the foreskin can reduce a man’s risk of heterosexually acquired HIV infection by 50 to 65 percent, findings that prompted large-scale circumcision campaigns in countries with high infection rates, such as sub-Saharan Africa, where heterosexual sex is primarily responsible for the HIV epidemic. Studies had also suggested that circumcision could reduce the rate of male-to-female transmission of the virus, but that turns out not to be the case.
A Ugandan study, led by Dr. Maria J. Wawer of Johns Hopkins Bloomberg School of Public Health in Baltimore, was stopped early after it became apparent that male circumcision offered no protection to female partners. The study involved 922 uncircumcised, HIV-infected men between 15 and 49 years of age who were randomly chosen to either be circumcised or remain uncircumcised. The HIV-free female partners of the male participants were also enrolled in the study, 90 in the circumcised group and 70 in the uncircumcised group, and their HIV status was evaluated after 6, 12 and 24 months. All participants were intensively schooled in HIV prevention and provided free condoms.
After two years, 18 percent of the women in the circumcised group had become infected with HIV, compared with 12 percent in the uncircumcised group. Cumulative probability of HIV infection at 24 months was 22 percent among women in the circumcised group and 13 percent among those in the uncircumcised group. The majority of the infections in the circumcised group occurred within the six months following the procedure. The researchers said the infections were caused because some of the men had intercourse before their circumcision wounds had healed, exposing their female partners to HIV-infected blood in the vagina.
The researchers said though they were disappointed with the outcome of the study, circumcision campaigns are still valid. “The efficacy of male circumcision for prevention of HIV in uninfected men is clear, and reductions in male acquisition of HIV attributable to circumcision are likely to reduce women's exposure to HIV-infected men. Male circumcision programs are thus likely to confer an overall benefit to women," the researchers concluded.
In an editorial accompanying the study, Dr Jared M. Baeton, from the University of Washington in Seattle, and colleagues stressed the importance of circumcision programs for men at risk of HIV, and argued for more effort being focused on people in relationships where one partner is HIV-infected and the other is not. “Prevention services for this population, including HIV testing for couples, facilitated disclosure of HIV seropositivity, and ongoing counseling services, should be a public health priority,” they write. “Such services should be incorporated into male circumcision programs, thereby providing further protection to HIV uninfected women.”
An estimated 33 million people worldwide are living with HIV/AIDS, but the World Health Organization (WHO) says circumcision has the potential to dramatically reduce the toll of the virus, averting an estimated 5.7 million new infections and three million deaths over the next 20 years in sub-Saharan Africa alone.
Both the study and the editorial appear in the July 18 issue of The Lancet

Pregnancies & Sexually Transmitted Diseases on the Rise Among Teens

More teenagers and young adults are having sex, sparking an increase in teen births in both 2006 and 2007, and putting an end to more than a decade of significant decline. In fact, nearly three quarters of a million pregnancies occurred among American females under the age of 20 in 2004 that reversed the downward trend from 1991 to 2004.
To make matters work, sexually transmitted diseases (STDs) among young Americans are also on the rise. The annual rate of AIDS cases among boys ages 15 to 19 has almost doubled over the past decade, while the number of syphilis diagnoses are up among both teens and young adults. In addition, almost a quarter of teen girls aged 15 to 19 were infected with a human papilomavirus (HPV) from 2003 to 2004, as were almost half of young women between the ages of 20 and 25.
The troubling news comes from the Centers for Disease Control and Prevention (CDC) in their Morbidity and Mortality Weekly Report. The report was based on data compiled during the years 2002 through 2007 that was gathered from the National Vital Statistics System, the National Health and Nutrition Examination Survey, the National Survey of Family Growth and studies of hundreds of thousands children and young adults ranging in age from 10 to 25.
According to the report, the numbers indicate that the American youth is in need of better sex education that includes emphasis on STD and pregnancy prevention. In the report, the CDC writes, “The data presented in this report indicate that many young persons in the United States engage in sexual risk behavior and experience negative reproductive health outcomes.”
The report found that although more than 80 percent of boys and girls reported having received formal instruction before age 18 on how to say no to sex, among those 18 to 19 years of age, only 49.8 percent of girls and just 35 percent of boys had discussed methods of birth control with a parent. In general, nearly 70 percent of teen girls as well as 66 percent of boys reported receiving instruction on methods of birth control.
Other discoveries included that for boys ages 15 to 17, about 32 percent had engaged in sex compared to thirty percent of girls in the same age range. However, among those ages 18 to 19, almost 65 percent of boys and 71 percent of girls had experienced sex. Disturbingly, nearly 10 percent of young women ranging from 18 to 24 years reported that their first intercourse had been involuntary. About 100,000 females among the age range of 10 to 24 were treated in hospital emergency departments for non-fatal sexual assault injuries during the period between 2004 and 2006.
Among those sexually active teens, infections with the human immune deficiency virus that causes AIDS rose from 1.3 cases per 100,000 in 1997 to 2.5 cases in 2006 among boys aged 15 to 19. The syphilis rates among females aged 15 to 19 increased from 1.5 cases per 100,000 in 2004 to 2.2 cases per 100,000 in 2006 after having significantly declined between 1997 and 2005. Gonorrhea infections rates have leveled off after decreasing for more than two decades. Approximately 1 million American teens and young adults ages 10 to 24 reported contracting chlamydia, gonorrhea or syphilis in 2006, accounting for nearly half of all incident sexually transmitted diseases and 25 percent of the sexually active population.
The researchers concluded from their findings, “The sexual and reproductive health of America's young persons remains an important public health concern,” and also noted, “Earlier progress appears to be slowing and perhaps reversing

American Spending on Alternative Medicine Continues to Skyrocket

American consumers spent an estimated $34 billion on alternative medicine in 2007. In fact, alternative medicine accounts for over 11 percent of out-of-pocket spending on health care in the United States. This surprising information comes from the first national estimate of dollars spent on alternative medicine in over ten years. The last government estimate of spending on alternative medicine was reported based on a 1997 survey that found spending to be at about $27 billion.
Alternative medicine includes any healing practice not falling within the realm of conventional medicine. Many such practicies include herbalism, homeopathy, hypnosis, naturopathy, chiropractic, acupuncture, yoga, biofeedback, diet-based therapies, Unani and traditional Chinese medicine. These practices are very diverse and may be based upon traditional medicine, folk knowledge, spiritual beliefs, newly conceived approaches to healing or a combination thereof.
According to Dr. Josephine Briggs, director of the National Center for Complementary and Alternative Medicine, “We are talking about a very wide range of health practices that range from promising and sensible to potentially harmful.” She further explained that there is a critical need for more research into which therapies are effective due to the substantial amount of money consumers are spending on them.
Briggs also noted that as the number of uninsured Americans increases, the use of these therapies may grow even more as some of them are relatively inexpensive. Because the data gathered for the estimate was collected prior to the current recession, it is not know if the economy played a role in jump in alternative medicine spending.
The U.S. Centers for Disease Control and Prevention (CDC) surveyed more than 23,000 adults across the nation and found that over one-third of American adults use alternative medicine. A report of this information was released in December of 2008.
The newly released report on the survey revealed that pain was the primary reason people sought massages and chiropractic care as well as other alternative therapies. Approximately 35 cents of each dollar spent on alternative went for appointments with acupuncturists, chiropractors, massage therapists and other practitioners. With a total of almost $12 billion, this represents about one-fourth of what is spent on mainstream physicians.
The most popular supplements used were found to be glucosamine to battle against joint pain, and fish oil to reduce the risk of heart disease. A total of $15 billion, or 44 cents out of each alternative medicine dollar spent, went for such products as these and echinacea. This is about equivalent to one-third of what American consumers spend out-of-pocket for prescription drugs.
Regarding supplement use, Briggs said, “I personally am pretty conservative about supplement use.” She also said that the center’s research has played a role in consumer behavior regarding their use. For example, when studies revealed that echinacea was ineffective for colds, and that St. John's wort did not quell major depression, consumers use of these products dropped. On the other hand, the use of fish oil has increased following research indicating that it might help lower risk of heart problems. Although many consumers believe that all products that they purchase have been cleared by the Food and Drug Administration, the fact is that they do not need proof of safety or effectiveness to go on the market.
The survey also showed that a stunning $3 billion was spent on homeopathy. Homeopathy is a system of medical practice that treats disease through the administration of minuscule doses of a remedy that would produce symptoms in healthy persons when used in larger amounts.
Findings concluded that 38 million adults visited alternative medicine practitioners for which they paid less than $50 on average per visit, and the average annual spending per person was about $122. For services such as acupuncture, homeopathy and hypnosis, the average was a higher at $75 plus. The average spending for products was $177