Dealing with Family Addictions

By Kathryn Berlá, Ed.D.

 Dear Dr. Berlá,

 My 23-year-old sister still lives at home with my parents.  She has been abusing alcohol and cocaine since she was around sixteen.  She has made a couple of attempts at getting substance abuse counseling, but she has not been able to stick with it.  I am frustrated with her, but am more frustrated with my parents who continue to support her financially, even as her addiction is tearing up our family.  Everything revolves around her, to the point where my parents’ activities and routines are becoming restricted. She has destroyed property and even stolen from them.  They complain to me, but get angry and accuse me of sibling rivalry when I make suggestions that sound harsh to them.  I have been seeing a lot on television lately about interventions for addictions.  What do my parents and I need to know?

–D.P., Louisville

Dear D.P.,

In my experience, the only thing more intractable than an actual addiction is changing the dynamics of the family of an addict.  It doesn’t mean it can’t be done, but it is difficult, and the statistics are not pretty. Studies show that the relapse rate for addicts getting treatment for the first time can be anywhere from 45-95%.  It is not uncommon for severe addicts to go through several treatment programs, if they can survive that long, before getting clean and staying clean.  The costs of addiction to the addict and to society are pretty obvious.  Treatment costs alone can rival that of college tuition. The “hidden” costs of addiction are not the ones we automatically think of.  Addictions chew through families, create estrangement, financial hardship and social ostracism.  Addicts, by definition, are selfish; they don’t care who they take down with them, and all too often it is the loved ones with whom they are closest.

Loving an addict, the way your parents love your sister, is a complicated endeavor. Parents love their children and can’t tolerate seeing them in pain.  The presence of an addiction can cloud a parent’s view of how best to protect their child.  Often, a parent or loved one believes that by “helping” the addict just a little bit, that they can save the addict from a much worse fate and much greater pain.  For example, your parents may believe that by letting your sister live with them, they are saving her from being homeless, because she would use her rent money for drugs.  They could be right about the homeless part, but the problem remains:  she is still using her rent money, and all the rest of her money, for drugs.  In addition, she now has a comfortable place to do drugs and crash.

Your parents probably think that they are taking care of your sister the only way they know how,  but they are doing it at their own and everyone else’s expense. They would do well to ask themselves: is what we are doing helping to perpetuate a bad situation?  Remember that “enabling” means providing the means or opportunity. If we provide the means or opportunity for a friend or loved one to abuse drugs or alcohol, then we are enabling their addiction.

Changing enabling behavior and surviving addiction in one’s family is very difficult to accomplish without outside help.  There are many fine support groups, such as Al-Anon and parent groups at drug treatment centers. In addition to a good support group, you and your family may benefit from psychotherapy independent from any treatment your sister may receive. Look in the phone book, ask friends, or ask your family physician.  Get some names of some therapists and start interviewing.

For many addicts, the first real attempt to quit using comes after an intervention. A formal intervention is facilitated by a trained therapist who may be in private practice or affiliated with a treatment center.  The intervention requires careful preparation and the participation of many friends and family members who are committed to the addict’s recovery.  It is usually an emotionally wrenching experience where everyone tells the addict in a direct yet loving way how the addiction has negatively affected their lives.  It also requires a commitment from the participants that they will not engage in enabling behavior any longer. Usually, inpatient treatment has been prearranged for the addict, and the expectation is that the addict will go directly to treatment from the intervention. It is standard and encouraged for family members to give the addict ultimatums if they do not take advantage of treatment. They can include statements such as “If you do not go to treatment today, you will no longer be allowed to live in our house,” or “If you do not start treatment today, will no longer be allowed around my children.”  These can be hard things to say, but they are harder to follow through on.  Tough love can feel counterintuitive and just plain bad when it comes to someone you care about.  Maintaining resolve, however, can be easier when you consider the alternatives.

Addiction counselors say that intervention is inevitable for every addict.  Sometimes it takes the form of death by overdose or accident.  Sometimes it takes the form of arrest and jail time.  Sometimes, and preferably, it takes the form of the decision to seek treatment.  The point is, something will happen to intervene with the addiction spiral.  We just have more control over a planned intervention now than we do arrest or death later.  If the intervention can occur under these more controllable circumstances, then there is always hope.

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Kathryn Berlá, Ed.D. is a licensed psychologist in private practice in Louisville.  She may be reached at 502-412-2226.


UofL experts featured at free Alzheimer’s disease conference Sept. 17

Howard University researcher, local Alzheimer’s Association staff also among presenters

University of Louisville faculty researchers and clinicians with expertise in polypharmacy, caregiving and more will join with a Washington-based geriatric researcher at a free conference examining Alzheimer’s disease.

The University of Louisville Schools of Medicine and Nursing join with the Greater Kentucky and Southern Indiana Chapter of the Alzheimer’s Association to present “The Journey: Alzheimer’s Disease and Caregiving” from 9 a.m. to 3 p.m., Saturday, Sept. 17, at Crowne Plaza Louisville Airport Hotel, 830 Phillips Lane.

Admission, parking and lunch are free to participants but pre-registration is required by Sept. 15 to or 1-800-272-3900.

The conference will provide information on the risk factors for Alzheimer’s disease, the reasons why certain populations are at greater risk for developing it, and current practices in caregiving.

Opening the event will be Thomas Obisesan, M.D., chief of geriatrics at Howard University Hospital and professor of medicine at Howard University College of Medicine in Washington. Obisesan’s research is focused on finding a cure for Alzheimer’s disease and disentangling the overlap of cardiovascular disease with Alzheimer’s disease risk.

 Also presenting will be:

  • 10 a.m.: Robert Friedland, M.D., professor and the Mason and Mary Rudd Chair of Neurology at UofL, “Risk Factors, Prevention, Lifestyle Changes”
  • 10:45 a.m.: Karen Robinson, Ph.D., professor in the UofL School of Nursing, “Skills for Caregivers and Interventions”
  • 11:25 a.m.: David Casey, M.D., senior vice chair and head of clinical services, UofL Department of Psychiatry and Behavioral Sciences, “Behavioral Problems”
  • 1 p.m.: Teri Shirk, chapter president and CEO, and JoAnna Weiss, director of education and outreach, Greater Kentucky and Southern Indiana Chapter, Alzheimer’s Association, “Community Resources”
  • 1:35 p.m.: Demetra Antimisiaris, Pharm.D., assistant professor, UofL Department of Family and Geriatric Medicine, and director of the UofL Geriatrics Polypharmacy Program, “Polypharmacy”

Lunch will be provided at noon and the conference will conclude with a question-and-answer session from 2:10-3 p.m.

The conference is supported with grants from Eisai Co. Ltd. and the Signature Research Institute.

Hearing Loss in Adults

By Melanie Driscoll, Au. D.

Do you get your eyes tested every year?  That’s right, eyes, it’s not a typo.  So, do you?  Are annual eye exams a part of your yearly healthcare routine?  Well, what about your ears?  Do you schedule an annual hearing test to determine your hearing status, and to see if changes in your hearing have occurred?  If you are like most people, the answer is probably no.

Why is this?  Why are most people concerned with monitoring their vision yet chose to neglect hearing?

Annual eye exams are performed to monitor changes in your vision, likewise annual hearing tests should be completed in order to monitor changes in your hearing.  According to a recent study, vision loss and hearing loss may be linked.  Roughly 2,000 men and women between the ages of 55 and 98 participated in a study at the University of Sydney that linked hearing loss and vision loss.  Results indicated having either type of loss created a greater risk for the other.  Those with hearing loss were 50% more likely to have vision impairment, while those with visual loss were 60% more likely to have some hearing impairment. This correlation was greatest in those under the age of 70.  Additionally, both cataracts and macular degeneration were also associated with hearing loss.

Hearing loss is more common than you may think.  On average people experience hearing loss for approximately seven years before seeking help, while a loss in visual acuities are usually addressed immediately.  It is estimated that over 28 million Americans have hearing loss that affects their ability to communicate; that translates to over 500 million people worldwide.

We are all losing our hearing at a much younger age than we were 30 years ago.  In the U.S., one out of twelve 30-year-olds, and one out of eight 50 year olds suffer from hearing loss.   More that 10 million baby boomers (aged 45 – 64) have hearing loss.

Nine million seniors (age 65 and older) have hearing loss.  Among seniors, hearing loss is the third most prevalent, but treatable disabling condition, behind arthritis and hypertension.

More than a third of all hearing loss is attributed to noise exposure: loud music, loud workplaces, and loud recreational equipment.  Other causes of hearing loss include hereditary, disease, medications, head injury and serious systemic infections (i.e. meningitis).  Many times, the cause of hearing loss remains unknown.

People with hearing loss will frequently have the following complaints: people mumble; they mistake one word for another; they can hear, but not understand; hear only portions of a conversation; ask people to repeat what has been said; turn the television/radio up too loud; and often have trouble hearing sirens, doorbells, and/or telephones.  Another common complaint from those with hearing loss is that they have enormous difficulty understanding in noisy situations.

Delaying the identification and treatment of hearing loss will deprive the auditory system of adequate stimulation, leading to a reduced ability to function in various listening environments.  Research has shown that those who pursue amplification early, rather than wait the usual seven years, find greater benefit, especially in situations where background noise is present.

The risk for social isolation, depression, and withdrawal is greater for those with untreated hearing impairments than individuals with normal hearing.  Add on visual difficulties and the risks increase even more.     

If you think you may have a hearing loss, you need to make an appointment with an audiologist.  An audiologist is a professional who diagnoses, treats, and manages individuals with hearing loss.  A comprehensive hearing evaluation by an audiologist can identify the presence of hearing loss.  Following the evaluation, the audiologist will then make an appropriate recommendation based on the test results.

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Dr. Melanie Driscoll is an audiologist  and is co- owner of Hear Here located at 970 Breckenridge Lane.  Dr. Driscoll earned her doctorate in Audiology from the University of Louisville School of Medicine.  Dr. Driscoll is licensed by the State of Kentucky. She is a Fellow of the American Academy of Audiology and is board certified by the American Board of Audiology. Dr. Driscoll, and her husband and business partner, Jeff, reside in Louisville with their six children: Adam; Michael; Olivia; Ben; Sarah; and Caroline. They are active members, and volunteers, at Southeast Christian Church.

Material for this article was obtained from the following sources:;;;

Lights Out: Getting Your Child to Sleep

By Julie M. Schuster, MD

We are all familiar with the energy of a toddler, especially at bedtime.  “Please, just one more story!?”  One might think it must be easier to convince North Korea to shut down its nuclear program than get your child to go to bed.  Here are some tips to help establish good sleep hygiene for your little one.

Establishing effective sleep habits starts in infancy.  While it will certainly vary by age, it is never to early to start a bedtime routine.  It may consist of singing a song in a quiet room during infancy.  Nighttime feedings should be different from daytime ones – lights out, no noise, no playtime.  While newborns must eat every few hours during the night, these feedings should start to decrease as your infant gets older.  By four months, your baby does not physiologically need to eat during the night.  It is mostly a routine to awaken for a bottle and you can try to comfort your baby when she awakens without a feeding.  Your infant should always sleep alone.  This is also something that must be established early.  From 0 – 6 months, your infant is at risk for Sudden Infant Death Syndrome (SIDS) if they sleep in your bed.  After that, there is the risk of the baby falling out of the bed and getting injured.  It is much easier to have your baby sleep alone from the beginning rather than trying to move them to their own bed later.

Many parents ask when they can move their child from a crib to a toddler bed.  Once your baby is old enough to sit up and later pull up to standing, you must lower the crib mattress so they do not climb out.  Once your toddler has acquired skills that they could use to effectively climb out of a crib with a lowered mattress, it is time to move them to a toddler bed.  Having a routine established where your child knows this is their bed where they are to stay all night is mandatory by this age.  Otherwise, your toddler can now get out of bed, walk to the door, open the door, and either roam freely about the house with numerous dangers awaiting them, or incessantly bother you until you allow them to get into your bed.  This often happens if good sleep habits are not already in place.

Toddlerhood is a time to hopefully continue the good routines you have already established.  Your bedtime routine has now evolved, and will likely consist of activities such as brushing teeth, going to the bathroom, putting on pajamas, reading a book, then a hug and lights out!  Having this routine lets your child’s brain and body know that bedtime is coming and helps them to prepare.  It is also important to have a consistent bedtime (other than special occasions).  Children thrive with routine and go to sleep more readily if bedtime comes at the same time each night.  One strategy some parents have used is to make a chart of bedtime tasks and check them off as each one is completed.  You can draw a picture next to each step of your child happily completing each task.  Make bedtime activities desirable by letting your child have a cute toothbrush, picking the toothpaste, and commenting on how beautiful his clean teeth are or how nice he looks in his new pajamas.

Some children try to negotiate their bedtime each night (“I’m not ready”, “One more game”).  When they sense the time for bed is nearing, they may dig in their heels.  Perhaps they are fearful of going to bed.  Be calm and reassure them that you or someone they trust will be nearby.  Avoid active physical play before bed, as well as sugar and caffeine late in the day and evening.  These can all make it difficult for a young child to go to sleep.  If your child has problems with bed-wetting, avoid liquids after dinner and make sure they urinate before bedtime.

If your child throws a tantrum during the bedtime routine, do not beg or plead with them to complete their tasks and go to bed.  Always remember that you are the adult and you are in charge.  Tantrums should be ignored.  You can tell your child that you are leaving the room.  When they are finished with their fit, you will return.  Don’t feel obligated to negotiate with your child over expected activities such as bedtime.  Minimize distractions, such as siblings who are not going to bed at the same time.  Do not allow your children to routinely fall asleep with you or your spouse while in front of the TV.  Studies have shown that TV interferes with children’s sleep and should not be allowed in their bedrooms.  Set a limit to either the number of books you read or the time you will spend reading prior to bedtime and stick with it.

Ensure your child is getting appropriate daytime naps as too much or too little time spent napping can interfere with nighttime sleep.  According to the American Academy of Pediatrics, a newborn should sleep 15+ hours per day.  From 4 months to 3 years old, a child should sleep about 13 hours at night plus a 1+ hour nap.  From ages 3 to 5 years, they should sleep 12 hours at night and as needed naps.  Some children no longer require naps at this age.  From 5 years and onward, children should sleep 10-11 hours per night with no daytime naps.

Bedtime can be fun and keeping your child well-rested is important for her growth and development.  It’s also helpful for a busy mom or dad to have time in the evening to spend with each other or finishing other activities for the day!

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Dr. Schuster is a pediatrician with Oldham County Pediatrics  Their office locations are in LaGrange and behind the Summit shopping center.  Dr. Schuster is married to Bryce, who is a general surgeon.


How To Choose A Pediatrician

By Beverly Gaines, M.D.

Finding the right pediatrician for your children is an important decision.  You are looking for a partner in your children’s health care.  Your pediatrician will be a part of your life from birth to college and beyond in some cases.

The American Academy of Pediatrics (AAP), the national organization of 60,000 board-certified pediatricians, promotes the concept of you finding a medical home for your child.  A medical home is defined as primary care that is accessible, continuous, comprehensive, family-centered, coordinated, compassionate and culturally effective.

The concept of medical home is based on you finding a pediatrician who you feel will deliver high quality care to your children, someone with whom you feel mutual trust and respect and who will respect your family’s cultural and religious beliefs. A medical home includes connections and services to meet the medical and non-medical needs of your children and your family, provides after hours and weekend access to medical consultation and coordination of care with a team of other health-care providers when needed.

So, how do you find a pediatrician and a medical home for your children?  If you are expecting, your obstetrician may recommend a pediatrician. This is an important and reliable referral because your obstetrician is familiar with the professional reputation of this person and has worked with this person over a period of time.

If you are not expecting, you can ask your primary care physician for a referral to a pediatrician.  Family and friends with children are another excellent source of referral.  They can also give you a perspective of what it feels like to be a patient of that pediatrician.

In addition, there are community-based referral programs; most hospitals have a list of the pediatricians with staff privileges at their hospital. The local and state professional medical associations (Kentucky Medical Association, Jefferson County Medical Association and Falls City Medical Society) have referral programs of the pediatricians who belong to their organizations.  The national medical association, the professional association of the African American physicians in the country, has a referral program on their website,, and the AAP has a referral program of their members available on their website,

Take a personal inventory of your needs and prioritize them – assess what is most important.  The list should include professional credentials, reputation in the community, communication style, age, gender, race, ethnicity, office location, office staff, insurances accepted, size of the practice and whether you can choose which pediatrician you will see at each visit, appointment availability, policy regarding sick visits (can you get in the same day?) and payment methods.

The last step in your selection process is an interview or prenatal consultation with your prospective pediatrician.  Most pediatricians are happy to do a consultation with a prospective new patient at no charge. This is the most critical step in your selection process, because it allows you to try on a relationship on with this pediatrician.  It answers questions for you that no one else can.

  • How do you feel about this person?
  • Are they qualified? Competent? Professional? Caring?  Communicative?
  • Are they sensitive to the special needs of a person of your race, ethnicity, religion and cultural beliefs?
  • Are they sensitive to the special needs of your lifestyle?
  • Can you effectively communicate to this person?
  • Do you feel you can trust them?
  • Do you feel confident in their abilities to care for your child?
  • Are they accessible and available?
  • Do you like them, their office and their office staff?
  • Are you comfortable entering into a partnership with this person and feel they respect you?


Once you have made your decision, inform your obstetrician of your selection.  Then sit back and relax until the baby comes.  Your pediatrician will be notified when your baby is born.  If you already have children, your next step is to set up your first visit with your new pediatrician.

Enjoy this relationship!


Beverly Gaines, M.D., F.A.A.P., is a board-certified pediatrician and has practiced in Louisville since 1984.  She owns and operates Beverly Gaines, M.D. & Associates PSC.  Dr. Gaines career is long and distinguished locally and nationally.


Cooling Down Kids in the Summer

By Ashli Collins, MD

Growing up a few decades ago we thought water was for sissies.  Sports drinks weren’t invented except for maybe Tang and we didn’t even have bottled water.  Occasionally at a picnic someone would bring a big water cooler with a spigot and that was the pinnacle of rehydration.  Thankfully, someone decided that an unnamed team in the South needed replenishment after hours of practice in the hot sun and the world of sports drinks and better hydration was started.

Several noted sports figures have died in recent years from “heatstroke” or heat related illnesses.  What is under appreciated though, is the danger of heat illness in our young athletes.  The dramatic increase in competitive, year round sports for our youth has caused a similar increase in the number of cases of heat related illness.

Children are especially susceptible to heat related problems for several reasons.  Kids have fewer sweat glands than adults, thus limiting the amount of sweat they produce to cool their body.  Their bodies generate more heat than adults and thus increase their core body temperature sooner.  They have a higher ratio of body surface area to body mass.  And as children, are usually dependent on their coaches/parents to provide fluid and shade.

Our bodies, both adults and children, gain heat from internal and external forces.  Internally, we generate heat by the amount of work expended-from couch sitting to being outside running we generate heat.  Externally, our body “gains heat” by the surrounding  temperature.  We lose heat by several mechanisms, the most important being evaporation and radiation.  As our “heat in” exceeds our “heat out”, we run into heat related problems.  Interestingly, when the humidity is greater than 75%, the air is so saturated with moisture that sweat cannot be evaporated.  Thus, high heat, high humidity days are the most dangerous.

Heat related illnesses range from mild cramping to death.  Heat cramps are the earliest sign of a problem with short muscle spasms or cramps that usually last less than a minute.  The legs, shoulders and abdomen are the most common areas to have cramping.  They may also occur during or after exercise.

Treatment for heat cramps includes moving the child to a cooler place, allowed to rest and given fluids.  Fluid support can either be water or electrolyte enriched sports drinks.  Salty foods, such as pretzels or chips, may also aid in recovery as a large volume of salt is lost in sweat.

As practice/play in the heat progresses, so can heat illness.  Heat exhaustion from either excessive water loss or excessive salt loss can occur.  Symptoms of this include nausea, vomiting, headache and fever.  Weakness, dizziness or confusion may also occur in some children.

Treatment for heat exhaustion begins with the same measures as that of cramping with rest, moving to a cooler environment and fluids.  If the child is vomiting, IV fluids may be needed as well as monitoring of labs.

Heatstoke, the most serious heat related illness, is described by high temperatures (above 104.9o), coma and hot, dry skin.  Seizures, increased heart rate and low blood pressure may also be seen.  This is an emergency and must be treated aggressively by an emergency room.  Untreated heatstroke can lead to total cardiorespiratory collapse and death.

In addition to our children out playing and increasing their chances for heat related illness, children left in cars on a warm day may also suffer.  One report states that an outdoor temperature between 86o and 104o can raise the temperature inside a car to 120-140o within minutes.  Another forgotten danger zone for children are hot tubs and saunas.

Preventative measures go a long way in keeping heat related illnesses away.  Hydrating before activity is recommended.  Urine should be a very light yellow before activities in the heat.  Rehydrating during activity is also paramount.  One recommendation is that a 40 kg child should consume 5 oz of fluid for every 20 minutes of activity and a 60kg child 9 oz/20 minutes.  For activity lasting an hour or less, water is ok.  But, for longer activity, a glucose/electrolyte replacement drink is preferred.

Other helpful hints are to dress your child in lightweight, lightly colored clothing for play.  Also, weighing your young athlete before and after practice can help you estimate how much fluid they are losing.  Adjustments to their rehydration can then be more adequately figured.  Coaches need to be aware of the duration of practice in regards to temperature and humidity. Mandatory water breaks based on those conditions should then be instituted to protect their athletes.

Ashli Colins, MD.  Dr. Collins is a pediatrician with Oldham County Pediatrics, PLLC.  They have offices in LaGrange and in Louisville near the Summit.  She has two kids, twins, Sarah and P.J.  For more information call 502-225-6277 or










Kids: Fuel Like a Champion!

By: Christopher R. Mohr, PhD, RD

Parents often contact me looking for nutrition advice for their child and they all swear their kid is going to get a college scholarship, while even more are going pro!  Sound familiar?  Hopefully it is true, but aside from the training they have, there’s often one component of an overall program that’s missing from making sure they’re successful – learning how to fuel like a champion is important!
Let’s delve a bit into some specific nutrition tips for young athletes.


Carbohydrates should absolutely be the cornerstone of anyone’s diet.  The key, is to focus heavily on quality — “think fiber, not carbs!”  There is a huge difference between white bread and whole grain, high fiber bread; a sugar coated cereal and oatmeal; French fries vs. sweet potatoes.  Focus on the quality of the carbohydrates.


For example, definitely eat breakfast, but try a whole grain based cereal with some fresh fruit for the nutrients and fiber.  Sandwiches should be made with whole grain bread, rather than their white counterpart.  Snacks can be whole grain crackers with peanut butter, fruit or veggie sticks with peanut butter, etc.  The list can go on.  The focus of carbohydrates should always be on foods that provide a few grams of fiber per serving (exception is milk and yogurt, which are very healthy and carbohydrate based, but provide little, if any fiber).


Fruit and vegetables are also a crucial element to a healthy diet.  Kids often shy away from them and parents don’t always push them.  However, research has suggested it can take as many as one dozen times to determine if a child likes a particular food.  The key for a parent is to introduce kids to as many of these nutrient dense, colorful foods as possible!  Make it fun.  Here are a few ideas:


  • Ants on a log (celery with natural peanut butter and raisins)
  • Sailboats (apple slices with toothpicks holding a cheddar cheese “sail”— of course watch your child to ensure they don’t eat the toothpick).
  • Homemade trail mix (mixed nuts, dried fruit, and some whole grain cereal)


Keep in mind that dried fruit counts towards the total fruit intake for the day, as does 100% juice (of course this shouldn’t be the mainstay, though, as whole fruit provides more fiber), along with fruit puree.

Protein Needs of Young Athletes


In the world of athletics, no other macronutrient has received the same level of attention as protein.  Everywhere you look, everything you see, tells us we need more and more protein, whether you’re trying to lose weight or gain muscle.  But how about for adolescent athletes; do they too have higher protein requirements like other fitness enthusiasts?  As you know, they too are trying to improve performance, put some muscles on those bodies, and of course just improve overall health (at least we hope they are!).


Of course protein plays a role and a very important one at that!  One important message is to make sure young athletes always focus on food first.  High quality protein sources include:

  • fish and other seafood
  • low or non fat milk or yogurt
  • chicken and turkey breast
  • lean red meat
  • tofu
  • mixed nuts
  • eggs
  • beans
  • natural peanut butter and more.


The greater the variety in the diet, the better off they will be getting the most “bang for their buck” in terms of various amino acids and other nutrients.

We need to teach young athletes proper nutrition habits, which should include whole, nutrient dense foods rather than teaching them to immediately turn to supplements, which is common with protein.


At the same time, there are quality supplements out there that can be of use.  I would much rather have a teen athlete have a high quality protein shake, blended with some fruit versus a snack like those served at the soccer game I alluded to earlier, or fast food, which is way too common these days.


  • Do they need a protein supplement?  No.
  • Will it make them into the next college or pro athlete?  Of course not!
  • Can it be beneficial and a healthier option than many of the alternative high sugar, high fat foods marketed directly towards children?  Absolutely!


But food first as whole foods provide more nutrients than any supplement does or ever will be able to provide.


Chewing the Fat


Fat is another crucial nutrient for children.  The key, like with the other macronutrients, is to focus on quality.  In fact, there have been a handful of scientific studies to even show that one component of omega-3 fats, DHA, is crucial in terms of brain development.  Fat also provides a lot of calories (over double that of protein or carbohydrates), which can be important for very active, young athletes who need more calories than most to develop healthy, strong bodies.


Here are a few fats to choose:

  • Fish
  • Whole eggs
  • olive oil
  • Raw mixed nuts
  • Natural peanut butter
  • Avocadoes and more


Don’t overdo the fats, but definitely don’t skimp on them either—moderation and quality is king!



These are actually the most important nutrient anyone can consume.  The quality of the fluid is a struggle for kids in particular; they are surely drinking more fluids, but not the type we’d encourage.  Over the past few decades, milk consumption has decreased dramatically and is being replaced with soft drinks.  This is unfortunate because of the nutrients being lost without the milk and the empty calories they’re being replaced with.  Remember I mentioned earlier that 100% juice does count as fruit; however, we also don’t want kids to live off this, as it doesn’t provide all the same fiber and nutrients whole fruit does, in addition to being way too easy to over consume.  Keep in mind that 4 oz of juice counts as one fruit; this is ½ of a cup of juice.  It would be very easy to drink 2 whole cups of juice, but you are less likely to eat the equivalent 4 whole oranges, meaning it is easy to pack in a lot of excess calories.
Water is really the best option.  The 2005 Dietary Guidelines do in fact make a recommendation to consume at least 3 servings of low-fat milk or other dairy products, and the majority of other fluids should be water.  If you need to make water more exciting for kids, add a squeeze of orange, lemon, lime, or cucumber.  And always keep a pitcher in the refrigerator, so there is cold water at their fingertips.


In summary, here are a few tips to keep in mind when fueling young athletes.


  • Variety is crucial—the more the variety, the better
  • The more fruits and vegetables each day, the better
  • Think fiber, not carbs
  • Protein is absolutely important, just as it is with adults.
  • Fat quality is crucial
  • Be creative to get kids to eat a variety of foods
  • Hydrate, hydrate, hydrate!
  • Very basic supplements, such as a high quality protein, are OK, within reason, but the food first approach is always the best with folks of all ages.


Most important, make sure your child has a chance to try a variety of activities, has fun, and enjoys him/herself.  At 9 or 10 years old, they are not trying out for the majors; they are trying to play and have fun.  Let them be kids, learn some basic skills, and camaraderie; it’s not the Superbowl, World Series, or World Cup!  In the meantime, feed them well and teach them positive nutrition habits that will stay with them for life!  For more information on how to make the best nutrition decisions for young athletes, visit


Christopher R. Mohr, PhD, RD is the co-owner of Mohr Results, Inc.  He has a PhD in exercise physiology, is a registered dietitian, and board certified sports dietitian.  Visit to learn more about their weight loss seminars in Louisville, DVD’s, and other educational materials!



New Ideas for Fast & Easy-to-Make Breakfasts for Kids

By Barbara Day, M.S., R.D., C.N.
Kids and adults, too, need to eat breakfast every day. Breakfast means break the fast. Kids will do better in school and parents will do better at work if they eat breakfast. Here’s few easy recipes: Nutty Fruit Breakfast Wrap -1 whole wheat tortilla, ¼ cup low fat vanilla yogurt, ½ cup fresh or frozen fruit like blueberries, ¼ tablespoon of toasted wheat germ (high in folic acid and vitamin E) and 1 tablespoon chopped nuts like walnuts. Fold in sides of tortilla, then roll. 1 serving = 314 calories, 10 grams of protein, 39 grams of carbohydrate, 14 grams of fat, 4 grams of fiber. Crunchy Fruited Yogurt- 1 tablespoon low fat granola, 8 ounces low fat vanilla yogurt, 1 tablespoon nuts like walnuts, ½ cup of fresh or frozen fruit like strawberries. 1 serving = 289 calories, 13 grams of protein, 43 grams of carbohydrate, 8 grams of fat, 3 grams of fiber. Here’s a resource to figure out how many calories your kids need per day.

Barbara Day, M.S., R.D., C.N., is a registered dietitian with a Master’s Degree in clinical nutrition. The former publisher of Kentuckiana HealthFitness Magazine, Kentuckiana Healthy Woman magazine and radio show host of Health News You Can Use, Barbara has over 30 years of experience in promoting healthy lifestyles to consumers. Barbara worked as Nutrition Consultant to the Navy SEALs (8 years) and the University of Louisville Athletic Department (10 years). Barbara has private practice, DayByDay Nutrition,, where she counsels clients on weight loss, cholesterol management, performance nutrition and an array of other medical issues. Visit Barbara’s new website which is an on-line health & wellness magazine, Barbara writes nutrition and health columns for as well as a weekly nutrition column for the Southeast Outlook. She also designs and presents employee wellness programs to small and large businesses. Barbara is a runner, cyclist, hiker and a mother and grandmother to 9 grandchildren.