The One About Easy Ways to Eat Healthy

Summer is almost here and getting out of our regular routines can sometimes lead to unhealthy eating habits.  Summertime also seems to lend itself to easier access to sugary snacks.

Here are some tips to kick off your summer on the right foot and get your family involved in making healthier choices.


Make Half of Your Plate Fruits and Vegetables: Incorporate fruits and veggies on a regular basis as a great source of fiber, vitamins, minerals, and other nutrients.  Take a field trip with your family to the local farmers’ market, this is a great way to get everyone involved in selecting fresh fruits and veggies for the dinner table.

Make Half The Grains You Eat Whole Grains: Increasing whole grains in your diet can help with satiety, glucose control and cholesterol levels.  As you grocery shop, put the kiddos to work and have them help you find products that promote whole grain ingredients.

Choose Low Fat or Fat Free Milk, Yogurt, or Cheese: Dairy products can be a great source of Calcium, Vitamin D and Protein. Choosing low fat or fat free options can make them even healthier.

Drink Water Instead of Sugary Drinks: This is Texas and it stays hot all summer long… Water is the best way to stay hydrated at a normal activity level. Eliminating sugary drinks is an easy way to cut calories.  Turn your water consumption into a fun game of keeping track.  See who can drink the most water in a day or week.

Lean Sources of Protein: Choose lean meats or go meatless with proteins such as beans and nuts.  Summertime is a great time to start Meatless Mondays – get creative with legumes and whole grain pasta dishes.

Watch Portion Sizes: Pay attention to portion sizes on Nutrition Food Labels.  Promote reading over the summer by teaching children how to read food labels, including how much is actually in a serving. This is a great way to make them aware of what they are actually putting in their bodies.

Eat the Rainbow: Add fruits and vegetables that include a variety of colors to your weekly diet.  Make it a friendly family competition to see how many colors you can get on your plate.

Online Resources – Website for the Academy of Nutrition and Dietetics. Great tips for planning a healthy diet, including fun recipes to try with your kids. – Great resource for developing an active lifestyle – US Department of Agriculture’s website encouraging healthy meal choices and portion sizes. – Great overall resource for parents by the American Academy of Pediatrics


CPPFM Doctor Recommended Snacks

We have been sharing healthy recommendations all week on Facebook, Instagram, and Twitter for Every Kid Eat Healthy Week. We wanted to end the week with our Cedar Park Pediatric & Family Medicine Doctor’s favorite recommended snacks:

Dr. Keegan

  • Yogurt
  • Fruit (sometimes with nut butters)
  • Nuts

Dr. Moore

  • String cheese
  • Yogurt

Dr. Jennifer Cardwell

  • Fresh fruit: my kids like mandarin oranges
  • Nuts: I keep at work the Emerald 100 calorie packs of almonds and walnuts
  • String cheese

Dr. Brent Cardwell

  • Nuts: Almonds
  • Vegetables: Carrots
  • Trail Mix

The One About Giving Thanks and Giving Back

Volunteering has always been an important part of my life. When I was in elementary school, my mother and I would serve ice cream each Sunday to residents of our local nursing home. When I was in college, I spent a lot of time accumulating volunteer experiences that I hoped would prepare me for a career as a doctor. Once my training was complete and my family and I had moved back to Austin, my mother and I resumed our joint volunteering by cleaning crates and walking dogs at Texas Humane Heroes.

Two years ago, my husband and I joyously welcomed our son, Henry, into our lives. While I wish him joy and success academically, athletically and musically, my greatest wish for him is to be kind. In an effort to foster this kindness and to make a difference in the lives around us, I began looking for family volunteer opportunities – no easy feat it would seem with a two year old in tow!

Pediatric research shows that children who are involved in community service develop greater self-esteem and are less likely to engage in risky behaviors as they get older. In addition, research also suggests that families who volunteer together have tighter family bonds and more positive relationships with one another. In a world that can sometimes appear frightening, chaotic and divided, volunteering can allow us to make a difference, to spread kindness and to inspire our littlest world citizens to strive for a better world. What follows are some helpful hints to motivate all of us in our volunteer efforts with our children.

Start at home. Even the smallest of children can be taught the power of caring by encouraging small acts of kindness, like caring for a pet or simply helping or listening to a family member who has had a long day.

Be a good role model. Children love to imitate the adults in their lives, so having them see us get excited about volunteering can spread the excitement. Use volunteering as a time to bond with your child, and chances are, they will look forward to the activity even more.

Give kids a vote. Volunteering does not have to be a chore, but can become fun when we allow our passions to drive the activity. Into animals? Volunteer at a local shelter or collect items to give to a local shelter. Love playing outdoors? Go on a nature walk while picking up trash. Have an outgoing, talkative child? Take them to visit residents at a nursing home.

Enlist family and friends. When volunteering in groups, it makes the activity more fun for the child and also allows your child to see that giving back is important to the family and community as a whole.

Start locally. Young children often find it easier to see the value in helping those in their immediate vicinity, because they can immediately see the impact. Helping to clean up a neighbor’s yard or making meals for a sick neighbor allows children the immediate gratification of seeing the difference their efforts made. These local efforts can be used as a take-off point for talking about how to make differences in the world at large.

Make it a habit or a tradition. Just like children get into the routine of going to school and after-school activities, volunteering can also be incorporated into the routine as well. Some families also build holiday traditions around volunteer opportunities, which helps get the whole family involved and gets children even more excited about giving back.

Debrief. Get your child’s feedback on what they liked about volunteering and on how it made them feel. Having conversations about their experience can help make them feel appreciated, help them see the difference their activity made, and help them get excited about volunteering again!

To make a small start in our volunteer efforts, Henry and I plan to make small care bags to hand out to the homeless of our city when we are driving downtown and to make some artwork to give to our local nursing homes. I hope these tips help inspire you to get out there with your own children, and I can’t wait to see the differences that we can make together!


Written by Dr. Lee Keegan

Healthy Summer Snacks for Kids

by Erin K. Newman, ARNP, PPCNP-BC

Encouraging your kids to eat healthy snacks can sometimes be a challenge. Below are some ideas to make eating just a little more fun!

  • “Bunny Ears”: Sprinkle a lettuce leaf with small amount of salt and roll it into a “bunny ear” for a quick snack after a long day in the sun.
  • Berry Smoothie Popsicle: Blend Greek yogurt, honey, berries, banana and ice. Pour into popsicle mold and freeze. Delicious and high in antioxidants.
  • Apple Slice Nachos: Slice apples into thin wedges, spread on plate, drizzle with melted peanut butter and sprinkle with coconut
  • Hummus and Veggie dip: Spoon hummus into a small cup to fill the bottom.  Add strips of carrots, celery, and bell pepper for a fun treat.
  • “Ants on a Log”: Slice celery into long strips, apply peanut butter and line with raisins. A classic!
  • Fruit and Cheese Kabobs: Line pineapples, cheddar cheese cubes, grapes, strawberries, Swiss cheese cubes on a kabob stick and enjoy!
  • Fruit and cottage cheese parfait: In a tall parfait glass alternate layers of cottage cheese with various types of berries. Then drizzle the top with honey.  Yum!

For more delicious ideas visit ….

Fight the Bite

by Sarah Givner, MD, MPH

Now that Memorial Day has come and gone, it’s unofficially the start of summer! That means cookouts, camping, swimming and lots of time spent outdoors. It also means lots of bugs, sweat and sun. To kickoff this summer season, we’re kick-starting a summer series about those summer pitfalls — insects, heat illnesses and sun burn.

Insect Repellents

For the majority of us, bug bites are more of a nuisance than a cause for concern, but for a sizable minority, they can be truly debilitating. Bug bites carry the potential for allergic reactions and diseases. This summer season, it’s important for you and your loved ones to use insect repellents to #FightTheBite. Of note, insect repellents only work to prevent bites from biting insects – not stinging ones, such as bees, wasps or hornets.

Insect repellents come in a variety of flavors, if you will. From aerosols and sprays to liquids, creams and sticks, they are a ubiquitous presence in nearly any drug or big box store. Wading through which ones are effective can be daunting. Thankfully, we are here to separate the wheat from the chaff.

Let’s begin by going through what products are NOT effective:

  1. Wristbands soaked in insect repellent
  2. Orally-taken garlic or vitamin B1
  3. Ultrasonic devices that emit sound waves
  4. Backyard bug zappers (that paradoxically may attract insects to your home)
  5. Bat or bird houses

While we all grew up using these products to some degree (who could forget those humming blue backyard lanterns!), they are not considered to be effective per the American Academy of Pediatrics and therefore not worth your time or expense.

Now, let’s go through the stuff that works.

DEET-based repellants:

DEET (or diethyltoluamide) is a synthetic chemical oil used in insect repellent. Developed in 1944 for use by the US Army in jungle terrain during WWII, it became commercially available for civilian use in 1957. Since then, it has become the mainstay of insect repellents and is the most common active ingredient in bug sprays the world over. Currently, DEET is considered the best defense against biting insects.

The amount of DEET in insect repellents varies from product to product, ranging from <10% to >30%. DEET-based products typically last between 2-5 hours. While products with higher DEET concentrations last longer, DEET concentrations >30% do not offer any additional benefit, and are actually contraindicated by the AAP.

Potential side effects of DEET include, based on exposure-type:

  1. Skin Exposure: Irritation, redness, rash, swelling
  2. Eye exposure: Irritation, pain, watery eyes
  3. Ingestion: Stomach upset, vomiting, nausea, and (very rarely) seizures

Of note, combination DEET-Sunscreen products are a NO-NO! They can make the SPF less effective and can over-expose your child to DEET due to the need for frequent reapplication.

Picardin-Based Products

Picardin (KBR 3023, Bayrepel, and icaridin) is another synthetic compound used in insect repellent. Designed to resemble piperine, a natural chemical used in the production of black pepper, it was first made in the 1980s. Since then, it has been widely used as an insect repellent in Europe and Australia, but has only recently crossed the Atlantic and Pacific, becoming commercially available in the US in 2005. It is used to repel mosquitos, biting flies, ticks, fleas and chiggers. The amount of picardin varies from product to product, and typically lasts between 3-8 hours depending on the concentration. The maximum concentration of this product is 20%.

Potential Side Effects of Picardin, based on exposure:

  1. Skin Exposure: Irritation
  2. Eye Exposure: Irritation, redness, burning sensation
  3. Ingestion: No toxicity has been reported in humans; however, liver toxicity has been described in rats in high doses

Essential Oil-Based Products

Essential oils are derived from plants that have natural repellent properties. This group includes both synthetic and natural oils. Some synthetic variants have durations of action similar to those of the more established DEET and Picardin while natural botanical oils typically last between 30min – 2 hours.

Oil of Lemon Eucalyptus

Oil of Lemon Eucalyptus is a synthetic version of the “pure” oil of lemon eucalyptus. Registered by the EPA in 2000, it has been shown to be effective for up to 6 hours.

Potential Side effects: Skin irritation

Of note, Oil of Lemon Eucalyptus cannot be used on children less than 3 due to the potential for skin irritation.

Natural (Non-synthesized) Plant Oils

Natural oils (including soybean, lemongrass, citronella, cedar, peppermint, lavender, geranium or geraniol, and others) are exempted from registration by the EPA. They are considered safe for human use, but their efficacy has not been well-studied. The American Academy of Pediatrics has no recommendation on their use. Reports note that they can last from between 30 min – 2 hours and may not be as effective as conventional repellents.

Potential Side Effects: Skin irritation

Permethrin-Based Products

Permethrin is a synthetic pyrethoid that mimics natural chrysanthemum extract and is used as a clothing tick repellent, killing ticks on contact. It was first registered with the EPA in 1979 for agricultural use and in 1990 as a clothing repellent for the military. Today, permethrin is commonly used in agriculture and for household pest control. It is endorsed by both the EPA and the CDC due to its safety and biodegradability. For personal use, it is ONLY to be used on clothing. Spray-on applications typically last through 5-6 washes with pretreated clothing lasting up to 70 washings! Sunlight and oxygen affect permethrin’s efficacy, so place treated garments in dark, airtight bags when not in use. Once dry, permethrin is odorless.

Potential Side Effects, based on exposure:

  1. Skin Exposure: Irritation
  2. Eye Exposure: Irritation, redness, burning sensation
  3. Ingestion: Sore throat, abdominal pain, nausea, vomiting

Ground-rules for Safe Repellent Use:

  1. Read the label and carefully follow all directions and precautions
  2. Only apply insect repellant to exposed skin or the OUTSIDE of clothes
  3. Spray repellents in open areas to avoid breathing in the fumes
  4. Help apply insect repellents on younger children; supervise older children when using these products
  5. Wash skin with soap and water to remove repellents when they return indoors
  6. Wash clothing after use with insect repellents
  7. NEVER apply insect repellents on children less than 2 months-old

Lastly, insect repellents are not the only way to protect children from biting bugs! Please keep these other tactics in mind while enjoying your outdoor summer season.

Other Ways to Protect Children from Insect Bites

  • Avoid areas known to attract flying insects, such as garbage cans, stagnant pools of water or gardens, orchards or flowerbeds
  • Dress children in lightweight pants, long sleeved shirts, closed-toed shoes and socks if going to a known insect-prone area
  • Avoid scented soaps and perfumes
  • Avoid wearing brightly-colored or floral-patterned clothing
  • Make sure home door and window screens are in good condition
  • Check your children’s skin for ticks at the end of the day

My Children’s Favorite Vegetable is Kale

food salad healthy summer

I have a confession to make. My children’s favorite vegetable is kale. I really can’t explain it. I would be lying to say that they are generally good vegetable eaters. It just isn’t true (though they are getting better). They are far from the worst, and I have every confidence it will continue to get better with age, but they eat far fewer vegetables than I would like.

My eldest knows a lot about veggies. She can name them, identify them, likes to grow them. The actual eating of them is where things fall off the rails. I just keep serving them and enjoying my own. Slowly but surely, she is starting to eat and enjoy more.

But, KALE, that is a whole different story. Kale pesto, to be more specific. This is literally my eldest’s favorite food. My youngest loves it, too. I am not sure why. Perhaps because it is typically served on pasta, that makes it more desirable, but they will both eat it by the spoonful, too.

So, let me share the magic of kale pesto:

You will need:

  1. Bunch of kale, washed and stems removed
  2. Olive oil
  3. 2 cloves garlic, sliced or coarsely chopped
  4. 1 lemon- juice from 1/2 of it
  5. Salt- start with a tsp
  6. Walnuts- 1/4 cup
  7. 1 box Rotini pasta

Now when I make this, I don’t follow a recipe. I am sure there was one we used to begin with. I just add until it tastes right. When I make it, it has more lemony flavor, heavier on the garlic when my husband does.

  • Bring a large pot of salted water to a boil
  • Blanch kale for 1-2 minutes. Remove kale from water and rinse under cool water. (You will use your pot of boiling water to cook pasta)
  • Cook pasta according to instructions. When pouring into colander after cooking, keep 1/2 cup of pasta water.
  • While pasta is cooking, you can make the pesto.
  • Into blender or food processor, add kale (squeeze out all of the water first), olive oil, garlic, salt, walnuts, and lemon juice. Pulverize until you have a good texture. Adjust olive oil and salt to taste.
  • Once pasta is done, stir in pesto and a little pasta water to help mix well.
  • Top with parmesan if you like. Voila!

Like I said, my girls will eat it plain, sometimes I put a dollop on top of a slice of cheese. Next I plan to mix it into scrambled eggs.

Enjoy! And feel free to share your own kid-approved veggie dishes.

Graduation Wishes

Dear High School Senior,

Congratulations to you! Enjoy this time. For most this is a time full of fun and parties, celebrations, and moving on to next stages and steps in life.

Please be safe. Drive safely and only ride with people who do the same. Please don’t get in the car with anyone under the influence (of anything!). Wear your seat belt. Really, that one is so important. Many of you know or will know someone who is seriously injured or killed because their seat belt wasn’t on.

Take care of yourself. After all, if you don’t, who will? Create daily habits that keep you healthy and happy both now and in the long run. The basics are important- healthy foods, some regular physical activity, and a decent amount of sleep.

And as you head into this next phase of life, surround yourself with good people. Finding friends in the next phase can look the same as high school, or much different, but strive to spend time with people who make you your best self. Who you surround yourself with matters greatly as you move out from the family you have grown up with.

Congratulations, good luck, take care of yourself!

accomplishment ceremony education graduation