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Guidelines for Childhood Nutrition Mariel Aloise, RN Mavis Scott, RN Maria Traudes, RN Definitions Obesity: Defined as excessive adipose (fatty) tissue in the body inappropriately proportioned with height and weight BMI: Body Mass Index defined as measurement of obesity. In children used along with the ideal body weight/height ratio, gender, and age to define obesity (Burns, Dunn, Brady, Starr, & Blosser, 2004) To graph your child’s BMI log on to: http://www.kidsnutrition.org/bodycomp/bmiz2.html Causes of Obesity Family life style: Diet high in calories and fat with larger portions Sedentary lifestyles: More TV and video games, computer games and internet activities Genetic: Susceptible genes are passed on (Burns et al., 2004) Absenteeism/Academic Time Loss Stomachaches and other gastrointestinal complaints secondary to poor nutritional choices Headaches result of no meals or skipped meals (breakfast) General malaise/less energy resulting in decreased academic success Decreased classroom time with increased time spent in health office Poor nutrition negative impact on learning outcomes Stomachaches and Headaches Nutritional correlation • Children who ate breakfast showed a decrease in the number of visits to the health office • Also, when they eat breakfast there are less complaints of hunger and headache (Sweeney, Tucker, Reynosa, & Glaser, 2006) Meal frequency • Be flexible – appetites and preferences of children vary from their parents’ • Provide a variety of healthy, nutrient-rich foods • Provide meals at the table to prevent unhealthy food choices (Burns et al., 2004) Effects of Food and Water Food effects on blood sugar and performance • Teachers judged the children who did not eat breakfast and were chronically hungry as twice as likely to be hyperactive, absent, and tardy (Sweeney et al., 2006) Hydration • Water is the primary component of the body tissue, maintaining fluid balance is essential to good health • Sports drinks are not recommended since electrolytes are consumed in adequate amounts in the American diet (Burns et al., 2004) Role Models Parents Have at least one meal together as a family Promote increased outdoor activity as a family affair Limit sedentary time indoors Provide healthy nutritional choices avoiding high fat, sweetened beverages and sodas Limit fast food meals Never taunt, tease, or degrade to induce weight loss Focus on your own personal healthy life style, your child will watch (Lindsay, Sussner, Kim, & Gortmaker, 2006) Role Models School Nurses and Teachers: Show by example with own healthy weight Educate on good nutritional habits/healthy body Track students heights/weight/BMI Promote the school nurse as health educator in the classroom Entertainment Figures Perception that actresses, models, etc must be skeletal thin to look good Sports figures may engage in anorexic/bulimic lifestyle to keep weight off (Selekman, 2006) Family Mealtimes Benefits of eating together as a family Increase consumption of fresh fruits, whole grains and vegetables Reduce consumption of fatty food Reduce/elimination of soft drinks from diet Positive parental modeling influences child’s eating habits Promotes communication and interaction (Lindsay et al., 2006) Tips on Meal Planning Eat a variety of healthy and colorful food Get the most nutrients from the calories eaten Learn healthy portion sizes Make meal planning a family time Ask children to help with preparation Go to http://www.mypyramid.gov/ to learn how to use the new healthy diet tool (Bobroff, 2005) Portion Sizes ½ Cup = Size of a rounded handful 6 baby carrots 16 grapes 4 large strawberries 1 cup = Size of a baseball 1 orange 1 large ear of corn 1 large sweet potato (Bobroff, 2005) Portion Size Continued 3 oz portion of Size of your fist meat = Deck of playing cards 1 Ounce = Size of tip of your thumb (Bobroff, 2005) Grab‘nGo Goodies PACKAGE IT AND PUT IT AT EYE LEVEL FOR EASY GRAB Trail Mix (make your own with dried fruits, nuts, cereals, etc) in snack size baggies. Low fat and non fat yogurts (add some trail mix to it) Cut up an package snack size veggies (carrots, celery sticks, cucumber rounds, grape tomatoes, bell pepper strips, etc) Pretzels, popcorn & nuts in snack size baggies Fruits of all kinds fresh, dried and frozen for a cold treat Applesauce cups (unsweetened) String cheese Whole wheat crackers with peanut butter (Bobroff, 2005) Label Literacy How many servings are there in the package? How many calories per serving? Calories from fat? Limit total fat to less than 65 g daily. Saturated fats to less than 20 g/day. Limit Sodium to less Cholesterol to less than 2400 mg per day than 300 mg/day (Food and Drug Administration, 2004) At least 25 g of Aim for low fat You want a lot of these fiber per day and sodium Increase fiber and vitamins aiming high These are dietary guidelines based on caloric intakes of 2,000 or 2,500 (FDA, 2004) Put it all together ½ cup serving, 4 servings in this container 90 x 4= 360 calories in this container 30 x 4= 120 calories from fat in the container Low in fat and cholesterol OK in sodium and fiber Excellent source of Vitamin A and C Low in Calcium and Iron, yet better than nothing (FDA, 1999) Sports Nutrition Energy needs • 50% of caloric intake should be from carbohydrates to maintain blood glucose and to restore the muscle stores of glycogen • Protein and fat needs are satisfied in the diet • Caloric needs vary with the age of the child and the activity level, to estimate caloric need log on to: http://www.bcm.edu/cnrc/energy_calculator.ht m (Cotugna, Vickery, & McBee, 2005) Meals and Snacking • Pre-event meals: should be high in carbohydrates and be consumed 3-4 hours prior to sports event • To maintain blood sugar consume sips of sports drinks • After the event: a carbohydrate and protein diet to replenish glycogen stores and muscle repair • A balanced meal following every 2-4 hours • Be flexible – appetites and preferences of children vary • Provide a variety of healthy, nutrient-rich foods • Log on to view more grab 'n go goodies (student athlete and then nutrition) http://www.ncaa.org/wps/portal/!ut/p/kcxml/04_Sj9SPykssy0xPL MnMz0vM0Y_QjzKLN4j3CQXJgFjGpvqRqCKOcAFfj_zcVH1v_ QD9gtzQiHJHRUUAc0tpTA!!/delta/base64xml/L3dJdyEvUUd3 QndNQSEvNElVRS82XzBfTFU!?CONTENT_URL=http://www1. ncaa.org/membership/ed_outreach/nutrition- performance/index.html (Burns et al., 2004; Cotugna et al., 2005) More Nutrients Water and electrolyte needs • Water is the most important - 10-12 cups (80-96 oz) a day • Sports drinks with 4-8% carbohydrate are useful for endurance athletes to maintain blood sugar and hydration, although plain water is also appropriate Growth • Energy intake should be high enough to support growth, maturation, and overall health (Cotugna et al., 2005) How many calories does your child need? The number of calories a child needs varies according to the child's size, growth rate and activity level. Generally in the preschool years (1 – 5 y/o) a typical child will need: 1,000 cal + 100 cal per year up to age 5 Example for a 3 year-old: 1,000 + 100 + 100 + 100= 1,300 calories (D. Barker-Benfield, RD, personal communication, April 10, 2007) Calories continued School-aged children (6 – 13 y/o) For ages 6 – 9 needs are about 1,500 calories. For ages 9–13 males need 1,800 calories For ages 9–13 females need 1,600 calories Adolescent years (14 – 18 y/o) Males 2,200 calories Females 1,800 calories (D. Barker-Benfield, RD, personal communication, April 10, 2007) Still have questions? If you still have questions about your child’s caloric needs log on to: http://www.kidsnutrition.org/bodycomp/e nergy/energyneeds_calculator.htm Healthy Behaviors Love and acceptance of child The child is more important than their weight Ask your child about his/her feelings and LISTEN to what is said Don’t push a child to eat if not hungry Don’t force children to eat foods they do not like, everyone has food likes and dislikes Be active together as a family Have healthy snacks available Offer water instead of soda and flavored drinks Reward your child with time and love, not food References Baylor College of Medicine. (1999). Energy calculator. Retrieved April 9, 2007, from http://www.bcm.edu/cnrc/energy_calculator.htm Bobroff, L. B. (2005). My pyramid for a healthy family. University of Florida,1-10 Retrieved April 8, 2007 from http://fycs.ifas.ufl.edu/pyramid/adobe/healthyfamilyppt.ppt Burns, C. E., Dunn, A. M., Brady, M. A., Starr, N. B., & Blosser, C.G. (2004). Pediatric primary care: A handbook for nurse practitioners (3rd ed.). St. Louis, Missouri: Sanders. Cotugna,N., Vickery, C. E., & McBee, S. (2005). Sports nutrition for young athletes. The Journal of School Nursing, 21 (6), 323-328. Food and Drug Administration. (1999). The food label. Retrieved April 9, 2007, from http://www.fda.gov/opacom/backgrounders/foodlabel/newlabel.html Food and Drug Administration. (2004). How to understand and use the nutrition facts label. Retrieved April 9, 2007, from http://www.cfsan.fda.gov/~dms/foodlab.html References Lindsay, A. C., Sussner, K. M., Kim, J., & Gortmaker, S. (2006). The role of parents in preventing childhood obesity. Harvard School of Public Health,16(1),169-176 National Collegiate Athletic Association. (2005). Nutrition and performance. Retrieved April 9, 2007, from http://www.ncaa.org/wps/portal/!ut/p/kcxml/04_Sj9SPykssy0xPLMnMz 0vM0Y_QjzKLN4j3CQXJgFjGpvqRqCKOcAFfj_zcVH1v_QD9gtzQiHJ HRUUAc0tpTA!!/delta/base64xml/L3dJdyEvUUd3QndNQSEvNElVRS 82XzBfTFU!?CONTENT_URL=http://www1.ncaa.org/membership/ed_ outreach/nutrition-performance/index.html Selekman, J. (Ed.) (2006). School nursing: a comprehensive text. Philadelphia, PA: F.A. Davis Company. Sweeney, N. M., Tucker, J., Reynosa, B., & Glaser, D. (2006). Reducing hunger-associated symptoms: the midmorning nutrition break. The Journal of School Nursing, 22 (1), 32-39.
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