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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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