Preventing Childhood Obesity: Best Practice Strategies in Nutrition and Physical Activity in Early Learning

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Preventing Childhood ObesityBest Practice
Strategies in Nutrition and Physical Activity in
Early Learning
Adapted by Betty Williams, MSW Betty.Williams_at_seat
tlecolleges.edu

• Cathe Paul, MPH, BSN
• Katy Levenhagen, MS, RD
• Coalition for Safety and Health in Early Learning

This project was made possible by funding from
the Department of Health and Human Services and
Public Health - Seattle King County
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What are Best Practices?

• Defined by Caring for Our Children Preventing
  Childhood Obesity in Early Care and Education
  Programs, 2010
• CFOC Best Practice Standards for Early
  Learning

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Outline for the Workshop

• Overview of Childhood Overweight/Obesity
• Best Practices Nutrition and Mealtime
  Socialization
• Menu Planning and Mealtime Activities for Early
  Learning
• Wellness for Caregivers
• Best Practices Physical Activity and Screen
  Limits
• Physical Activities for Early Learning
• Evaluations and Wrap-up

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Childhood Obesity RatesCDC data, 2008

• 2 to 5 yrs has more than doubled (from 5 to
  10.4) during the past 3 decades.
• 6 to 11 yrs has more than quadrupled, during past
  4 decades (from 4.2 to 19.6)
• 12 to 19 yrs has more than tripled (from 4.6 to
  18.1 percent) during the past four decades.)

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• In Washington State 2008
• 14.4 of low income 2 - 5 year olds were obese
• Pediatric Nutrition Surveillance Report, 2008,

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Long Term Health Risks

• Diabetes Type 2
• High Blood Pressure/Hypertension
• High Cholesterol
• Heart Disease/Stroke
• Higher health care costs
• Quality of Life issues

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Short Term Health Risks

• Premature puberty
• Sleep Apnea
• Asthma
• Bone/joint issues
• Social discrimination
• Depression and low self-esteem
• Risk for eating disorders

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Thirty years ago, most people led lives that
kept them at a healthy weight. Kids walked to and
from school every day, ran around at recess,
participated in gym class, and played for hours
after school before dinner. Meals were
home-cooked with reasonable portion sizes and
there was always a vegetable on the plate. Eating
fast food was rare and snacking between meals
was an occasional
treat. M. Obama, letsmove.gov
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Contributing Factors

• Too Many Calories
• More added fats, sugar and salt
• Too much food/more snacking
• Larger servings
• Lack of family meals
• Too much sedentary time/screen time
• Lack of enough physical activity
• Viewing more food advertisements

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NHLBI Portion Distortion Quiz
OEI-NHLBI Slide Show Menu Page http//hp2010.nhlbi
hin.net/oei_ss/menu.htmPD2
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Healthy Weight for Children

• Infant Feeding Practices
• Nutrition
• Mealtime Socialization
• Screen Time Limits
• Physical Activity

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Childhood Obesity PreventionInfants and Toddlers

• Breastfeed
• Practice cue feeding
• No TV, computer or media for babies under 2
• Provide many opportunities for activity across
  the day

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CFOC StandardsInfant Feeding

• Support, encourage and accommodate breastfeeding
  Moms

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CFOC StandardsInfant Feeding

• Feed according to babys cues
• hunger and satiety
• need time to explore
• Introduce solid foods
• Make a plan with parents
• Preferably closer to 6 mths as indicated by needs
• Matt and Baby Ellyn Satter
• Oh Baby...Feeding Young Children in Group Settings

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Childhood Obesity PreventionNutrition

• Expose children to a wide variety of foods
• Eat at home most often
• Limit high calorie, highly processed foods
• Limit sugar sweetened beverages and juice
• Strive for 5-A-Day

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CFOC Nutrition Standards

• Serve a 3 component breakfast to all kids
• 1 milk to kids over 2/whole for kids under 2
• Limit juice to lt 2, 4 oz glasses a week
• Limit high fat, sugar and sodium foods
• Serve a fruit and/or vegetable at snack
• Supplement parent supplied meals
• Provide nutrition/education guidance to parents

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Low fat, low sodiumless added sugar

• Less processed foods (canned, box, package)
• More whole foods (fruits, veggies, whole grains)
• More foods made from scratch
• Eat 5 servings of fruits and veggies/day

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ABCs of Menu Planning

• Nutrient Adequacy and Food Appeal
• Meet CACFP meal pattern
• Balance
• Ensure variety, at least 2 week
  menu cycle,
• limit juice to lt 2/wk
• Fruit and veggies for PM snack
• Calories
• Serve 1 milk
• Limit high fat, sugar and sodium foods to lt 1/week

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We suggest that helping children attend to
internal cues of hunger and satiety should be
promoted as a productive child-feeding strategy
and as an alternative to coercive or restrictive
practices.Susan Johnson, PhD, Improving
Preschoolers Self Regulation of Feeding,
Pediatrics, 2000
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Childhood Obesity PreventionMealtime Environment

• Eat together often (6-19 yrs)
• Model healthy eating habits (Preschoolers)
• Help children self regulate (infancy on)
• Avoid using food for rewards or punishment (all)

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Division of Responsibility During Eating

• Main goal - self regulation
• Adults decide what, when, where
• Kids decide if, what and how much
• Ellen Satter, Feeding with Love and Good Sense,
• Bull Publishing, 2nd Edition, 2000

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CFOC Meal Time Standards

• Sit with kids
• Eat with kids
• Role Model
• Serve family style
• Let the kids help
• Follow Division of Responsibility

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I hear and I forget. I see and I remember. I do
and I understand and One picture is worth a
thousand words.
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Take Good Care of YourselfKeys to Wellness

• Sleep
• Exercise
• Diet
• Stress
• Happiness Factor

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By the time a child is 3 the brain has formed
1000 trillion connectionsThe infant brain
thrives on feedback from its environmentwhich is
mostly YOU! Brain Games for Babies, Jackie
Silberg, 2nd Edition, 2005
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CFOC Infant Movement Standards

• Infants have at least 3, 5 minute sessions of
  supervised tummy time when they are awake
• Infant environment is least restrictive at all
  times
• Container use is limited to 15 minutes/day
• Infants go outside 2-3 times a day

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For many families, media use has become part of
the fabric of daily life. The Media Family,
Electronic Media in the Lives of Infants,
Toddlers and Preschoolers and Their Parents, The
Kaihttp//www.kff.org/entmedia/upload/7500.pdfser
Family Foundation
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Media Use and Young Children

• Children 6 months 6 years average 2 hours of
  media time compared to 40 minutes a day of
  reading
• The older a child gets the more media time they
  spend
• (40 minutes, 0-1 yrs and 159 minutes 4 6 yrs)
• Among 6 23 month olds, about 40 can turn on
  the TV and change channels by themselves
• The Media Family, Kaiser Institute, 2006

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CFOC Screen Time Limits

• No TV for infants ( lt 2 yrs)
• All ages over 2
• 1/2 hr or less per week
• Limit to educational program
• Computers mostly for homework

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National Physical Activity Guidelines

• gt 60 minutes of moderate to vigorous activity
• Several 15 minute bouts of physical activity
• Daily activity that supports health, wellness,
  fitness and performance
• 2 or more hours of inactivity is discouraged
• Outdoor play 2 or more times/day
• Limit TV to lt 2 hrs/day
• No TV in Bedrooms
• NASPE Statement of Guidelines for Infants and
  Young Children, 2nd Edition, 2008

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CFOC Standards for Outside Play Time

• All Children in Full Time Care
• Centers - 2-3 times/day
• Homes - 2-3 times/day
• School Age Programs -
• at least once for children in part time care

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Benefits of Moderate to Vigorous Play

• Physical Development
• Fitness
• Energy Balance
• Disease Prevention
• Social/Emotional Development

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FitnessAn Ongoing Process

• Endurance
• muscular/cardiovascular
• Strength
• Flexibility

The more active, the more fit. Rae Pica, Your
Active Child, Contempory Books, 2003
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CFOC Standards for Physical Activity

• Moderate to Vigorous Activity
• Toddlers 60 - 90 minutes
• Preschoolers 90 - 120 minutes
• School Age gt 20 minutes/3 hours of care
• Active play is never withheld as a form of
  punishment
• National Resource Center, Motion Moments Video
  Clips
• http//video.ucdenver.edu/users/lfields/c413a27e-b
  88f-4899-a6a2-9d2108041553.html

It All Adds Up!
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Types of Physical Activity

• Adult Led/Structured Time
• Motor skill development
• Balance
• Guided fun and games w/assists
• Unstructured Activities
• Motor skill practice
• Promote self motivation and exploration
• Child selected fun and games