Guidelines for Childhood Nutrition

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Guidelines for Childhood Nutrition

• Mariel Aloise, RN
• Mavis Scott, RN
• Maria Traudes, RN

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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 childs BMI log on to
  http//www.kidsnutrition.org/bodycomp/bmiz2.html

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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)

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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

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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)

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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)

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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)
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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)
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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 childs
  eating habits
• Promotes communication and interaction

(Lindsay et al., 2006)
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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)

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Portion Sizes

• ½ Cup
• 1 cup

• Size of a rounded handful
• 6 baby carrots
• 16 grapes
• 4 large strawberries
• Size of a baseball
• 1 orange
• 1 large ear of corn
• 1 large sweet potato

(Bobroff, 2005)
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Portion Size Continued

• 3 oz portion of meat
• 1 Ounce

• Size of your fist
• Deck of playing cards
• Size of tip of your thumb

(Bobroff, 2005)
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GrabnGo GoodiesPACKAGE 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)
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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.
Cholesterol to less than 300 mg/day
Limit Sodium to less than 2400 mg per day
(Food and Drug Administration, 2004)
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At least 25 g of fiber per day
Aim for low fat and sodium
You want a lot of these
Increase fiber and vitamins aiming high
These are dietary guidelines based on caloric
intakes of 2,000 or 2,500
(FDA, 2004)
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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)
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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.h
  tm

(Cotugna, Vickery, McBee, 2005)
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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/wp
  s/portal/!ut/p/kcxml/04_Sj9SPykssy0xPLMnMz0vM0Y_Qj
  zKLN4j3CQXJgFjGpvqRqCKOcAFfj_zcVH1v_QD9gtzQiHJHRUU
  Ac0tpTA!!/delta/base64xml/L3dJdyEvUUd3QndNQSEvNElV
  RS82XzBfTFU!?CONTENT_URLhttp//www1.ncaa.org/memb
  ership/ed_outreach/nutrition-performance/index.htm
  l
• (Burns et al., 2004 Cotugna et al., 2005)

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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)

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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)
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Calories continued

• School-aged children (6 13 y/o)
• For ages 6 9 needs are about 1,500 calories.
• For ages 913 males need 1,800 calories
• For ages 913 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)
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Still have questions?

• If you still have questions about your childs
  caloric needs log on to
• http//www.kidsnutrition.org/bodycomp/energy/ener
  gyneeds_calculator.htm

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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
• Dont push a child to eat if not hungry
• Dont 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

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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/pyrami
  d/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

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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/kc
  xml/04_Sj9SPykssy0xPLMnMz0vM0Y_QjzKLN4j3CQXJgFjGpv
  qRqCKOcAFfj_zcVH1v_QD9gtzQiHJHRUUAc0tpTA!!/delta/b
  ase64xml/L3dJdyEvUUd3QndNQSEvNElVRS82XzBfTFU!?CONT
  ENT_URLhttp//www1.ncaa.org/membership/ed_outreac
  h/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.