For the Family

Sarah Vaughn, RD, LDNNFD/MNPD Wellness Initiative Nutrition Consultant

•My Pyramid: Calorie needs, food groups, physical activity recommendations, current statistics.

•Meal and Snack ideas: Healthy eating habits for children and adolescents, picky eaters, sample menus.

•Healthy shopping time: How to budget a healthy lifestyle, get the most nutrients for little cost, and creating shopping lists.

•Describe My Pyramid and recommendations for kids.

•Name at least two healthy snacks for kids.

•Explain 1 tip on how to purchase healthy snacks with a budget.

Inside the pyramid, recommendations for kids and adults, physical activity recommendations

•Make smart choices from every food group.

•Find your balance between food and physical activity.

•Get the most nutrition out of your calories.

•Stay within your daily calorie needs.

The Dietary Guidelines describe a healthy diet as one that :

Emphasizes fruits, vegetables, whole grains, and fat-free or low-fat milk and milk products

Includes lean meats, poultry, fish, beans, eggs, and nuts AND

Is low in saturated fats, trans fats, cholesterol, salt (sodium), and added sugars.

Reference: http://www.mypyramid.gov/guidelines/index.html

•Whole Grains: Important source of fiber, other phytonutrients, some key vitamins and minerals. Make at least half your grains whole!

•Vegetables: Important sources of many nutrients including carbohydrates, vitamins A, C, and E, folate, potassium, and dietary fiber. Get a variety of color: dark greens, deep-orange, and legumes.(2)

•Fruits: Supplies carotenoids, vitamin C, folate, potassium, fiber, and many other phytonutrients. Paint your plate with color!

•Milk: Includes calcium, phosphorus, and vitamin D for building and maintaining bone mass and build healthy teeth. Select low-fat or fat-free dairy products.

(2)

•Meats and Beans: Protein-rich foods and supply varying amounts of iron, zinc, magnesium, B vitamins, and vitamin E. Choose lean meats and small portions of healthy nuts.

•Oils: Plant oils contain heart-healthy monounsaturated and polyunsaturated fats. Essential fatty acids are important for nervous system and skin, and is your body’s main source of vitamin E. Omega-3 fatty acids in fatty fish may help promote heart health.

(2)

•What are the estimated daily calorie needs?

•How does my pyramid assign calorie levels?

•What are the suggested intake patterns?

•Discretionary calories: what are they and how many can we have?

Reference: www.mypramid.gov

Estimated Needs:

Reference: www.mypramid.gov

Reference: www.mypramid.gov

Reference: www.mypramid.gov

For Preschoolers, children, and adults

•Consume whole-grain products often (at least half of your grains whole).

•Children 2 to 8 years should consume 2 cups per day of fat-free or low-fat milk or equivalent milk products.

•Children 9 years of age and older should consume 3 cups per day of fat-free or low-fat milk or equivalent milk products.

(3)

•Keep total fat intake between 30 to 35 percent of calories for children 2 to 3 years of age and between 25 to 35 percent of calories for children and adolescents 4 to 18 years of age.

• Most fats should come from sources of polyunsaturated and monounsaturated fatty acids, such as fish, nuts, and vegetable oils.

•Engage in at least 60 minutes of physical activity on most, preferably all, days of the week. (3)

•Two cups of fruit and 21/2 cups of vegetables per day are recommended for a reference 2,000-calorie intake, with higher or lower amounts depending on the calorie level. Choose a variety in color.

•Consume 3 or more ounce-equivalents of whole-grain products per day, with the rest of the recommended grains coming from enriched or whole-grain products.

•Consume 3 cups per day of fat-free or low-fat milk or equivalent milk products.

(3)

•Consume less than 10 percent of calories from saturated fatty acids and less than 300 mg/day of cholesterol, and keep trans fatty acid consumption as low as possible.

•Keep total fat intake between 20 to 35 percent of calories, with most fats coming from sources of polyunsaturated and monounsaturated fatty acids, such as fish, nuts, and vegetable oils.

•When selecting and preparing meat, poultry, dry beans, and milk or milk products, make choices that are lean, low-fat, or fat-free. (3)

•To reduce the risk of chronic disease in adulthood: Engage in at least 30 minutes of moderate-intensity physical activity, above usual activity, most days of the week.

•To help manage body weight and prevent gradual, unhealthy body weight gain in adulthood: 60 minutes of moderate- to vigorous-intensity activity on most days of the week.

•To sustain weight loss in adulthood: Participate in at least 60 to 90 minutes of daily moderate-intensity physical activity while not exceeding caloric intake requirements.

(3)

• Improves self-esteem and feelings of well-being

• Increases fitness level

• Helps build and maintain bones, muscles, and joints

• Builds endurance and muscle strength

• Enhances flexibility and posture

• Helps manage weight

• Lowers risk of heart disease, colon cancer, and type 2 diabetes

• Helps control blood pressure

• Reduces feelings of depression and anxiety

(1)

Environmental Factors: Bigger food packages and larger portionsBigger size= cheaper $....”Supersize”All-you-can-eat buffets

Less Physical Activity:Escalators/elevators, moving sidewalks,Drive-thru windows, intercoms, tele-commutingCable movies, computer games, cellular phones

(4)

Over the past 4 decades:

•Quadrupled among children ages 6-22 yrs.

•Tripled among adolescents ages 12-19 yrs.

•Doubled among children ages 2-5 yrs.

•Today nearly 23 million children and teens are either overweight or obese.

•Obesity strongly associated with cardiovascular disease risk, hypertension, type 2 diabetes, and dyslipidemia.(5,6)

A New Growth Chart

•Overweight children and adolescents are more likely to become overweight adults.

•Estimated cost of obesity to the U.S. was $177 billion in 2000.

•Prevalence of childhood overweight/obesity highest among certain ethnic groups and racial groups as well as low-income youth.

(5, 7, 8)

•Eating behaviors are strongly influenced by the foods available in immediate environments.

•Two key settings that impact children’s diets are home and school.

•There is a wide availability of competitive foods and beverages at schools-vending machines, snack bars, school stores, fundraising in US public schools.(9,10)

Based on SNDA-III:

•>70% schools serve meals that meet standards for many nutrients found in a healthful diet, and NSLP participants consume more than 6 key nutrients at lunch than do nonparticipants.

•6-7% schools met all nutrition standards in 2004-2005, mainly because most meals contain too much fat, too much saturated fat, or too few calories.

•There is an opportunity to select balanced meals, but few students make the choice.(11)

Questions to ask:

•Breakfast: What’s in the pantry? Is this meal skipped? Is it on-the-go?

•Snacks: What’s available? Portion sizes?

•Dinner: At the dinner table? At a restaurant? Portion sizes?

REAL question: How can we make it healthier?

•Participation in school lunch programs vs. competitive foods (a la carte, stores and snack bars, etc.). Cafeteria VS Competitors

•Teach children positive eating habits-My Pyramid food groups and making healthy selections.

•Communicate with parents on how to become involved with wellness policies, provide nutrition education in the classrooms, and encourage physical activity as part of every school day.

(2)

•Involve the entire family in healthy habits: cooking at home, eating a variety of foods, and doing physical activity together.

•Smart tips: keep low-calorie snacks available, store food out of sight, tailor portion sizes.

•Brown bag options: If children prefer, pack fun meals that are healthy, safe, and nutritious.

(2)

•Calorie needs for children, adolescents, and adults.

•Recommended physical activity and its importance.

•Statistics on childhood obesity.

•School vs. Home: two important food environments.

Next Section…Meal and Snack Time!

•Healthy eating habits for children and adults

•How to handle the picky eaters.

•Examples for meals and snacks.

•Try rewarding children with attention and affection instead of food to prevent unhealthy attitudes and/or emotional eating. Avoid labeling foods as “good” and “bad.”

•Children learn by parents and older siblings: create healthy habits by eating together at the table, less TV and more talk, and healthy serving sizes for all.

•Let children participate: in preparing meals, in making their food choices, and give them enough time to eat.

(2)

•Younger children may need to eat 5-6 times a day because of smaller stomachs.

•Let the child’s appetite guide how much food is enough: overeating=overweight.

•Get into a routine! Have meals and snacks around the same time each day.

•Don’t worry about the child’s weight: focus on positive eating relationship.

(2)

•“Choosy” eating may be the child’s early attempts to make decisions and be assertive.

•Don’t offer too many choices.

•Avoid extreme temperatures: a lot of children dislike extreme cold/hot foods.

•Kids may need to eat a food 8-10 times before they learn to like it…try, try again!(2)

•Breakfast: items suggestions, examples

•Lunch and Dinner: ideas, food groups, tips when eating out.

•Snack time: “The good, the bad, and the ugly”

• Iron-fortified cereals

• Fat-free/low-fat milk and products

• Whole wheat bread, whole grain bagels, etc.

• Fruit: bananas, berries, applesauce, fruit cups (light syrup or own juice)

• 100% fruit juice

• Scrambled eggs

• Oatmeal, whole grain waffles, pancakes

• Limit: poptarts, high-fat meals such as bacon, sausage, biscuits and gravy, high-sugar foods such as cinnamon rolls, strudel

•1 slice whole wheat toast with peanut butter or jelly, low-fat milk, and an apple.

•1 cup cereal with banana slices, ½ cup low-fat milk.

•1 scrambled egg, 1 slice whole wheat toast, cup mixed berries.

•½ cup yogurt with low-fat granola and blueberries.

•Oatmeal mixed with raisins (or other fruit), low-fat milk.

•Think about the food groups from My Pyramid: lean meats/protein, low-fat dairy, whole grains, fruits and vegetables.

•Encourage children and adolescents to make healthy selections at school.

•Watch portion sizes, avoid placing food in serving bowls on the table, put away leftovers.

•Kids’ menus are helpful, but switch up the fries with a side order of veggies!

•Kids getting fussy? Get a to-go box.

•Let children participate in ordering and selecting their food.

•Good: nutrient-rich foods such as fruits, vegetables, whole grains, and low fat dairy.

•Bad: Sodas, juices, potato chips, cookies, “junk food” at home and vending machines.

•Ugly: High-fat, high-calorie foods such as fast food, cookies/pastries/chips, coke PLUSno physical activity!

•Shopping list and budgeting for food

•Shopping Time!

•The Price is Right: Dining Out VS Home Cooked

•Sit with the family and plan out meals for the week. Include children in planning.

•Write down what items are needed for meals, staples, and discuss needs vs. wants.

•Organization is a key player! Make planning a habit.

Look in local newspapers for store weekly specials.

Visit your Local Farmers’ market for great deals.

Coupons ROCK!

Store competition: some will match special deals.

•Shop outer parameter first: breads/whole grains, lean meats, dairy, fruits/vegetables.

•Don’t go shopping hungry!

•Leave the kids at home if able.

•Stick to the list!

Making the Outer Loop!

•The middle isles: money can easily disappear.

•Get cereals/juices, baking needs, frozen products.

•Watch out for eye view: look above and below eye view for better prices.

•Brand names vs. generic.

Product prices and nutrition differences

$0.99 $0.99

Calories: 60Fat: 1 gram

Fiber: 2 gramsProtein: 4 grams

Calories: 24Fat: 0.3 gram

Fiber: 0.2 gramsProtein: 0.7 grams

Calories per serving: 110Fiber: 2 gramsProtein: 3 gramsSugar: 9 grams

Calories per serving: 110Fiber: 0.5 gramsProtein: 1 gramsSugar: 12 grams

•Crock Pot opportunities: search websites for recipes, cook throughout day for evening dinner.

•OAMC: once a month cooking (cook and freeze meals) for the week or month.

•You CAN prepare quick and easy meals at home. Example: vegetable steamers, baked fish, brown rice = 10-15 minutes.

•Plan when you can!

•Stick to your list and hit the outer loop!

•There is time for at home meals….you just have to make it happen.

•My Pyramid: Calorie needs, food groups, physical activity recommendations, current statistics.

•Meal and Snack ideas: Healthy eating habits for children and adolescents, picky eaters, sample menus.

•Healthy shopping time: How to budget a healthy lifestyle, get the most nutrients for little cost, and creating shopping lists.

Describe My Pyramid and recommendations for kids.

Answer: Healthy choices from every food group, find a balance with calories and physical activity, get the most nutrition out of your calories, and fit in physical activity

Name at least two healthy snacks for kids.Answer: Low fat dairy options, fruits and vegetables, whole grains

Explain 1 tip on how to purchase healthy snacks with a budget.

Answer: Plan ahead, make a shopping list, use coupons, shop outer parameter in the grocery store.

Sarah Vaughn, RD, LDNNFD/MNPD Wellness Initiative

Nutrition Consultant311 23rd Avenue N

Nashville, TN 37203(615)-416-4606

sarah.vaughn@nashville.gov

1. United States Department of Agriculture. MyPyramid.gov. Retrieved from the World Wide Web: http://www.mypyramid.gov.

2. Duyff, Roberta L. American Dietetic Association: Complete Food and Nutrition Guide, 3rd Edition. Hoboken, NJ. 2006: 399-434.

3. United States Department of Agriculture: Dietary Guidelines for Americans Executive Summary. Retrieved from the World Wide Web: http://pubs.niaaa.nih.gov/publications/AA74/AA74.htm

4. Foster, Gary, PhD. Behavior Management of Obesity. Certificate of Training In Adult Weight Management. Sir Frances Drake Hotel, San Francisco, CA. 18 September 2008.

5. Institute of Medicine, Committee on Prevention of Obesity in Children and Youth. Koplan J, Liverman CT, Kraak VI, eds. Preventing Childhood Obesity: Health in the Balance. Washington, DC: National Academies Press; 2005.

6. Ogden CL, Carroll MD, Flegal KM. High body mass index for age among US children and adolescents, 2003-2006. JAMA. 2008; 299: 2401-2405.

7. US Department of Health and Human Services. Healthy People 2010: Midcourse Review-Nutrition and Overweight. 2nd ed. Washington, DC: US Government Printing Office; 2006.

8. Federal Interagency Forum on Child and Family Statistics. America’s Children in Brief: Key National Indicators of Well-Being. Washington, DC: US Government Printing Office, Federal Interagency Forum on Child and Family Statistics, 2008.

9. Institute of Medicine. Nutrition Standards for Foods in Schools: Leading the Way Toward Healthier Youth. Washington, DC: The National Academies Press; 2007.

10. Fox MK, Gordon A, Nogales R, Wilson A. Availability and consumption of competitive foods in US public schools. J Am Diet Assoc. 2009; 109 (suppl 1): S57-S66.

11. Fox MK, Crepinsek MK, Connor P, Battaglia M. School Nutrition Dietary Assessment Study-II: Final Report. Alexandria, VA: US Department of Agriculture, Food and Nutrition Service, Office of Analysis, Nutrition, and Evaluation; 2001. http://www.fns.usda.gov/oane/MENU/Published/CNP/cnp-archive.htm. Accessed March 4, 2009.