Healthy Eating Initiative Nicole Morrissey RD, CDE

School-Aged Children Key issues: adequate intake of fruits, vegetables, calcium, vitamin D, and fiber avoidance of energy- rich/nutrient-poor snacks (e.g. salty snacks, cookies, sweetened beverages) overconsumption of sugar- sweetened foods and beverages development of a healthy body image

In the past 15 years… Good News Bad News Children and adolescents are drinking less sugar-sweetened beverages Empty calories contribute to 40% of daily caloric intake in those ages 2-18 and sugar-sweetened beverages still account for 10% of total calorie intake Total fruit and vegetable intake increased Most youth do not meet fruit and vegetable recommendations Changing Beverage Consumption Patterns Have Resulted in Fewer Liquid Calories in the Diets of US Children: National Health and Nutrition Examination Survey 2001–2010. Journal of the Academy of Nutrition and Dietetics. 2015;115(4):559–66. Water and beverage consumption among children age 4–13y in the United States: analyses of 2005–2010 NHANES data. Nutr J. 2013;12(1):85.

Food for Thought…(pun intended!) Do you offer a non-starchy vegetables at lunch AND dinner? Does your child drink fruit juice or pop on a daily basis? Do you make assumptions about what your child will or will not eat or sample? Does your family eat dinner together at least 5 nights/week?

Nutrition Matters Poor nutrition in childhood: Obesity Memory loss Depression Hyperactivity disorder Anxiety Learning disabilities Lower IQ Missed school Repeat grades Lack of energy Chronic illnesses

Obesity is an Epidemic

Portion Distortion

Benefits of Healthy Eating Decreased risk of malnutrition Decreased risk of obesity Sufficient energy intake for energy expenditure Reduce risk of iron deficiency Decrease risk of vitamin A, vitamin C, and vitamin D deficiencies

Healthy vs. Nutrient-Dense Healthy eating means that the person is eating a balanced diet -- a diet that provides the correct amount of nutrients for the need of the individual There are six major classes of nutrients found in food: Carbohydrate Protein Fat Vitamins Minerals Water

Nutrient-Density Nutrient density identifies the proportion of nutrients in foods In other words, nutrient dense foods give you the "biggest bang for the buck.". You get lots of nutrients, and it doesn't cost you much in terms of calories.

Daily Reference Intakes (DRIs) Infancy (0-6 months and 6-12 months) Early childhood (1-3 years) Late childhood (4-8 years) Early adolescence (9-13 years) Late adolescence (14-18 years)

Energy Needs A child’s target for energy intake can be estimated based upon their age, gender, and activity. Macronutrients: fats, carbohydrates, and protein targets for energy-producing macronutrients are expressed as percentage of the total energy (calories) in the diet

Estimated Daily Caloric Needs Age (y) Males sedentary moderate activity Females sedentary Females 2 1000 3 1400 1200 4 5 6 1600 7 8

Fat - Early childhood (1-3 years) – 30-40% of total daily calories - Late childhood (4-8 years) – 25-35% of total daily calories

Carbohydrates ~45-65% of total daily calories <10% from added sugars Added sugars should be avoided in children <2 and limited to <5% in children ≥2 years

Protein - Early childhood (1-3 years)- 5-20% of total daily calories - Late childhood (4-8 years)-10-30% of total daily calories

Daily Recommendations Food Group 1200 cals 1400 cals 1600 cals 1800 cals Grain 4 ounces 5 ounces 6 ounces Vegetable 1 ½ cups 2 cups 2 ½ cups Fruit 1 cup Diary 3 cups Protein 3 ounces Grains (1 oz) = 1 slice of bread, ½ cup cooked rice or pasta Vegetables =1 cup raw or ½ cup cooked Protein (1 oz) = slice of cheese, 1 egg

Grains Focus on whole grains: ½ of grains should be whole grain Examples: whole wheat bread, whole wheat pasta, oats, rye, barley, corn, brown or wild rice, quinoa, popcorn Source of fiber, rich in B vitamins, iron, magnesium, and selenium. Enriched vs fortified

Vegetables Fresh is best, low-sodium options readily available Offer a variety of vegetables Find fun ways to incorporate vegetables Okay to be sneaky, but don’t disguise them all Cauliflower mashed potatoes Kale smoothies Expose kids to vegetables through gardening and preparing meals Provide vegetables with lunch, dinner, and at least one snack per day

Fruit Expose children to a variety of fruits Make fruits more accessible Add fruits to cereals Buy no sugar added canned Consider smoothies, fruit/nut bars (e.g. Larabars), dried fruit without sugar added in a snack mix with nuts Pick fruit locally – Michigan offers peaches, apples, blueberries, strawberries, grapes, cherries, and pears within 10 miles!

Dairy Milk should be fat-free or low-fat after 2 years of age After 12 months of age, children are more at risk of iron deficiency because they no longer drink iron fortified formula Limit milk intake to 16-24 ounces/day Choose yogurts low in added sugar Look for 10 grams or less of added sugar and less than 18 grams of total sugar per cup

Proteins Choose lean proteins that are low in saturated fat Use low-fat cooking methods. Avoid frying. Incorporate vegetarian protein sources, such as tofu, tempeh, beans, nuts, nut butters, seeds, cheese Heme vs non-heme sources of protein Amino acid profiles and bioavailability Role of vitamin C with non-heme

Snacks Snacks are an essential component of the young child's diet Should be planned so they contribute to the days total nutrient intake Include a fruit and/or vegetable Children should be consuming three meals and two snacks per day

Snack Ideas

Avoid Sugary Beverages The average can of sugar-sweetened soda is 150 calories, almost all of them from sugar or high-fructose corn syrup 12 oz can = 10 teaspoons of table sugar If you were to drink just one can of a sugar-sweetened soft drink every day, and not cut back on calories elsewhere, you could gain up to 15 pounds in a year.

Fruit Juice Age Serving < 12 months None 1-3 years 4 oz (1/2 cup) Buy 100% fruit juice, if buying Cut juice with water to decrease the sweetness and “stretch” the portion Best option: no juice. Eat fruit. Changing Beverage Consumption Patterns Have Resulted in Fewer Liquid Calories in the Diets of US Children: National Health and Nutrition Examination Survey 2001–2010. Journal of the Academy of Nutrition and Dietetics. 2015;115(4):559–66.

Speak Positively Avoid labels such as “bad food” Refer to less nutrient dense foods as “sometimes foods” Role modeling healthy nutrition is a strong predictor as to what foods children will try and accept – your kids are watching you!

Eat the Rainbow

MyPlate Balance each meal Variety Translates to holidays, potlucks, etc.

Lunch Box Ideas

Tips & Tricks Establish a predictable schedule Don’t force kids to clean their plates Don’t bribe or reward kids with food Avoid using dessert as the prize for eating Don’t use food as a way of showing love Give a hug, your time, or praise

Tips & Tricks Introduce new foods along with old favorites Serve small portions Offer colorful foods Let kids help with food preparation Grow a vegetable garden Make food attractive; arrange food into shapes or animal faces Limit choices Try changing the venue – try a picnic Parents control which foods are available at meals and snacks

Parents: A place to start Provide a serving of protein with every meal Avoid white breads and pasta. Convert to whole wheat or whole grain starches Offer a serving of vegetables with lunch, dinner, and at least one snack Offer a serving of dairy with at least two meals per day Incorporate fresh fruit for at least one snack per day

Parents & Children: A Place to Start Cook or prepare 1 meal together each week From start-to-finish, include in choosing meal, preparing, serving, and eating Try 1 new fruit or vegetable every week Shop together, let the child choose Research together how to peel, cut, serve Sample together Document ratings together

Small Group Activity In groups of 3-4 people share your child’s 2 favorite… Breakfasts Packed school lunches Dinners Snacks

Questions?