l Growth l Nutrient needs l Nutritional concerns l Feeding skills l Food preferences l Division of feeding responsibility »parents »child l School and nutrition l Eating Pattern Messages Nutrition during Childhood

Growth l Period of _____________ (until adolescence) l Wide variations expected in rate of growth, body size, physical activity, nutrient intake l Once established, growth percentiles should track for _________________ l BMI-for-age, however, should _______________

Nutrient Needs 1-3 YO4-6 YO7-10 YO Kcal/kg/ day ( ) Kcal/day Pro/kg/d Protein/d13 g19 g34 g 0.95

Nutrient Needs 1-3 YO4-8 YO9-13 YO Iron Fiber Zinc Folic acid Vit. D* Calcium* Vit. E 7 mg10 mg8 mg 19 g25 g31/26 g 3 mg 150 μg200 μg 600 IU 5 mg8 mg 300 μg 700 mg1000 mg 1300 mg 6 mg7 mg11 mg *National Academy of Sciences. (2011) Dietary Reference Intakes for Calcium and Vitamin D, Institute of Medicine, November See for more information.

Nutrient Needs l Energy »varies child-to-child and day-to-day l Protein »vegan children: l Calcium l ________ »wound healing, appetite, immunity, growth l Trace elements, vitamins

Nutrient Needs l Fat »Do NOT »1-3 YO: »4-18 YO: l Fiber »14 g/1000 kc » l Fluids »since 1970s: _____ vs. sodas and noncitrus juices »only ___% of school children do not drink soda!!

Nutritional Concerns l Iron-deficiency anemia »more common: » physical and mental development » immune resistance l Dental caries l Constipation

Nutritional Concerns l Lead poisoning l Food security l Food safety »smaller body size increases risk l Overweight/obesity »steadily increasing since 1970s

Predictors of Overweight/Obesity l gestational diabetes l __________ obesity l early l (<5.5 YO) »lowest BMI ~4-6 YO l low l lower l ________ food restriction » forbidden foods and guilt

Characteristics of Overweight Children l taller l “older” bones l earlier sexual maturity l risks for obesity consequences (chronic disease) »Type 2 diabetes l concerns with dieting start ever younger

What to do? l seek energy balance »support innate food regulation »physical activity l change habits as a family l focus on ________, not weight loss

Stages of Childhood StageAge Characteristics Feeding Skills Toddler1-3 Pre- schooler 3-5 Middle Child- hood 5-10 Preado- lescence ~9-12

Feeding Skills l most skills mature by »cup management »finger (pincer) grasp »less risk of l able to cut foods by

Food Preferences l “I like…” » :-) – :-( – :-| »single foods »mixture of » temperature »mild flavors »colorful! »familiar l jags and rituals are

l Children will eat l Children are capable of l Children generally react negatively to new foods but l Parents can either support or disrupt their child’s food acceptance and regulation l Both ____________ and ____________ are harmful Division of Feeding Responsibility--Facts

l Parent is responsible for: l Child is responsible for: Division of Feeding Responsibility—Toddler+

l select and buy appropriate food l make and present meals l regulate time of meals and snacks l present food in appropriate form l don’t be a short-order cook l be realistic about portions l don’t make dessert a reward l keep mealtimes pleasant l help child participate in meals l help child feed if necessary l maintain standards of behavior at table Tips for Parents

Miscellaneous l Vegetables »keep trying without fighting »model good intake l Adjust portion sizes smaller »______ per year of age for f/v l Encourage calcium intake »remember alternatives to milk l Plan meals and snacks

School Considerations l Breakfast— l Establish healthful lifestyles l School meals »NSLP: nutrition, education l “Enemies” or “Allies”: »____________________ –competitive foods »____________________ –follow guidelines »___________ opportunities –intake better if lunch is after

Recommendations/ Goals l DRIs for infants: »all are AIs l DRIs for other stages: »mix of AIs and RDAs l Healthy People 2010 goals »read lists in text

Eating Pattern Messages: 1-2 YOs l Encourage drinking from a cup l Let your child decide how much food to eat l Offer a fruit and/or vegetable at each meal and snack l Give your child whole milk until age two l Offer cheese, cereal, and fruit for snacks l Cut foods into pieces smaller than a dime to prevent choking l Eat meals together and talk

Eating Pattern Messages: 2-5 YOs l Switch to skim or 1% milk l Let your child decide how much food to eat l Offer a fruit and/or vegetable at each meal and snack l Offer cheese, raisins, cereal, and fruit for snacks l Cut foods into pieces smaller than a dime to prevent choking l Offer foods at least 10 times before deciding your child doesn’t like them l Encourage physical activity throughout the day l Eat meals together and talk