1. Healthy Eating Initiative
Nicole Morrissey RD, CDE

2. 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

3. 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.

4. 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?

5. 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

6. Obesity is an Epidemic

7. Portion Distortion

8. 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

9. 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

10. 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.

11. 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)

12. 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

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

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

15. 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

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

17. 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

18. 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

19. 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

20. 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!

21. 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 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

22. 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

23. 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

24. Snack Ideas

25. 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.

26. 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.

27. 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!

28. Eat the Rainbow

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

31. Lunch Box Ideas

32. 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

33. 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

34. 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

35. 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

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

37. Questions?